Abdomen wk 1 Flashcards

(47 cards)

0
Q

Origin of External Oblique Muscle

A

The lower 8 ribs (V-XII)

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1
Q

Describe the arrangement of the dermatomes of the abdomen.

A

The skin in the right and left hypochondriac regions are innervated by T7-T9 lat and ant cutaneous branches

The skin over the umbilicus is innervated by T10

The skin of the inguinal region is innervated by L1 via the iliohypogastric and ilioinguinal nerves

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2
Q

Insertion of External Oblique Muscle

A

Linea alba

Lateral lip of iliac crest

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3
Q

Innervation of External Oblique

A

Thoracoabdominal nerves (T7-T11/T12) and sometimes Subcostal nerve

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4
Q

Main Action of External Oblique Muscle

A

Compresses abdominal contents
Flexes the trunk
Bends the trunk to the same side
Turns the ant abdomen to the opposite side

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5
Q

Origin of Internal Oblique Muscle

A

Intermediate Zone of iliac crest
Thoracolumbar fascia
Lat 1/2 of inguinal ligament

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6
Q

Insertion of Internal Oblique Muscle

A

Linea alba
Lower 3-4 ribs
Pubic Crest
Conjoint tendon/pecten pubis

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7
Q

Innervation of Internal Oblique Muscle

A

Anterior rami or Lower 6 thoracic spinal nerves T7-T12, L1

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8
Q

Main Action of Internal Oblique

A

Compresses abdominal contents
Flexes the trunk
Bends the trunk to the same side
Turns the trunk to the same side

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9
Q

Origin of Transversus Abdominis

A

Medial lip of iliac crest
Thoracolumbar fascia
Lat 1/3 of inguinal ligament
Lower 6 Costal cartilages

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10
Q

Insertion of Transversus Abdominis Muscle

A

Linea alba
Conjoint tendon
Pubic crest

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11
Q

Innervation of Tranversus Abdominis Muscle

A

T7-T12, L1

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12
Q

Main Action of Transversus Abdominis Muscle

A

Compresses abdominal contents

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13
Q

Origin of Rectus Abdominis Muscle

A

Pubic Crest, Pubic Tubercle, Pubic Symphysis

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14
Q

Insertion of Rectus Abdominis Muscle

A

Xiphoid process, V-VII costal cartilages

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15
Q

Innervation of Rectus Abdominis Muscle

A

T7-T12

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16
Q

Main Action of Rectus Abdominis Muscle

A

Compresses abdominal contents
Flexes the vertebral column
Tenses the abdominal wall

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17
Q

Origin of Pyramidalis Muscle

A

Front of pubis, pubic symphysis

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18
Q

Insertion of Pyramidalis Muscle

19
Q

Innervation of Pyramidalis Muscle

A

Subcostal nerve (T12)

20
Q

Main Action of Pyramidalis Muscle

A

Tenses linea alba

21
Q

What is the combined functions of the anterolateral muscles of the abdominal wall

A

Move the trunk and maintain posture
Depress ribs during expiration
Support and protect viscera
Compress abdomen

22
Q

Describe The rectus sheath

A

The strong, incomplet fibrous compartment of the rectus abdominis and pyramidalis mm & neurovascular structures

It is formed by the aponeurosis of External Oblique, Internal Oblique and transversus abdominus.

At approximately 1/3 the distance between the umbilicus and the pubic crest there is a line known as the arcuate line

Above the arcuate line the rectus sheath has posterior and anterior compartments but bellow it, it has only anterior

23
Q

Boundaries of the Rectus Sheath

A

Above the umbilicus:
Ant: External Oblique Muscle
Post: Xiphoid process, 6th & 7th costal cartilages.

At the umbilicus:
Ant: External Oblique m, ant layer of Internal Oblique.
Post: post layer of Internal Oblique, Transversus Abdominis

At arcuate line:
Ant: external & internal oblique, Transversus Abdominis
Post: Transversalis fascia

23
Contents of Rectus Sheath
Rectus Abdominis muscle Pyramidalis muscle Superior and inferior epigastric vessels Lymphatics
25
Describe the inguinal canal.
fibromuscular canal oblique in disposition. about 4cm long. extends from deep to superficial inguinal ring, running parallel to and just above the inguinal ligament
26
Boundaries of the inguinal canal:
anterior wall: skin, superficial fasica, aponeuroses of EO and IO muscles at its lateral 1/3 end posterior wall: medially conjoint tendon (insertion of IO and TA into pubic crest) and laterally, reflected inguinal ligament with transversalis fascia roof: arched fibres of IO and TA, medial crus of EO and transversalis fascia floor: inguinal ligament and the lacuna ligament
27
Describe the superficial ring of the inguinal canal
the triangular external ring 1.25cm above and lateral to the pubic crest larger in males (two crura) lateral to pubic tubercle and medial to the insertion of EO on the pubic bone
28
Describe the deep ring of the inguinal canal
oval internal ring 1.25cm superior to the middlle of the inguinal ligament larger in males than females demarcated medially by inferior epigastric vessels
29
List the contents of the inguinal canal that are specific to males
the spermatic cord and its constituents 3 coverings: external spermatic fascia cremasteric fascia internal spermatic fascia ``` vas deferens testicular arteries artery to vas deferens cremasteric artery pampaniform plexus of veins lymphatics genital branch of genitofemoral nerve extraperitoneal fat ```
30
List the contents of the inguinal canal specific to females
round ligament of the uterus
31
List the contents of the inguinal canal common in both sexes
ilioinguinal nerve sympathetic nerves lymphatics
32
Define Hernia
Abnormal protrusion of a structure through tissues which normally contain it
32
Inguinal Hernia
Protrusion of intra-abdominal structures through the inguinal canal as a site of weakness in abdominal wall two types: direct and indirect
33
Indirect inguinal Hernia
Congenital Caused by an embryological descent of the testis with persistant processus vaginalis. Canal of Nuck in females Passes through the entire inguinal canal via deep and superficial rings Lat to inf epigastric vessels Lies directly behind the spermatic cord Most common inguinal hernia More common in young males
34
What is the transversalis fascia (4)
Thin layer of loose connective tissue Continuos posteriorly with anterior part of thoracolumbar fascia And inferiorly with iliac and pelvic fascia
35
What is the extraperitoneal fascia
Layer of variable amount of loose areolar tissue Abundant in posterior part of posterior abdominal wall With lots of adipose especially around the kidneys Thin in children but thick in obese males
36
Direct inguinal Hernia
Acquired Caused by weakness or defect of the transversalis fascia Does not pass via deep ring, rarely descends into scrotum Med to inf epigastric vessels Less common inguinal hernia More common in males
37
Inguinal Hernia vs Femoral Hernia
Inguinal Hernia: passes superomedially to the pubic tubercle Femoral Hernia: passes inferolaterally to the pubic tubercle
39
Anatomical features of Inguinal Canal that minimise herniation
Obliquity of canal ensures that the two rings do not overlie one another. The strongest part of ant wall lies in front of deep ring and strongest part of post wall lies behind the superficial ring. Therefore when intra-abdominal pressure rises, ant/post walls of canal are firmly opposed. Canal is also compressed when abdominal muscles contract by descent of fibres of Internal Oblique and Transversus Abdominis (arched roof) Slit valve action of the two crural rings of External Oblique muscle Contraction of cremasteric muscle closes superficial ring.
40
Peritoneum
A large, thin, transparent serous membrane that lines the abdominopelvic cavity.
41
Composition of peritoneal fluid
Water, electrolytes and solvents from: - interstitial fluid of neighbouring tissues - plasma of adjacent tissues Proteins, desquamated mesothelial cells, macrophages, fibrolasts & lymphocytes.
42
Where are the umbilical peritoneal folds found?
on the infraumbilical surface of the posterior surface of the anterolateral abdominal wall passing towards the umbilicus
43
How many umbilical peritoneal folds are there and how are they distributed?
5 | one in the median plan and two on each side
44
Name the umbilical peritoneal folds and describe them briefly
the median umbilical fold: extends from the apex of the urinary bladder to the umbilicus and covers the umbilical ligament the two medial umbilical folds: lateral to the median umbilical folds they cover the medial umbilical ligaments two lateral umbilical folds: lateral to the medial ones cover the inferior epigastric vessels and bleed if cut
45
What are peritoneal fossae and what is their significance?
they are the depressions lateral to umbilical folds | and they are potential sites for a hernia
46
Name the peritoneal fossae, give their locations and briefly describe them.
supravesical fossae: between the median and medial folds the level falls and rises with the filling and emptying of the bladder medial inguinal fossae: between medial and lateral umbilical folds this area is commonly known as the inguinal triangle of hesselbach triangles. it is a common site for direct inguinal herniation lateral inguinal fossae: lateral to the lateral umbilical folds include deep inguinal rings and are the site of indirect inguinal hernias