Abdominal Region Flashcards
(36 cards)
What is the function of the abdominal wall?
Made up of sheets of muscle and their corresponding sheets of tendon. Hold the abdominal viscera within the abdominal cavity and play an important part in rotating the body, in respiration, coughing, sneezing, micturition, defecation and childbirth by contracting to increase intra-abdominal pressure.
What is a hernia?
The abnormal exit of tissue or an organ, such as the bowel, through the wall of the cavity in which it normally resides.
What is the rectus abdominis muscle?
A pair of vertical muscles. Originates from the crest of the pubis, before inserting into the xiphoid process of the sternum and the costal cartilage of ribs 5-7. Acts to assist the flat muscles in compressing the abdominal viscera, stabilise the pelvis during walking, and depress the ribs.
What is the external oblique muscle?
Most superficial flat muscle in the abdominal wall. Its fibres run inferomedially. Originates from ribs 5-12, and inserts into the iliac crest and pubic tubercle. Acts to contralaterally rotate the torso. Innervated by Thoracoabdominal nerves (T7-T11) and subcostal nerve (T12).
What is the internal oblique muscle?
Deep to external oblique, runs superiomedially. Originates from the inguinal ligament, iliac crest and lumbodorsal fascia, and inserts into ribs 10-12.Bilateral contraction compresses the abdomen, while unilateral contraction ipsilaterally rotates the torso.Thoracoabdominal nerves (T7-T11), subcostal nerve (T12) and branches of the lumbar plexus.
What is the transversus abdominis?
Deepest muscle. Runs transversely. Deep to this muscle runs the transversalis fascia. Originates from the inguinal ligament, costal cartilages 7-12, the iliac crest and thoracolumbar fascia. Inserts into the conjoint tendon, xiphoid process, linea alba and the pubic crest. Acts to compress the abdominal contents. Thoracoabdominal nerves (T7-T11), subcostal nerve (T12) and branches of the lumbar plexus.
What is the inguinal ligament?
The lowest most extent of the external oblique muscle is ligamentous throughout its length and is attached to the anterior superior iliac spine laterally and the pubic tubercle medially.
What is the linea alba?
A fibrous line that splits the rectus abdominis into two. It is visible as a vertical groove extending inferiorly from the xiphoid process.
What makes up a six pack?
The Rectus Abdominis muscle is intersected by fibrous strips, known as tendinous intersections. The tendinous intersections and the linea alba give rise to the ‘six pack’ seen in individuals with a well-developed rectus abdominis. When exercised the muscle hypertrophies (becomes bigger) but the tendinous part stays the same. The result is three bulges (of muscle) between the tendons. This occurs on either side of the midline; six bulges in all.
For anatomical division of the abdomen, what are the vertical lines?
he vertical line on each side extends from the mid-clavicular point to the mid-inguinal point (halfway between the anterior superior iliac spine of the pelvis and the pubic symphysis).
For anatomical division of the abdomen, what are the horizontal lines?
The lower transverse line is drawn between the tubercles of the iliac crests (intertubercular plane) - L4. The upper transverse line is the subcostal (or transpyloric) plane, joining the lowest part of the costal margins on both sides (L1).
What are the 9 anatomical regions? Label on a diagram
Upper: right hypochondrium, epigastic, left hypochondrium
Middle: right lumbar, umbilical, left lumbar
Lower: right flank/groin/iliac, hypogastric/suprapubic, left flank/groin/iliac
What is McBurney’s point?
This point lies ⅔ of the way along a line joining the umbilicus to the right anterior superior iliac spine. It marks the usual site of the base of the appendix. It also gives a guide to the position of the caecum.
What is the umbilicus?
Variable and unreliable landmarks that marks the point of insertion of the umbilical cord during embryonic life and the level of the L3 vertebra.
How is visceral and parietal pain different?
Parietal: sharp pain well-localised to area
Visceral: dull achy pain poorly-localised to area
How does referred pain of the internal organs work in the abdomen?
Foregut: supplied by the greater splanchnic nerve (T5-T9), referred pain in the epigastrium
Midgut: supplied by the lesser splanchnic nerve (T10-T11), referred pain in the periumbilical area
Hindguit: supplied by the least splanchnic nerve (T12), referred pain in the suprapubic area
Where is pain felt if the peritoneum is diseased?
The peritoneum covering the inside of the abdominal wall has the same sensory nerve supply as the skin overlying the same area of the abdominal wall. If the disease process involves the abdominal wall, the pain is felt very precisely over that area.
Where would pain from an inflamed diaphragm be felt?
Disease which inflames the diaphragm like cholecystitis (inflammation of the gall bladder) may be felt as referred pain the in C3, C4, C5 distribution. This pain is felt in the shoulder.
Where would pain from the kidneys be felt?
The sensory innervation of the kidney is via the sympathetic plexus which accompanies the renal artery (T10, T11, T12), same plexus as the gonad. Pain from the kidney can be referred through the cutaneous nerves of T10, 11, 12 and the pain is often described as radiatinng from the loin to the groin. Renal pain can also be felt in the gonal area.
Label some of the bony landmarks of the pelvis on a diagram
Iliac Crest
Anterior Superior Iliac Spine
Pubic tubercle
Pubic Symphysis
Where would pain from the appendix be felt?
Typical history for appendicitis is a vague dull central abdominal pain which after a few hours or days moves to the right iliac fossa and changes character, from dull to sharp as the pain is felt in the skin
Where would pain from an aortic aneurysm be felt?
An aortic aneurysm is an abnormal swelling of the aorta which can burst and cause sudden death. Because the aorta only extends as far as the intertubercular plane, an aortic aneurysm is only felt above this point (epigastrium down to the umbilicus).
How is shingles a good example of a disease which presents with dermatomal effects?
Shingles is caused by the Herpes Zoster which becomes dormant in the sensory dorsal root ganglia and can activate when the patient becomes ill. The virus reproduces and travels down the sensory nerve fibres to the skin which it produces a very itchy rash with vesicles If the virus is in the T10 spinal nerve the rash will form as a ribbon from the T10 vertebra at the back to the umbilicus at the front (T10 dermatome).
What is the inguinal canal?
A short passage that extends inferiorly and medially through the inferior part of the abdominal wall. It is superior and parallel to the inguinal ligament.
