Part II. Anterolateral abdominal wall pg 33-39 Flashcards
(102 cards)
1
Q
The abdominal cavity is located between what two anatomical landmarks?
A
Thoracic diaphragm and pelvic inlet/superior pelvic aperture
2
Q
The abdominopelvic cavity is located between what two anatomical landmarks?
A
Thoracic diaphragm and Pelvic diaphragm
3
Q
Are the abdominal and pelvic cavities continuous with each other?
A
Yes
4
Q
What landmark denotes the transition between the abdominal and pelvic cavity
A
Superior pelvic aperture/pelvic inlet
5
Q
What lines the abdominal cavity and viscera?
A
Peritoneum
6
Q
The potential space between the peritoneal layers of the abdominal cavity is called what?
A
Peritoneal cavity
7
Q
What are the planes that delineate the abdomen into 9 regions, as clinicians often do?
A
- subcostal plane
- transtubercular plane
- midclavicular plane (x2)
8
Q
Where is the subcostal plane?
A
It is the horizontal plane between and inferior to the 10th costal cartilages
9
Q
Where is the transtubercular plane?
A
Horizontal plane through iliac tubercles and L5 vertebrae.
10
Q
Where are the midclavicular planes?
A
Vertical planes through the midpoint of each clavicle to ipsilateral midinquinal region.
11
Q
What re the 9 regions of the abdominal cavity?
A
- Epigastric region bordered on either side by R/L hypochondriac region
- Umbilical region bordered on either side by R/L lateral region
- Pubic region bordered on either side by R/L inguinal region
12
Q
More general divisions of the abdominal cavity are delineated by only 2 planes. What are they?
A
Transumbilical plane
Median plane
13
Q
Where is the transumbilical plane?
A
Horizontal plane through umbilicus and L3-L4 IVD
14
Q
Where is the median plane?
A
Vertical plane through the midpoint (midsagittal) of the body
15
Q
Using the more general divisions of the abdomen (using 2 lines), what are the 4 regions of the abdomen?
A
- R/L Upper Quadrants
- R/L Lower Quadrants
16
Q
Contents in RIGHT upper quadrant of the abdomen:
A
- Liver (right lobe)
- Gall bladder
- Stomach (pylorus)
- Duodenum
- Pancreas (head)
- R Suprarenal gland
- R Kidney
- R Colic (hepatic) flexure
- Ascending colon (superior part)
- Transverse colon (right half)
17
Q
Contents in LEFT upper quadrant of the abdomen:
A
- Liver (left lobe)
- Spleen
- Stomach
- Jejunum and proximal Ileum
- Pancreas (body and tail)
- L Suprarenal gland
- L Kidney
- L Colic (splenic) flexure
- Transverse colon (left half)
- Descending colon (superior part)
18
Q
Contents in RIGHT lower quadrant of the abdomen:
A
- Cecum
- Appendix
- Ascending colon (inferior part)
- Ileum (most of it)
- R Ovary
- R Uterine tube
- R Ureter
- R Spermatic Cord
- Uterus (if enlarged)
- Urinary bladder (if very full)
19
Q
Contents in LEFT lower quadrant of the abdomen:
A
- Descending colon (inferior part)
- Sigmoid colon
- L Ovary
- L Uterine tube
- L Ureter
- L Spermatic cord
- Uterus (if enlarged)
- Urinary bladder (if very full)
20
Q
Where is the anterolateral abdominal wall located?
A
- Inferior to ribs 7-10 costal cartilages and xiphoid process
- superior to inguinal ligament and pelvic bones
21
Q
What are the two superficial fascia layers of the anterolateral abdominal wall?
A
- Camper’s fascia (superficial fatty layer)
- scarpa’s fascia (deep membranous layer
22
Q
What is Camper’s fascia equivalent to histologically?
A
Hypodermis
23
Q
Describe Scarpa’s fascia histologically.
A
It is a thin layer of Dense irregular CT with a thin layer of loose CT separating it from the deep fascia
24
Q
What is the functional significance of the thin layers of loose CT that separates Scarpa’s fascia from the deep fascia?
A
It allows for independent movement of superficial and deep fascia
25
What is the dense irregular CT they surround the abdominal muscles and their anoneuroses?
Deep fascia (investing fascia)
26
What is the loose CT located between muscles/aponeuroses and parietal peritoneum?
Endoabdominal fascia
27
Endoabdominal fascia is analogous to ____________ in the thorax and continuous with _________ in the pelvis.
Endothoracic fascia: endopelvic fascia
28
What fascia provides a potential surgical dissection plane for extraperitoneal and/or retroperitoneal organs
Endoabdominal fascia
29
What are the 5 muscles of the anterolateral abdominal wall?
- external oblique m.
- internal oblique m.
- transversus abdominis m.
- rectus abdominis m.
- pyramidalis m.
30
Orientation of the muscle fibers of external oblique muscles?
Inferioanteriorly (like external intercostal)
31
Origin of external oblique
Ribs 5-12
32
Insertion of external oblique muscle
- linea alba
- pubic tubercle
- anterior 1-2 of iliac crest
33
The aponeurosis that begins approximately at the midclavicular line
Linea semilunaris
34
The inferior margin of the linea alba thickens and rolls to form what?
Inguinal ligament
35
The inguinal ligament extends from where to where?
ASIS to pubic tubercle
36
The inguinal ligament is the anterosuperior attachment point for what?
Fascia lata
37
What innervates the external obliques and rectus abdominis muscle?
- T7-11 thoracoabdominal nerves
- subcostal nerve (T12)
Note: internal oblique and transversus are innervated by those nerves as well as iliohypogastric nerve and ilioinguinal nerve.
38
Orientation of the muscle fibers of the internal oblique
Fan out anteromedially from ASIS
39
What is the origin of internal oblique muscles?
- Thoracolumbar fascia
| - anterior 2/3 of iliac crest - inguinal ligament
40
What is the insertion of the internal oblique muscles?
- Ribs 10-12
- linea alba
- pectin pubis via conjoint tendon
41
What muscle arches over the spermatic cord while it is in the inguinal canal?
Internal oblique m.
42
Is the rectus abdominis muscles wider superiorly or inferiority?
Superiorly
43
Is the rectus abdominis muscles thicker superiorly or inferiorly?
Inferiorly
44
The aponeurosis associated with external oblique m., internal oblique m., and transversus abdominus is _________ and it contributes to _________.
- linea semilunaris
| - anterior rectus sheath
45
Inferomedial aponeurosis fibers of the internal oblique deccusate and join with aponeurotic fibers of the transversus abdominis muscle to form what structure?
Conjoint tendon
46
Where does the conjoint tendon attach?
Pubic crest and pectin pubis
47
What are the actions of both the internal and external oblique?
- Compress abdominal viscera
| - flex and rotate trunk
48
What is the orientation of the muscle fibers of transversus abdominis muscle?
Mostly transverse and medically
49
What is the origin of the transversus abdominis muscle?
- Thoracolumbar fascia
- costal cartilages 7-12
- iliac crest
- inguinal ligament
50
What is the insertion of transversus abdominis muscle?
- Linea alba
- pubic crest via conjoint tendon
- pectin pubis via conjoint tendon
51
What innervates internal obliques and transversus abdominis muscles?
T7-11 thoracoabdominal nerves, subcostal nerve, ilihypogastric nerve, ilioinguinal nerve
52
What is the action of the transversus abdominis muscle?
Compress and support the abdominal viscera and trunk
53
How is rectus abdominis muscle attached to the anterior rectus sheath?
By 3 semitendinous rings
54
_________ is located midline between 2 rectus abdominis muscles and ________ is located at the lateral margins of each rectus abdominis muscle.
Linea alba: linea semilunaris
55
What is the origin of rectus abdominis muscle?
Pubic symphysis and pubic crest
56
What is the insertion of rectus abdominis muscle?
Xiphoid process and costal cartilages
57
What is the action of the rectus abdominis muscles?
Flex trunk and compress abdominal viscera
58
What is the small triangular muscle that overlaps inferior portion of rectus abdominis but is absent in 20% of people?
Pyrimidalis muscle
59
Where does the pyramidalis muscles span from, if present?
Pubis and linea alba
60
Fibrous envelope surrounding Rectus Abdominis M (and Pyramidalis M if present)
Rectus Sheath
61
What forms the rectus sheath?
decussation/interweaving of aponeuroses of lateral abdominal wall Ms
62
Defect in Linea Alba through which fetal Umbilical AV passed and where all lateral abdominal wall aponeuroses fuse
Umbilical ring
63
The landmark for a structural change in the rectus sheath, located on posterior rectus sheath about 1/4 way up from pubic crest
Arcuate line
64
What is the composition of the anterior rectus sheath superior to the arcuate line?
- Aponeurosis of External Oblique M
| - Anterior lamina of aponeurosis of Internal Oblique M
65
What is the composition of the posterior rectus sheath superior to the arcuate line?
- Posterior lamina of aponeurosis of Internal Oblique M
- Aponeurosis of Transversus Abdominis M
- Endoabdominal (Transversalis) fascia
66
What is the composition of the anterior rectus sheath inferior to the arcuate line?
- Aponeurosis of External Oblique M
- Aponeurosis of Internal Oblique M
- Aponeurosis of Transversus Abdominis M
67
What is the composition of the posterior rectus sheath inferior to the arcuate line?
- Endoabdominal (Transversalis) fascia
68
Combined Function of Anterolateral Wall Muscles
- Move trunk and maintain posture (both standing and sitting)
- Protect abdominal viscera from injury
- Compress abdominal viscera (increasing intra-abdominal pressure) which assists in defecation, urination, coughing, sneezing, forced expiration and childbirth
69
Which Anterior abdominal branch of ventral primary rami innervates the dermatome at the level of the umbilicus?
T10
70
Thoracoabdominal nerves come from what VPRs?
T7-T11
71
Thoracoabdominal nerves run in plane between ______ and ______ muscles.
Internal oblique and transversus abdominis
72
What do the thoracoabdominal nerves innervate?
Lateral abdominal wall muscles (internal oblique, external oblique, transversus abdominis, rectus abdominis) and skin in the corresponding dermatomes
73
What nerve is the anterior continuation of T12 VPR?
Subcostal nerve
74
What does the subcostal nerve innervate?>
abdominal wall muscles and skin above ASIS and below umbilicus
75
Superior terminal branch of ventral primary ramus of L1
Iliohypogastric Nerve
76
Anterior cutaneous component of iliohypogastric nerve pierces _________.
External Oblique aponeurosis
77
What does ilihypogastric nerve innervate?
- Internal Oblique M
- Transversus Abdominis M
- hypogastric skin and skin over iliac crest (superior to inguinal canal)
78
Inferior terminal branch of ventral primary ramus of L1
Ilioinguinal N
79
What does Ilioinguinal nerve innervate?
- Internal Oblique M
- Transversus Abdominis M
- Innervates skin of anterior scrotum/labia majora, mons pubis and medial thigh
80
What nerve passes through the Inguinal Canal with round ligament/spermatic cord?
Ilioinguinal nerve
81
What are the segmental branches from descending aorta that supply lateral flank and lumbar regions?
Posterior Intercostal As, Subcostal A and Lumbar As
82
What is the branch from internal thoracic artery in the 6th intercostal space that descend along the costal margin of the thoracic cage?
Musculophrenic artery
83
What is the branch from internal thoracic artery in the 6th intercostal space that descends between posterior rectus sheath and rectus abdominis muscle?
Superior epigastric artery
84
What is the branch from external iliac artery just superior to inguinal ligament that ascend in transversalis fascia and enters rectus sheath inferior to arcuate line?
inferior epigastric a
85
Superior and inferior epigastric arteries anastomoses to supply what?
rectus abdominis muscle and lower umbilical region
86
What does musculophrenic artery supply?
hypochondriac region and anterolateral thoracic diaphragm
87
What is the branch from external iliac artery that starts superior to and parallels the inguinal ligament to pass toward ASIS?
Deep circumflex artery
88
What does the deep circumflex artery supply?
Deep inguinal region
89
What branches from the femoral artery inferior to the inguinal ligament and then parallels it to pass toward the ASIS?
Superficial circumflex iliac artery
90
What does the superficial circumflex iliac artery supply?
Skin in inguinal region
91
What branch from the femoral artery, inferior to inguinal ligament, and ascend in superficial fascia towards the umbilicus?
Superficial epigastric artery
92
What does the superficial epigastric artery supply?
Skin in pubic and lower umbilical region
93
Venous drainage of anterolateral abdominal wall superior to umbilicus via:
- Lateral Thoracic V to Axillary V to Subclavian V - Internal Thoracic V to Subclavian V
94
Venous drainage of anterolateral abdominal wall inferior to umbilicus via:
- Inferior Epigastric V to External Iliac V
| - Superficial Epigastric V to Great Saphenous V to Femoral V to External Iliac V
95
Small superficial tributaries of Hepatic Portal V associated with Caput Medusa
Parumbilical Vs
96
What vein sometimes develops between Lateral Thoracic V and Superficial Epigastric V and may indicate underlying problems with venous return: i.e. IVC blockage?
Thoracoepigastric V
97
Superficial lymphatics of the anterolateral abdominal wall above transumbilical plane drain primarily to where? A small percentage drain to where?
- axillary nodes
| - parasternal nodes
98
Superficial lymphatics of the anterolateral abdominal wall below transumbilical plane drain to where?
superficial inguinal nodes
99
Deep lymphatics of the anterolateral abdominal wall drain to where?
nodes along the External Iliac A
100
Two artery branches that supply the lesser curvature of the stomach
Right and left gastric
101
Two artery branches that supply the greater curvature of the stomach
Right and left gastro-omental/ gastroepiploic arteries
102
Artery branches that supply the fundus
Short gastric
