Unit 4 Flashcards

(117 cards)

0
Q

9 region pattern

A

Right and left hypochondrium
Right and left flank
Right and left groin
Epigastric, umbilical and pubic regions

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1
Q

4 quadrant pattern

A

Right and left upper quadrants

Right and left lower quadrants

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2
Q

Quadrants and interior anatomy

A

Right upper - liver and gallbladder
Left upper- stomach and spleen
Right lower- cecum and appendix
Left lower- end of descending colon and sigmoid colon

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3
Q

Planes of nine region pattern

A

Midclavicular planes, subcostal plane and intertubercular plane

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4
Q

Abdominal wall boundaries

A

Superiorly- Xiphoid process and costal margins
Posteriorly- vertebral column
Inferiorly- upper parts of pelvic bones

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5
Q

Layers of abdominal wall

A

Skin, superficial fascia, muscles and deep fascia, extraperitoneal fascia, parietal peritoneum

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6
Q

Superficial fascia

A

layer of fatty connective tissue
usually single layer, forms two layers below umbilicus
1. Camper’s fascia
2. Scarpa’s fascia

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7
Q

Campers fascia

A

Part of superficial fascia- superficial fatty layer- super fatty, continuous with fascia of the thigh, men- continues into penis, forms dartos fascia in scrotum, women- continuous with labia majora

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8
Q

Scarpa’s fascia

A

Part of superficial fascia- deep membranous layer- thin, not much fat, continues shortly below inguinal ligament (where its called fascia lata), attaches to linea alba and pubic symphysis, also forms Colles’ fascia in perineal membrane, where it attaches to ischiopubic rami
men- blends with superficial over penis, also forms dartos fascia, help form fundiform ligament of penis, women- labia majora and perineum

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9
Q

Anterolateral muscles

A

5 total
3 flat- internal and external oblique, and transversus abdominis
2 vertical- rectus abdominis and pyramidalis

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10
Q

Flat muscles

A

3 anterolateral, replaced by aponerosis near , innervated by anterior rami of lower 6 thoracic spinal nervres, all compress abdominal contents

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11
Q

Vertical muscles

A

2 muscles, enclosed by tendentious sheath formed by aponerosis of flat muscles

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12
Q

Function of anterolateral muscles

A
  1. maintenance of physiological functions
    • quiet and forced expiration (pushing viscera upward)
    • coughing and vomiting
    • partutition (childbirth), micturition (urination) and defication
  2. hold abdominal viscera in abdominal cavity
  3. protect viscera from injury,
  4. maintaining position of viscera in erect posture
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13
Q

Eternal oblique

A

flat, anterolateral muscle

  • most superficial of flats
  • origin: muscle slips of outer surface of lower 8 ribs
  • insertion: iliac crest and linea alba
  • innervation: lower 6 thoracic spinal nerves
  • function: compresses abdominal contents, bending trunk to same side, turning anterior abdomen to same side
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14
Q

Inguinal ligament

A

formed by lower border of external oblique, ligament folds back on itself to form the inguinal canal

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15
Q

lacunar ligament

A

extension of inguinal ligament, crescent shaped, attaches to pecten pubis of pubic bone

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16
Q

Cooper’s ligament

A

formed by fibers from the lacunar ligament, runs along pectan pubis to pelvic brim

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17
Q

Internal oblique

A

deep to external oblique

origin: thoracolumbar fascia, iliac crest, inguinal ligament
insertion: inferior border of lower 3 ribs, aponeurosis ending in linea alba, pubic crest and pectineal line
innervation: anterior rami of lower 6 thoracic spinal nerves
function: compress abdominal contents, flex and bend trunk, turns anterior abdomen to same side

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18
Q

Transverse abdominis

A

deep to internal oblique

origin: thoracolumbar fascia, iliac crest, inguinal ligament, costal cartilage of lower 6 ribs
insertion: aponerosis ending in linea alba, pubic crest, pectoral line
innervation: anterior rami of lower 6 thoracic spinal nerves
function: compression of abdominal contents

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19
Q

Gallbladder

A

on visceral surface on right side of liver
fundus- rounded end, projects from inferior border of liver
body- against transverse colon and superior to duodenum
neck- narrowest part
Arterial supply- cystic artery from right hepatic artery
Function- receives, concentrates and stores bile from liver

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20
Q

Pancreas

A
Posterior to stomach
in retropareteneal cavity
uncinate process- inferior to head
head- within C shaped area of duodenum
neck
body- connects neck to tail
tail- passes between splenorenal ligament
Pancreas originated from dorsal and ventral buds of foregut
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21
Q

Pancreatic duct

A

begins at tail of pancreas

joins with bile duct at heptopancreatic ampulla

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22
Q

Hepatopancreatic ampulla

A

joining of pancreatic duct and bile duct
enters descending duodenum at major duodenal papilla
surrounded by sphincter of ampulla (collection of smooth muscles)

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23
Q

accessory pancreatic duct

A

empties into duodenum at minor duodenal papilla

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24
Annular pancreas
If dorsal and ventral buds of foregut do not fuse, they may constrict the duodenum, and may cause it to be absent, causing the child to vomit and be sickly
25
Pancreatic oragins
dorsal bud- forms head, neck, body | ventral bud- forms part of head and uncinate process
26
Pancreatic cancer
tumors occur anywhere in pancreas, but usually head and neck, causing nonspecific symptoms. May obstruct common bile duct, causing jaundice. Usually found after its spread to portal vain and into liver and lymph nodes. other stuff on pg 170
27
Duct system for bile
Liver -> gallbladder -> descending duodenum right and left hepatic ducts join to form common hepatic duct, joins with cystic duct from gallbladder to form bile duct, joins with pancreatic duct to enter descending duodenum omental formamen is posterior to these structures
28
Gallstones
mixture of cholesterol and pigment, that may undergo calcification, may lodge in neck of gallbladder. Then the gallbladder cannot empty normally, and pain occurs
29
Cholecystectomy
removal of gallbladder, sometimes because of gallstones
30
cholecyst
inflamed gallbladder, pain may refer to right shoulder.
31
Jaundice
yellow discoloration of the skin, caused by excessive bile pigment in plasma. Any obstruction of the biliary tree can cause it.
32
Spleen
- develops as part of the vascular system in dorsal mesentary - spleen lies against diaphragm, in area of ribs 9 to 10 - in left upper quadrant and left hypochondrium - connects to: greater curvature of stomach by gastrosplenic ligament (contains short gastric and gastro-omental vessels) AND left kidney by splenorenal ligament (contains splenic vessels) -> both ligaments are part of greater omentum
33
splenic hilum
entry point for splenic vessels, on medial surface of spleen
34
stuff surounding spleen
diaphram, stomach, kidney, visceral peritoneum (except on splenic hilum)
35
Spleen arterial supply
spleenic artery from celiac trunk
36
2 categories of spleenic disorders
1. rupture | 2. splenic enlargement
37
splenic rupture
occurs if there is localized trauma to the left upper quadrant, thin capsule makes it susceptible to damage. Bleeds a lot due to high vascularization
38
Splenetic enlargement
Since spleen is part of reticuloedothelial system, diseases of the system (leukemia, lymphoma) may produce spleen enlargement (splenomegaly)
39
Splenomegaly
Spleen enlargement
40
Abdominal aorta
- begins at aortic hiatus of diaphragm (at lower border of T12) - descends through abdomen - ends at L4 - > branches into 2 common iliac arteries
41
anterior aortic branches
superior to inferior: Celiac trunk Superior mesentaric artery Inferior mesentaric artery
42
3 primitive gut tube divisions and components
1. foregut- supplied by celiac trunk; abdominal esophagus -> ends inferior to major duodenal papilla 2. midgut- supplied by superior mesenteric artery 3. hindgut- suplied by inferior mesenteric; arterior left colic flexure -> ends midway through anal canal
43
Foregut
supplied by celiac trunk abdominal esophagus -> inferior to major duodenal papilla (includes: esophagus, stomach, duodenum, pancreas, liver, gallbladder, kind of spleen)
44
Midgut
supplied by superior mesenteric artery; begins inferior to major duodenal papilla -> transverse colon (includes: part of duodenum, jejunum, ileum, cecum, appendix, ascending colon, some of transverse colon)
45
Hindgut
suplied by inferior mesenteric; arterior left colic flexure -> ends midway through anal canal (includes: left 1/3 of transverse colon, descending colon, sigmoid colon, rectum, upper anal canal)
46
Anterior aorta
``` Terminal branches (2 common iliac arteries) 3 anterior branches: 1. celiac trunk 2. superior mesenaric artery 3. inderior mesentaric artery ```
47
Celiac trunk
``` arises immediately after aortic hiatus through diaphram anterior to vertebra L1 supplies foregut Immediately divides into 3 branches 1. left gastric 2. splenic 3. common hepatic ```
48
Left gastric artery
smallest branch of celiac trunk - esophageal branches go upwards to abdominal part of esophagus - left gastric artery turns right to and descends along lesser stomach curvature to lesser omentum - > supplies both stomach surfaces and merges with right gastric artery
49
esophageal branches of left gastric artery
come from left gastric artery (which comes from the celiac trunk), go upwards to abdominal esophagus, some continue through esophageal hiatus to connect with esophageal branches of thoracic aorta
50
splenic artery
largest branch of celiac trunk - travels along superior border of pancreas in splenorenal ligament and divides into branches that enter hilum of spleen - also branches into pancreas - short gastric arteries which go to the fundus of the stomach - left gastro-omental artery- runs on greater curvature of stomach and anastomoses with right gastro-omental artery
51
common hepatic artery
``` medium sized branch of celiac trunk divides into 2 terminal branches 1. hepatic artery proper 2. gastroduodenal artery more on pg 174 ```
52
hepatic artery proper
ascends towards liver, to left of bile duct, anterior to portal vein divides into right and left hepatic arteries right hepatic artery gives off cystic artery to gall bladder
53
Superior mesenteric artery
``` 2nd anterior branch of abdominal artery Branches: 1. Inferior pancreaticoduodenal artery 2. jujunal and ileal arteries 3.middle colic artery 4. right colic artery 5. ileocolic artery ```
54
Inferior pancreaticoduodenal artery
1st branch of superior mesenteric artery divides into anterior and posterior branches, which ascend into same sides of pancreas. Network supplies head and uncinate process of panceas of duodenum
55
Jujunal and ileal arteries
large number of them arise off of superior mesenteric artery. pass between 2 layers of mesentary. form arcades to supply the small inestine image pg 176
56
vasa recta
branch from terminal arcade | supply small intestine
57
Middle colic artery
branch of superior mesentaric artery, emerges below pancreas | enters transverse mesocolon-> divides into right and left branches
58
right colic artery
branch of superior mesentaric artery passes into the retroparitineum to supply to ascending colon more on pg 176
59
Ileocolic artery
final branch from right side of the superior mesenteric artery, divides into superior and inferior branches: 1. superior branch- passes along ascending colon, anastomoses with right colic artery 2. Inferior branch- continues toward ileocolic junction, dividing into 4 branches: - colic (supplies ascending colon) - cecal (supply cecum) - appendicular (mesoappendix and appendix) - ileal (supplies ilium)
60
Inferior mesenteric artery
branch of abdominal aorta supplying hindgut smallest branch, branches off aorta at L3 3 main branches 1. left colic artery 2. sigmoid arteries 3. superior rectal arteries more on page 177
61
Venous drainage
all gastrointestinal tract except for rectum is drained via the portal system- that delivers blood to the liver blood travels through hepatic sinusoids -> hepatic vein -> inferior vena cava
62
Portal vein
formed by union of splenic vein and superior mesenteric vein | divides into right and left branches as it approaches the liver
63
Splenic vein
``` forms from small vessels leaving hilum of spleen. joins with superior mesenteric vein to form portal vein. Tributaries: 1. short gastric veins 2. left gastro-omental vein 3. pancreatic veins 4. inferior mesenteric vein ```
64
Superior mesenteric vein
Drains blood from: 1. small intestine 2. cecum 3. cecum 4. ascending colon 5. transverse colon
65
Inferior mesenteric vein
drains blood from rectum, sigmoid colon, descending colon, splenic flexure Begins as superior rectal vein
66
Hepatic cirrhosis
cirrosis is a complex liver disorder cirrosis implies previous or continuing liver cell damage often manifests as jaundice. pg 179
67
Lymphatics
pre-aortic lymph nodes
68
Centents passing through the posterior abdominal region
1. abdominal aorta and associated nerves 2. inferior vena cava 3. symapthetic trunk 4. lymphatics
69
Features of lumbar vertebra
- largest - short pedicles - long transverse processes - large, stubby spinous processes - large articular processes
70
boundries of posterior abdominal wall
formed by - upper margin of sacrum - iliac bones and related muscles - ribs 11 and 12 (rib 11- posterior to superior left kidney, rib 12-posterior to superior part of both kidneys)
71
Joints of sacrum and ilium
sacro-iliac joints
72
Muscles forming boundaries of posterior abdominal wall
medially- psoas major and minor muscles laterally- quadratus lumborum muscle inferiorly- iliacus muscle superiorly- diaphagm
73
Psoas major
Origin: lateral surface of vertebral bodies T12 and L1 to L5, transverse process of lumbar vertebrae, intervertebral disks of T12 to L5 Insertion: lesser trochanter of femur Innervation: anterior rami L1 to L3 Function: flexion of thigh at hip joint
74
Psoas minor
sometimes not present Origin: lateral surface T12 to L1 and disks Insertion: pectoral line of pelvic brim and iliopubic eminence Innervation: anterior rami of L1 Function: weak flexion of lumbar vertebral column
75
Quadratus lumborum
fills space between ribs 12 and iliac crest Origin: transverse process of L5, ilioculumbar ligament and iliac crest Insertion: transverse process of L1 to L4 and inferior border of rib 12 Innervation: anterior rami of T12, L1- L4 Function: rib 12 (depresses and stabilizes), laterally bends trunk
76
Iliacus
fills iliac fossa, and passes into thigh Origin: iliac fossa, sacro-iliac and iliocolumbar ligaments and iliac crest Insertion: Lesser trochanter of femur Innervation: femoral nerver Function: flexation of thigh at hip joint
77
muscles flexing thigh at hip joint
iliopsoas - psoas major and iliacus
78
Diaphragm
musculotendinios sheet, forms superior boundary of posterior abdominal region seperates abdominal and thoracic cavities anchored to vertebra by musclotendinous cruca: 1. right crus (attached to bodies of vertebras L1 to L3 and disks) 2. left crus (attached to vertrebra L1 and 2 and disks)
79
ligament connecting right and left crus
median arcuate ligament, passes over aorta (tendinous arch anterior to aorta)
80
tendinous arch lateral to crura
medial arcuate ligament, 2nd tendinous arch, attached to L1 and L2
81
3rd tendinous arch
lateral arcuate ligament, formed by fascia covering quadratus lumborum, attached to transverse process of L1 and rib 12
82
Structures passing through or around diaphagm
Aorta-aortic hiatus-passes at vertebra T12, posterior to median acuate ligament, left of midline; other things in aortic hiatus: -thoracic duct -azygos vein Esophagus- esophageal hiatus, at T10 other things in esophageal hiatus: -anterior and posterior vegus trunks -lymph vessels -left gastric artery and vein Inferior vena cava- caval opening, at T8 with: -right phrenic nerve Left phrenic nerve, passes on its own in left side of diaphragm cruca- greater and lesser splenctic nerves left crus- hemiazygos vein posterior to medial arcuate ligament- sympathetic trunk of least splanchnic nerves anterior to diaphram- superior epigastric nerves
83
Domes
left and right domes of diaphagm -formed by upward pushing of abdominal contents, and fibrous pericardium Right: formed by liver Left: fundus of stomach
84
Diaphragm and breathing
inspiration- diaphragm contracts, causing inferior drawing of central tendon- flattening diaphragm, increasing thoracic cavity space
85
innervation of diaphragm
phrenic nerves
86
Psoas muscle abcess
since psoas connects to intervertebral disc, disc may become infected and form mass
87
Diaphragm hernias
may be caused by failed fusion of 4 embryological diaphragm parts Common types: 1. Morgagni's hernia- on right, between xiphoid process and costal margins 2. Bochdalek's hernia- on left, where pleuroperitoneal cavity fails to close paericardioperitineal canal 3. may also occur in central tendon or esophageal hiatus 1 and 2 usually appear shortly after birth, and should be surgically closed, b/c otherwise bowels may enter thoracic cavity and interfer with breating
88
Hiatal hernia
when esophogeal hiatus is lax, allowing fundus of stomach to herniate into posterior mediastinum
89
Kidney location
retroparetenial in posterior abdominal region, in extraperitineal connective tissue, extend from T12 to L3. Right kidney is lower than left b/c liver
90
Right Kidney in relation to other structures
be able to draw figure on 190
91
extraperitaneal fat outside of renal capsul
peritaneal fat
92
fascia enclosing the peritaneal fat
renal fascia, fuse with diaphragm fascia and inferiorly- enclose ureters
93
fat that accumulated posteriorly and posterlaterally to each kidney
pararenal fat
94
kidney vascularization
``` renal artery (right and left) renal vein (right and left) ```
95
Lymph drainage of kidney
lumbar nodes
96
Ureters
muscular tubes transporting urine from kidneys to bladder- continuous superiorly w/ renal pelvis
97
Renal pelvis
formed by condensation of major cylices
98
ureteropelvic juntion
at hilum of kidney- where renal pelvis and ureter connect
99
Constrictions of ureters (3)
1- ureteropelvic junction 2- ureters crossing common iliac vessels at pelvic brim 3- ureters enter wall of bladder -where kidney stones lodge
100
Ureteric vasculature
upper end- renal arteries middle- abdominal aorta, common iliac arteries pelvic cavity- internal iliac
101
Lymph drainage of kidneys
Upper- lumbar nodes Middle- lymph nodes of common iliac vessel inferior- nodes of external and internal iliac vessels
102
Uretic innervation
by nerves that follow blood vessels - renal, aortic and superior hypogastric - inferior hypogastric plexuses
103
Urinary tract stones
crystalline agates of calcium, phosphate, urate and other salts form when urine becomes saturated w/ salts and salts precipitate
104
hematuria
blood in urine
105
urinary tract cancer
usually indicators that there is cancer in the kidneys- more on pg 193
106
Kidney transplant
usually put new kidney in iliac fossa
107
Suprarenal glands
``` at superior pole of each kidney Components: 1. outer cortex 2. innermedulla right- shaped like a pyramid left- semilunar shaped, larger surrounded by perinephric fat and enclosed in renal fascia thin septum separates gland from kidney ```
108
Branches of abdominal aorta
1) visceral- supply organs 2) posterior- diaphragm and abdominal wall 3) terminal- at the end
109
Visceral branches of abdominal aorta
``` celiac trunk, superior and inferior mesentaric paired: 1) middle suprarenal arteries 2) renal arteries 3) ovarian or testicular arteries ```
110
Posterior branches of abdominal aorta
supply diaphragm or abdominal wall - inferior phrenic - lumbar - medial sacral arteries
111
Inferior phrenic arteries
imediatly inferior to aortic hiatus | -supply suprarenal gland and inferior surface of diaphragm
112
Lumbar arteries
usually 4 pairs | -supply spinalcord
113
Medial sacral artery
fianl posterior branch
114
Abdominal aortic stent graft
putting some of femoral artery inside the aorta to stop it from rupturing
115
Inferior vena cava
returns blood from all structures below the diaphragm
116
Will it sync
Hopefully