Abdomen Flashcards
(198 cards)
1
Q
3 muscles of abdominal wall
A
external oblique, internal oblique, transverse abdominus, rectus abdominus
2
Q
innervation of abdominal wall
A
ventral rami of T7-L1
3
Q
blood supply of abdominal wall
A
intercostal, musculophrenic, and superior/inferior epigastric vessels
4
Q
aponeuroses
A
flat tendons
5
Q
which muscles of the abdominal wall have aponeuroses
A
external/internal obliques and transverse abdominus
6
Q
linea alba
A
central tendinous line where the aponeuroses interdigitate
7
Q
what muscles of abdominal wall have linea alba
A
rectus abdominus - breaks up the muscle bellies
8
Q
aponeuroses relationship to rectus abdominus muscle
A
wrap around it to form the anterior and posterior rectus sheaths (below umbilicus is anterior sheath only)
9
Q
transversalis fascia
A
deep fascia of abdomen that sits posterior to rectus abominus muscle below umbilicus
10
Q
3 flat muscles of abdominal wall and what are they a continuation of
A
internal/external obliques and transverse abdominus, continuation of the 3 intercostal muscle layers
11
Q
tendinous intersections
A
transverse fibrous bands where rectus sheath attaches to rectus abdominus muscle
12
Q
anterior rectus sheath
A
aponeurosis of external oblique and part of aponeurosis of internal oblique
13
Q
posterior rectus sheath
A
aponeurosis of internal oblique and aponeurosis of transverse abdominus
14
Q
arcuate line
A
where posterior rectus sheath ends
15
Q
layers of abdominal wall (superficial to deep)
A
skin, superficial fascia (Camper’s fascia and Scarpa’s fascia), external oblique, internal oblique, transverse abominus, transversalis fascia, parietal peritoneum
16
Q
direct inguinal hernia
A
protrudes through Hesselbach’s triangle
17
Q
inguinal canal
A
oblique passageway through which the spermatic cord or round uterine ligament passes
18
Q
indirect inguinal hernia
A
due to congenital defect in inguinal canal
19
Q
direct inguinal hernias occur ____ to inferior epigastric arteries
A
medial
20
Q
indirect inguinal hernias occur ________ to inferior epigastric arteries
A
lateral
21
Q
which type of hernia occurs more often in women
A
femoral
22
Q
location of femoral hernias
A
in medial-most compartment of femoral triangle, below inguinal ligament
23
Q
inguinal ligament
A
free edge of aponeurosis of external oblique muscle
24
Q
inguinal hernias occur ____ to inguinal ligament
A
superior
25
what normally occupies most medial compartment of femoral triangle
lymphatics
26
umbilicus lies at what vertebral level
T10
27
pain in epigastric region referred from
foregut
28
pain in umbilical region referred from
midgut
29
pain in pubic/hypogastric region referred from
hindgut
30
NVB of anterolateral abdominal wall travels between which muscles
transverse abdominis (deep), internal oblique (middle)
31
nerves of anterolateral abdominal wall have what origin
ventral rami of T7-L1
32
T7-T11 NVB
continuations of intercostal NVB
33
T12 nerve is called
subcostal nerve
34
L1 nerve branches are called
iliohypogastric, ilioinguinal
35
terminal branches of the internal thoracic artery
superior epigastric, musculophrenic arteries
36
branches of the external iliac artery
inferior epigastric, deep circumflex arteries
37
superior and inferior epigastric arteries location
run posterior to the rectus abdominis muscle within the posterior rectus sheath
38
planes of abdominal quadrants
midsaggital, transumbilical (T10)
39
McBurney's point location
1/3 between anterior iliac spine and umbilicus
40
McBurney's point significance
attachment point between appendix and cecum, pain is indicative of appendicitis
41
Planes of abdominal regions
midclavicular, subcostal, intertubercular
42
3 superior regions (R to L)
Right hypochondriac, epigastric, left hypochondriac
43
3 middle regions (R to L)
Right flank, umbilical, left flank
44
3 inferior regions (R to L)
R groin/inguinal, pubic/hypogastric, L groin/inguinal
45
peritoneum is composed of (histology)
simple squamous epithelium
46
visceral and parietal peritoneum are continuous at the
mesentery
47
the peritoneum is ____ in men and ____ in women
closed, open
48
what penetrates the peritoneum in women
the uterine tubes
49
what does the peritoneal cavity contain
serous peritoneal fluid
50
any organ that has a mesentery is
intraperitoneal
51
parietal peritoneum sensory innervation
T7-L1
52
lesser sac aka
omental bursa
53
location of lesser sac
posterior to the stomach and inferior to the liver
54
greater and lesser sac communicate through
epiploic foramen of Winslow
55
mesentery
double layer of peritoneum reflecting from the abdominal wall to enclose viscera
56
mesentery of small intestine aka
mesentery proper
57
mesentery of transverse colon aka
transverse mesocolon
58
mesentery of sigmoid colon aka
sigmoid mesocolon
59
omentum
a broad, double layer of peritoneum passing from the stomach to another organ
60
greater omentum
passes from stomach to transverse colon
61
lesser omentum
passes from stomach to liver
62
greater omentum drapes over the
transverse colon
63
ligaments
parts of mesenteries between organs or between organ and body wall
64
lesser omentum forms the anterior wall of the
lesser sac
65
divisions of greater sac and what they are divided by
supracolic and infracolic compartments divided by transverse mesocolon
66
gutters of the infracolic compartment and their locations
right and left paracolic gutters to the left and right of ascending and descending colon
67
3 unpaired branches of abdominal aorta
celiac trunk, superior mesenteric artery, inferior mesenteric artery
68
celiac trunk supplies
foregut
69
SMA supplies
midgut
70
IMA supplies
hindgut
71
components of foregut
esophagus, stomach, first half of duodenum, liver, pancreas, gallbladder, spleen
72
components of midgut
second half of duodenum, jejunum, ileum, ascending colon, first 2/3 of transverse colon
73
components of hindgut
last 1/3 of transverse colon, descending colon, sigmoid colon, rectum
74
anastomosis at foregut-midgut junction
superior pancreaticoduodenal artery (celiac trunk) with inferior pancreaticoduodenal artery (SMA)
75
anastomosis at midgut-hindgut junction
middle colic artery (SMA) with left colic artery (IMA)
76
location of anastomosis at foregut-midgut junction
mid-duodenum
77
location of anastomosis at midgut-hindgut junction
splenic flexure
78
which anastomosis is most vulnerable to ischemia
midgut-hindgut junction
79
marginal artery
arterial arch formed by anastomoses of left, middle, and right colic arteries
80
why are the loops of small intestine vulnerable to ischemia?
intestinal branches of SMA do not anastomose with branches of celiac trunk or IMA
81
rectal anastomosis
superior rectal artery (IMA) with middle and inferior rectal arteries (internal iliac artery)
82
pre-aortic lymph nodes
celiac nodes, SMA nodes, IMA nodes
83
path of lymph from viscera
travel along arterial paths to pre-aortic nodes, then to cisterna chyli to enter venous circulation
84
cisterna chyli
dilated proximal end of thoracic duct
85
enteric nervous system
intrinsic network of ganglia with connections to ANS that coordinates peristalsis and secretion
86
sympathetic innervation to foregut
greater splanchnic nerves to celiac ganglion
87
sympathetic innervation of midgut
greater and lesser splanchnic nerves to superior mesenteric ganglion
88
sympathetic innervation of hindgut
lumbar and sacral splanchnic nerves to inferior mesenteric ganglion and hypogastric plexus/pelvic ganglia
89
greater splanchnic nerves level
T5-T9
90
lesser splanchnic nerves level
T10-T11
91
lumbar and sacral splanchnic nerves level
L1-L2
92
enteric ganglia and nerve plexuses
myenteric plexus and submucosal plexus within layers of intestinal wall
93
origin of preganglionic sympathetic nerves for foregut
T5-T9
94
sympathetic action in gut
decreased motility, contraction of sphincters, pathway for afferent fibers for visceral referred pain
95
preganglionic sympathetic nerve fibers for foregut are the
greater splanchnic nerves
96
postganglionic sympathetic nerve fibers fibers for foregut
celiac plexus via the celiac ganglia
97
preganglionic parasympathetic nerve fibers for foregut
vagus
98
parasympathetic action in gut
increased motility, relaxation of sphincters
99
preganglionic sympathetic nerve fibers in midgut
greater and lesser splanchnic nerves
100
postganglionic sympathetic nerve fibers in midgut
superior mesenteric plexus via the superior mesenteric ganglia
101
preganglionic parasympathetic fibers in midgut
vagus
102
route of referred pain in foregut
greater splanchnic nerves
103
route of referred pain in midgut
lesser splanchnic nerves
104
origion of preganglionic sympathetic neurons in hindgut
L1-L2
105
preganglionic sympathetic neurons in hindgut
lumbar and sacral splanchnic nerves
106
postganglionic sympathetic neurons in hindgut
inferior mesenteric plexus via the inferior mesenteric ganglia, hypogastric plexus via the pelvic ganglia
107
route of referred pain for hindgut
lumbar and sacral splanchnic nerves
108
preganglionic parasympathetic neurons in hindgut
pelvic splanchnic nerves
109
origin of preganglionic parasympathetic neurons in hindgut
S2-S4
110
2 main lobes of liver
right and left
111
2 smaller lobes that are part of left lobe
caudate and quadrate
112
portal vein
carries venous drainage from GI tract, accessory organs, and spleen to liver
113
exocrine secretion of liver
bile
114
what does the liver store
glycogen, fat, proteins, vitamins, iron
115
what does the liver produce
fuels and plasma proteins, bile acids
116
what does the liver metabolize
toxins
117
what does the liver excrete
bilirubin
118
blood supply to liver
proper hepatic artery
119
proper hepatic artery is a branch of
common hepatic artery off the celiac trunk
120
hepatoduodenal ligament carries
the portal triad
121
components of portal triad
proper hepatic artery, portal vein, common bile duct
122
what percentage of blood enters liver from proper hepatic artery
30%
123
what percentage of blood enters liver from portal vein
70%
124
path of blood out from liver
hepatic veins to IVC
125
path of bile out of liver to gallbladder
left and right lobes drain to left and right hepatic ducts which combine to form common hepatic duct, then travels through cystic duct to gallbladder
126
path of bile from gallbladder
leaves GB to enter cystic duct then goes to common bile duct, then to hepatopancreatic ampulla of Vater, then through major duodenal papilla to enter second part of duodenum
127
hepatopancreatic ampulla is surround by
sphincter of Oddi
128
function of gallbladder
stores and concentrates bile
129
gallstones aka
cholelithiasis
130
gallstones form from
bile, billirubin, and cholesterol
131
most common place gallstones lodge
distal end of common bile duct
132
common places gallstones lodge
hepatic and cystic ducts
133
biliary colic
intense, spasmodic pain caused by gallstone lodged in cystic duct
134
cholecystitis
inflammation of gallbladder caused by obstruction of cystic duct and buildup of bile within GB
135
referred pain from cholecystitis
posterior thoracic wall and right shoulder
136
pain of cholecystitis course
starts epigastric and becomes right hypochondriac
137
choledocholithiasis
stones in common bile duct
138
symptoms of choledocholithiasis
RUQ/epigastric pain, N/V, jaundice
139
cause of jaundice
bilirubin is not excreted and instead seeps into bloodstream
140
hepatopancreatic ampulla
where pancreatic duct joins bile duct
141
how can pancreatitis result from gallstone
if the stone lodges in the major duodenal papilla, causing bile to back up into the pancreatic duct
142
pancreas location
posterior wall of lesser sac
143
parts of pancreas
head, neck, body, tail
144
pancreas head location
c-shaped curve of duodenum
145
path of pancreatic exocrine secretions (other than pancreatic duct)
accessory pancreatic duct to minor duodenal papilla to duodenum
146
location of spleen
posterolateral to stomach
147
spleen is connected to stomach via the
gastrosplenic ligament
148
spleen is connect to left kidney via the
splenorenal ligament
149
___contributes to the anterior roof of the inguinal canal
internal oblique
150
covering of spermatic cord
cremasteric fascia and muscle
151
where does the spermatic cord emerge from
behind lower part of internal oblique
152
course of spermatic cord
passes inferior to transversus abdominis and carries a layer of transversalis fascia
153
inguinal hernia definition
protrusion of abdominal contents (usually intestine covered by peritoneum and extraperitoneal fat) into some part of the inguinal canal
154
indirect inguinal hernia
does not pass directly through abdominal wall
155
indirect inguinal hernia course
herniating mass enters deep inguinal ring, transverses the inguinal canal, and emerges at the superficial ring
156
coverings of herniating mass in indirect inguinal hernia
cremasteric fascia and muscle
157
internal spermatic fascia
transversalis fascia
158
direct inguinal hernia
pushes directly through posterior wall of inguinal canal medial to the inferior epigastric artery
159
course of direct inguinal hernia
after emerging into inguinal canal, it traverses the medial end of the canal, and emerges at the superficial ring
160
____can progress to the scrotum, but ____ usually do not
indirect inguinal hernias, direct inguinal hernias
161
areas of weakness in the posterior aspect of anterior abdominal wall (inferior)
deep inguinal ring, femoral ring, Hesselbach's triangle, supravesical fossa
162
first veins to receive blood in portal system
portal tributaries
163
capillaries in liver
liver sinusoids
164
anastomoses between portal and systemic circulation are called
portosystemic anastomoses
165
purpose of portosystemic anastomoses
to allow blood to return to the heart via the systemic circulation when a portal vein is occluded
166
locations of 3 major portosystemic anastomoses
lower esophagus, rectum, umbilical region
167
is the abdominal aorta intraperitoneal or retroperitoneal
retroperitoneal
168
where does abdominal aorta start
T12 at the aortic hiatus
169
paired branches of the abdominal aorta
middle adrenal, renal, gonadal, inferior phrenic, lumbar
170
retroperitoneal organs
suprarenal glands, aorta/IVC, duodenum (last 2/3), pancreas, ureters, colon (ascending and descending), kidneys, esophagus, rectum
171
terminal branches of abdominal aorta
common iliac arteries
172
most common location of abdominal aortic aneurysm
IMA
173
major causes of AAA
HTN, atherosclerosis
174
symptom of ruptured AAA
sharp, tearing back pain
175
systemic venous system aka
caval system
176
common iliac vein is formed by
internal and external iliac veins
177
where is common iliac vein formed
pelvic brim
178
what drains into IVC
gonads, kidneys, posterior abdominal wall, liver, diaphragm
179
IVC drains into right atrium just after receiving
hepatic veins
180
3 major branches of celiac trunk
common hepatic, left gastric, splenic
181
what does left gastric supply
lesser curvature
182
major branch of left gastric
esophageal
183
3 major branches of common hepatic artery
proper hepatic, right gastric, gastroduodenal
184
what does right gastric artery supply
lesser curvature
185
what does gastroduodenal artery supply
first part of duodenum
186
2 major branches of gastroduodenal artery
right gastroepiploic, pancreaticoduodenal
187
what does right gastroepiploic artery supply
greater curvature
188
what are 2 major branches of the splenic artery
left gastroepiploic, short gastrics
189
what does the left gastroepiploic artery supply
lesser curvature
190
what do the short gastrics supply
fundus and top part of lesser curvature
191
what anastomosis is responsible for caput madusae
paraumbilical and short epigastric veins
192
what anastomosis is responsible for esophageal varices
left gastric and esophageal veins
193
what anastomosis is responsible for hemorrhoids
superior and inferior rectal veins
194
ampulla of vater aka
hepatopancreatic ampulla
195
what structure can be compressed by SMA after rapid weight loss
third part of the duodenum
196
2 ligaments that make up the lesser omentum
gastrohepatic, hepatoduodenal
197
which ligament contains the portal triad
hepatoduodenal
198
retroperitoneal anastomosis for portal system
retroperitoneal/lumbar veins, colic veins
