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2. HLTH 109 > Trunk wall II > Flashcards

Trunk wall II Flashcards

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1
Q

diaphragm: features

A
  • seals inferior thoracic aperture
  • post attachment more inferior than ant (coz of angulation of aperture)
  • R dome high than L
  • muscle fibres arise radially, converge to central tendon
  • diaphragm contracts, height of dome decreases, increase volume of thorax
  • pericardium attached to middle part of central tendon
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2
Q

diaphragm: list all attachments

A
  • xiphoid
  • costal margin of thoracic wall
  • rib 11-12 ends
  • ligaments across post ab wall
  • lumbar vertebra
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3
Q

diaphragm: post attachment

A
  • crura: anchors to anterolateral surface of vertebral column
  • L3 (R), L2 (L)

arcuate ligs:

  • median arcuate lig (btw crura)
  • medial arcuate lig (TP L1)
  • lateral arcuate lig (rib 12)
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4
Q

diaphragm: openings

A

inf vena cava:
- in central tendon

oesophagus:
- muscular part

aorta:
- posteriorly

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5
Q

respiration: general features

A
  • pressure difference btw lungs + atmosphere

inhalation (inspiration): decrease alveolar pressure (increase lung size, contract diaphragm, elevation/outward of ribcage, intercostals)

exhalation (expiration): opposition, increase alveolar pressure

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6
Q

respiration: accessory muscles of inspiration

A
  • sternocleidomastoid
  • scalene
  • pec minor
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7
Q

respiration: role of abdomen in inspiration

A
  • relaxes
  • accomodate expansion of thoracic cavity
  • inferior displacement of abdominal viscera during diaphragm contraction
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8
Q

respiration: role of abdomen in expiration

A
  • contracts
  • assist in elevating domes of diaphragm
  • reduce thoracic volume
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9
Q

Valsalva manoeuvre:

A
  • contraction of ab muscles increase intra-abdominal pressure when diaphragm is in a fixed position
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10
Q

abdominal wall: consists of

A
  • skin
  • superficial (subcutaneous) fascia
  • muscles
  • deep fascia
  • extraperitoneal fascia
  • parietal fascia
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11
Q

abdominal wall: skeletal elements

A
  • 5 lumbar vertebra + IV discs
  • superior parts of pelvis
  • inferior parts of thoracic cage
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12
Q

abdominal wall: muscle elements parts

A
  • posterior
  • lateral
  • anterior
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13
Q

abdominal wall: post muscle elements

A
  • lateral to vertebral column
  • quadratus lumborum
  • psoas major
  • iliacus
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14
Q

abdominal wall: lateral muscle elements

A
  • transverse abdominus
  • internal oblique
  • external oblique
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15
Q

abdominal wall: anterior muscle elements

A

rectus abdominus

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16
Q

what continues btw posterior, lateral and anterior parts of ab wall:

A
  • fascia posteriorly

- aponeurosis from muscles in lateral wall

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17
Q

anterior abdominal wall: features

A

flat muscles, posterolateral -> replaced by aponeurosis towards midline

  • external oblique
  • internal oblique
  • transversus abdominus

vertical muscles near midline -> enclosed in tendinous sheath from aponeurosis of flat muscles

  • rectus abdominus
  • pyramidalis
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18
Q

external oblique: sup attach

A
  • muscular slips from outer surfaces rib 5-12
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19
Q

external oblique: inf attach

A
  • lateral lip of iliac crest

- aponeurosis ending in linea alba (midline raphe)

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20
Q

external oblique: innervation

A

anterior rami of lower 6 thoracic spinal nerves (T7-T12)

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21
Q

external oblique: action

A
  • compress abdominal contents
  • flex trunk together
  • each ipsilateral bend -> turning ant part of abdomen to opposite side
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22
Q

internal oblique: sup attach

A
  • thoracolumbar fascia
  • iliac crest
  • inguinal lig (lateral 2/3)
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23
Q

internal oblique: inf attach

A
  • lower 3/4 ribs

- aponeurosis ending in linea alba/ pubic line/ pectineal line

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24
Q

internal oblique: innervation

A
  • anterior rami of lower 6 thoracic spinal nerves (T7-T12)
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25
internal oblique: action
compress ab contents - flex trunk together - each mm bends trunk to same side, turning ant part of abdomen to same side
26
transversus abdominis: sup attach
- thoracolumbar fascia - iliac crest - inguinal lig (medial 1/3) - costal cartilage of lower 6 ribs
27
transversus abdominis: inf attach
aponeurosis ending in linea alba/ pubic crest/ pectineal line
28
transversus abdominis: innervation
anterior rami of lower 6 thoracic spinal nerves (T7-T12)
29
transversus abdominis: action
compress abdominal contents
30
rectus abdominis: sup attach
costal cartilages of ribs 5-7 | - xiphoid process
31
rectus abdominis: inf attach
- pubic crest - pubic tubercle - pubic symphysis
32
rectus abdominis: innervation
T7-T12
33
rectus abdominis: action
flexes vertebral column | - compress abdominal content
34
pyramidalis: sup attach
linea alba
35
pyramidalis: inf attach
anterior pubis and pubic symphysis
36
pyramidalis: innervation
T7-T12
37
pyramidalis: action
tenses linea alba
38
rectus sheath: features
- encloses rectus abdominis + pyramidalis - layering of aponeuroses of EO/ IO/ TA - encloses 3/4 of RA - covers ant surface of lower 1/4 - post surface of lower 1/4 direct contact w transversalis fascia
39
rectus sheath: upper 3/4
anterior wall: aponeurosis of - external oblique - 1/2 internal oblique (splits at lateral margin of rectus abdominis) posterior wall: aponeurosis of - other 1/2 internal oblique - transversus abdominis
40
rectus sheath: lower 1/4
- midway btw umbilicus and pubic symphysis: all aponeuroses anterior to rectus muscle (arcuate line) - no post sheath - ant sheath: EO/ IO/ TA - rectus abdominis direct contact with transversalis fascia
41
inguinal region: features
- junction btw abdomen and thigh - ab wall is weakened -> testes/ ovaries descend from initial high position of post abdominal wall - peritoneal outpouching (processus vaginalis) forms protruding through layers of ant abdominal wall
42
inguinal canal: initially, features
- processus vaginalis acquires coverings from - transversalis fascia (deepest) - musculature of internal oblique - aponeurosis of ext oblique (superficial) becomes tubular structure w multiple layers - basic structure of inguinal canal
43
inguinal canal: final development
- descent of testes into scrotum/ ovaries into pelvic cavity men: - descend with assoc. ducts/vessels/nerves which also pass through inguinal canal -> same fascial layers of ab wall women: - become assoc. w developing uterus, round lig (remnant of gubernaculum)
44
inguinal canal: concludes
- vaginalis obliterates | - if not, potential weakness and hernia may occur
45
inguinal canal: definition
- slit like passage downwards medially - parallel to lower half of inguinal lig - begins at deep inguinal ring -> superficial inguinal ring
46
inguinal canal: contents
- genital branch of genitalfemoral nn - spermatic cord (men) round lig (women) - ilioinguinal nn
47
inguinal canal: deep inguinal ring
- beginning of inguinal canal - midway btw ASIS and pubic symphysis - above inguinal lig, lateral to inferior epigastric vessels
48
inguinal canal: superficial inguinal ring
- end of inguinal canal - superior to pubic tubercle - triangular opening in aponeurosis of the external oblique with apex: pointing superolaterally and base formed by pubic crest - medial/ lateral crus (remaining sides of triangle) attached to the pubic symphysis and pubic tubercle
49
inguinal canal: anterior wall
- aponeurosis of ext oblique - reinforced laterally by lower fibres of internal oblique (potential site weakness) - internal oblique mm covers deep inguinal ring contributing layer (cremasteric fascia) to covering structures tranversing inguinal canal
50
inguinal canal: posterior wall
- transversalis fascia - reinforced along medial 1/3 by conjoint tendon - conjoint tendon also supports superficial inguinal ring
51
inguinal canal: superior wall (roof)
- arching fibres of transversus abdominis and IO fibres | - from lateral points of origin from inguinal lig -> common medial attachment at conjoint tendon
52
inguinal canal: inferior wall (floor)
- medial half of inguinal lig - this free margin of lowest part of EO forms gutter which contents of inguinal canal are positioned - lacunar lig reinforces medial part of gutter
53
inguinal hernia: indirect
- most common - more men vs women - some/ all of processus vaginalis remaining - peritoneal sac to enter inguinal canal passing deep inguinal ring - peritoneal sac can traverse entire canal, exit superficial ring and continue into scrotum/ labia majus
54
inguinal hernia: direct
- peritoneal sac enters medial end of inguinal canal: weakened post wall - common in mature men - bulging occurs: medial/ inferior epigastric vessels - does NOT traverse inguinal canal but may exit through superficial inguinal ring
55
posterior abdominal wall: muscles
- psoas major and minor - quadratus lumborum - iliacus
56
psoas major: origin
bodies/ transverse process T12-L5 + IV discs
57
psoas major: insertion
lesser trochanter
58
psoas major: innervation
anterior rami: L1,2,3
59
psoas major: action
flex the hip
60
psoas minor: origin
bodies of T12 + L1 IV discs
61
psoas minor: insertion
pectineal line, iliopubic eminence
62
psoas minor: innervation
anterior rami of L1
63
psoas minor: action
weak flexion of lumbar spine
64
iliacus: origin
iliac fossa
65
iliacus: insertion
lesser trochanter
66
iliacus: innervation
femoral n
67
iliacus: action
flexion of hip
68
quadratus lumborum: origin
TP of L1-L4 | - rib 12
69
quadratus lumborum: insertion
TP of L5 | - iliac crest
70
quadratus lumborum: innervation
- depresses and stabilises rib 12 | - laterally flexes vertebral column
71
iliacus: features
- fills iliac fossa - passes inferiorly, joins psoas major and attaches to lesser trochanter (iliopsoas) - flexes thigh at hip when trunk is stabilised

2. HLTH 109 (29 decks)

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