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A. White- Human Anatomy > Abdominal Wall And Peritoneum > Flashcards

Abdominal Wall And Peritoneum Flashcards

1
Q

What are the four major bony landmarks of the anterior abdominal wall?

A

The xiphoid process

Cotsal margins

Ilium (crest, ASIS, iliac crest)

Pubis

Ribs 6 & 7

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2
Q

What is the linea terminalis/pelvic inlet?

A

A line that separates the true pelvis from the false pelvis.

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3
Q

What is found superior to the linea terminalis?

A

The abdomen or false pelvis

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4
Q

What is found inferior to the linea terminalis?

A

Pelvis or true pelvis

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5
Q

What is the pelvic inlet formed from?

A

Pectin pubis (pubic bone)

Arcuate line (ilium)

Sacral promontory (sacrum)

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6
Q

Where is the deep inguinal ring found?

A

At the transversalis facia.

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7
Q

What are fascial layers of the abdomen continuous with?

A

The fascia of the thigm

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8
Q

What is the difference between the perineum and the periotneum?

A

The perineum are exteral reproductive structures.

The peritoneum is the outer layer fascial covering.

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9
Q

What is the superficial layer of the abdominal cavity? What is it continuous with?

A

Camper’s fascia (fatty layer)

It is continuous with the superficial fatty layers in the thorax, thigh and perineum.

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10
Q

What is the deeper layer of the abdominal cavity? What is it continuous with?

A

Scarpas layer (membranous layer)

It is continuous with the fascia lata in the thigh and with the deep layer of the superificial perineal fascia.

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11
Q

What three ligaments oconnect the fascia to the pubic bone?

A

Pectineal ligament

Lacunar ligament

Illioinguinal ligament

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12
Q

True or false: superficia blood vessels run in the fatty layer of the superficial fascia.

A

True

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13
Q

What does Scarpa’s fascia fuse with?

A

The fascia lata.

It is continuous over the penis and scrotum

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14
Q

Why is fascia thicker in the lower limb and abdomen?

A

Because more weight is present in the lower limb and abdomen, and a greater fascia is needed to support it.

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15
Q

What are the contents of the abdominal region?

A

Peritoneal cavity

GI tract (with associated glands and digestive organs)

Nerves (ANS and parasympathetics), lymphatics, vessels

Renal system

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16
Q

Why can fluid leak into the potential space between the membranous layer of superfiical fascia and the deep fascia of the external abdominal oblique muscle?

A

Because there are weak areas in the fascia into which fluid can leak.

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17
Q

What is the transverse plane midway between the superior borders of the pubic syphysis and the manubrium?

A

Transpyloric plane

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18
Q

What is the plane at the lowest level of the costal margin?

A

Subcostal plane

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19
Q

What is the plane passing through the summits of the iliac crests?

A

Supracrestal plane

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20
Q

What is the plane at the level of the iliac tubercles?

A

Transtubercular plane

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21
Q

What is the plane at the level of the ASIS?

A

Interspinous plane

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22
Q

What organs are found in the most anterior/superficial layer of the abdominal wall?

A

Liver

Stomach

Transverse colon

Small intestine

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23
Q

What organs are found in the middle layer of the abdominal wall?

A

Spleen

Pancreas

Duodenum

Descending colon

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24
Q

What organs are found in the most posterior/deep region of the abdominal wall?

A

Kidneys

Abdominal aorta

Ureters

Urinary bladder

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25
Q

In what quadrant is the liver found?

A

Right upper quadrant

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26
Q

In what quadrant is most of the stomach found?

A

Left upper quadrant

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27
Q

In what quadrants is most of the small intestine found?

A

Right and left lower quadrants

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28
Q

In what quadrant is the gall bladder found?

A

Right upper quadrant

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29
Q

In what quadrant is the spleen and pancreas found?

A

Left upper quadrant

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30
Q

In what quadrants is the descending colon found?

A

Right and left lower quadrants.

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31
Q

In what quadrants are the kidneys found?

A

Right and left upper quadrants

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32
Q

What are the four pairs of muscles found in the anterior and lateral portions of the abdominal wall?

A

External obliques

Internal obliques

Transversus abdominis

Rectus abdominis

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33
Q

The external obliques, internal obliques, transversus abdominis and rectus abdominis are found in the anterior and lateral portions of the abdominal wall. What are their functions?

A

They collectively compress and hold the abdominal organs in place.

They also flex and stabilize the vertebral column and laterally flex it.

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34
Q

What are the four muscles located in the posterior portion of the abdominal wall?

A

Iliacus

Psoas major

Psoas minor

Quadratus lumborum

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35
Q

The iliacus, psoas major, psoas minor and quadratus lumborum are located in the posterior region of the abdominal wall. What are the functions of these muscles?

A

They flex the spine and lower limb.

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36
Q

What is the rectus sheath?

A

An aponeurosis formed by three muscles of the anterior/lateral abdominal wall. (External obliques, internal obliques, transversus abdominis, rectus abdominis)

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37
Q

What does the rectus sheath enclose?

A

The rectus abdominis

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38
Q

What is the term for the midline of the rectus sheath?

A

Linea alba

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39
Q

True or false: the layers of fascia and aponeuroses of the muscles forming the rectus sheath are arranged differently in the upper abdominal wall than they are in the lower wall.

A

True

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40
Q

The layers of fascia and aponeuroses of the muscles forming the recturs sheath are arranged differently in the upper abdominal wall than they are in the lower wall. What is the line where this arrangement changes?

A

The arcuate line is the line where this arrangment changes.

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41
Q

What is found above the arcuate line?

A

Skin

Fatty layer of superficial fascia

Aponeurosis of external abdominal oblique fascia

1 layer of internal abdominal oblique aponeurosis

Rectus abdominis muscle

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42
Q

Skin, fatty layer of superficial fascia, aponeurosis of external abdominal oblique, abdominal oblique aponeurosis and rectus abdominis muscle are found above the arcuate line of the rectus sheath. What is also found above the arcuate line?

A

1 layer of internal oblique aponeurosis

Aponeurosis of transversus abdominus

Transversalis fascia

Extraperitoneal tissue

Parietal peritoneum

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43
Q

What is found below the arcuate line?

A

Skin

Fatty layer of superficial fascia

Membranous layer of superficial fascia

Aponeurosis of external abdominal oblique

Aponeurosis of internal abdominal oblique

Aponeurosis of transversus abdominis

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44
Q

The skin, fatty layer of superficial fascia, membranous layer of superficial fascia, aponeurosis of external abdominal oblique and aponeurosis of transversus abdominus are found below the arcuate line. What are some other things that are found below the arcuate line?

A

Rectus abdominis muscle

Transversalis fascia

Extraperitoneal tissue

Parietal peritoneum

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45
Q

How does the aponeurosis surround muscles above the arcuate line?

A

Above the arcuate line, the aponeurosis from the internal oblique splits to surround the rectus abdominis.

The aponeurosis from transversus abdominus runs posterior to rectus abdominus.

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46
Q

Where does the rectus abdominis directly lie?

A

It lies directly on the transversalis fascia.

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47
Q

What is the most superficial muscle of the abdominal wall?

A

External obliques

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48
Q

What is the most posterior/deep muscle of the abdominal wall?

A

Transversus abdominus

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49
Q

What muscles are found, from superficial to deep, in the anterior and lateral abdominal wall?

A

External obliques

Internal obliques

Rectus abdominus

Transversus abdominus

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50
Q

What muscle in the anterior/later abdominal wall forms the inguinal ligament?

A

External oblique

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51
Q

What is the primary function of the posterior muscles of the abdominal wall (iliacus, psoas major, psoas minor, quadratus lumborum)?

A

Flexors of the trunk and/or hip

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52
Q

Where do the deep system of arteries originate?

A

Superiorly from the subclavian artery.

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53
Q

Where does the deep system of the arteries branch?

A

In the mid-abdomen are from the abdominal aorta.

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54
Q

Where does the deep system of arteries originate?

A

Inferiorly from the external iliac artery.

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55
Q

Where does the superifical system of arteries originate?

A

They originate superiorly from perforating branches.

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56
Q

Where does the superficial system or arteries originate?

A

Inferiorly from branches of the femoral artery

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57
Q

The deep system of arteries includes … ?

A

Musculophrenic

Superior epigastric

Inferior epigastric

Intercostal

Subcostal

Lumbar

Deep circumflex

Iliac

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58
Q

Where does the superficial system of arteries run?

A

In the superficial fascial layer.

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59
Q

What are the major anterior abdominal wall veins?

A

Subclavian

External iliac

Lumbar and intercostal

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60
Q

What is the superficial drainage of the abdominal wall?

A

Thoracoepigastric veins

Lateral thoracic veins

Superficial epigastric veins

61
Q

What is the innervation of the abdominal cavity?

A

Thoracoabdominal intercostal.

Lateral cutaneous branches emerge anterior axillary region, bifurcate into anterior and posterior branches.

Anterior cutaneous branches end with medial and lateral branches.

62
Q

True or false: nerves in the anterior abdominal wall are ventral rami.

A

True

63
Q

The inguinal fold is innervated by what intercostal nerves?

A

T7 - L1

64
Q

The xiphoid region is innervated by what intercostal nerve?

A

T7

65
Q

The umbilical region is innervated by what intercostal nerve?

A

T10

66
Q

The inguinal fold region is innervated by what intercostal nerve?

A

L1

67
Q

What are the vertebrae from which the intercostal nerve emerges?

A

T7 - T11

68
Q

What are the vertebrae from which the subcostal nerve emerges?

A

T12

69
Q

What are the vertebrae from which the lumbar nerve arises?

A

L1 - L4

70
Q

What innervates the anterior abdominal wall nerves?

A

Cutaneous branches of ventral rami, intercostal nerves.

71
Q

Where do the cutaneous branches of ventral rami and the intercostal nerves lie between?

A

The internal abdominal oblique and transversus abdominis.

They also pierce the recus sheath and innervate the rectus abdominis muscles.

72
Q

What does the anterior abdominal wall nerves supply?

A

The skin, muscle and parietal peritoneum.

73
Q

What does the iliohypograstric nerve supply?

A

The suprapubic region.

74
Q

Where does the ilioinguinal nerve enter the pubic region?

A

Through the inguinal canal.

It emerges through the superficial inguinal region.

75
Q

What does the ilioinguinal nerve supply?

A

The groin and scrotum/labium majus

76
Q

What are the two branches of the genitofemoral nerve?

A

Genital branch

Femoral branch

77
Q

Where does the genital branch exit the inguinal canal?

A

Through the superficial inguinal ring.

78
Q

What does the genital branch innervate?

A

The cremaster muscle

It may also be cutaneous to the labium majus

79
Q

Where is the femoral branch of the genitofemoral nerve cutaneous to?

A

The femoral triangle area.

80
Q

Where does the anterior abdomen drain superiorly from?

A

The umbilical region to anterior axillary and sternal nodes.

81
Q

Where does the superficial lymphatic drainage drain inferiorly from?

A

The umbilical region to superficial inguinal nodes.

82
Q

Where does the deep lymphatic drainage drain?

A

Along posterior intercostal and lumbar vessels to deep abdominal nodres from testes to deep abdominal nodes.

83
Q

What is a hernia?

A

A hernia is when a portion of the viscera protrudes through a weakened point of the muscular wall of the abdominopelvic cavity.

84
Q

Why is a hernia a significant medical problem?

A

Blood flow to the trapped segment may diminish, causing that portion of the intestine to die.

It is called a strangulated intestinal hernia.

85
Q

What are the two types of hernias?

A

Inguinal

Femoral

86
Q

What is the most common type of hernias?

A

Inguinal

It occurs because the inguinal region is one of the weakest areas of the abdominal wall.

87
Q

True or false: females are more likey to develop inguinal hernias than males.

A

False. Males are more likely to develop inguinal hernias than males.

88
Q

What provides the force to push a segment of the small intestine into the canal?

A

Rising pressure in the abdominal cavity.

89
Q

What are the two types of inguinal hernia?

A

Direct inguinal hernia

Indirect inguinal hernia

90
Q

What is a direct inguinal hernia?

A

When a loop of small intestine protrudes directly through the superficial inguinal ring, but not down the entire length of the inguinal canal, and creates a bulge in the lower abdominal wall.

91
Q

What is an indirect inguinal hernia?

A

When a herniation travels down the entire inguinal canal and may even extend al lthe way into the scrotum.

92
Q

What occurs in an indirect inguinal hernia?

A

A herniation passes lateral to inferior epigastric vessels to enter deep inguinal ring.

93
Q

What occurs during a direct inguinal hernia?

A

Herniation passes medial to inferior epigastric vessels punching through peritoneum and transversalis fascia.

94
Q

Where does a femoral hernia occur?

A

In the upper thigh, just inferior to the inguinal ligament, originating in the femoral triangle.

The medial part of the femoral triangle is relatively weak and prone to sress injury, allowing a loop of small intestine to protrude.

95
Q

Why do women more commonly develop femoral hernias?

A

Because of the greater width of their femoral triangle.

96
Q

What occurs in an umbilical hernia?

A

It is when a portion of the intestine pushes through the abdominal wall musculature in the periumbillical or umbilical region.

It is most common in infants

97
Q

What organs comprise the foregut?

A

Esophagus

Somtach

Duodenum

Liver

Gallbladder

Spleen

Pancreas

98
Q

What organs comprise the midgut?

A

Duodenum

Jejunum

Ileum

Cecum & appendix

Ascending colon
2/3 of transverse colon

99
Q

What organs comprise the hindgut?

A

1/3 transverse

Descending and sigmoid colon

Rectum

Anal canal

100
Q

What are the subdivisions of the peritoneum?

A

Parietal layer

Visceral layer

101
Q

What layer of the peritoneum contains pain fibers?

A

The parietal layer

102
Q

What layer of the peritoneum lines the body wall?

A

Parietal layer

103
Q

What is the intraperitoneal region covered on most sides by?

A

The visceral peritoneum.

It is susupended by the mesentery from the body wall.

104
Q

What do the retroperitoneal organs lie deep to?

A

The parietal peritoneum.

It is covered by parietal peritoneum on one side only.

105
Q

What is the nerve supply to the peritoneum?

A

Nerves from the adjacent body wall supply parietal peritoneum.

They supply pain and vasomotor fibers.

106
Q

What are the retroperitoneal organs?

A

Kidneys

Ureters

Adrenals

Gonads

Aorta and inferior vena cava

107
Q

What are the secondary retroperitoneal organs?

A

Duodenum

Pancreas

Ascending and descending colon

108
Q

What are the mesenteries?

A

2 layered fold of the peritoneum.

It attaches free small intestine to the posterior body wall.

It also includes the jejunum and ileum.

109
Q

What is the function of the transverse mesocolon?

A

It holds the transverse colon to the posterior body wall. It also fuses with the posterior layer of the greater omentum.

110
Q

What is the function of the sigmoid mesocolon?

A

It holds the sigmoid colon to the posterior body wall.

111
Q

What is the mesoappendix?

A

The mesentery of the vermiform appendix

112
Q

The mesenteries of the duodenum, ascending colon, descending colon and cecum are usually lost during development. Since they are no long susupended by a mesentery, what are they held by?

A

Secondary retropritoneal.

113
Q

What are features of peritonea ligaments?

A

They usually transmit nerves and vessels

They usually lack connective tissue and are not the same as ligaments that join bones.

They may be subdivisions of a larger structure.

114
Q

What are two examples of peritoneal ligaments?

A

Gastrosplenic ligament

Splenorenal ligament

115
Q

What is the omentum (epiploon)?

A

A broad, 2-4 layered sheet of peritoneum that attaches the stomach to other viscera.

116
Q

What does the lesser omentum develop from?

A

The ventral mesograstrium (mesentery).

It is divided into the hepatogastric ligament (stomach to liver) and the heptaduodenal ligament (liver to duodenum)

117
Q

What are peritoneal ligaments associated with the liver?

A

Coronary ligaments

Right and left triangular ligaments

Falciform ligament

Ligamentum teres hepatis

118
Q

What is a fold?

A

A ridge or elevation in the peritoneum produced by underlying vessels.

119
Q

What are fossae?

A

Depressions between folds.

120
Q

What are exapmles of some folds and fossae?

A

Superior duodenal fold and fossa

Paraduodenal fossa

Inferior duodenal fold and fossa

Retroduodenal fossa

Fold is formed by inferior mesenteric vein posterior to peritoneum.

121
Q

What are the structures coursing through the extraperitoneal tissue that form elevations on the interior abdominal wall called?

A

Peritonal folds

122
Q

Where is the median umbilical fold found?

A

Midline from the bladder

123
Q

What folds are found in the internal aspect of the abdominal wall?

A

Medial umbilical folds

Lateral umbilical folds

124
Q

What is a supraumbilical structure located on the internal aspect of the anterior abdominal wall?

A

The falciform ligament.

It is a curved remnant of the ventral mesograstrium.

125
Q

What fossa is the site for supravesical hernias?

A

The supravescial fossa.

It is located between the median and medial umbilical folds.

126
Q

What is the site for direct inguinal hernias?

A

Medial inguinal fossa.

It is between the medial and lateral umbilical folds.

127
Q

What is another term for the medial inguinal fossa?

A

The inguinal triangle

128
Q

What is a site for indirect inguinal hernias?

A

Lateral inguinal fossa.

It is lateral to umbilical folds.

129
Q

What forms most of the “potential” space within the abdomen?

A

The greater sac

130
Q

What can the greater sac be subdivided into?

A

The supracolic and infracolic regions by the colon and transverse mesocolon.

131
Q

What is the supramesocolic (supracolic region)?

A

A region superior and anterior to the liver and stomach.

It includes the hepatorenal and subphrenic spaces and fossae of the anterior wall.

132
Q

What is the peritoneal cavity?

A

A closed potential space between the parietal and visceral layers of peritoneum.

133
Q

What are three recesses and fossae of the peritoneal cavity?

A

Subphrenic recess

Subhepative/hepatorenal recess

Rectovesical/rectouterine recess.

134
Q

Why is the greater sac of clinical importance?

A

It is important because abscesses may develop and excess fluid (ascites) will pool here.

135
Q

What is the inframesocolic (infracolic) region?

A

The inferior and posterior part of the greater sac. It is subdivided by mesenteries and ligaments.

136
Q

Where are the right and left pracolic gutters located?

A

Lateral to the ascending and descending colon.

137
Q

What are the upper and lower parts of the inframesocolic region dividd by?

A

The right and left infracolic spaces

138
Q

Why is the inframesocolic region clinically important?

A

Because it is where intraperitoneal infections spread.

139
Q

What in the inframesocolic region limits the spread of fluid superiorly?

A

The phrenicocolic ligament.

140
Q

True or false: the lesser sac (omental bursa) develops as a part of the greater sac

A

True

141
Q

Where is the lesser sac located (in terms of the stomach)?

A

Posterior and inferior to the stomach.

142
Q

How do the greater and lesser peritoneal sacs communicate?

A

Through the epiploic foramen (of Winslow)

143
Q

What are the three recesses of the lesser sac

A

Superior recess (posterior to the liver)

Inferior recess (potential space between the 2 layers of the gastrocolic ligament)

Splenic recess (posterior to and left of the stomach)

144
Q

What is the clinical importance of the lesser sac?

A

It has a clinically important relationship to the liver, pancreas, stomach and spleen.

145
Q

What is the epiploic foramen?

A

The opening between the greater and lesser sacs.

146
Q

What is found in the anterior region of the epiploic foramen?

A

Hepatoduodenal ligament with portal vein, hepatic artery and bile duct.

147
Q

What is found in the posterior region of the epiploic foramen of winslow?

A

IVC, diaphragm

148
Q

What is found in the superior region of the foramen of Winslow?

A

Liver, caudate lobe

149
Q

What is found in the inferior part of the epiploic foramen of WInslow?

A

Duodenum

A. White- Human Anatomy (23 decks)

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