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Medicine Sem 4 > Case 1 Anatomy > Flashcards

Case 1 Anatomy Flashcards

1
Q

what are the abdominal lines?

A
  • midclavicular
  • subcostal
  • transtubercular
  • transpyloric
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2
Q

what is the midclavicular line?

A

vertical line that extends from the midpoint of the clavicle to the midinguinal point

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3
Q

what is the subcostal line?

A

horizontal plane that passes through the inferior border of the tenth costal cartilage and lies at the level of L2

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4
Q

what is the transtubercular line?

A

horizontal plane that passes though the iliac tubercles and lies at the level of L5

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5
Q

what is the transpyloric line?

A

horizontal plane that lies halfway between the umbilicus and the xiphisternum, or midway between the upper border of the manubrium and the symphasis pubis and lies at the level of L1

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6
Q

what divides the abdominal cavity into 9 regions?

A

the midclavicular, subcostal and transtubercular planes

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7
Q

what are the abdominal regions?

A 
· Right hypochondriac
· Epigastric
· Left hypochondriac
· Right lumbar
· Umbilical
· Left lumbar
· Right inguinal/iliac
· Hypogastric/suprapubic
· Left inguinal/iliac
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8
Q

which planes divide the abdomen into quadrants?

A

median plane and transumbilical plane

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9
Q

what is the median plane?

A

a vertical line drawn through the umbilicus

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10
Q

what is the transumbilical plane?

A

a horizontal line drawn through the umbilicus

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11
Q

what are the quadrants of the abdomen?

A

· Right upper quadrant (RUQ)
· Left upper quadrant (LUQ)
· Right lower quadrant (RLQ)
· Left lower quadrant (LLQ)

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12
Q

what is in the right upper quadrant?

A 
· Hepatic flexure
· Gallbladder
· Right kidney
· Right suprarenal gland
· Right lobe of liver
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13
Q

what is in the left upper quadrant?

A 
· Left lobe of liver
· Left suprarenal gland
· Splenic flexure
· Spleen
· Left kidney
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14
Q

what is in the right lower quadrant?

A 
· Appendix
· Right ovary
· Right ureter
· Caecum
· Right uterine tube
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15
Q

what is in the left lower quadrant?

A

· Left ureter
· Left uterine tube
· Left ovary
· Sigmoid colon

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16
Q

what does the abdominal cavity extend from and to?

A

from the thorax to the pelvic inlet

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17
Q

what forms the roof of the abdominal cavity?

A

diaphragm

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18
Q

what is the floor of the abdominal cavity?

A

no floor, it is continuous

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19
Q

what contributes to the superior part of the abdominal wall?

A

thoracic cage

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20
Q

what is the anterolateral wall bounded superiorly by?

A
  • costal margin

- xiphisternum

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21
Q

what is the abdomen wall bounded by inferiorly?

A
  • iliac and pubic crests
  • pubic symphasis
  • inguinal ligament
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22
Q

what does the abdominal wall consist of?

A
  • skin
  • fascia
  • muscles
  • their aponeuroses
  • endoabdominal fascia
  • extraperitoneal fat
  • parietal peritoneum
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23
Q

how is the skin attached to the underlying tissue?

A

loosely except at the umbilicus where it is firmly bound to the scar tissue that marks the site of attachment of the umbilical cord in the foetus

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24
Q

what can the superficial fascia be divided into?

A

two layers; the fascia of Camper and the fascia of Scarpa

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25
Q

what is Scarpa’s fascia? what does it turn into?

A

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

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26
Q

what is Camper’s fascia?

A

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

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27
Q

does the trunk possess a deep fascia?

A
  • doesn’t possess a true deep fascia as this would restrict breathing and eating
  • however, there is a thin layer of areolar connective tissue which lies deep to Scarpa’s fascia and covers the muscles
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28
Q

what are the muscles of the anterolateral abdominal wall?

A 
· Internal oblique muscles
· External oblique muscles
· Transversus abdominis
· Rectus abdominis
· Pyramidalis
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29
Q

where does the external oblique originate from?

A

the lower eight ribs

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30
Q

where does the transversus abdominis originate from?

A
  • lower six costal cartilages
  • lumbodorsal fascia
  • iliac crest
  • inguinal ligament
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31
Q

what forms the inguinal ligament?

A

the free lower border of the external oblique

32
Q

what does the internal oblique muscle insert into?

A
  • ribs ten to twelve
  • linear alba
  • pecten pubis (pectineal line)
33
Q

what inserts into the linea alba?

A
  • external oblique
  • internal oblique
  • pyramidalis
  • transversus abdominis
34
Q

what is the conjoint tendon formed from?

A

the tendons of the internal oblique and transversus abdominis

35
Q

what is the linea alba?

A

white part of the anterior abdominal aponeurosis in the middle line of the abdomen, made of connective tissue, representing the fusion of three aponeuroses into a single tendinous band extending from the xiphoid process to the symphysis pubis

36
Q

when do the anterolateral abdominal wall muscles contract?

A
  • Abdominal wall muscles protect the abdominal viscera from injury
  • Anterolateral abdominal wall muscles don’t contract during inspiration
  • Anterolateral abdominal wall muscles contract during defection, urination, vomiting and parturition
37
Q

do the anterolateral abdominal wall muscles extend the trunk?

A

no

38
Q

which movements are the anterolateral abdominal wall muscles involved in?

A

both lateral flexion and rotation of the trunk

39
Q

describe the rectus sheath

A
  • Anteriorly, the external and internal oblique muscles and the transversus abdominis muscles become aponeurotic
  • The aponeurotic fibres merge together to form a strong fibrous sheath that encloses the rectus abdominis and pyramidalis muscles
  • The anterior and posterior components of the sheath differ according to location
40
Q

what is the anterior wall of rectus sheath at level above ASIS?

A

aponeurosis of external oblique and anterior lamina of aponeurosis of internal oblique

41
Q

what is the posterior wall of rectus sheath at level above ASIS?

A

posterior lamina of aponeurosis of internal oblique and aponeurosis of transversus abdominis

42
Q

what is the anterior wall of rectus sheath at level below ASIS?

A

aponeurosis of external oblique, internal oblique and transversus abdominis

43
Q

what is the posterior wall of the rectus sheath at level below ASIS?

A

wall deficient, no aponeurosis

44
Q

what is the arcuate line?

A

free lower border of the posterior wall of the rectus sheath

45
Q

what is the linea alba formed by?

A

the anterior and posterior fibres of the rectus sheath as they interlace in the anterior median line

46
Q

what is the anterior layer of the rectus sheath anchored to the rectus abdominis by?

A

the tendinous intersections

47
Q

what is the arterial supply of the anterior abdominal wall?

A

superior and inferior epigastric arteries (two main vessels which supply it)

48
Q

what does the superior epigastric artery arise from?

A

internal thoracic artery

49
Q

what does the inferior epigastric artery arise from?

A

external iliac artery

50
Q

what do the superior and inferior epigastric arteries run in and where?

A

in the rectus sheath posterior to the rectus abdominis muscle

51
Q

what does the abdominal wall also receive blood from?

A
  • musculophrenic
  • subcostal
  • superficial epigastric
  • superficial circumflex iliac
  • deep circumflex iliac arteries
52
Q

what does the musculophrenic artery arise from?

A

internal thoracic artery

53
Q

what does the subcostal artery arise from?

A

thoracic aorta

54
Q

what does the superficial epigastric artery arise from?

A

femoral artery

55
Q

what does the superficial circumflex iliac artery arise from?

A

femoral artery

56
Q

what does the deep circumflex iliac artery arise from?

A

external iliac artery

57
Q

describe the lymphatic drainage of the abdominal wall

A
  • Most lymph from above the transumbilical plane drains to the axillary nodes
  • Some lymph from above the transumbilical plane drains towards the midline to the parasternal nodes
  • Lymph from below the transumbilical plane drains to the superficial inguinal nodes
58
Q

what is the innervation of the innervation of the anterolateral abdominal wall?

A
  • Provided by T7 – T12 and L1
  • T7 – T9 = above the umbilicus (3)
  • T10 = around the umbilicus (1)
  • T11 – L1 = below the umbilicus (3)
59
Q

what is the route for the nerves supplying the anterolateral abdominal wall?

A
  • These nerves emerge from the intercostal spaces and run forwards and downwards between the internal oblique and transversus abdominis muscles
  • They enter the rectus sheath from the side and run horizontally through it
  • Branches pierce and supply the muscles and overlying skin
60
Q

what forms the posterior wall of the inguinal canal?

A

transversalis fascia and conjoint tendon

61
Q

what does the external oblique aponeurosis contribute to on the inguinal canal?

A

floor

62
Q

what does the lacunar ligament contribute to in the inguinal canal?

A

forms most medial part of floor

63
Q

where does the deep inguinal ring lie in relation to the inferior epigastric vessels?

A

laterally

64
Q

where does the superficial inguinal ring lie in relation to the pubic tubercle?

A

superolaterally

65
Q

what is the lacunar ligament?

A

ligament of the inguinal region – sometimes regarded as the medial part of the inguinal ligament, nevertheless, it connects the same to the pectineal ligament near the point there thy both insert on the pubic tubercle – basically, it is part of the aponeurosis of external oblique muscle that is reflected backward and laterally – it is attached to pectineal line of pubis

66
Q

where is the inguinal canal in relation to the inguinal ligament?

A

superior and parallel

67
Q

what forms the anterior wall of the inguinal canal?

A

aponeurosis of the external oblique, reinforced by the internal oblique muscle laterally

68
Q

what forms the posterior wall of the inguinal canal?

A

transversalis fascia (and conjoint tendon)

69
Q

what forms the roof of the inguinal canal?

A
  • transversalis fascia
  • internal oblique
  • transversus abdominis
70
Q

what forms the floor of the inguinal canal?

A

inguinal ligament (a ‘rolled up’ portion of the external oblique aponeurosis), thickened medially by the lacunar ligament

71
Q

describe the deep inguinal ring

A

found above the midpoint of the inguinal ligament, which is lateral to the epigastric vessels – the ring is created by the transversalis fascia, which invaginates to form a covering of the contents of the inguinal canal

72
Q

describe the superficial inguinal ring

A

marks the end of the inguinal canal and lies just superior to the pubic tubercle = it is a triangle shaped opening, formed by the evagination of the external oblique, which forms another covering of the inguinal canal contents

73
Q

what are the contents of the inguinal canal?

A
  • Spermatid cord (males)
  • Round ligament (females) – originates from the uterine horn and travels through the inguinal canal to attach at the labia majora
  • Ilioinguinal nerve – contributes towards sensory innervation of the genitalia (doesn’t pass through deep inguinal ring)
  • Genital branch of the genitofemoral nerve – supplies the cremaster muscle and anterior scrotal skin in males and skin of the mons pubis and labia major in females
74
Q

what are the walls of the inguinal canal normally like and why?

A

usually collapsed around their contents, preventing other structures from potentially entering the canal and becoming stuck

75
Q

where does the endoabdominal fascia lie?

A

deep to the muscles of the abdominal wall

76
Q

how is the endoabdominal fascia divided? give an example

A
  • Can be divided into a number of parts which are names according to the muscles that each part underlies
  • Transversalis = endoabdominal fascia that is located in the region of the anterolateral abdominal wall
77
Q

what does the gastrointestinal system consist of?

A
  • Consists of gastrointestinal tract and its associated glands
  • Pharynx
  • Oesophagus
  • Stomach
  • Liver
  • Gallbladder
  • Pancreas
  • Duodenum
  • Jejunum
  • Ileum
  • Caecum
  • Ascending colon
  • Transverse colon
  • Descending colon
  • Sigmoid colon
  • Rectum
  • Anus

Medicine Sem 4 (23 decks)

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