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Clinical Anatomy II > LOs abdomen > Flashcards

LOs abdomen Flashcards

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1
Q

boundaries of abdomen

A

anterior: abdominal wall
posterior: vertebral column
superior: diaphragm
inferior: pelvic inlet (pubic tubercle to lumbar spine)

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2
Q

functions of anterior abdominal wall

A
  1. support trunk
  2. support abdominal viscera
  3. manage intra-abdominal pressure during respiration
  4. move trunk and maintain posture
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3
Q

greater versus lesser sac

A

greater sac: main abdominal space
lesser sac: omental bursa, posterior to stomach, diverticulum (extension) of greater sac

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4
Q

mesentery

what vessels do these mesenteries cover?
1. mesentery proper
2. sigmoid mesocolon
3. transverse mesocolon

A

double layer of peritoneum, conduit of neurovascular supply between organ and body wall

  1. superior mesenteric vessels – since mesentery proper is connected to small intestine (midgut)
  2. inferior mesenteric vessels – since sigmoid mesocolon is connected to sigmoid (hindgut)
  3. middle colic vessels – since transverse colon is innervated by middle colic of SMA
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5
Q

ligaments of greater omentum

A

gastrosplenic
gastrocolic
gastrophrenic

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6
Q

ligaments of lesser omentum

which one contains the portal triad?

A

hepatoduodenal – contains portal triad
hepatogastric

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7
Q

intraperitoneal

A

organs fully enclosed by visceral peritoneum and suspended by mesenteries; organ developed within peritoneal cavity

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8
Q

retroperitoneal

A

organs enclosed only by parietal peritoneum; organ developed posterior to peritoneal cavity

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9
Q

primarily retroperitoneal

A

developed posterior to peritoneal cavity, never had mesentery

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10
Q

intraperitoneal organs

A

superior/1st segment of duodenum
jejunal, ileum
transverse colon
liver
gallbladder

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11
Q

retroperitoneal organs: primary

A

primary:
1. kidney
2. suprarenal glands

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11
Q

retroperitoneal organs: primary and secondary

A

primary:
1. kidney
2. suprarenal glands

secondary
1. duodenum (2nd/desc, 3rd/horz, 4th/ascend)
2. colon (asc, desc)
3. rectum (upper 2/3)
4.

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12
Q

retroperitoneal: secondarily

A
  1. descending (2nd seg) duodenum
  2. horizontal (3rd seg) duodenum
  3. ascend (4th seg) duodenum
  4. ascend colon
  5. descend colon
    rectum (upper 2/3)
  6. pancreas
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13
Q

secondarily retropertioneal

A

previously intraperitoneal but moved posteriorly to peritoneal cavity during development

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14
Q

inguinal canal content female

A

round ligament of uterus (homolog to ductus deferens)
ilioinguinal nerve

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15
Q

components of rectus sheath above vs. below arcuate line

A

above arcuate line
1. anterior rectus sheath: EAO, IAO
2. posterior rectus sheath: IAO, TA

below arcuate line
1. anterior rectus sheath: EAO, IAO, TA
2. posterior to RA: transversalis fascia

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16
Q

significance of arcuate line

A

provides passageway for INFERIOR EPIGASTRIC VESSELS to innervate RA

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17
Q

arcuate line

A

demarcates transition between posterior rectus sheath and transversalis fascia

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18
Q

inguinal canal boundaries

A

floor: inguinal ligament
posterior: transversalis fascia
anterior: EAO aponeurosis

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19
Q

inguinal canal content male

A

spermatic cord
1. ductus deferens
2. ductus deferens a. and v.
3. testicular a. and v. (pampinform plexus)
4. ilioinguinal nerve
5. genital branch of genitofemoral n.

covered by: cremaster muscle, its fascia, and vessels

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20
Q

superficial fascia: camper vs. scarpa

A

camper = more superficial, fatty layer right under skin

scarpa = deep to camper, membranous layer directly superficial to EAO. where sutures happen

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21
Q

innervation of anterior abdominal mm

A

RA: T6-T12
EAO: T7-T12
IAO and TA: T6-L1

T6-T11 = thoracoabdominal nerve
T12 = subcostal nerve

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22
Q

landmarks for abdominal skin

A

T4 = xiphoid process
T5/6 = nipple
T10 = umbilicus

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23
Q

indirect inguinal hernia

A
  1. more common 66%
  2. congenital
  3. protrusion is LATERAL to inferior epigastric vessels
  4. protrusion passes through deep and superficial inguinal ring
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24
direct inguinal hernia
1. less common 2. acquired 3. protrusion is MEDIAL to inf epigastric vessels 4. passes only through superficial inguinal ring
25
stomach quadrant and functions
LUQ, RUQ 1. store food 2. HCl disinfects food and denatures protein 4. activates protease pepsin 3. produces chyme
26
esophagus functions
1. transports food from mouth to stomach 2. warms or cools food 3. muscles enable peristalsis of foods -- transitions from skeletal to smooth muscle (voluntary --> involuntary)
27
small intestine quadrant and function
LUQ, RUQ 1. enzymatic digestion of food 2. absorption of nutrients
28
liver quadrant and function
RUQ 1. produces bile and plasma proteins 2. detoxifies 3. stores glycogen
29
gallbladder quadrant and function
RUQ 1. stores and releases bile -- bile emulsifies fats and enhances digestion/absorption 2. consists of bilirubin, cholesterol, water, ions
30
major duodenal papilla: location and function
on superior duodenum; all bile comes through this from gallbladder via common bile duct
31
portal triad
within lesser omentum (primarily hepatoduodenal ligament); all are anterior to omental foramen consists of: 1. hepatic artery proper 2. hepatic portal vein 3. common bile duct
32
pancreas quadrant and function
RUQ, LUQ 1. makes enzymes 2. makes bicarbonate to neutralize chyme an endocrine gland
33
large intestine function
NO digestion 1. absorbs water and minerals 2. has lots of bacteria 3. incomplete longitudinal layer
34
foregut arterial main supply and content
arterial: celiac trunk contents (6): 1. stomach 2. pancreas 3. duodenum 4. spleen 5. gallbladder 6. liver
35
midgut arterial main supply and content
arterial: SMA contents (5): 1. cecum 2. appendix 3. ascending colon 4. transverse colon 5. small intestine
36
hindgut arterial main supply and content
arterial: IMA contents (4) 1. transverse colon 2. descending colon 3. sigmoid 4. rectum
37
retroperitoneal: secondarily
1. descending (2nd seg) duodenum 2. horizontal (3rd seg) duodenum 3. ascend (4th seg) duodenum 4. ascend colon 5. descend colon rectum (upper 2/3) 6. pancreas
37
caput medusae
HPV --> paraumbilical --> superficial and inferior epigastric vv --> IVC **EPIGASTRIC**
38
esophageal varicies
HPV --> L gastric --> esophageal --> azygos --> SVC
39
rectal varicies
IMV --> superior rectal --> middle and inferior rectal --> internal iliac --> IVC
40
retroperitoneal dilated veins
IMV --> L colic --> lumbars --> IVC
41
lymph nodes in abdomen
preaortic (anterior of abdomen) --> cisterna chyli retroaortic (posterior) --> cisterna chyli lateral aortic (within AA) -- drains into lumbar trunk --> cisterna chyli
42
lymph nodes in pelvis
external iliac internal iliac common iliac
43
what LE lymph node drains into external iliac?
deep inguinal
44
psoas major attachments
origin: T12-L5 transverse processes insertion: lesser trochanter of femur
45
QL attachments
origin: 12th rib, L1-L4 insertion: iliac crest
46
iliacus attachments
origin: iliac fossa, iliac crest, sacroiliac lig insertion: lesser trochanter femur
47
what passes through median arcuate ligament?
aortic hiatus
48
aortic hiatus
T12 contents: 1. descending aorta 2. thoracic duct aortic hiatus marks transition of thoracic aorta into abdominal aorta
49
what passes through medial arcuate ligament?
psoas
50
what passes through lateral arcuate ligament?
QL
51
caval opening
T8 contents: IVC
52
esophageal hiatus
T10 contents: 1. parasymp vagal trunk 2. esophagus
53
pelvic inlet boundaries
sacral promontory arcuate line of ilium pectineal line of ischium pubic symphysis function: divides pelvis into lesser and greater
54
pelvic outlet boundaries
coccyx sacrotuberous and sacrospinous ligament ischial tuberosity pubic arch (inf pubic ramus --> pubic symphysis)
55
lesser (true) pelvis
bounded superiorly by pelvic inlet, inferiorly by pelvic outlet
56
greater (false) pelvis
above pelvic inlet
57
SI joint stabilizers (3)
1. sacrospinous: sacrum --> ischial spine 2. sacrotuberous: sacrum --> ischial tuberosity 3. anterior sacroiliac: sacrum --> ilium
58
male vs. female pelvis
male: 1. subpubic angle 70 deg 2. heart shaped inlet (due to greater prominence of sacral promontory) 3. narrower outlet and cavity 5. narrower sacrum and more convex female: 1. subpubic angle 90-100 deg 2. oval shaped inlet 3. wider outlet and cavity 4. wider sacrum (ala) and more flat
59
ischioanal fossa boundaries
ceiling: levator ani lateral wall: obturator internus medial-inferior: rectum
60
ischioanal fossa contents
1. fat pads 2. connective tissue 3. pudendal canal: -pudendal nerve -internal pudendal a/v outside of canal, these become inferior rectal a,v,n
61
features of scrotum (deep --> superficial)
testis visceral testis parietal internal spermatic fascia cremasteric muscle external spermatic fascia tunica dartos (deep layer) superficial fascia skin
62
functions of pudendal nerve and branches
1. defecation 2. urination/micturition 3. parturition (childbirth) 4. erection 5. ejaculation
63
erection innervation
parasympathetic S2-S4 pelvic splanchnic nn. --> prostatic plexus --> cavernous nerves --> corpus cavernosum relax and enlarge
64
ejaculation innervation
sympathetic L1-L2 lumbar splanchnic --> superior and inferior hypogastric plexus --> muscles contract
65
most commonly injured artery due to pelvic fracture?
internal/external iliac artery obturator artery
66
pelvic viscera sympathetic innervation
1. sympathetic trunk > gray rami: postganglionic nerves that synapsed within trunk > sacral splanchnic: preganglionic nerves that synpases outside of trunk > ganglion impar: end of sacral sympathetic trunks that unite at coccyx tip 2. periarterial plexus -- vasoconstricts arteries starting at internal iliac 3. hypogastric plexus: superior and inferior (inf is mixed)
67
inferior hypogastric plexus
mixed innervation! parasympathetic: pregang pelvic splanchnic sympathetic: pregang sacral splanchnic

Clinical Anatomy II (8 decks)

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