Anterior Abdominal Wall Flashcards
(36 cards)
Right Upper Quadrant
Liver: right lobe gallbladder stomach: pylorus duodenum: parts 1-3 pancreas: head right suprarenal gland right kidney right colic flexure ascending colon: superior part transverse colon: right half
Left upper quadrant
liver: left lobe spleen stomach jejunum and proximal ileum pancreas: body and tail left kidney left suprarenal gland left colic flexure transverse colon: left half descending colon: superior part
Right lower quadrant
cecum appendix most of ileum ascending colon: inferior part right ovary right uterine tube right ureter: abdominal part right spermatic cord: abdominal part uterus (if enlarged) urinary bladder (if very full)
Left lower quadrant
sigmoid colon descending colon: inferior part left ovary left uterine tube left ureter: abdominal part left spermatic cord: abdominal part uterus (if enlarged) urinary bladder (if very full)
Transpyloric plane
L1 level
level of gallbladder fundus, pylorus, pancreatic neck, SMA origin, hepatic portal vein, root of transverse mesocolon, hila of kidney
Subcostal plane
passes inferior border 10th costal cartilage
level of transverse colon
L3
transtubercle plane
L5
between iliac tubercles
level of iliocecal junction
interspinous plane
S2
between ASIS
level of appendix, sigmoid colon
Abdominopelvic cavity
includes abdomen and pelvis
-between thoracic diaphragm and pelvic diaphragm
-can extend as high as 4th ICS
-abdomen separated from pelvis by imaginary border of pelvic inlet (greater pelvis is above pelvic inlet)
-walls mostly bone, muscle, CT
lined by peritoneum
Anteriolateral Abdominal Wall
mostly muscle and aponeurosis
- boundaries: upper 7-10 costal cartilage and lower inguinal ligament/pelvic bone
- outer layer: skin, camper’s fascia, and scarpa’s fascia
Aponeurosis
tough, relatively thick because it’s made of several layers (overlies/envelopes rectus abdominis forming rectus sheath)
Camper’s and Scarpa’s fascia
integument
- campers fascia: fatty layer of superficial fascia
- scarpa’s fascia: membranous underlying CT layer of superficial fascia
Scarpa fascia
It is continuous with colle’s fascia of perineum but fused with fascia lata of lower limb
-fluid cant go from abdominal wall into leg but could flow into or out of superficial perineum
External oblique muscle
runs in downward medial direction (hands in pocket)
-interdigitates w/ serratous anterior
O: outer surface of lower 6 ribs
I: aponeurosis and linea alba, ant iliac crest and pubic tubercle (the lower portion rolls to make inguinal l. which is attached to ASIS and pubic tubercle) it also makes the opening of superficial inguinal canal, some reflected under to make lacunar lig.
-innervated by ventral rami of T7-12 of intercostal nerves
action- compress abdomen (forceful exhale), increase intrabdominal pressure, move trunk and retain posture
Internal oblique muscle
runs 90 degree from external oblique m.
O: iliac crest and some of thoracolumbar fascia
I: lower 10-12 ribs, aponeurosis, linea alba and pubic crest, lower part makes part of conjoint tendon (some fibers follow spermatic cord to make cremasteric muscle)
-aponeurosis part splits to encompass rectus m. in upper 3/4s, otherwise all go in front in lower 4th
-innervated by T7-12 and L1
-action: compresses and supports viscera, lateral flexes and rotates.
Transversus Abdominus Muscle
runs transverso-medially except for some running toward pubic crest (to contribute to conjoint tendon)
- originate of lower 7-12 costal cartilages, thoracolumbar fascia, iliac crest, and some even off upper inguinal ligament
- insert on linea alba, pecten pubis, and pubic crest
- aponeurosis contributes to rectus sheath
- innervated by T7-L1
- action: compresses and supports visceral
Rectus Abdominus Muscle
paired muscle of anterior abdominal wall; wider at top than bottom
-O: pubic symphysis and pubic crest
-I: xiphoid process and outer surface of 5-7th intercostal cartilage
-tendinous intersections form part of rectus sheath at umbilical, xiphoid and midway levels
-innervated by ventral rami of T7-T12
-action: flexes abdomen and compresses it
linea semilunaris: lateral border of rectus abdominus m.
pyramidis m: missing in 20% (pubic symphsis to linea alba)
Rectus Sheath
made of fascia and aponeurosis of muscles encompassing RA
- EO aponeurosis is always anterior
- IO aponeurosis splits in upper 3/4 but is all ant lower 1/4
- TA apon. is post except in lower 1/4
- arcuate line, sharp transition where all 3 become ant
- below line, the RA is in contact w/ transversalis fascia(which is beneath TA)
Thoraco-abdominal n
T7-T11
continuation of intercostal n. both motor and sensory innervation
run btwn TA and IO m
Subcostal n
T12
runs along inferior 12th rib; motor, sensory is superior to iliac crest
Iliohypogastric n
L1
runs between 2nd and 3rd muscle layers, motor to IO and TA, sensory to upper inguinal and hypogastric region
Ilioinguinal n
L1
motor lower IO and TA, sensory to lower inguinal, anterior srotum/labia, near medial thigh
Abdominal wall arteries
continuation of intercostal arteries
lumbar artery: off abdominal aorta
Superficial epigastric a
off femoral a
