abdomen LOs Flashcards
(37 cards)
1
Q
explain the function of the abdomen and its boundaries
A
- function: flexible container for abdominal organs
- bony framework provides sites for muscle attachment
- bony protection to certain organs
- boundaries
- superior: diaphragm
- anterior: abdominal wall
- posterior: vetebral column
- inferior: pelvic inlet
2
Q
explain the functions of the anterior abdominal wall
A
- no definite boundaries with muscles – anterior to lateral to posterior
- functions
- support trunk
- supper abdominal viscera (organs)
- manage intra-abdominal pressure during respiration – muscle
- move trunk and maintain posture
3
Q
organization of greater and lesser sacs, mesenteries, peritoneal “ligaments”
A
- greater sac: main abdominal cavity
- lesser sac/onmental bursa/diverticulum: posterior to stomach, anterior to pancreas
- mesenteries: continuous set of tissues located in abdomen
- suspend peritoneal layers
- double layer of peritoneum
- provides conduit for neurovascular supply between organ and body wall
- peritoneal “ligaments:” falciform ligaments, liver to posterior of anterior abdominal wall
- A -> P, inferiorly, encloses round ligament of the liver
- splits the L and R liver lobes
4
Q
distinguish between intraperitoneal and retroperitoneal visceral categorization
A
- intraperitoneal: enclosed by visceral peritoneum, suspended by mesentaries
- retroperitoneal: behind the peritoneum
- primarily: never had a mesentery, truly posterior to peritoneal cavity
- kidney, suprarenal glands
- secondarily: looks retroperitoneal but not really, were previously intrapertioneal but mesentery fused during development
- duodenum, colon, pancreas, upper 2/3 rectum
- primarily: never had a mesentery, truly posterior to peritoneal cavity
5
Q
explain the layers of the rectus sheath
A
- separated by arcuate line
- above arcute line (upper 2/3 of rectus abdominis):
- anterior rectus sheath: external abdominal oblique, internal abdominal oblique
- posterior rectus sheath: internal abdominal oblique, transversus abdominis
- below arcuate line (lower1/3 of rectus abdominis): no posterior sheath
- (anterior) rectus sheath: EAO, IAO, TA
- posterior: transversalis fascia
- above arcute line (upper 2/3 of rectus abdominis):
6
Q
explain the significance of the arcuate line
A
- demarcates transition between aponeurotic (tendon) posterior rectus sheath and transversalis fascia
- forms passage for blood from abdomen to rectus abdominis
- inferior epigastric vessels perforate RA
- 2/3 between xiphoid process, 1/2 between umbilixus and pubic symphysis
7
Q
describe the anatomy of the inguinal canal including its contents in both males and females
A
- inguinal region: interface of LE to abdomen
- passage 4 cm long, parallel to inguinal ligament
- openings are known as “rings” – deep and superficial
- primarily occupied by
- spermatic cord
- round ligament (homolog to ductus deferens)
- – > with ilioinguinal nerve outside
- boundaries
- floor: inguinal ligament (ASIS to pubic tubercle) reinforced medially by lacunar ligament
- anterior wall: external oblique (aponeurosis) reinforced laterally by internal oblique
- posterior wall: transversalis fascia reinforced by conjoint tendon
8
Q
list the layers of the anterior abdominal wall from superficial to deep
A
- skin
- superficial fascia (adipose)
- muscles and fascia – 3 layers
- extraperitoneal adipose
- peritoneum
9
Q
describe the innervation of the skin of the abdomen via T7-T12 spinal nerves
A
- peripheral NS –> spinal nerves
- dermatomal pattern
10
Q
describe the division of the abdomen into quadrants
A
- vertical line at midline/xiphoid process
- horizontal line at umbilicus
11
Q
direct vs indirect inguinal hernias
A
- both: protrusion of peritoneal sac through weakned abdominal wall
- predisposing factors: obesity, aging, genetics, male, certain occupations
- viscera may become trapped or twisted, compromises blood supply
- indirect: through both superficial and deep inguinal rings
- bowels passes lateral to inferior epigastric vessels, into scrotum
- congenital, most common (>66%)
- direct: only through the superficial ring
- bowel passes medial to inferior epigastric vessels
- acquired and not congenital, least common (<33%)
12
Q
name the composition of the portal triad
A
- endclosed in lesser omentum
1. common bile duct
2. hepatic portal vein
3. hepatic artery proper
13
Q
abdominal aorta arterial supply drawing
A
14
Q
celiac trunk arterial supply drawing
A
15
Q
superior and inferior mesenteric artery arterial supply drawing
A
16
Q
sympathetic/thoracolumbar innervation (T1-L2)
A
17
Q
parasympathetic/craniosacral innervation
A
18
Q
biliary tree drawing
A
19
Q
caval venous drainage
A
20
Q
portal venous drainage
A
21
Q
venous pathways involved in 4 primary portal hypertension scenarios
A
- L gastric: esophageal <> azygos, IVC
- IMV: superior rectal <> middle and inferior rectals to internal iliac to common iliac, IVC
- paraumbilical: <> inferior epigastric/superficial epigastric, EI/femoral, CI, IVC
- IMV: L colic <> lumbars, IVC
22
Q
abdomen lymph drainage
A
23
Q
foregut
A
liver, spleen, stomach, duodenum, pancreas, gallbladder - supplied by celiac trunk
24
Q
midgut
A
cecum, small intestine, appendix, ascending colon, transverse colon - supplied by SMA
25
hindgut
descending colon, transverse colon, sigmoid colon, rectum - supplied by IMA
26
explain the three layers of thoracolumbar fascia including what attaches to each
* 3 layers: anterior, middle, posterior
* 2 spaces containing quadratus lumborum and erector spinae
* anterior | QL | middle | ES | posterior --\> latissimus dorsi
27
name the openings in the diaphragm and the structures that pass through them
* caval opening (T8)
* inferior vena cava
* esophageal hiatus (T10)
* esophageal hiatus, parasympathetic (vagal trunks)
* aortic hiatus (T12)
* descening aorta, thoracic duct
28
lumbar plexus drawing
29
describe arterial supply and venous drainage of the posterior abdominal wall
* arterial supply
* abdominal aorta
* celiac trunk, superior mesenteric artery, inferior mesenteric artery, suprarenal arteries (superior, middle, inferior), renal aa, gonadal aa (anterior to ureter), inferior phrenic aa, lumbar aa (4 pairs), median sacral
* venous drainage
* inferior vena cava
* inferior phrenic vv, renal and suprarenal vv, lumbar vv (4 pairs), ascending lumbar vv (parallel abd aorta), left gonadal into L renal v, R gonadal vein into IVC
30
review retropeitoneal structures and their relation to the posterior abdominal wall
* primary retroperitoneal: kidney, suprarenal gland
* secondarily retroperitoneal: duodenum, pancreas, spleen, upper 2/3 rectum, colon
31
describe external and internal features of the kidneys
32
autonomic innervation of the kidneys and urinary bladder -- parasympathetic
* vagus CNX
* esophageal plexus
* posterior vagal trunk
* celiac ganglion plexus
* renal nerve plexus
* _kidney (synpase in organ wall)_
33
autonomic innervation of the kidneys and urinary bladder -- sympathetic
* lesser splanchnic (T10-T11) or least splanchnic (T12)
* _aorticorenal ganlgion (synapse)_
* renal n plexus
* kidney
34
explain the relation between the ureter and testicular artery
testicular/ovarian artery passes anterior to the ureter
35
define the trigone of the urinary bladder
* triangular region or tissue at the base of the urinary bladder between openings of the ureters and urethra
36
contrast anatomy of male and female urethra
* male
* 20 cm
* through prostatic, membranous, and spongy tissue to penis
* female
* 4 cm
* opens to outside
37
