Abdominal Wall Flashcards
(53 cards)
1
Q
Iliac Crest
A
- superior edge of the ilac bone
2
Q
Location of Superior Portion of Iliac Crest
A
- L4
3
Q
Anterior Superior Ilac Spine
A
ASIS
- the anterior point of the iliac crest
- serves as a site of muscle attachment
4
Q
Iliac Fossa
A
- the shallow area on the anteromedial surface of the iliac bone
- servies as a site of origin for the iliacus muscle
5
Q
Arcuate Line
(iliac)
A
- bony ridge on the ilium that forms part of the pelvic brim
6
Q
Arcuate Line
(abdominal)
A
- line that represents the transition of the layers of the rectus sheat
- created when all three muscular layers pass anterior to the rectus abdominus thus leaving no musclular layers posterior to the rectus muscle
7
Q
Pubic Symphysis
A
- joint between the two pelvic bones anteriorly
- disc is comprised of fibrocartilage
8
Q
Pubic Crest
A
- flat area on the superior surface of the public bones
- serves as site of muscle attachment
9
Q
Pubic Tubercle
A
- rounded elevation on the superior ramus of the pubis
- serves as a site of attachment for the inguinal ligament
10
Q
Pectineal Line
A
- a ridge on the pubis that forms part of the pelvic brim
- continuous with the arcuate line
(Arcuate line on ilium, pectineal line on pubuis)
11
Q
Sacral Promontory
A
- the anterior projecting part of the superior edge of the sacrum
- used as a landmark for pelvic measurements in obstetrics
12
Q
Landmarks of the Abdominal Wall
A
Superior - Xiphoid Process, Ribs 11 & 12, Costal Margin
Posterior - Lumbar Vertebral Column
Inferior - superior part of the bony pelvis - linea terminalis
13
Q
Linea Terminalis
A
- lateral edge of the pelvic inlet
- comprised of the pubic crest, pectineal line and arcuate line
- separates the abdomen from the pelvic cavitiy (imaginary)
- aka Pelvic Brim
14
Q
Bony Pelvis
A
- formed by the fusion of three bones:
Ilium
Ischium
Pubis
15
Q
Abdominal Quadrants
A
- used to describe where organs are located
Verticle Line - Median Plane
Horizontal Line - Transumbilical Plane
16
Q
Abdominal Regions
A
Epigastric - superior to the umbilicus
Periumbilical - around the umbilicus
Suprapubic - inferior to the umbilicus, superior to the pubic bone
17
Q
Umbilicus
A
- found at L3/L4 vertebral discs
- located at T10 dermatome
18
Q
Linea Alba
A
- midline tendinous structure that forms the medial border of the rectus sheath
- visible groove down the center of the abdomen
- created by the aponeuroses of the three layered abdominal muscles
19
Q
Semilunar Line
A
- surface indentation that marks the lateral border of the rectus sheath
- horizontally between are “tendinous intersections”
20
Q
McBurney’s Point
A
- 2/3 along a line drawn from the umbilicus to the ASIS
- markst he position of the cecum and appendix (tenderness or pain indicative of appendicitis)
21
Q
External Oblique
A
- outermost muscle layer of the abdominal wall
(fibers towards pubis - hands in pocket)
- inferior edge folds in on itself to form the inguinal ligament between the ASIS and the pubic tubercle
22
Q
Internal Oblique
A
- middle muscle layer of the abdominal wall
(fibers towards xiphoid - 90 degrees from external oblique fibers)
23
Q
Transversus Abdominus
A
- innermost muscle layer of the abdominal wall deep to the internal oblique
(muscle fibers horizontal)
24
Q
Transversalis Fascia
A
- layer of the fascia between the abdominal wall muscles and the parietal peritoneum
- deep to the transcersalis abdominus (above arcuate line, and rectus abdominus below arcuate line)
25
**Rectus Abdominus**
- muscle of the anterior abdominal wall
- right and leff extend from the costal margin to the pubic crest on either side of the midline
- surrounded by aponeurotic sheath bordered medially by the linea alba and laterally by the semilunar line.
26
**Abdominal Fascia**
Skin → Superficial Fascia (fat) → Deep Fascia → Muscles
27
**Superficial Fascia**
- fat in abdomen; tends to accumulate and be especially thick
- therefore lower portion of abdomen has two distinct layers of superficial fascia
**Camper's Fascia** - fatty layer
**Scarpa's Fascia** - membranous layer (different from deep fascia on muscles)
28
**Scarpa's Fascia**
- only in the pubic and perineal region
- at thigh, it fuses with the deep fascia that is continuous with the deep fascia of the abdomen
29
**Layered Abdominal Muscle "Sheath"**
- aponeuroses of the three layered abdominal muscles contribute to the sheath of the rectus abdominus
30
**Origings of Internal Oblique and Transversus Abdominus**
Internal Oblique - lateral 2/3s of inguinal ligament
Transversus Abdominus - lateral 1/3 of inguinal ligament
31
**Tendinous Intersections**
**(of rectus abdominus)**
- where the rectus abdominus has attachments to the anterior layer of the aponeuroses of the abominal muscles (rectus sheath)
32
**Rectus Sheath**
- made up of aponeuroses of the abdominal muscles
_Above the arcuate line:_
Anterior - External Oblique Apon. and half of Internal Oblique Apon.
Posterior - other half of Internal Oblique Apon. and Transversus Abdominus Apon.
_Below the arcuate line:_
All aponeuroses are anterior to rectus abdominus
33
**Parietal Peritoneum**
- serious membrane that lines the abdominal cavity
34
**Extraperitoneal Fascia**
- fat and loose connective tissue between the transversalis fascia and the parietal peritoneum
Further divided into:
**Preperitoneal Fascia** - anterior part of the body
**Retroperitoneal Fascia** - posterior part of body
35
**Functions of Abdominal Muscles**
- support and protect abdominal viscera
- compress abdominal contents to increase intra-abdominal pressure (helps with coughing, vomiting, singing, defecation, urination, and child birth).
- flex the trunk (all except the transverse abdominus)
- rotates the trunk (obliques only)
- support for lower back
- breathing (relax to inspire, contract to expire)
36
**Innervation of Abdominal Wall**
- includes skin and muscles
**T7-L1**
**Intercostal Nerves** - T7-T11
**Subcostal Nerve** - T12
**Iliohypogastric N.** - L1
**Ilioinguinal N.** - L1
(all ventral rami)
37
**Abdominal Dermatomes**
T7 → Inferior to Xiphoid Process
T10 → Umbilicus
T12 → Suprapubic
L1 → upper medial thigh and genitalia
38
**Blood Supply to Abdomen**
**(Overview)**
Aorta → (bifurcates) R. and L. Common Iliac Arteries
Common Iliac Artery → (bifurcates) Internal and External Iliac Arteries
External Iliac Artery → (becomes) Femoral Artery (in thigh)
39
**Abdominal Wall Blood Supply**
Two major sources:
- Aorta and Epigastric Arteries
40
**Abdominal Wall Blood Supply from Aorta**
Descending Aorta →
→ Posterior Intercostal Arteries
→ Subcostal Arteries
- travel around abdominal wall between internal oblique and the transversus abdominus
41
**Abdominal Wall Blood Supply from Epigastric Vessels**
Internal Thoracic Artery → **Superior Epigastric Artery** (enters superior aspect of rectus abdominus)
External Iliac Artery → **Inferior Epigastric Artery** (enters inferior aspect of rectus abdominus
- _anastomose_ with each other and with branches of abdominal aorta
42
**Venous Drainage of Abdominal Wall**
Superficial Veins - drain superficial fascia
Deep Veins - drain muscles and deep tissue
43
**Thoracoepigastric Veins**
- superficial veins of the abdomen
- form longitudinal venous channels in superficial fascia
Drainage:
Superiorly - veins of axilla
Inferiorly - veins of the groin
Medially - into veins around umbilicus
44
**Deep Veins of Abdomen**
- same names as arteries
Drain:
Superiorly - into subclavian vein
Inferiorly - external iliac vein
Posteriorly - into IVC and azygos system
45
**Lympatic Drainage of Abdominal Wall**
- generally follow veins
Upper half of abomen - drain to axillary nodes
Lower half of abdomen - drain to the inguinal nodes
46
**Lympatic Drainage of Deep Abdomen**
- drain to lymph nodes located along major vessels
**lumbar nodes** adjacent to aorta → **cisterna chyli** → **thoracic duct**
47
**Ligamentum Teres Hepatis**
- round ligament of the liver
- fold in the peritoneum of the fibrous remnant of the umbilical vein
48
**Medial Umbilical Fold**
- middle fold in the peritoneum
- remnant of the umbilical arteries
49
**Median Umbilical Fold**
- fold along the linea alba from the urachus (remnant of allantois oblierates)
- extrends from the umbilicus to the bladder
50
**Lateral Umbilical Fold**
- most lateral fold in the peritoneum due to the inferior epigastric vessels (seen before they enter the rectus abdominus)
51
**Urachus**
- remnant of the allantois obliterates
- causes median umbilical fold
52
**Medial Umbilical Ligaments**
- remnant of the umbilical artery
- causes medial umblical folds
53
