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Anatomy BMSc > Abdomen > Flashcards

Abdomen Flashcards

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1
Q

which planes divide the abdomen into quadrants

A

median plane

trans umbilical plane

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2
Q

which planes divide the abdomen into regions

A

mid-clavicular lines vertically

subcostal and trans tubercular lines horizontally

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3
Q

what are the abdominal regions

A 
right and left hypochondrium
epigastric 
right and left lumbar 
umbilical 
right and left inguinal 
suprapubic
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4
Q

what are the layers of the abdominal wall

A 
skin
superficial fascia
muscle
deep fascia 
extraperitoneal fascia 
parietal peritoneum
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5
Q

what are the two layers of superficial fascia below the umbilicus

A

campers fascia

scarpas fascia

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6
Q

what are the characteristics of campers/scarpas fascia

A 
campers = fatty 
scarpas = membranous
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7
Q

________ fascia is continuous over inguinal ligament and into fascia of thigh and peritoneum

A

campers fascia

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8
Q

which structure continuous with the fascia of the penis in males and fascia of the labia majora in females

A

campers fascia

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9
Q

describe campers fascia as a structure contributing to the male external genitalia

A

loses the fatty layer and fuses with deeper later of superficial fascia to become the dartos muscle of the scrotum

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10
Q

what are the attachments of scarpas fascia

A

pubic symphysis and linea alba

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11
Q

what does scarpas fascia fuse with below the inguinal ligament

A

fuses with the fascia of the thigh to form fascia late

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12
Q

which male genital structures does the scarpas fascia contribute to

A

fascia of penis
dartos fascia of scrotum
fungiform ligament of penis

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13
Q

which female genital structures does the scarpas fascia contribute to

A

labia majora

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14
Q

where do the fibres of external oblique run from and to

A

from ribs 5-12 to iliac crest and linea alba

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15
Q

which direction to the fibres of external oblique travel

A

inferomedially

hands in pockets

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16
Q

attachments of the aponeurosis of external oblique

A

linea alba from xiphoid to pubic symphysis

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17
Q

which structure is formed by the inferior border of external oblique

A

inguinal ligament

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18
Q

action of external oblique

A

bilateral contraction = flexion of trunk

unilateral contraction = lateral flexion of trunk

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19
Q

external oblique forms which aspect of the rectus sheath

A

anterior wall

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20
Q

innervation of external oblique

A

anterior rami T7-12

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21
Q

where do fibres of internal oblique run from and to

A

from thoracolumbar fascia, inguinal ligament and iliac crest to ribs 9-12

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22
Q

direction of fibres of internal oblique

A

superomedial

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23
Q

action of internal oblique

A

bilateral contraction = flexion of trunk

unilateral contraction = lateral flexion of trunk

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24
Q

innervation of internal oblique

A

T7-12 and L1

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25
direction of fibres of transversus abdominis
transverse
26
attachments of transversus abdomens
thoracolumbar fascia, iliac crest, inguinal ligament, costal cartilages of ribs 7-12 to linea alba, pubic crest and pectineal line
27
innervation of transversus abdominis
T7-12, L1
28
attachments of rectus abdominis
pubic tubercle, crest and symphysis to diploid process and costal cartilages of ribs 5-7
29
action of rectus abdominis
flexion of trunk | support/compression of abdominal wall
30
innervation of rectus abdominis
T7-12
31
which blood vessels travel on posterior of rectus sheath
inferior epigastric
32
which muscle is part of the abdominal wall but is often absent
pyramidalis
33
attachments of pyramidalis
pubis to linea alba
34
action of pyramidalis
tenses linea alba
35
innervation of linea alba
anterior rams T12
36
which structures form the anterior wall of rectus sheath above the umbilicus
external oblique aponeurosis | superficial layer of internal oblique aponeurosis
37
which structures form the posterior wall of rectus sheath above the umbilicus
deep later of internal oblique aponeurosis | transversus abdominis fascia
38
which structures form the anterior wall of the rectus sheath below the umbilicus
all of the aponeuroses | internal oblique, and both layers of internal oblique
39
which structures form the posterior wall of the rectus sheath below the umbilicus
transversalis fascia
40
which structure marks the transition of the structures of the anterior wall of rectus sheath
arcuate line
41
what is the median umbilical ligament
urachus remnant
42
what is the medial umbilical ligament
umbilical artery remnant
43
what is contained in the lateral umbilical fold
inferior epigastric vessels
44
where do superficial epigastric veins drain
femoral vein
45
thoracoepigastric vein drains where
axillary vein superiorly and femoral vein inferiorly
46
the musculophrenic artery is a branch of which artery
internal thoracic
47
the superficial epigastric artery and superficial circumflex iliac artery are branches of which artery
femoral artery
48
which nerves provide innervation to superficial abdominal wall
lateral cutaneous branches 6-12 intercostal nerve and iliohypogastric (L1) anterior cutaneous branches of 6-12 intercostal nerves
49
where do the lumbar arteries arise from
abdominal aorta
50
where does the deep circumflex iliac artery arise from
femoral artery
51
where does they inferior epigastric artery arise from
external iliac artery, just before it turns into femoral artery
52
which nerves supply the deep aspect of abdominal wall
iliohypogastric nerve | ilioinguinal nerve
53
which areas of abdominal wall drain into superficial inguinal lymph nodes
bit of thigh | bit of anterolateral wall below umbilicus
54
which areas of abdominal wall drain into axillary nodes
above umbilicus (superficial)
55
describe the flow of lymph in the deep aspects of abdominal wall
via abdominal aorta to lumbar nodes or via external iliac artery to external iliac nodes then via internal thoracic to parasternal nodes
56
which nerves supply the skin, muscle and parietal peritoneum of the anterolateral abdominal wall
T7-11 (intercostal), T12 (subcostal) L1 (iliohypogastric and ilioinguinal) all anterior rami
57
which structures are present in the inguinal canal in males
spermatic cord | ilioinguinal nerve
58
which structures are present in the inguinal canal of females
round ligament of uterus | ilioinguinal nerve
59
which structure in the inguinal canal passes through the superficial ring but not the deep ring
ilioinguinal nerve | pierces the internal oblique to enter the canal
60
describe the superficial ring of the inguinal canal
triangular shaped defect in the aponeurosis of external oblique
61
what are the margins of the superficial ring of inguinal canal
medial and lateral crura
62
describe the deep ring of inguinal canal
oval opening in the transversalis fascia | halfway between the ASIS and pubic symphysis
63
which vessels lie medially to deep ring
inferior epigastric vessels
64
which structure gives origin of the internal spermatic fascia
deep ring (transversalis fascia)
65
what forms the anterior wall of inguinal canal
aponeurosis of external oblique | internal oblique in lateral third
66
why does internal oblique contribute to the anterior wall of inguinal in the lateral third
to give further protection anterior to the weakening as the opening of the deep ring
67
what forms the floor of the inguinal canal
inferior rolled edge of external oblique aponeurosis and medially the lacunar ligament
68
what forms the roof of the inguinal canal
fibres of internal oblique and transversus abdominis
69
which nerves pierce through internal oblique to enter the inguinal canal
ilioinguinal and iliohypogastric
70
what forms the posterior wall of the inguinal canal
transversalis fascia plus conjoint tendon in medial third
71
what is the conjoint tendon and what is its function in the posterior wall of the inguinal canal
common insertion of internal oblique and transversus abominis to pubic crest and pectineal line strengthens the canal behind the opening of superficial ring in anterior wall
72
which ligament extends from the medial end of the inguinal ligament
lacunar ligament
73
describe the lacunar ligament
extends superiorly and posteriorly from medial end of inguinal ligament attaches to pectineal line n superior pubic rams
74
the free edge of the lacunar ligament forms which structure
medial margin of femoral ring
75
how is the weakness in the abdominal wall created by the inguinal canal protected
oblique passage makes it harder of abdominal cavity contents to pass through it strengthened areas corresponding to deep and superficial rings increased abdominal pressure causes muscles to contract and flatten the canal squatting position in defecation closes the canal as thighs press into abdominal wall
76
indirect vs direct hernia
``` indirect = inguinal canal entered via the deep ring (normally due to congenital weakness) direct = pushed through weak spot directly out of superficial ring ```
77
what are the three layers of spermatic cord fibres and the structures they originate from
``` internal spermatic fascia (transversalis fascia) cremasteric fascia (internal oblique) external spermatic fascia (external oblique aponeurosis) ```
78
where does the spermatic cord originate
deep inguinal ring
79
what is contained in the sporadic cord
``` vas deferens testicular artery testicular veins lymph vessels autonomic nerves cremasteric artery artery of vas deferens genital branch of genitofemoral nerve ```
80
at which level do the gonadal arteries branch from the abdominal aorta
L2
81
where do the testicular veins drain
Right to IVC | left to left renal vein
82
where does lymph from the testes drain
paraaortic nodes
83
where does the cremasteric artery arise from
inferior epigastric
84
what does the cremasteric artery supply
cremasteric fascia
85
where does the artery of vas deferens arise
inferior vesical artery
86
what does the genital bench of genitofemoral nerve supply in the spermatic cord
cremaster muscle
87
how does the superficial fascia of the scrotum differ from the abdominal wall
fat replaced with dartos muscle
88
what is scarpas fascia called in the scrotum
colles'
89
what are the attachment of colles' fascia in the scrotum
perineal body and membrane | ischiopubic rami
90
what is the function o the cremaster muscle
raises testes and scrotum to control temperature
91
what is the tunica vaginalis the remains of
processus vaginalis
92
the seminiferous tubules open into which structure
rete testes
93
how are the retentions testes connected to the epididymis
efferent ductules
94
testes and epididymis drain lymph to
para-aortic nodes
95
scrotal wall and fascia drain lymph to
superficial inguinal nodes
96
what is the mesentery
double fold of peritoneum
97
which modalities is parietal peritoneum sensitive to
pain touch temperature pressure
98
which nerves supply the parietal peritoneum
lateral and anterior walls by the lower 6 thoracic nerve central part by phrenic nerves pelvic part by obturator
99
what is the visceral peritoneum sensitive to
stretch
100
which type of nerve fibres are present in the visceral peritoneum
ANS afferent fibres
101
what does intraperitoneal mean
organ is totally surrounded by visceral peritoneum and attached to body wall via a mesentery
102
examples of intraperitoneal organs
``` stomach gall bladder small intestine (only 1st part of duodenum) spleen liver caecum transverse colon sigmoid colon ```
103
what does retroperitoneal mean
partially covered in peritoneum
104
what is the difference between primary and secondary retro-peritoneal organs
primary = no mesentery ever secondary = mesentery lost in development
105
examples of primary retroperitoneal organs
kidneys | suprarenal glands
106
examples of secondary retroperitoneal organs
2, 3, 4th parts of duodenum pancreas ascending and descending colon upper 2/3rd rectum
107
what does infraperitoneal mean
below the peritoneum | in the pelvic cavity
108
what are the attachments of the greater omentum
greater curvature of the stomach | anterior surface of transverse colon
109
describe how the greater omentum functions as the 'policeman of the abdomen'
the omentum is usually spread out across the anterior surface of the intestines by the movement of the intestine underneath if part of the intestine is unhealthy, it is less motile so the omentum tends to gather over this area, as it is not moved away if it remains static, over time it will form adhesions, which block off the area from the rest of the cavity, preventing spread of infection etc
110
how many layers are present in the omentum
4 layers | double layer of peritoneum
111
how is the transverse colon attached to the body wall
transverse mesocolon
112
which two compartments does the transverse mesocolon split the abdominal cavity into
``` supracolic (liver, gall bladder, stomach) infra colic (intestines) ```
113
which vessels are found in the superior border of the greater omentum and which structure do they supply
left and right gastro-epiploic arteries (and veins) | supply the greater curvature of the stomach
114
where do the gastro-epiploic arteries originate
right = hepatic artery left = splenic artery both branches of coeliac axis
115
what is the lesser sac also known as
omental bursa
116
what is the lesser sac
portion of the peritoneal cavity behind the lesser omentum and stomach
117
where does the lesser omentum extend from
lesser curvature of stomach
118
how many layers in the lesser omentum
2
119
what is the function of the lesser omentum
communication between stomach and porto-hepatic
120
what is located at the free edge of the lesser omentum
omental/epiploic foramen
121
what structures are contained within the free edge of the lesser omentum
``` hepatic artery (left, anterior) bile duct (right, anterior) portal vein (posterior) ```
122
what are the boundaries of the epiploic foramen
``` anterior = lesser omentum and its contained structures posterior = inferior vena cava superior = liver ```
123
what is contained in the mesentery
blood vessels autonomic nerve lymphatics fat
124
which blood vessels supply the mesentery proper
superior mesenteric artery/vein
125
what is the function of the mesentery proper
allows movement of small intestine required for peristalsis
126
examples of mesenteries in the abdominal cavities
transverse mesocolon sigmoid colon mesentery vermiform appendix mesentery
127
blood supply of transverse colon (within the transverse mesocolon)
marginal artery
128
which structures are included in the foregut | 6
``` distal oesophagus stomach liver spleen proximal duodenum part of pancreas ```
129
arterial supply of foregut structures
coeliac axis (aorta T12)
130
venous drainage of foregut structures
portal vein
131
lymphatic drainage of foregut structures
pre-aortic nodes at T12 (coeliac nodes)
132
the stomach is retro-peritoneal/intra-peritoneal
intra-peritoneal
133
which structure extends from the lesser curvature of the stomach
lesser omentum
134
which structure extends from the greater curvature of the stomach
greater omentum
135
what are the layers of the stomach wall
serosa muscularis externa submucosa mucosa
136
what are the layers of the muscularis externa of the stomach
outer longitudinal layer middle circular layer inner oblique layer
137
what is the function of the differently orientated muscle fibres of the stomach
to allow the stomach to contract in all directions to churn food up with acid n whatnot
138
what are the main areas of the stomach
``` oesophageal region fundus body pyloric antrum pyloric valve ```
139
what are the two notches located in the stomach and where are they located
cardiac notch - located between the oesophageal opening and fundus angular notch - in the lesser curvature of stomach
140
what is the name given to the fold on the internal surface of the stomach
rugae
141
how does the shape of the stomach change depending on body type
shorter, wider people tend to have a stomach sitting higher in their abdomen that is more rounded taller, thinner people tend to have a lower hanging stomach that is j-shaped
142
structures anterior to the stomach
transverse colon
143
structures posterior to the stomach
``` pancreas spleen top pole of left kidney 1st part of duodenum left suprarenal gland ```
144
branches of the coeliac axis
left gastric common hepatic splenic artery
145
structures supplied by left gastric a.
lesser curvature of stomach
146
structures supplied by the common hepatic a.
liver, gall bladder, parts of stomach
147
structures supplied by the splenic a.
spleen parts of stomach pancreas duodenum
148
arterial supply to the lesser curvature of the stomach
``` right gastric (branch of hepatic artery) left gastric (branch of coeliac axis) <> ```
149
arterial supply to fundus of stomach
short gastric artery (branch of splenic)
150
arterial supply to greater curvature of stomach
``` right gastroepiploic (gastroduodenal from common hepatic artery) left gastroepiploic (from splenic artery) ```
151
venous drainage of lesser curvature of stomach
gastric veins to hepatic portal vein
152
venous drainage of greater curvature of stomach
left gastroepiploic into splenic vein, then portal vein | right gastroepiploic vein to superior mesenteric vein, then portal vein
153
venous drainage of fundus of stomach
short gastric vein, to splenic vein, to portal ven
154
lymphatic drainage of stomach
small nodes: cardiac ring around entrance to oesophagus, gastro-mental, gastric, pyloric, pancreaticosplenic and pancreaticoduodenal nodes ``` important nodes: coeliac nodes (pre-aortic T12) ```
155
autonomic innervation of the stomach
coeliac plexus
156
parasympathetic innervation of stomach
anterior and posterior vagal trunks
157
sympathetic innervation of stomach
greater splanchnic nerve to coeliac plexus
158
which parts of the duodenum are intra-peritoneal and why
the first part - attaches to the stomach so needs to be able to move with it as it contracts the last (4th) part - attaches to the small intestine which is attached to a mesentery so needs more movement
159
describe the 4 parts of the duodenum
1st part duodenal cap, intraperitoneal 2nd part descending, retroperitoneal 3rd part, transverse, retroperitoneal 4th part, ascending, intraperitoneal
160
in which part of the duodenum is the entrance of the bile and pancreatic ducts
2nd part (descending)
161
what are the folds of the duodenum called
plicae circularis
162
what is the name given to the union of the common bile duct and main pancreatic duct
hepatopancreatic ampulla (of Vater)
163
what is the name of the structure that controls the flow of pancreatic and bile fluids onto the duodenum
sphincter of Oddi
164
at which level is the start of the duodenum located
transpyloric plane (L1/2)
165
what is the approximate location of the duodenal jejunal junction
3 cm to left of midline
166
structures related to the 1st part of the duodenum
``` liver gall bladder bile duct portal vein IVC ```
167
structures related to the 2nd part of the duodenum
transverse colon right kidney and ureter pancreas
168
structures related to the 3rd part of the duodenum
``` superior mesenteric vessels jejunum right ureter right poses IVC aorta pancreas ```
169
structures related to the 4th part of the duodenum
root of mesentery jejunum aorta left psoas
170
arterial supply of duodenum
proximal: superior pancreaticoduodenal artery (branch of gastroduodenal --> common hepatic) distal: inferior pancreaticoduodenal artery (branch of SMA)
171
venous drainage of duodenum
proximal: superior pancreaticoduodenal vein to portal vein distal: inferior pancreaticoduodenal vein to superior mesenteric vein then portal vein
172
innervation to duodenum
sympathetic: greater and lesser splanchnic nerves parasympathetic: vagal trunks
173
where is pain from the duodenum referred to
epigastric region
174
describe lymph drainage from the duodenum
proximal: pre-aortic coeliac axis nodes at T12 distal: pre-aortic superior mesenteric nodes at L1
175
lobes of the liver
``` anteriorly: right and left lobe posteriorly: quadrate lobe caudate lobe ```
176
which ligaments are visible anteriorly on the liver
``` falciform ligament (between left and right lobes) ligamentum teres (remnant of umbilical vein) ```
177
what is the porta hepatis
point where structures enter the liver
178
which structures are present in the porta hepatis
``` right and left hepatic ducts hepatic arteries portal vein ANS fibres lymph nodes ```
179
which structures are carried to the porta hepatis in the lesser edge of the lesser omentum
common bile duct hepatic artery portal vein
180
where are the hepatic veins
within the liver | drain into the IVC
181
which structures are associated with the anterior surface of liver
ribs and costal cartilages
182
which structures are associated with the posterior surface of the liver
``` oesophagus stomach duodenum right colic flexure right kidney right suprarenal gland gall bladder ```
183
which structures are associated with the superior surface of the liver
diaphragm
184
what are the surface markings of the gall bladder
9th costal cartilage, right midclavicular line
185
what are the surface markings of the superior border of the liver
between ribs 5-6
186
why is there a bare area on the liver
the part of the liver in contact with the diaphragm is not covered in peritoneum
187
what are the falciform, right and left triangular ligaments made of
folds of peritoneum
188
arterial blood supply to liver
hepatic artery
189
describe blood flow through liver
blood supplied to liver by hepatic artery and portal vein arterial and venous blood conducted to central vein of each liver lobule by sinusoids central veins drain into right and left hepatic veins (often up to four) hepatic veins drain into IVC
190
lymph drainage of liver
nodes at porta hepatis --> coeliac nodes (T12) | small amount passes through diaphragm to posterior mediastinum
191
autonomic innervation of liver
coeliac plexus sympathetic: greater splanchnic parasympathetic: vagal trunks
192
where is pain from the liver referred to
epigastric region | right shoulder if diaphragmatic irritation
193
what is another name for the sphincter of Oddi
major duodenal papilla
194
parts of the gall bladder
superior neck (connected to cystic duct) body (in contact with posterior surface of liver) fundus (hangs below level of liver)
195
how does bile and the gallbladder aid in digestion
fat in the duodenum causes release of cholecystokinin from the small intestine mucosa causes gall bladder to contract smooth muscle in distal bile duct and ampulla relaxes to allow bile to enter the duodenum bile emulsifies fat
196
arterial supply of gall bladder
cystic artery (branch of right hepatic artery)
197
venous drainage of gallbladder
cystic vein drains to portal vein
198
lymph drainage of gallbladder
cystic nodes --> hepatic nodes --> coeliac nodes
199
innervation of gallbladder
coeliac plexus
200
where is pain from the gall bladder referred to
epigastric region
201
parts of the pancreas
head (uncinate process posteriorly) neck body tail
202
where is the head of the pancreas located
in the curvature of the duodenum
203
which vessel is posterior to the neck of the pancreas
superior mesenteric artery
204
in which ligament is the tail of the pancreas located
leinorenal ligament
205
which artery runs along the superior border of the pancreas
splenic
206
which structures are anterior to the pancreas
transverse colon | stomach
207
which structures are posterior to the pancreas
``` bile duct portal vein splenic vein IVC aorta SMA left posts left suprarenal gland left kidney spleen ```
208
what is the course of the main pancreatic duct
from the tail to the ampulla of vater
209
if present, what is the course of the accessory pancreatic duct
drains into the upper part of the head and into the duodenum (superior to ampulla of vater)
210
arterial supply of pancreas
right side: superior pancreaticoduodenal artery (common hepatic, CA) inferior pancreaticoduodenal artery (SMA) left side: dorsal pancreatic artery (splenic, CA)
211
venous drainage of pancreas
splenic or superior mesenteric veins --> portal system
212
lymphatic drainage of pancreas
coeliac (T12) and superior mesenteric (L1) pre-aortic nodes
213
innervation of pancreas
coeliac and superior mesenteric plexuses
214
surface markings of spleen
deep to ribs 9-11 in left hypochondrium
215
which vessels are carried in the gastrosplenic ligament
short gastric | L. gastro-epiploic
216
arterial supply to spleen
splenic artery --> CA
217
venous drainage of spleen
inferior mesenteric vein --> splenic vein --> superior mesenteric vein --> portal vein
218
innervation of spleen
coeliac plexus
219
which structures are classed as midgut
``` distal 1/2 duodenum jejunum ileum caecum appendix ascending colon proximal 2/3 of transverse colon (not including splenic flexure) ```
220
what is the arterial supply of midgut structures
superior mesenteric artery
221
which structures are classed as hindgut
``` distal 2/3 transverse colon descending colon sigmoid colon rectum anal canal ```
222
what is the arterial supply of hindgut structures
inferior mesenteric artery
223
difference in appearance between jejunum and ileum
``` jejunum = upper, red ileum = lower, pale ```
224
difference in wall of jejunum and ileum
``` jejunum = thicker, more plicae circularis ileum = thinner, less plicae ```
225
difference in bore of jejunum and ileum
``` jejunum = wider ileum = narrower ```
226
difference in mesenteric vessels of jejunum and ileum
``` jejunum = 1 or 2 arcades, long branches to wall ileum = 3 or 4 arcades, many short branches to wall ```
227
difference in adipose tissue of jejunum and ileum
``` jejunum = most near root of mesentery ileum = all through mesentery ```
228
difference in lymphoid tissue in jejunum and ileum
``` jejunum = small amount ileum = numerous Peter's patches ```
229
arterial supply of small intestine
mostly jejunal and ill branches from SMA | lower parts of ileum by ileocolic arteries
230
venous drainage of small intestine
to superior mesenteric veins
231
lymph drainage of small intestine
mesenteric nodes --> pre-aortic nodes at superior mesenteric artery (L1)
232
innervation of small intestine
superior mesenteric ganglion
233
pain from small intestine is referred where
umbilical region
234
features unique to large intestine
haustra = sacculation of body wall appendices epiploicae = fatty tags teniae coli = longitudinal muscles collected into 3 bands
235
structures related to caecum
small intestine psoas iliacus
236
arterial supply of caecum
caecal arteries from ileocolic artery (SMA) | anterior and posterior caecal arteries
237
venous drainage of caecum
SMV
238
lymphatic drainage of caecum
mesenteric --> superior mesenteric nodes
239
innervation of caecum
superior mesenteric plexus
240
how is the appendix attached to the body wall
small mesoappendix mesentery
241
where is MacBurney's point
1/3 along line from ASIS to umbilicus
242
blood supply to appendix
appendicular artery (from either caecal artery or directly from ileocolic artery)
243
venous drainage of appendix
posterior caecal vein
244
where is pain from appendix referred to
umbilicus | until inflammation reaches body wall --> MacBurney's point
245
the ascending colon is intraperitoneal/retropertioneal
retroperitoneal
246
structures related to ascending colon
``` small intestine greater omentum iliacus iliac crest quadratus lumborum right kidney ilioinguinal and iliohypogastric nerves ```
247
blood supply to ascending colon
ileocoloc and right colic branches of SMA
248
venous drainage of ascending colon
superior mesenteric vein via ileocolic and right colic veins
249
lymph drainage of ascending colon
superior mesenteric nodes (L1)
250
nerve supply of ascending colon
ANS from superior mesenteric plexus
251
how is transverse colon attached to body wall
transverse mesocolon
252
relations of transverse colon
greater omentum pancreas small intestine
253
blood supply of transverse colon
proximal: middle colic artery (SMA) distal: left colic (IMA) <>
254
venous drainage of transverse colon
proximal: superior mesenteric veins distal: inferior mesenteric veins
255
lymph drainage of transverse colon
proximal: superior mesenteric nodes distal: inferior mesenteric nodes
256
innervation of transverse colon
ANS: superior and inferior mesenteric plexuses parasympathetic: vagus (proximal) and pelvis (distal)
257
relations of descending colon
``` small intestine greater omentum left kidney Quadratus lumborum psoas femoral, ilioinguinal and iliohypogastric nerves ```
258
blood supply of descending colon
left colic and sigmoid arteries (IMA)
259
venous drainage of descending colon
inferior mesenteric --> splenic vein --> portal vein
260
innervation of descending colon
``` sympathetic = inferior mesenteric plexus parasympathetic = pelvis ```
261
how is sigmoid colon attached to body wall
pelvic mesocolon
262
relations of sigmoid colon
urinary bladder (M) uterus/vagina (F) rectum, sacrum (both)
263
arterial supply to sigmoid colon
sigmoidal branches of L colic artery (IMA)
264
innervation of sigmoid colon
ANS from inferior hypogastric plexus
265
arterial supply of rectum
superior rectal artery (IMA) middle rectal artery (internal iliac) inferior rectal artery (internal pudendal)
266
venous drainage of rectum
superior to portal system via IMV | middle and inferior veins to internal iliac and internal pudendal veins
267
lymph drainage of rectum
upper to inferior mesenteric nodes | lower to nternal iliac nodes
268
innervation of rectum
inferior hypogastric plexus
269
define retroperitoneal
lies posterior to parietal peritoneum
270
what is the difference between primary and secondary retroperitoneal structures
primary: develops behind the peritoneum, has always been attached to body wall secondary: develops within the body wall totally covered by peritoneum and moves to body wall by end of development
271
primary retroperitoneal structures | 4
kidneys suprarenal glands vessels nerves
272
secondary retroperitoneal structures | 5
``` 2nd/3rd parts of duodenum pancreas ascending colon descending colon upper 2/3 rectum ```
273
which ribs protect the kidneys
left kidney: 11/12 | right kidney: 12
274
anterior relations of right kidney | 4
suprarenal gland liver 2nd part of duodenum right colic (hepatic) flexure
275
posterior relations of right kidney | 6
``` diaphragm rib 12 psoas Quadratus lumborum transversus abdominis subcostal nerve ```
276
anterior relations of left kidney | 6
``` suprarenal gland spleen stomach pancreas left colic (splenic) flexure jejunum ```
277
posterior relations of left kidney | 6
``` diaphragm ribs 11/12 psoas Quadratus lumborum transversus abdominis subcostal nerve ```
278
structures in the renal hilum
``` renal vein renal artery renal pelvis (and ureter) lymph sympathetic fibres ```
279
in which renal vein is variation more common and why
left renal vein | longer and more communications
280
where do the renal arteries branch from the aorta
L1 | bilateral
281
how do the renal arteries branch when they reach the kidney
anterior and posterior branches, then segmental branches
282
what are the segmental branches of the renal arteries
anterior: apical, upper, middle, lower | posterior
283
describe the course of the right renal artery
longer than left | passes posterior to IVC
284
describe the course of the right renal vein
shorter than left | passes behind the descending duodenum
285
describe the course of the left renal vein
longer than right travels over aorta and under SMA passes behind splenic vein and body of pancreas
286
which veins drain into the left renal vein
left gonadal | left suprarenal
287
where do the kidney receive their nerve supply from
renal sympathetic plexus | lesser and least splanchnic nerves
288
where do afferent fibres from the kidney meet the spinal cord
T10-12
289
where does lymph from the kidneys drain
lateral aortic nodes at origin of renal artery (L1)
290
describe the course of the ureters
runs vertically from hilum on surface of psoas crosses bifurcation of common iliac anterior to SI joint runs on lateral wall of pelvis towards ischial spine enters inferior surface of bladder at trigone
291
where are the three natural constrictions of the ureters
at junction with renal pelvis as it crosses pelvis brim as they enter bladder
292
describe the arterial supply of the ureters
superior: renal artery middle: gonadal artery (l2) inferior: superior vesical artery (one in pelvis)
293
describe venous drainage of ureters
superior: renal veins middle: gonadal veins inferior: vesical veins
294
where does lymph from the ureters drain
``` lateral aortic (L1) nodes iliac nodes ```
295
what is the nerve supply of the ureters
renal, gonadal and hypogastric plexuses
296
where does pain from the ureters refer
groin pain
297
what shapes are the suprarenal glands
``` right = pyramidal left = crescentic ```
298
arterial supply of suprarenal glands
``` superior = suprarenal branch of inferior phrenic artery middle = suprarenal artery (branch of aorta) inferior = suprarenal branch of renal artery ```
299
venous drainage of suprarenal glands
single vein on each side right to IVC left to renal vein
300
how is the fascia of the posterior abdominal wall named
after the muscles is covers | eg fascia over Quadratus lumborum
301
the fascia below the arcuate line is called...
transversals fascia
302
attachments of Quadratus lumborum
iliac crest to 12th rib and L1-4 transverse processes
303
action of quad lumborum
``` unilateral = lateral flexion bilateral = pressure, forced expiration, support of 12th rib ```
304
innervation of quad lumborum
anterior rami T12-L4
305
attachments of iliacus
iliac fossa (joins with posts to form Iliopsoas) to lesser trochanter
306
action of iliacus
hip flexion
307
innervation of iliacus
femoral nerve
308
attachments of psoas
T12-L4 bodies and IV disc (superficial) and L1-5 (deep) to lesser trochanter (joins iliacus)
309
innervation of psoas
lumbar plexus direct branches from L2-4
310
muscles within the abdominal cavity are innervated by anterior/posterior rami
anterior rami posterior rami for muscles of the back
311
what is the lateral accurate ligament
thickening of fascia over Quadratus lumborum
312
what are he two divisions of psoas
minor (superficial, long tendon) | major (deep)
313
what is the medial arcuate ligament
thickening of the fascia over psoas
314
which levels does the right crus attach
L1-3
315
which levels does the left crus of diaphragm attach
L1-2
316
which branch of the abdominal aorta supplies the diaphragm
inferior phrenic
317
at which level does the aorta bifurcate
L4
318
what are the anterior branches of the abdominal aorta
coeliac axis SMA IMA
319
lateral branches of the abdominal aorta
real arteries gonadal arteries middle suprarenal artery
320
posterior branches of abdominal aorta
lumbar arteries
321
which structures drain into the IVC
body wall diaphragm suprarenal glands right gonadal vein
322
where do the digestive organs drain blood to
portal vein NOT IVC
323
at which level is the IVC formed, and by the union of which vessels
L5 | union of common iliac veins
324
where do the ascending lumbar veins arise, and what is their course/purpose
from external iliac run upwards to join the azygous system, sometimes communicating with the renal veins provides collateral venous drainage
325
where do the lumbar veins normally drain
L1/2 into ascending lumbar vein (superiorly) L3/4 into IVC L5 into iliolumbar vein (then common iliac) or ascending lumbar (inferiorly)
326
what are the main ganglia in the abdomen
coeliac superior mesenteric inferior mesenteric superior/inferior hypogastric
327
describe the parasympathetic innervation of the abdominal ganglia
posterior vagal trunks to coeliac plexus and superior mesenteric ganglia pelvic parasympathetic fibres (S2-3/4) to inferior mesenteric and superior/inferior hypogastric ganglia
328
where does lymph from the pelvis drain
iliac nodes
329
lymph from which structures drains to para-aortic (lateral) nodes
body wall kidneys testes/ovaries
330
lymph from which structures drain to pre-aortic nodes
digestive tract | includes coeliac, superior mesenteric and inferior mesenteric nodes
331
which level is the cisterns chill at
L1/2
332
the cistern chill is the start of which structure
thoracic duct
333
the lumbar plexus is made up of which nerve roots
L1-4
334
the branches of the lumbar plexus can all be identified in relation to which muscle
psoas
335
roots of iliohypogastric nerve
L1
336
sensory innervation of iliohypogastric nerve
lateral gluteal skin | pubic skin
337
motor innervation of iliohypogastric nerve
internal oblique | transversus abdominis
338
nerve roots of ilioinguinal nerve
L1
339
sensory innervation of ilioinguinal nerve
medial thigh | root of penis/scortum or mons pubis/labium magus
340
nerve roots of genitofemoral nerve
L1/2
341
sensory innervation of genitofemoral nerve
scrotum or mons pubis | upper anterior thigh
342
motor innervation of genitofemoral nerve
cremasteric muscle
343
where does the genitofemoral nerve lie in relation to psoas
runs on the surface of psoas
344
roots of lateral cutaneous nerve of thigh
L2/3
345
sensory innervation of lateral cutaneous nerve of thigh
skin on anterior and lateral thigh
346
roots of femoral nerve
L2-4
347
motor innervation of femoral nerve
pectineus iliacus anterior compartment of thigh
348
which branch of femoral nerve supplies the leg
saphenous nerve
349
sensory innervation of femoral nerve
skin on anterior thigh and medial leg
350
roots of obturator
L2-4
351
sensory innervation of obturator
medial thigh
352
motor innervation of obturator nerve
obturator externus medial compartment of thigh sometimes pectineus

Anatomy BMSc (9 decks)

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