abdominal wall and GI tract overview Flashcards by Olivia Swinn

identify the regions and the lines

orange = midclavicular
green = subcostal
purple = transtubercular

A = epigastric
B = umbilical
C = hypogastric/suprapubic
D = right hypochondriac
E = right lumbar/flank
F = right inguinal/iliac
G = left hypochondriac
H = left lumbar/flank
I = left inguinal/iliac

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what are the 4 quadrants of the abdomen and what divides them?

right and left upper quadrants, right and left lower quadrants

median plane and umbilical plane

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name things in the right upper quadrant

right kidney
right suprarenal gland
right lobe of liver
hepatic flexure
gallbladder

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name things in the right lower quadrant

right ureter
right ovary
right uterine tube
caecum
appendix

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name things in the left upper quadrant

left kidney
left suprarenal gland
left lobe of liver
spleen
splenic flexure

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name things in the left lower quadrant

left ureter
left uterine tube
left ovary
left sigmoid colon

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what are the functions of the abdominal wall?

• forms a firm yet flexible boundary which keeps the abdominal viscera in the abdominal cavity and assists the viscera in maintaining their anatomical position against gravity
• protects the abdominal viscera from injury
• assists in forceful expiration by pushing the abdominal viscera upwards
• is involved in any action (coughing, vomiting, defecation) that increases intra-abdominal pressure

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the anterolateral abdominal wall extends from the _____ to the _______. roof is diaphragm. thoracic cage contributes to superior part of the abdominal wall. inferiorly there is no floor as the abdominal cavity is continuous with the_______. it is bounded by the _____ and _____ crests, _________ and _______ ligament

the anterolateral abdominal wall extends from the thorax to the pelvic inlet. roof is diaphragm. thoracic cage contributes to superior part of the abdominal wall. inferiorly there is no floor as the abdominal cavity is continuous with the pelvic cavity. it is bounded by the iliac and pubic crests, pubic symphysis and inguinal ligament

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from superficial to deep, what are the 4 main layers of the anterolateral abdominal wall?

skin, superficial fascia, muscles and associated fascia, parietal peritoneum

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describe the superficial fascia of the anterolateral abdominal wall above the umbilicus

a single sheet of connective tissue
it is continuous with the superficial fascia in other regions of the body

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describe the superficial fascia of the anterolateral abdominal wall below the umbilicus

divided into 2 layers — the fatty superficial layer (Camper’s fascia) and the membranous deep layer (Scarpa’s fascia)

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what runs between Camper’s fascia and Scarpa’s fascia?

the superficial vessels and nerves

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what are the flat muscles of the abdominal wall?

external + internal obliques and transversus abdominis

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in the anteromedial aspect of the abdominal wall, each flat muscle forms an ___________ which covers the vertical _________

aponeurosis (a broad, flat tendon)
rectus abdominis

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the aponeuroses of all the flat muscles become entwined in the midline, forming the what?

the linea alba

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what is the linea alba?

a fibrous structure that extends from the diploid process of the sternum to the pubic symphysis

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describe the external oblique

• most superficial
• muscle fibres run downwards and forwards
• origin = external surface of lower 8 ribs
• insertion = linea alba, pubic tubercle, anterior half of iliac
crest

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what does the free lower border of the external oblique form?

inguinal ligament

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describe internal oblique

• intermediate muscle
• muscle fibres run forward and upwards
• origin = thoracodorsal fascia, anterior 2/3rds of iliac crest,
lateral half of inguinal ligament
• insertion = inferior border of lower 3 ribs, linea alba,
pubis via conjoint tendon

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describe transversus abdominis

• deepest
• fibres run horizontally
• origin = internal surface of lower 6 costal cartilages,
thoracodorsal fascia, iliac crest, lateral third of inguinal
ligament
• insertion = linea alba, pubic crest, pubic via conjoint
tendon
• lower thoracic nerves leave the intercostal spaces and run
anteriorly, superficial to this muscle

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what are the vertical muscles of the abdominal wall?

rectus abdominis and pyramidalis

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the rectus abdominis is a long, paired muscle split into 2 by what?

the linea alba

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the lateral borders of rectus abdominis create a surface marking known as what?

the linea semilunaris

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what gives rise to the ‘six pack’

at several places the muscle is intersected by fibrous strips, knows as tendinous intersections — the tendinous intersections and the linea alba give rise to the ‘six pack’

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origin, insertion and function of rectus abdominis

• origin = crest of pubis bone • insertion = xiphoid process of the sternum and the costal cartilage of ribs 5-7 • function = flexes trunk, compresses abdominal viscera, stabilises the tilt of the pelvis

describe pyramidalis

• superficial to rectus abdominis • small and triangular • origin = pubic crest • insertion = linea alba • function = tenses linea alba • only present in 80% of the population

what makes up the rectus sheath above the level of the ASIS?

skin, external oblique, internal oblique, transversus abdominis, transversalis fascia

what makes up the rectus sheath below the level of ASIS?

external oblique, internal oblique, transversus abdominis, transversalis fascia

label A-G

A = parietal peritoneum B = transversalis fascia C = trans versus abdominis D = internal oblique E = external oblique F = linea alba G = rectus abdominis

what form the anterior wall of the rectus sheath at H and I?

H = the aponeurosis of external oblique and anterior lamina of internal oblique I = aponeurosis of external oblique, inner oblique and transversus abdominis

where is the arcuate line formed?

where the posterior wall of the sheath thins out (as the aponeurosis of the muscles pass anterior to the rectus abdominis)

what are the contents of the rectus sheath?

• rectus abdominis • pyramidalis • superior and inferior epigastric vessels • lymphatic vessels • ventral rami of nerves T7-T12

The rectus sheath is a tendon sheath (______) which encloses the __________ and ________ muscles. It is an extension of the tendons of the external abdominal oblique, internal abdominal oblique, and transversus abdominis muscles. In addition to these muscles, the rectus sheath also contains __________ of the anterior abdominal wall. Its function is to ______ the contents it encloses.

The rectus sheath is a tendon sheath (aponeurosis) which encloses the rectus abdominis and pyramidalis muscles. It is an extension of the tendons of the external abdominal oblique, internal abdominal oblique, and transversus abdominis muscles. In addition to these muscles, the rectus sheath also contains neurovasculature of the anterior abdominal wall. Its function is to protect the contents it encloses.

inferior epigastric artery anastomoses with the __________ artery which arises from the _________ artery. it enters the _______ aspect of the sheath, posterior to ____________

inferior epigastric artery anastomoses with the superior epigastric artery which arises from the musculophrenic artery. it enters the superior aspect of the sheath, posterior to rectus abdominis

label A-D

A = pyramidalis B = rectus abdominis C = tendinous intersections D = inferior epigastric artery

what does inferior epigastric artery arise from?

external iliac

what run horizontally within the sheath from lateral to medial?

thoracic nerves

what structures contribute to the posterior wall of the sheath at A and B? identify C and D

A = posterior lamina of internal oblique and aponeurosis of trasnversus abdominis B = transversalis fascia C = arcuate line D = superior epigastric vessels

which nerves supply the anterolateral abdominal wall?

T7-11, T12 (subcostal), and L1 (ilioinguinal and iliohypogastric)

between which muslces do the nerves of the abdominal wall run?

internal oblique and transversus abdominis

where do the lateral cutaneous branches of the abdominal wall nerves pass through the subcutaneous tissue to reach the skin?

at the level of the anterior axillary line

through which structure do the anterior cutaneous branches pass before entering the subcutaneous tissue?

rectus sheath

which dermatomes supply the regions labelled a,b and c?

A = epigastric region - T5-T9 B = umbilical region - T10-T11 C = hypogastric region - T12-L1

what is the inguinal canal?

oblique passage through the abdominal wall just above the medial end of the inguinal ligament

what does the inguinal canal extend from and to?

deep inguinal ring to superficial inguinal ring

what are the anterior, posterior, floor and roof boundaries of the inguinal canal?

anterior = external oblique and internal oblique posterior = transversalis fascia and conjoint tendon floor = inguinal ligament and lacunar ligament roof = archiving fibres of internal oblique and transversus abdominis and transversalis fascia

what does the inguinal canal contain?

the spermatic cord (or round ligament in female), blood and lymphatic vessels, ilioinguinal nerve

identify A-D

A = aponeurosis of external oblique B = inguinal ligament C = superficial inguinal ring D = spermatic cord

where is the deep ring found?

above the midpoint of the inguinal ligament, lateral to the epigastric vessels

where is the superficial ring found?

superolateral to the pubic tubercle

what form the deep and superfical rings?

deep ring = created by the transversalis fascia, which invaginates to form a covering of the contents of the inguinal canal superficial ring = triangle shaped opening, formed by the invagination of the external oblique, which forms another covering of the inguinal canal contents

the superficial ring contains ___________, whcih run perpendicular to the aponeurosis of the external oblique and prevent the ring from _______

- intercrural fibres - widening

during periods of increased intra-abdominal pressure, the abdominal viscera are pushed into the ________. to prevent herniation, the muscles of the anterior and posterior wall ______, and ‘clamp down’ on the canal

- inguinal canal - contract

what is the name of the fibrous cord of tissue that attaches the inferior portion of the gonad to the future scrotum or labia, and guides them during their descent?

gubernaculum

in the embryological stage, the inguinal canal is flanked by an out-pocketing of the peritoneum (____________) and the abdominal musculature

processus vaginalis

the processus vaginalis normally __________, but a failure to do so can cause an _______ inguinal hernia, a hydrocele, or interfere with the ______ of the tests

- degenerates - indirect - descent

the gubernaculum, once it has shortened in the process of the descent of the testes, becomes what? function?

a small scrotal ligament, tethering the testes to the scrotum and limiting their movement

in women, the gubernaculum attaches the ovaries to the ______ and future __________. because the ovaries are attached to the _______, they are prevented from descending as far as the testes, instead moving into the pelvic cavity. the gubernaculum then becomes 2 structures in the adult = the ____________and the _____________

in women, the gubernaculum attaches the ovaries to the uterus and future labia majora. because the ovaries are attached to the uterus, they are prevented from descending as far as the testes, instead moving into the pelvic cavity. the gubernaculum then becomes 2 structures in the adult = the ovarian ligament and the round ligament of uterus

at what level is the transpyloric line and what is it crossed by?

- L1 - crossed by pancreas

at what level is the subcostal line?

L2 passes through the inferior border of the 10th costal cartilage

what level does the trasntubercular level lie at?

L4 - passes through iliac tubercles

where is the swallowing centre?

medulla

what is the anterolateral wall bounded superiorly by?

the costal margin and the xiphisternum

what is the abdominal wall bounded inferiorly by?

iliac and pubic crests, pubic symphysis and the inguinal ligament

which layer of fascia forms the deep membranous layer which blends with the fascia of the inner thigh and extends into the scrotum and labia majora as Colles’ fascia?

Scarpa’s fascia

which layer of fascia is the outer fatty layer which is continuous with the superficial fat over the rest of the body?

Scarpa’s fascia

what muscle originates from the lower 6 costal cartilages, lumbodorsal fascia, iliac crest and inguinal ligament?

transversus abdominis

the inguinal ligament is formed by the free lower border of what muscle?

external oblique

what muscle originates from the lower 8 ribs?

external oblique

what muscle inserts into ribs 10-12, linea alba and pectin pubis?

internal oblique

what muscles insert into the linea alba?

external oblique, internal oblique, pyramidalis, transversus abdominis

the conjoint tendon is formed from the tendons of what 2 muscles?

internal oblique and transversus abdominis

true or false? the anterolateral abdominal muslces contract during inspiration

false

when do the anterolateral abdominal muscles contract?

defacation, urination, vomiting and parturition

true or false? the anterolateral abdominal wall muslces extend the trunk

false — they laterally flex and rotate

what name is given to the endoabdominal fascia that is located in the region of the anterolateral abdominal wall?

transversalis fascia

b c a d

inguinal ligament attachments

ASIS to pubic tubercle

the internal aspect of the anterior abdominal wall presents 5 peritoneal folds that extend towards the umbilicus, what are they and what do they cover?

- median umbilical fold x1 - medial umbilical fold x2 - lateral umbilical fold x2 — covers inferior epigastric artery

abdominal wall and GI tract overview Flashcards

(80 cards)