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GI Midterm > Anterior Abdominal Wall > Flashcards

Anterior Abdominal Wall Flashcards

1
Q

What are the 4 transverse planes of the anterior abdominal wall?

A

Transpyloric plane

Subcostal plane

Transtubercle plane

Interspinous plane

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2
Q

Which of the following is found at L1?

A. Subcostal plane
B. Transpyloric plane
C. Transtubercle plane
D. Interspinous plane

A

B. Transpyloric plane

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3
Q

The transpyloric plane at L1 is used as a reference point for the location of what organs?

A 
Gallbladder fundus
Pylorus
Pancreatic neck
SMA origin
Hepatic portal vein
Root of transverse mesocolon
Hila of kidneys
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4
Q

Where is the subcostal plane located?

A

Passes inferior border of 10th costal cartilage

Level of L3

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5
Q

The subcostal plane is an important landmark for what organ?

A

Transverse colon

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6
Q

Where is the transtubercle plane located

A

Between iliac tubercles at the level of iliocecal junction

Level of L5

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7
Q

Where is the interspinous plane located

A

Between ASIS

Level of S2

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8
Q

The interspinous plane is an important landmark for what 2 organs?

A

Appendix

Sigmoid colon

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9
Q

The abdominopelvic cavities include the abdomen and pelvis, existing between thoracic diaphragm and pelvic diaphragm; it can extend as high as the ____ intercostal space. The abdomen is separated from the pelvis by the imaginary border of the pelvic ______, above which is the ____ pelvis

A

4th
Inlet
Greater

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10
Q

The abdominopelvic cavity walls are mostly bone, muscle, and CT, lined by _______

A

Peritoneum

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11
Q

The anteriolateral abdominal wall is mostly made up of what 2 components?

A

Muscle

Aponeurosis

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12
Q

What are the boundaries of the anteriorlateral abdominal wall?

A

Upper 7-10 costal cartilages

Lower inguinal ligament and pelvic bones

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13
Q

Components of outer layer of anteriolateral abdominal wall

A

Skin
Camper’s fascia
Scarpa’s fascia
Aponeurosis (rectus sheath)

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14
Q

Differentiate between Camper’s and Scarpa’s fascia

A

Both are integument

Camper’s = fatty layer of superficial fascia

Scarpa’s = membranous underlying CT layer of superficial fascia; continuous with Colle’s fascia of perineum but fused with fascia lata of lower limb

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15
Q

What is the significance of Scarpa’s fascia in terms of fluid flow?

A

Fluid cannot go from abdominal wall into leg but could flow into or out of superficial perineum

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16
Q

The serratus anterior m. interdigitates with what abdominal muscle?

A

External oblique m.

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17
Q

Origin of external oblique m.

A

Lower 6 ribs

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18
Q

Insertion of external oblique m.

A

Aponeurosis and linea alba, anterior iliac crest and pubic tubercle

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19
Q

The inguinal ligament is formed by what structures? What are its attachment points?

A

The lower portion of the external oblique m. rolls under to form the inguinal ligament attached to ASIS and pubic tubercle

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20
Q

The lower portion of the external oblique m. rolls under to form the inguinal ligament which forms the opening of the __________, as well as a reflection beneath that forms the _______ ligament

A

Superficial inguinal canal; lacunar

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21
Q

Innervation of external oblique m.

A

Ventral rami of T7-12 of intercostal nn.

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22
Q

Action of external oblique m.

A

Compresses abdomen and increases intra abdominal pressure; moves trunk and retains posture

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23
Q

Origin of internal oblique m.

A

Iliac crest and some of thoracolumbar fascia

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24
Q

Insertion of internal oblique m.

A

Lower 10-12 ribs, aponeurosis, linea alba, and pubic crest; lower part makes part of conjoint tendon (falx inguinalis)

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25
Q

Some fibers of the internal oblique m. follow the spermatic cord to make the ______ muscle

A

Cremasteric

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26
Q

The upper 3/4s of the internal oblique aponeurosis splits to encompass what muscle

A

Rectus abdominis m.

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27
Q

Innervation of internal oblique m.

A

T7-12 and L1

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28
Q

Action of internal oblique m.

A

Compresses and supports viscera, laterally flexes and rotates

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29
Q

The _____ ______ m. runs transversomedially except for some running toward the pubic crest to contribute to the _____ tendon

A

Transversus abdominis

Conjoint

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30
Q

Origin of transversus abdominis m.

A

Lower 7-12 costal cartilages, thoracolumbar fascia, iliac crest, outer third of upper inguinal ligament

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31
Q

Insertion of transversus abdominis m.

A

Linea alba
Pecten pubis
Pubic crest

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32
Q

T/F: the aponeurosis of the transversus abdominis m. contributes to the rectus sheath

A

True

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33
Q

Innervation of transversus abdominis m.

A

T7-L1

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34
Q

Action of transversus abdominis m.

A

Compresses and supports viscera

35
Q

Origin of rectus abdominis m.

A

Pubic symphysis and pubic crest

36
Q

Insertion of rectus abdominis m.

A

Xiphoid process and outer surface of 5-7th intercostal cartilages

37
Q

Tendinous intersections of rectus abdominis muscle form part of rectus sheath at what 3 approximate locations?

A

Umbilical, xiphoid, and midway levels

38
Q

Innervation of rectus abdominis m.

A

Ventral rami of T7-12

39
Q

Action of rectus abdominis m.

A

Flexes abdomen and compresses it

40
Q

What forms the lateral border of the rectus abdominis m.?

A

Linea semilunaris

41
Q

What muscle, missing in 20% of the population, may be found at the inferior region of the rectus abdominis m., near the pubic crest?

A

Pyramidalis m.

42
Q

How do the aponeuroses of EO, IO, and TA muscles contribute to the rectus sheath?

A

EO aponeurosis is always anterior

IO aponeurosis splits in upper 3/4 but is all anterior in lower 1/4

TA aponeurosis is posterior except in lower 1/4

43
Q

______ = sharp transition where all EO, IO, and TA aponeuroses become anterior to rectus abdominis m.

A

Arcuate line

44
Q

Below the arcuate line, the rectus abdominis is in contact with _______ ______

A

Transversalis fascia

45
Q

Nerves of anterior abdominal wall

A

Thoracoabdominal n.

Subcostal n.

Iliohypogastric n.

Ilioinguinal n.

46
Q

Thoracoabdominal n. (T7-T11) form as continuation of _____ nn.

Motor or sensory?

A

Intercostal

Both motor and sensory

47
Q

The nerves of the anterior abdominal wall run between what 2 muscles?

A

Transversus abdominis m.

Internal oblique m.

48
Q

Location of subcostal n.

Is it motor or sensory?

A

Subcostal n. = T12, runs along inferior 12th rib

Motor; sensory is superior to iliac crest

49
Q

Location of iliohypogastric n.

Motor or sensory?

A

Iliohypogastric n. = L1, runs between 2nd and 3rd muscle layers

Motor to IO and TA; sensory to upper inguinal and hypogastric region

50
Q

Location of ilioinguinal n.

Motor or sensory?

A

Ilioinguinal n. = L1

Motor to lower IO and TA; sensory to lower inguinal, anterior scrotum/labia, near medial thigh

51
Q

Arteries of anterior abdominal wall exist as continuation of _____ arteries. Lumbar arteries branch from the _______ _______

A

Intercostal; abdominal aorta

52
Q

Major arteries of anterior abdominal wall

A 
Superficial epigastric a.
Superficial circumflex iliac a.
Deep circumflex iliac a.
Inferior epigastric a.
Superior epigastric a.
53
Q

The superficial epigastric a. branches from what a.?

A

Femoral a.

54
Q

Superficial circumflex iliac a. branches from what a.? What anatomical landmark does it run along?

A

Femoral a.

Runs along inguinal ligament

55
Q

Deep circumflex iliac a. branches from what a.? What anatomical landmark does it run along?

A

External iliac a.

Runs deep along inguinal ligament

56
Q

Inferior epigastric a. branches from what a.? What anatomical landmark does it run along and what does it anastomose with?

A

External iliac a.

Runs posterior to rectus abdominis m.

Anastomosis with superiro epigastric a.

57
Q

The superior epigastric a. is a terminal branch of what a.?

A

Internal thoracic a.

58
Q

What a. runs anterior to the posterior layer of the rectus sheath?

A

Inferior epigastric a.

59
Q

What fold exists on the interior surface of the anterior abdominal wall due to obliterated urachus?

A

Median umbilical fold

60
Q

What fold exists on the interior surface of the anterior abdominal wall due to obliterated umbilical aa.?

A

Medial umbilical fold

61
Q

What fold exists on the interior surface of the anterior abdominal wall due to inferior epigastric a.?

A

Lateral umbilical fold

62
Q

What fossa exists on the interior surface of the anterior abdominal wall as a gutter on either side of the upper bladder?

A

Supravesicular fossa

63
Q

What fossa exists on the interior surface of the anterior abdominal wall as a gutter lateral to medial umbilical folds?

A

Medial inguinal fossa

64
Q

What fossa exists on the interior surface of the anterior abdominal wall as a gutter lateral to lateral umbilical folds?

A

Lateral inguinal fossa

65
Q

What important anatomical landmark delineates the path of lymph drainage in the abdomen?

A

Transumbilical plane

66
Q

Superficial vessels superior to the umbilicus (transumbilical plane) drain into ______ nodes, with a few going to the ______ nodes

Superficial vessels below the umbilicus (transumbilical plane) drain to ________ nodes

A

Axillary; parasternal

Superficial inguinal

67
Q

T/F: deep lymph vessels accompany the deep veins of the abdominal wall like the external and internal iliac veins

A

True

68
Q

Where would you make a subcostal incision? What organs could you access here?

A

2.5 cm inferior from margin; access to gallbladder and biliary tract and spleen

69
Q

What type of incision can be made rapidly d/t few blood vessels or nerves?

A

Midline incision

70
Q

How would you make a paramedian incision?

A

Open anterior sheath, push rectus m. aside laterally and enter peritoneum

71
Q

What type of incision is typical of appendectomy?

A

Gridline (McBurney’s point) - muscle splitting

72
Q

What type of incision is used in most non-laparascopic gynecological/obstetrical surgeries?

A

Suprapubic

73
Q

Origin; insertion; innervation; action of:

External oblique m.

A

Origin: lower 6 ribs

Insertion: aponeurosis and linea alba, anterior iliac crest and pubic tubercle

Innervation: ventral rami of T7-12 of intercostal n.

Action: compress abdomen and increase intraabdominal pressure; move trunk; retain posture

74
Q

Origin; insertion; innervation; action of:

Internal oblique m.

A

Origin: iliac crest and some of thoracolumbar fascia

Insertion: lower 10-12 ribs, aponeurosis, linea alba, and pubic crest, lower part makes part of conjoint tendon (falx inguinalis)

Innervation: T7-L1

Action: compresses and supports viscera, laterally flexes and rotates

75
Q

Origin; insertion; innervation; action of:

Transversus abdominis m.

A

Origin: lower 7-12 costal cartilages, thoracolumbar fascia, iliac crest, and outer third of inguinal ligament

Insertion: linea alba, pecten pubis, and pubic crest

Innervated by T7-L1

Action: compresses and supports viscera

76
Q

Origin; insertion; innervation; action of:

Rectus abdominis m.

A

Origin: pubic symphysis and pubic crest

Insertion: xiphoid process and outer surface of 5-7th intercostal cartilages

Innervation: ventral rami of T7-12

Action: flexes abdomen and compresses it

77
Q

Organs found in RUQ

A 
Liver (R lobe)
Gallbladder
Stomach (pylorus)
Duodenum (parts 1-3)
Head of pancreas
R suprarenal gland
Right kidney
Right colic flexure
Ascending colon: superior part
Transverse colon: right half
78
Q

Organs found in LUQ

A 
Liver (L lobe)
Spleen
Stomach
Jejunum and proximal ilium
Pancreas: body and tail
L kidney
L suprarenal gland
L colic flexure
Transverse colon: left half
Descending colon: superior part
79
Q

Organs found in RLQ

A 
Cecum
Appendix
Most of ileum
Ascending colon: inferior part
R ovary
R uterine tube
R ureter: abdominal part
R spermatic cord: abd part
Uterus (if enlarged)
Urinary bladder (if full)
80
Q

Organs found in LLQ

A 
Sigmoid colon
Descending colon: inferior part
L ovary
L uterine tube
L ureter: abdominal part
L spermatic cord: abd part
Uterus (if enlarged)
Urinary bladder (if full)
81
Q

How might muscles of the anterior abdominal wall contribute to respiration?

A

Anterior abdominal mm. that increase intraabdominal pressure act to oppose the diaphragm and thus facilitate expulsion of air from the lungs

[forced exhalation]

82
Q

Actions of external, internal, and innermost intercostals for respiration

A

External = elevate ribs during forced inspiration

Internal = depression of ribs

Innermost = depression of ribs

83
Q

When would erector spinae be used for respiration?

A

Forced inhalation

GI Midterm (14 decks)

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