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DPT Anatomy > Abdominal wall > Flashcards

Abdominal wall Flashcards

(97 cards)

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1
Q

What are the boundaries of the abdomen?

A

between thorax and pelvis

superior: diaphragm
posterior: lumbar vertebrae and muscles
lateral and anterior: abdominal muscles
inferior: pelvic inlet - from sacral promontory to pubic symphysis along pectineal line

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2
Q

What internal structure correlates with T8?

A

inferior vena cava opening

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3
Q

What internal structure correlates with T10?

A

esophageal hiatus

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4
Q

What internal structure correlates with T12?

A

aortic hiatus - abdominal aorta and celiac trunk

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5
Q

What internal structure correlates with L1?

A

transphyloric plane: 1st part of duodenum, 8th intercostal space, superior mesenteric artery

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6
Q

What internal structure correlates with L2?

A

renal artery (sometimes found at L1) and L diaphragm crus attachment

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7
Q

What internal structure correlates with L3?

A

subcostal plane: 12th rib, inferior mesenteric arteries

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8
Q

What internal structure correlates with L4?

A

supracristal plane, umbilicus, abdominal aorta divides into R/L common iliac arteries

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9
Q

What internal structure correlates with L5?

A

intertubercular plane, IVC formed by R/L common iliac veins

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10
Q

which two planes make up the borders of the quadrants?

A

median sagittal plane: xiphoid process and pubic symphysis
(vertical)

transumbilical plane
(horizontal across belly button)

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11
Q

which structures are found in the right upper quadrant?

A

liver

duodenum

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12
Q

which structure is found in the left upper quadrant?

A

stomach

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13
Q

which structures are found in the right lower quadrant?

A

cecum
ascending colon
appendix

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14
Q

which structures are found in the left lower quadrant?

A

descending colon

sigmoid colon

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15
Q

what is McBurney’s point?

A

appendix referral pain

aka appendicitis

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16
Q

which planes make up the 9 abdominal regions?

A

mid-clavicular plane (x2): mid clavicle and mid inguinal ligament
(two vertical planes)

subcostal (L3) or transpyloric (L1) plane
(top horizontal plane)

intertubercular plane (L5)
(lower horizontal plane)
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17
Q

what are the 9 abdominal regions?

A 
right hypochondrium
epigastric
left hypochondrium
right lumbar/flank
umbilical
left lumbar/flank
right inguinal/groin
pubic
left inguinal/groin
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18
Q

what are the posterior, lateral, and anterior innervations of the abdominal wall?

A

posterior: dorsal rami of spinal nerves
lateral: intercostal nerve & lateral cutaneous branch
anterior: intercostal nerve & anterior cutaneous branch

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19
Q

which muscle causes T6/T7 lateral cutaneous branch impingement and what happens because of it?

A

serratus anterior

causes shoulder problems

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20
Q

which landmark is at T6 dermatome?

A

xiphoid process

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21
Q

which landmark is at T10 dermatome?

A

umbilicus

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22
Q

which landmark is at T12 dermatome?

A

ASIS

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23
Q

What is the relationship between innervation and the spinal nerve in the abdomen dermatome?

A

the innervation does not correlate with the spinal nerve exiting level from spinal cord in the lower part due to the spinal cord stopping at T12-L2.

Example: T9 spinal nerve is innervated at the L3 vertebral level

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24
Q

What is the lateral blood supply for the anterolateral abdominal wall?

A

posterior intercostal vessels

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25
what is the anterior blood supply for the anterolateral abdominal wall?
superior and inferior epigastric vessels | deep and superficial circumflex iliac artery
26
when there is an abdominal aorta malfunction, where do the lower extremities get blood supply from?
superior epigastric artery
27
when there is an inferior vena cava malfunction, where do lower extremities get their blood supply from?
blood can drain back to the superior vena cava
28
what is caput medusae?
portal hypertension a cluster of swollen veins in your abdomen that stem from around the belly button. this indicates a circulatory problem usually associated with liver disease
29
what are the 9 layers of the anterolateral abdominal wall? superficial to deep
``` skin superficial fascia: - fatty layer (Camper's) - membranous layer (scarpa's) external oblique muscle internal oblique muscle transversus abdominis muscle transversalis fascia extraperitoneal fascia parietal peritoneum ```
30
what is the clinical importance of the layers of the abdominal wall?
testis descending and herniation will push through different layers of structures
31
what direction do the external oblique muscles run?
superolateral to medio-inferior | "hands in pockets"
32
what direction does the internal oblique muscles run?
opposite of external oblique muscle
33
what are the two branches of L1 nerve and their parts?
iliohypogastric: internal oblique ilioinguinal: cremaster part
34
what kind of muscle is the transversus abdominis?
a core muscle
35
between which muscle layers do the intercostal nerves run?
between transversus abdominis and internal oblique
36
what distal attachment narrows down and forms a weak point on the anterior abdominal wall?
pyramidalis
37
what is the function of the rectus sheath?
it protects and keeps together the rectus abdominis and pyramidalis. the rectus abdominis is wrapped by aponeurosis of the 3 abdominal muscles
38
where is the arcuate line located?
~1/3 distance of umbilicus to pubic symphysis of posterior rectus abdominis
39
what structures are above the arcuate line?
superficial to rectus: aponeurosis of external oblique half aponeurosis of internal oblique deep to rectus: half aponeurosis of internal oblique aponeurosis of transversus abdominis
40
what are the structures below the arcuate line?
superficial to rectus: all aponeurosis of 3 layers of muscles deep to rectus: none - weakness of abdominal wall
41
what is aponeurosis fiber crossing and what is its function?
weaving of superficial and deep layers of same aponeurosis | function: improves strength and functions
42
what happens between two of the same layer obliques crossing?
intramuscular exchange, from superficial to deep
43
what happens between opposite external and internal oblique fiber crossing?
intermuscular exchange, from superficial to deep | the two different layers intertwine
44
what is the linea alba in relation to fiber crossing?
the midline of the aponeurosis fiber exchange
45
what are the umbilical folds/ligaments in order of lateral to medial?
lateral: inferior epigastric vessels medial: remnant umbilical artery median: remnant allantois (urachus), from umbilicus to suspend urinary bladder
46
what are the borders of Hesselbach's triangle (inguinal triangle)?
lateral: medial of lateral umbilical fold inferior: inguinal ligament medial: lateral rectus abdominis
47
what is the placenta?
landmark of development completed in the 3rd week of gestation - nutrients and oxygen exchange with mother's blood occurs here
48
Do the placenta and embryo have direct contact?
No! | embryo does not have direct contact with the placenta of the mother
49
does the fetus always have the same blood type as mother?
No! | because there is no direct contact, the fetus can have a different blood type
50
how is the fetus and placenta connected if there is no direct contact?
through the umbilical cord - blood vessels/urachus - remnant structures after birth
51
what do the umbilical arteries turn into after birth?
2 medial umbilical ligaments/folds --> not fully remnant (with 2 branches)
52
where do the umbilical arteries run to?
2 internal iliac arteries to placenta
53
what does the umbilical vein turn into after birth?
ligament teres and ligamentum venosum
54
where does the umbilical vein run to?
to liver and continue to inferior vena cava (ductus venosus)
55
what does the allantois turn into after birth?
median umbilical ligament/fold
56
what is the function of the allantois?
fetal urine drainage
57
what does the foramen ovale turn into after birth?
fossa ovalis
58
where is the foramen ovale located?
opening between right and left atrium
59
what does the ductus arteriosus turn into after birth?
ligamentum arteriosum
60
what does the ductus arteriosus bridge?
bridging blood vessel between aorta and pulmonary trunk
61
what is internal hemorrhoids?
anastomosis with rectal vein to IVC | painless
62
what is esophageal varices?
anastomosis of portal vein branches to esophageal veins to SVC
63
what is caput medusae?
anastomosis with epigastric veins to IVC or SVC if IVC has problems
64
what happens after birth in caput medusae?
paraumbilical veins are close after birth. | this re-opens in portal hypertension
65
what is the inguinal ligament formed by?
external oblique aponeurosis ASIS pubic tubercle
66
what are the layers of inguinal canal?
external oblique aponeurosis as scaffold internal oblique muscle slip transversus abdominis
67
what part of the inguinal canal is the external oblique aponeurosis?
distal part forming superficial inguinal ring
68
what does the internal oblique muscle slip do?
cover inner structures | cremaster muscle
69
what structure comes out of he transversus abdominis?
deep inguinal ring (spermatic duct/vessels in males, ligament teres in females)
70
what is the sensory innervation for the inguinal canal?
ilioinguinal nerve
71
what is the motor innervation for the inguinal canal?
genital branch of genitofemoral nerve
72
where does an indirect hernia happen?
at the deep inguinal ring
73
where does a direct inguinal hernia happen?
superficial inguinal ring
74
does the abdominal contents enter the scrotum in indirect inguinal hernia?
yes, abdominal contents enter the scrotum in the males and into groin in females
75
does abdominal contents enter the scrotum in direct inguinal hernia?
no, abdominal contents never enter the scrotum
76
what is the most common abdominal hernia?
indirect inguinal hernia (75%)
77
how does on get an indirect inguinal hernia?
can be congenital or acquired
78
how does one get a direct inguinal hernia?
all acquired but can be predisposed
79
where does a direct hernia have weakness?
weakness of abdominal wall at Hesselbach's (inguinal) triangle
80
what is an umbilical hernia?
abnormal closure after birth
81
what is a post-surgical/incisional hernia?
happens mainly after laparotomy/laparoscopy | artificially weakened anterior abdominal wall
82
what is a diastasis recti?
separation of linea alba | generally not a hernia but internal organs can push outward when intra-abdominal pressure increases
83
who does diastasis recti normally happen to?
happens equally in both genders | can happen to pregnant women
84
what worsens diastasis recti?
increasing intra-abdominal pressure
85
what are the layers of the thoracolumbar fascia?
anterior layer: internal oblique, transversus abdominis middle layer: quadratus lumborum posterior layer: erector spinae/extrinsic back muscles
86
how are the arcuate ligaments formed?
by tendinous structures of diaphragm, wrapping muscles and aorta
87
where is the median arcuate ligament located?
aortic hiatus - abdominal aorta
88
what is median arcuate ligament syndrome?
compression of aorta | which causes pain around stomach and leads to being afraid of eating
89
where is the medial arcuate ligament located?
psoas major
90
where is the lateral arcuate ligament located?
quadratus lumborum
91
what are the three arcuate ligaments?
median, medial, lateral | -- compare to abdominal folds in anterior wall
92
where do the ventral rami L1-L4 exit?
between quadratus lumborum and psoas major
93
what is the anterior core muscle?
transversus abdominis - active all the time without activity specificity
94
what is the posterior core muscle?
multifidi - possible contribution of psoas major
95
what does proximal stability mean?
if your core is stable, movement in your distal joints are better. Thus, if you have good stability, you're less likely to be injured
96
what is hyperlordosis?
too much lumbar lordosis | - over stretch transversus abdominis, resulting in weakness
97
what is flat back?
too little lumbar lordosis | - compromised shock absorption through the back

DPT Anatomy (8 decks)

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