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DPT 701: Clincal Anatomy > Abdominal Wall > Flashcards

Abdominal Wall Flashcards

(86 cards)

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1
Q

What structures can be found at L1

A

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

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2
Q

What structures can be found at L2

A

Renal artery, L diaphragm crus attachment.

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3
Q

What internal structures can be found at L3

A

Subcostal plane

12th rib and inferior mesenteric arteries

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4
Q

What internal structure can be found at L4

A

Supracristal plane

Umbilicis

Abdominal aorta divides into R and L common iliac a

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5
Q

What internal structures can be found at L5

A

Intertubercular plane, IVC formed by R/L common iliac v

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6
Q

Where does the median sagittal plane run

A

Xiohoid process to pubic symphysis

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7
Q

What are the contents of the R upper and lower quadrants

A

R upper- liver and duodenum

R lower- cecum, ascending colon, McBurney’s point

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8
Q

What are the contents of the L upper and lower quadrants

A

L upper- stomach and spleen

L lower- descending and sigmoid colon

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9
Q

What is the appendix referral point

A

McBurney’s point

Referred pain from appendix

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10
Q

Where does the midclavicular plane run

A

Mid clavicle to mid inguinal ligament in the sagittal plane

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11
Q

What is the more reasonable plane for the stomach region

A

Transpyloric L1

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12
Q

What is the innervation of the posterior abdominal wall

A

Dorsal rami of spinal nerves

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13
Q

What is the innervation of the lateral abdominal wall

A

Intercostal nerves- lateral cutaneous branch

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14
Q

What is the innervation of the anterior abdominal wall

A

Intercostal nerve- anterior cutaneous branch

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15
Q

What is a common impingement of the T6-7 lateral cutaneous nerve

A

Serratus anterior can impinge

Secondary to shoulder problems

Need to work back muscles

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16
Q

What nerve level corresponds to the xiohoid process

A

T6

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17
Q

What nerve level innervates the umbilicus

A

T10

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18
Q

What nerve level innervates to ASIS

A

T12

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19
Q

How is the dermatome of the abdomen correlated

A

They are not.

Spinal cord stops at T12-L2 so nerves travel inferior to the exiting level

T9 spinal nerve innervate transversely at L3 vertebral level

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20
Q

What is the blood supply of the lateral abdominal wall

A

Posterior intercostal vessels

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21
Q

What is the blood supply of the anterior abdominal wall

A

Superior and inferior epigastric vessels, deep and superficial circumflex iliac artery

Anastomosis of superior and inferior epigastric vessels

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22
Q

What if there is an abdominal aorta malfunction

A

LE can get blood from superior epigastric artery

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23
Q

What happens if there is an IVC malfunction

A

LE can drain back to the SCV

Portal hypertension=Caput medusae

Swollen superficial veins in abdomen to compensate

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24
Q

What are the 9 layers of the abdominal wall?

A 
Skin
Superficial fascia: fatty layer and membranous layer
External oblique 
Internal oblique 
Transverse abdominus
Transversalis fascia
Extraperitoneal fascia
Parietal peritoneum
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25
How are the external oblique muscle fibers oriented
Hands in pocket
26
What is the muscle fiber orientation of internal oblique
Oh my
27
What is the muscle fiber direction of transversus abdominis
Horizontal muscle fiber CORE muscle
28
Why is the transverse abdominus considered a CORE muscle
Muscle fibers interdigitate with diaphragm Weave together
29
Where do the intercostal nerves run in the abdominal muscles
Between the transverse abdominus and internal oblique
30
What is the pyramidalis
Small triangular muscle in the distal anterior recuts abdominis Doesn’t exist in all people or even on both sides
31
What is significant about the attachment of the recuts abdominus
As it narrows down to a point and forms a weak point on the anterior abdominal wall
32
What is the rectus sheath
Recuts abdominus is wrapped by an aponeurosis is of 3 muscles
33
What is the arcuate line
1/3 distance from umbilicus to pubic symphysis of posterior rectus abdominus
34
What is above the arcuate line
Superficial- 1 EO, .5 IO | Deep- .5 IO, 1 TA
35
What is below the arcuate line
Superficial- all 3 muscles | Deep- none, weakness of abdominal wall
36
What is the purpose of aponeurosis fiber crossing
Improves strength and functions Weaving of both superficial and deep layers of the same aponeurosis
37
What is intramuscular exchange
Fiber crossing between 2 layers of the same oblique
38
What is the inter muscular exchange
Fiber crossing between 2 layers of different obliques
39
What is line alba
Midline of aponeurosis fiber exchange
40
What is the lateral umbilical fold
Inferior epigastric vessels
41
What is the medial umbilical fold
Remnant umbilical artery
42
What is the median umbilical fold
Remnant allantois (urachus), from umbilicus to suspend the urinary bladder
43
What are the borders for hesselbachs triangle or inguinal triangle
Lateral- medial side of lateral fold Inferior- inguinal ligament Medial- lateral rectus abdominus ***very weak, common spot for hernia
44
What stage of gestation is the placenta completed
3 weeks
45
Functions of placenta
Nutrient and oxygen exchange with mothers blood No direct contact with fetus
46
What is the umbilical cord
Connection from fetus with placenta Remnant structures after birth Contains blood vessels/urachus
47
What do the umbilical arteries become
Start: 2 internal iliac arteries End: 2 medial umbilical ligaments/folds
48
What do the umbilical veins become
Start: veins to the liver and then IVC (ductus venosus) End: ligament teres and ligament venosum
49
What is the allantois and what does it turn into
Start: fetal urine drainage End: median umbilical ligament/ fold
50
What is the ductus arteriosus and what does it become
Start: bridging blood vessels between the aorta and pulmonary trunk End: ligament arteriosum
51
What are the esophageal varices
Anastomosis of portal vein branches to the esophageal veins to SVC
52
What are the causes of internal hemorrhoids
Anastomosis of rectal vein to IVC
53
What causes caput medusae
Portal hypertension Anastomosis with epigastric veins to IVC or SVC if IVC has problems too Paraumbilical veins can reopen during portal hypertension
54
What are the layers of inguinal ligament
External oblique Internal oblique Transverse abdominus
55
What does the external oblique form in the inguinal ligament
Distal part forms inguinal ring
56
What does the internal oblique form in the inguinal ligament
Cremaster muscle
57
What does the transverse abdominis form in the inguinal ligament
Deep inguinal ligament- spermatic duct in males and ligament teres in females
58
What is the innervation if the inguinal ligament/canal
Motor: genital branch of genitofemoral n Sensory: ilioinguinal n
59
What is an indirect inguinal hernia
Hernia happens at the deep inguinal ring Most common hernia 75% Abdominal contents enter scrotum in males and groin in females Can be congenital or acquired
60
What is the direct inguinal hernia
Hernia that happens at the superficial inguinal ring Weakness of abdominal wall in hesselbachs triangle Abdominal contents NEVER enter scrotum All are required, but some individuals can be predisposed
61
What is an umbilical hernia
Abnormal closing after birth
62
What is a post surgical/incisional hernia
Mainly after a laparotomy or laparoscopy Artificially weakened anterior abdominal wall
63
What is the diastasis recti
Separation of linea alba Happens equally in both genders Not a hernia, but internal organs push outward when intra abdominal pressure increases but returns afterwards **must design exercises accordingly
64
What muscles attach to the anterior layer of the thoracolumbar fascia
Internal oblique and transverse abdominis
65
What muscles attach to the middle layer of the thoracolumbar fascia
Quadratus lumborum
66
What muscles attach to the posterior layer of the thoracolumbar fascia
Erector spinal and extrinsic back muscles
67
What are the posterior arcuate ligament formed by
Tendinous structure of diaphragm, wrapping muscles, and aorta
68
Where is the posterior median arcuate ligament
Aortic hiatus; a round abdominal aorta
69
What is median arcuate ligament syndrome
Compression of aorta, pain around stomach, afraid to eat
70
Where is the medial arcuate ligament on the posterior abdominal wall
Over psoas major
71
Where is the lateral arcuate ligament from the posterior abdominal wall
Over quadratus lumborum
72
Where do the ventral rami of L1-4 exit
Between quadratus lumborum and psoas major
73
Where is the Subcostal n
T12, under 12th rib
74
Where is the iliohypogastric n
T12/L1 above ASIS
75
Where is the ilioinguinal n
L1, follows inguinal canal
76
Where is the lateral femoral cutaneous n
L2-3 under inguinal ligament
77
Where is the femoral n
Lateral and deep to psoas major L2-4
78
Where is the genitofemoral n
L1-2 crossing psoas major Genital branch follows inguinal canal Femoral branch follows femoral triangle
79
Where is obturator n
L2-4 medial and deep to psoas major
80
Where is the lumbosacral trunk
L4-5 deep to obturator
81
Which anterior core muscles contribute to stability of core
Transverse abdominis- active all the time Possible contribution of internal oblique through thoracolumbar fascia
82
Which posterior muscles contribute to core stability
Multifidi and psoas major Help maintain lordosis
83
What is hyperlordosis
Too much extension in lumbar spine Weakness in transverse abdominis
84
What causes flat back
Too little lordosis in lumbar Compresses shock absorption
85
What nerves innervate quadratus lumborum
Ventral rami spinal nerves
86
What nerves innervate the internal oblique and cremaster muscle
IO- iliohypogastric | C- ilioinguinal

DPT 701: Clincal Anatomy (12 decks)

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