Exam 2: Lecture 9 and 10 Flashcards
1
Q
How is the (Tunica) Dortos Muscle formed?
A
Campers and Scarpas Fascia continue into the scrotum to form the dortos muscle
2
Q
What is the purpose of the Dortos muscle?
A
It acts to regulate the temperature of the testis to promote spermatogenesis
3
Q
What is the directionality of the fibers of the tranverssus abdominus?
A
horzitontal
4
Q
What is the action of the Tranversalis abdominus?
A
Compresses abdomen
5
Q
What abdominal structures are found in the RUQ?
A
liver, gall bladder
6
Q
What abdominal structures are found in the LUQ?
A
stomach, spleen (posterior)
7
Q
How is the femoral artery formed?
A
common iliac artery branched to external and internal iliac artery at the inguinal ligament where it becomes the femoral artery
8
Q
What abdominal structures are found in the LLQ?
A
descending colon, sigmoid colon
9
Q
Where is the tranumblical l and vertical plane of the abdomen formed?
A
transumbilical plane is through the umbilicus and intervertebral disc between L3 and L4
Vertical plane is from xiphoid process to pubic symphysis
10
Q
What abdominal structures are found in the RLQ?
A
appendix, ascending colon
11
Q
What does the scrapes fascia become in the perineum?
A
Continues in anterior perineum as Colles fascia
12
Q
What does the scrapes fascia become in the thigh?
A
Continues into the thigh and fuses with fascia lata
13
Q
What is the rectus abdominus?
A
Long, flat, vertical muscle
Paired, separated at midline by linea alba
Runs from pubic symphysis to costal margin
14
Q
What aponeurosis makes up the rectus abdominus?
A
Enclosed in the rectus sheath (ant and post- continuous with internal oblique aponeurosis)
15
Q
What is the action of the rectus abdominus?
A
compress abdomen, flex trunk
16
Q
What lymphatics drain below the umbilicus?
A
Superficial below umbilicus drain via superficial inguinal nodes
17
Q
What lymphatics drain above the umbilicus?
A
Superficial above umbilicus drain via axillary nodes
18
Q
What lymphatics drain deep in the umbilicus?
A
Deep drain via parasternal nodes
19
Q
What is the action of the cremaster muscle?
A
Raises and lowers the testes in response to temperature of the body (sperm needs to be three degrees cooler than the body to develop)
20
Q
What are the accessory digestive organs?
A
Liver, Gall bladder (biliary tree), Pancreas, (Appendix)
21
Q
What are the Superficial inferior vasculature?
A
superficial epigastric artery (medial) and superficial circumflex artery (lateral); Branches of femoral artery
22
Q
What is the passageway through the abdominal wall?
A
Passageway through abdominal wall in the inguinal region is called the inguinal canal
23
Q
What components make up the foregut?
A
Esophagus to duodenum (until major duodenal papilla), liver, pancreas, gallbladder, spleen
24
Q
How is the inguinal ligament formed?
A
Formed by lower border of external oblique aponeurosis
25
Where does the inguinal ligament attach?
attaches at ant/superior iliac spine (palpable) and will run towards pubic bone and attach on pubic tubercle
26
What components make up the midgut?
Duodenum (after major duodenal papilla) through small intestine and large intestine to 2/3 of the transverse colon
27
What are the Deep inferior vasculature of abdomen?
inferior epigastric a. and deep circumflex iliac artery (lateral) (Branches of external iliac artery)
28
What components make up the hindgut?
Distal 1/3 of transverse colon through superior portion of the rectum
29
What is the deep membraneous layer of the abdomen?
Scarpes fascia
30
What is the superficial fatter layer of the abdomen?
Campers fascia
31
What is the Superficial perineal fascia of the abdomen?
Colle's fascia
32
What are 3 main unpaired branches of the abdominal aorta?
Celiac Trunk, Superior Mesenteric Artery, inferior Mesenteric Artery
33
What part of the gut does the celiac trunk supply?
Supplies the foregut
34
What part of the gut does the SMA supply?
Supplies the midgut
35
What part of the gut does the IMA supply?
Supplies the hindgut
36
What organ of the digestive track receives blood from the SMA and IMA?
duodenum
37
What organ of the digestive track receives blood from the Celiac Trunk and IMA?
pancreas
38
What makes up the anterior rectus sheath above the arcuate line?
made up of aponorsis of external and internal obliques
39
What makes up the posterior rectus sheath above the arcuate line?
made up of aponorsis of internal oblique and transversus abdominus
40
What are the 3 branches of the celiac trunk?
Left gastric, splenic, and common hepatic
41
What does the left gastric supply?
supplies Lesser curvature of stomach and distal esophagus
42
What does the splenic supply?
supplies Spleen
43
What does the common hepatic supply?
supplies Greater and lesser curvature of the stomach, liver and gallbladder, pancreas
44
What are the branches of the splenic artery?
Short gastrics, Left gastro-epiploic (gastro- omental)
45
What are the superficial superior vasculature drainage?
musculophrenic artery off of the Branch of internal thoracic artery
46
What are the branches of the common hepatic artery?
Right gastric, Proper hepatic branches right and left hepatic, cystic Gastroduodenal branches right gastro-epiploic (gastro- omental) and superior pancreaticoduodenal
47
What are the deep lateral vasculature drainage?
10th and 11th intercostal, and subcostal artery
48
What are the branches of the SMA?
Inferior pancreaticoduodenal, Jejunal,
Ileal, Middle colic, Right colic, and Iliocolic
49
What is the role of the tendinous insertions?
they help the rectus abdominus from over contracting and flexing to prevent huntch back
50
What is the branch of ilocolic artery?
appendicular
51
What is the external spermatic fascia equal?
external oblique muscle
52
What is the cremasteric fascia equal to?
internal oblique muscle
53
What is the internal spermatic fascia equal to?
transversalis fascia
54
What are the layers of the spermatic cord?
External spermatic fascia,
Cremasteric fascia, Internal spermatic fascia, Parietal layer of tunica vaginalis, Cavity of tunica vaginalis, Visceral layer of tunica vaginalis
55
What is the Qudratolumborum muscle?
sits above hips laterally, stems from lumbar vertebrae and makes up posterior muscular compartments of abdomen
56
What does the inferior pancreaticoduodenal supply?
Pancreas and duodenum
57
What does the inferior middle colic supply?
transverse colon
58
What does the right colic supply?
ascending colon
59
What does the iliocolic supply?
Cecum, Ilium, Appendix
60
What do the ileal and jejunal branch supply?
Jejunum, and
Ileum
61
What are the major branches of the IMA?
left colic, sigmoid, and superior rectal?
62
What does the left colic supply?
descending colon, and distal part of transverse colon
63
What does the sigmoid and superior rectal supply?
sigmoid colon, superior rectum
64
What is the origin of the external oblique?
Outer surfaces of lower 8 ribs
65
What is the insertion of the external oblique?
Iliac crest, linea alba
66
What is the innervation of internal oblique and transverse abdominus?
ventral ramus of T7-12, and L1
67
What is the Innervation of esophagus ?
Left and right vagus nerves change course and become the anterior and posterior vagal trunks
68
What muscles make up the iliopsoas muscle?
made up of the iliacs, psoas major
69
What is the role of the iliopsoas muscle?
deep hip flexors
70
What is the arterial supply of esophagus?
esophageal branches from celiac trunk and left inferior phrenic artery
71
What are the posterior muscular components of the abdominal wall?
QL, Iliopsoas
72
What are the anterior muscular components of the abdominal wall?
Rectus abdominus
73
What are the lateral muscular components of the abdominal wall?
3 layers of muscles (obliques and transverse abdominus)
74
What are the parts of the stomach?
```
Cardia - near esophagus
Fundus - above cardia
Body - middle, largest
Pyloric (distal end) - Pyloric antrum, Pyloric canal, Pylorus - Pyloric constriction, Pyloric sphincter, Pyloric orifice
Greater and greater curvature
Cardial notch
Angular incisure
```
75
What is the extra-peritoneal deep fascia?
Deep to tranversalis fascia, separates from peritoneum, and Lines abdominal and pelvic cavities
76
What are the Borders of Abdominal Cavity ?
Superiorly - diaphragm
Inferiorly - continuous with the pelvic cavity
Posteriorly - vertebral column and abdominal wall
Laterally and anteriorly - abdominal wall, ribs in superior portion
77
How is the stomach connected to the liver?
via the lesser omentum
78
What is an inguinal hernia?
Protrusion of peritoneal sac through a weakened part of the abdominal wall (large and small intestines)
79
What is the rectus abdominus?
straight muscle of the abdomen. Six pack muscle
80
How is the inguinal canal formed?
When the testes descend down into the scrotum, they will pull all of the layers of the abdomen (superficial to deep) with them and create the inguinal canal
81
What is the Angular incisure of stomach?
sharp turn of the lesser curvature marking the beginning of the pyloric region
82
What is the nerve supply of muscles and parietal peritoneum?
supplied by ventral rami of spinal nerves T7- L1 (sensory)
83
What does the short gastric artery supply?
supplies fundus and greater curvature of stomach
84
What is the blood supply to the stomach?
Left gastric artery From celiac trunk, Right gastric artery From hepatic artery proper or common hepatic, Right gastro-omental From gastroduodenal artery, Left gastro-omental From splenic artery, Short gastric artery From splenic artery
85
What is the external oblique?
Immediately deep to superficial fascia; Thick, flat tendinous insertion called aponeurosis attaches to midline linea alba
86
What are the 4 parts of the duodenum?
1. Superior part- from pyloric orifice to neck of gall bladder
2. Descending part- begins at neck of gall bladder, extends to L3; Contains major duodenal papilla (entrance for bile and pancreatic ducts)
3. Inferior part- crosses aorta, IVC and vertebral column
4. Ascending part- at L2 -Terminates at duodenojejunal flexure
87
What is the action of the external oblique?
Twists, Compress abdomen
88
What is the duodenal flexure?
turning point where duodenum becomes the jejunal
89
What is the major duodenal papilla?
has Spinchter of Oddi controlling the release of bile into the duodenum
90
What is the origin of the internal oblique?
Thoracolumbar fascia, iliac crest, inguinal ligament
91
What is the insertion of the internal oblique?
Inferior border of lower 3-4 ribs, linea alba, pubic crest, pectineal line
92
What is SMA syndrome?
When the SMA compresses inferior part of the duodenum
93
What is the insertion of the rectus abdominus?
Costal cartilages of ribs 5- 7; xiphoid process
94
What is the origin of the rectus abdominus?
Pubic crest, tubercle and symphysis
95
What is the blood supply to the duodenum from the gastroduodenal artery?
Supraduodenal artery, Ant. Sup. Pancreaticoduodenal artery, Post. Sup. Pancreaticoduodenal artery
96
What is the insertion of the transversus abdominus?
Linea alba, pubic crest, pectineal line
97
What is the origin of the transversus abdominus?
Thoracolumbar fascia, iliac crest, inguinal ligament, costal cartilage of lower 6 ribs
98
What is the blood supply to the duodenum from the SMA and inferior pancreticoduodenal artery?
Ant. Inf. Pancreaticoduodenal artery and Post. Inf. Pancreaticoduodenal artery
99
Where does the inguinal canal pass in men?
Passes spermatic cord
100
Where does the inguinal canal pass in women?
round ligament in woman from deep ring
101
What is the tranversalis fascia?
Deep to the transversus abdominus
Continuous layer of deep fascia that lines abdominal and pelvic cavities - Continuous with inferior surface of diaphragm and posterior muscles
In direct contact with rectus abdominus below arcuate line
102
How is the ileocecal valve formed?
the ileocecal fold joins with the cecum
103
What is the role of the ileocecal valave?
spinchter that allows for enough time for things to be digested
104
What is the order from outer to inner layer?
Skin -> Campers -> Scarpas -> External Oblique -> Internal Oblique -> Transversus Abdominus -> Transversalis Fascia -> Extraperitoneal Fascia -> Parietal Peritoneum
105
What are the anterior and posterior aspects of the extraperitoneal fascia?
anterior - preperitoneal
| posterior - retroperitoneal
106
What is a direct inguinal hernia?
through deep inguinal ring, lateral to epigastric (most common) - parts of the intestines goes down into the scrotum
107
What is the vascorecta in the ileum and jejunum?
jejunum - long
| ileum - short
108
What is the arcuate line?
where posterior rectus sheath stops, and the tranversalis fascia is right up against the rectus abdominus
109
What are the parts of the large intestines?
Cecum, Appendix
Colon - Ascending, Transverse, Descending, and Sigmoid
Rectum, Anal canal
110
What forms the rectus sheath below the arcuate line?
Anterior rectus sheath is made up of the aponeuroses of the external and internal obliques and transversus abdominus
Posterior rectus sheath no longer exists, rectus abdominus is in direct contact with tranversalis fascia
111
What are fat accumulations in the large intestines?
omental appendices
112
What is the longitudinal muscle in the large intestines?
taniea coli
113
How is the mesentery made?
folding of visceral peritoneum on itself creates a double layer
114
What is the role of omental appendices?
Fat droplets that accumulate, and only serve for extra storage of fat
115
What is the role of the internal oblique?
compresses abdomen, twists
116
What is the fiber directionality of the internal obliques?
Fibers run superomedially
117
What is the role of the tine coli in the large intestines?
Contracts and squishes the large intestines creating a sacculations (Haustra) to hold fecal matter to get the last bit of nutrients and water before defecating
118
What is the deep superior vasculature drainage?
superior epigastric artery (terminal branch of internal thoracic artery)
119
What is the blood supply to the appendix?
appendicular artery (from Iliocolic artery from SMA)
120
What is the Blood supply to Ascending colon?
Colic branch of ileocolic artery (from SMA), Anterior and posterior cecal arteries (from SMA), Right colic artery (from SMA)
121
How is a direct inguinal hernia formed?
through posterior wall of inguinal canal (through inguinal triangle), medial to epigastrics
122
What is the Blood supply of the transverse colon?
Right colic (from SMA), Middle colic (from SMA), Left colic (from IMA)
123
What is the Blood supply of the descending colon?
Left colic (from IMA)
124
What is the role of the mesentery?
holds organs to the posterior abdominal wall
125
What forms in the inguinal triangle?
formed by the rectus abdomenis on medial aspect, inguinal ligament and inferior epigastric on lateral border.
126
What is the right and left paracolic gutters?
located Immediately lateral to ascending and descending colon through which material can pass form one region to another
127
What is the Blood supply to the Rectum and anal canal?
Superior rectal artery (from IMA), Middle rectal artery (from internal iliac), Inferior rectal artery (from internal iliac)
128
What are the retroperitoneal structures?
```
Urinary system (kidney, ureter, bladder) and adrenal glands
Aorta and IVC, Part of the esophagus and rectum
Most of the pancreas (body and head) , Most of the duodenum (segment 2 and 3 distal-most portion) , Ascending and descending colon
```
129
Where is the rectosigmoid junction located?
Around S3
130
What are the intraperitoneal structures?
tail of pancreas, first portion of duodenum
131
What is the lymphatics of the GI
Celiac node - Foregut
Superior mesenteric node - Midgut
Inferior mesenteric node - Hindgut
132
Where is the mesenteric plexuses and what do they do?
embedded in walls of smooth muscle and control the smooth muscle
133
Where is the submucosal plexuses and what do they do?
in submucosa control granular secretions
134
What is the Sympathetic innervation of foregut and midgut?
Thoracic splanchnic: greater, lesser, and least splanchnic nerves
135
What is the ParaSympathetic innervation of foregut and midgut?
Vagus nerve (CN10)
136
What is the Sympathetic innervation of hindgut?
Lumbar splanchnic
137
What is the ParaSympathetic innervation of hindgut?
pelvic splanchnic directly from S2-4 (no sympathetic trunk)
138
What is the path of the lesser thoracic splanchnic?
Aries from - T9/10-11
| travels to - Aorticorenal ganglion
139
What is the path of the lumbar splanchnic?
Aries from - Lumbar part of sympathetic trunk
| Travels to - Prevertebral plexus
140
What is the path of the sacral splanchnic?
Aries from - Sacral part of sympathetic trunk
| Travels to - Inferior hypogastric plexus (extension of prevertebral plexus into pelvis)
141
What is the role of subphrenic recess of the liver?
separates liver from diaphragm (Divided into right and left by the falciform ligament)
142
What is the role of hepatorenal recess of the liver?
between liver and right kidney/ adrenal gland (Continuous anteriorly)
143
What is the role of the porta hepatis?
point of entry for the hepatic artery and portal vein, exit of bile duct (portal triad)
144
What is the falciform ligament?
Separated from right by falciform ligament (hangs as ligament teres remnant)
145
What is the caudate lobe of the liver?
arises from right lobe, on posterior part of visceral surface; Bound on left by fissure for ligamentum venosum (ductus tromentum for fetus to bypass liver) and on right by groove for IVC
146
What is the Qudrate lobe of the liver?
Bound on left by fissure for ligamentum teres and right by fossa of gall bladder; Functionally related to left lobe of liver
147
What are the parts of the gallbladder?
Fundus - rounded end
Body - middle, major part in fossa
Neck - narrow part formed by mucosal folds
148
What is the bilary tract?
Passage way of bile to the duodenum
149
What are the passage ways of the biliary tract?
1. Bile exits the liver via the right and left hepatic ducts
2. It travels down the common hepatic duct which runs with the proper hepatic artery and portal vein in the lesser omentum3. Joins with the cystic duct from the gallbladder to form the bile duct
4. Bile duct descends until it meets the main pancreatic duct and empties into the major duodenal papilla at the ampulla of Vater/Hepatopancreatic ampulla (opening of bile duct)
150
What is the ampulla called at the duodenum?
major duodenal papilla
151
What is the arterial supply of the liver?
Liver receives blood from right and left hepatic arteries from the common hepatic
152
What are the parts of the pancreas?
Head - within the C of the duodenum
Unicinate process - projects from the lower part of the head
Neck - ant to superior mesenteric vessels
Body - elongates from neck to tail
Tail - passes between splenorenal ligament (connects spleen to Kidney)
153
What is the difference between the ampulla of Vater and major doudenal papilla?
Hepatopancreatic Ampulla of Vater - opening inside the duodenum
Major Duodenal Papilla - opening outside of the duodenum
154
Where does the pancreatic duct empty?
empties into minor duodenal papillae, and Branches and enters duodenum superior to major papilla
155
How is the major duodenal papilla made?
Bile duct and main pancreatic duct joins together and enter the second part/descending of the duodenum at the major duodenal papilla.
156
What is the arterial supply to the pancreas?
Anterior superior pancreaticoduodeunal artery
| Posterior superior pancreaticoduodenal artery, inferior pancreatic artery
157
What is the splenic hilum?
Entry point for splenic artery (branch off of celiac trunk) And exit point for splenic vein
158
What is the arterial supply and venous drainage to the spleen?
splenic artery and splenic vein
159
What components make up the foregut?
Foregut: Esophagus to duodenum (until major duodenal papilla), liver, pancreas, gallbladder, spleen
