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GI > Lect 3: Anterior Abdominal Wall, Inguinal Region, and Peritoneum > Flashcards

Lect 3: Anterior Abdominal Wall, Inguinal Region, and Peritoneum Flashcards

0
Q

Transumbilical Plane (Location)

A

@ L3/L4 separates 4 quadrants of abdomen (along with median plane - vertical)

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1
Q

Lesser vs. Greater curvature of stomach

A

Lesser - faces right Greater - faces left

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2
Q

Subcostal Plane (Location)

A

L3

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3
Q

Transtubercular plane (location)

A

L5

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4
Q

Transpyloric plane (location, intersections)

A

@ L1 and 9th costal cartilage *Intersects: - pyloric sphincter of stomach - funds of gallbladder - duodenojejunal junction - neck of pancreas - hiatus of kidneys

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5
Q

Umbilicus (location)

A

L3-L4

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6
Q

Linea semilunaris

A

depression at lateral edge of each rectus abdominus muscle

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7
Q

Lowest level of costal margin

A

L3

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8
Q

Iliac crest (location)

A

L4

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9
Q

2 types of superficial fascia of abdomen

A
  1. Camper’s 2. Scarpa’s
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10
Q

Camper’s fascia

A
  • fatty, superficial fascia - continuous with tunica dartos in the scrotum (muscle that contracts when cold)
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11
Q

Scarpa’s fascia

A
  • membranous, superficial fascia - blends with fascia of thigh (although can be separated) - continuous with Colles’ fascia of perineum
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12
Q

Superficial Arteries of Abdomen

A
  1. Anterior perforating arteries (from superior and inferior epigastric A. - inferior epigastric from the external iliac A) 2. Lateral cutaneous arteries (from lower intercostal, subcostal, and lumbar A)
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13
Q

Superficial Arteries of Inguinal Region

A

From femoral A: 1. superficial epigastric (to lower abdomen) 2. superficial circumflex iliac (to lower abdomen above inguinal ligament) 3. superficial external pudendal (to pubic region)

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14
Q

Anterior perforating veins drain to the

A

superior and inferior epigastric VV

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15
Q

Lateral cutaneous veins drain to the

A

thoracoepigastric V (then will travel up to axillary vein or down to femoral vein)

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16
Q

Superficial inguinal vein drain to the

A

femoral V

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17
Q

Paraumbilical vein drain to the

A

portal V –> umbilical V (along the falciform ligament)

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18
Q

Caput medusae

A

portal drainage obstructed –> build-up of pressure –> drainage to tributaries of umbilical vein (distinctive pattern of visible superficial veins results)

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19
Q

Superficial lymphatics of abdomen

A
  • above umbilicus –> anterior axillary nodes - below umbilicus –> superficial inguinal nodes
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20
Q

Deep lymphatics of abdomen

A
  • parasternal (follows internal thoracic A) - lumbar (follows abdominal aorta) - external iliac nodes (follows external iliac A)
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21
Q

Cutaneous Nerves to abdomen (lateral, anterior, and pubic)

A
  1. lateral and anterior –> from T7 - T12 2. L1: - iliohypogastric N (lower hypogastric region) - ilioinguinal N (inguinal region)
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22
Q

Key features at T7, T10, and L1 dermatomes

A

T7 - just below xiphoid process T10 - umbilicus L1 - inguinal ligament and pubic symphysis

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23
Q

External spermatic fascia

A
  • from external oblique aponeurosis and fascia - outermost fascia of spermatic cord
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24
Q

Inguinal canal (deep and superficial rings and contents)

A

*deep *ring: evagination of transversalis fascia - lateral to inferior epigastric A and V *superficial *ring: b/w lateral and medial crura of external oblique Contains: 1. ilioinguinal N 2. (males) - spermatic cord (females) - round ligament of uterus

25
Q

Cremaster fascia (and muscle)

A
  • from internal oblique - middle layer of fascia for spermatic cord
26
Q

Internal spermatic fascia

A
  • from transversalis fascia - innermost fascia of spermatic cord
27
Q

Tunica vaginalis

A
  • serous sac that covers testis - parietal and visceral layers
28
Q

Scrotum (contents)

A
  • end of spermatic cord - epididymis - testis
29
Q

Scrotum (layers)

A
  1. skin 2. tunica dartos (smooth muscle that is a continuation of camper’s fascia of lower anterior abdomen)
30
Q

Epididymis

A
  • stores sperm - receives sperm from seminiferous tubules of testis via efferent ductules - epididymus –> vas deferens (begins at tail of epididymus)
31
Q

Vas deferens

A
  • thick-walled muscular tube - conveys spermatozoa - passes with spermatic cord and externally to peritoneum in the pelvic cavity - expands to form ampulla which forms an ejaculatory duct with the seminal vesicle
32
Q

3 arteries of scrotum

A
  1. testicular A - supplies testis and epididymis (from abdominal aorta) 2. artery of vas deferens - from inferior vesical artery 3. cremasteric artery - from inferior epigastric artery
33
Q

Pampiniform plexus

A
  • venous drainage of testis and epididymis - surround testicular artery to allow for cooling (needed for spermatogenesis) - combines into 1 testicular vein at inguinal canal - *varicocele - due to obstruction of vein
34
Q

Testicular veins terminates as

A

(right) - IVC (left) - left renal V.

36
Q

3 Inguinal nerves

A
  1. Genitofemoral N (L 1 and 2) - 2 branches: genital - enters spermatic cord via deep inguinal ring; motor to cremaster muscle femoral - enters thigh; sensory to thigh 2. Ilioinguinal N (L1): bw internal oblique and transversus abdominus, through inguinal canal but does NOT pierce deep inguinal ring - sensory to anterior scrotum/labia majora and to thigh 3. Iliohypogastric N (L1) - b/w I.O. and T.A. muscles - NOT within inguinal canal
37
Q

Descent of gonads by

A

processus vaginalis (guided by gubernaculum) - obliterated in females; becomes tunica vaginalis in males

38
Q

Gubernaculum remnants become

A
  • males: scrotal ligament - females: superior - ligament of ovary, inferior - round ligament of the uterus
39
Q

Hydrocele and Hematocele

A
  • accumulation of fluid or blood (respectively) in the tunica vaginalis via distention - can lead to inguinal hernias
39
Q

Femoral hernias

A
  • more common in females - pass posterior to inguinal ligament in thigh
40
Q

Direct vs. Indirect Hernias

A
  • DIRECT: push out though the Hesselbach’s (inguinal) triangle (usually don’t reach testis) - INDIRECT: pass through deep inguinal ring (and the entire inguinal canal); may reach scrotum ** BOTH pass through superficial inguinal ring
41
Q

Lymph drainage of scrotum

A

superficial inguinal –> deep inguinal –> external iliac nodes

42
Q

Lymph drainage of testis

A

along testicular arteries –> lumbar (para-aortic) nodes posteriorly

43
Q

Ligament (peritoneal reflection)

A

suspends/supports abdominal organ

44
Q

Mesentery (peritoneal reflection)

A

encloses an organ AND conveys blood and nerves and stores fat

45
Q

Falciform ligament

A

b/w diaphragm and anterior abdominal wall & liver

46
Q

Coronary ligament and R/L triangular ligaments

A

b/w diaphragm and liver

47
Q

Mesentery proper

A

b/w posterior abdominal wall and coils of jejunum/ileum

48
Q

Sigmoid mesocolon

A

b/w posterior abdominal wall and sigmoid colon

49
Q

transverse mesocolon

A

b/w pancreas and transverse colon

50
Q

ligament of Treitz

A

suspensory ligament of duodenum (made from right crus of diaphragm) junction of retroperitoneal duodenum and intraperitoneal jejunum

51
Q

Retroperitoneal organs

A
  1. Kidneys (ureters, adrenal glands) 2. Aorta and IVC 3. Duodenum (except 1st part) 4. Colon (except transverse) 5. Pancreas (except tail)
52
Q

Median umbilical fold covers

A

fetal urachus (median umbilical ligament)

53
Q

Medial umbilical fold covers

A

obliterated umbilical artery

54
Q

Lateral umbilical fold covers

A

inferior epigastric vessels

55
Q

Omental bursa (lesser peritoneal sac)

A
  • posterior to stomach and lesser omentum - hepatogastic and hepatoduodenal ligaments
56
Q

Epiploic foramen

A
  • communication b/w greater and lesser peritoneal sacs - extends to hilum of spleen (gastrosplenic and lienorenal ligaments) - anteriorly: portal vein, hepatic artery, and bile duct - posteriorly: IVC
58
Q

Greater omentum

A
  • hangs from greater curvature of stomach - can move - prevents spread of fluid and infection - fusion with omental bursa = gastrocolic ligament
58
Q

Hepatogastric ligament

A
  • prat of the lesser omentum - at lesser curvature of stomach - fuses with liver
59
Q

Hepatoduodenal ligament

A
  • Part of lesser peritoneal sac - from upper border of duodenum and porta hepatis
60
Q

Paracolic gutters

A
  • pathways that allow flow of fluid/infection - helps prevent spread into other areas - four of them: R lateral, R medial, L medial, and L lateral

GI (40 decks)

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