Week 1- Introduction to the abdomen Flashcards
Where does the abdominal cavity go to + from?
Abdominal cavity extends from the diaphragm to the pelvic girdle
What are the four quadrants?
- RUQ
- RLQ
- LUQ
- LLQ
What abdominal organs sit in the RUQ?
- Colon (hepatic flexure, ascending)
- Duodenum (parts 1-3)
- Gallbladder
- Liver
- Biliary tree
- IVC
- Pancreas
- Pylorus
- Right Kidney
- Right ureter
- Right adrenal gland
What abdominal organs sit in the LUQ?
- Colon (splenic flexure, descending)
- Duodenum (4 part)
- L Kidney
- L ureter
- L adrenal gland
- Pancreas (body, tail)
- Spleen
- Stomach
- Jujunum
- Ileum
What abdominal organs sit in the RLQ?
- Colon (caecum, appendix, ascending)
- IVC
- R ductus deferens
- Ovary
- R Uterine tubbe
- R ureter
- Ileum
What abdominal organs sit in the LLQ?
- Colon (descending, sigmoid)
- Left ductus deferens
- Left ovary
- Left uterine tube
- Left ureter
- Jejunum
- Ileum
What are the abdominal planes?
- Transpyloric (L1)
- Subcostal (L3)
- Supracristal (L4)
- Transtubercular (L5)
What are the 9 regions?
Which planes divide these?
- R + L Hypercondrium
- R + L Flank/Lumbar
- R + L Iliac Fossa
- Epigastric
- Umbilical
- Pubic
Above Subcostal is hypercondrium
Below Transtubercular is iliac fossa
What organs are in each of the 9 regions?
R Hypercondrium:
- Liver
- Hepatic flexure of colon
- Diaphragm
- Costodiaphragmatic recess
L Hypercondrium:
- Stomach
- Spleen
- Pancreatic tail
- Splenic flexure of colon
- Diaphragm
- Costodiaphragmatic recess
Epigastric:
- Liver
- Stomach
- Gallbladder
- Transverse colon
- Lesser sac
- Abdominal aorta
- Duodenum
- Pancreas
- Kidneys
- Supradrenal glands
- Origin + plexus of CT and SMA
Right F/L:
- Ascending colon
- Small intestine
Left F/L:
- Descending colon
- Small intestine
Umbilical:
- Small intestine
- Root of mesentery
- Abdominal aorta
- IMA + plexus
R IF:
- Cecum
- Appendix
L IF:
- Sigmoid colon
Pubic:
- Small intestine
- Sigmoid colon
- Upper rectum
- Ovary
- Uterine tube
- Distended bladder
- Enlarged uterus
- Common iliac arteries
Where does foregut, midgut + hindgut pain usually refer to?
Foregut= Epigastric
Midgut= Umbilical
Hindgut= Pubic
What pain may refer to the R Hypercondrium?
- Liver abcess
- Hepatitis
- Gall bladder
- Biliary tree
- Choleocystitis
- Choleolithiasis
What pain may refer to the left hypercondrium?
- Constipation
- Splenic infarct
- Abcess
- Colitis
- Diverticulitis
- Pyelonephritis
What pain may refer to the Epigastrium?
- Foregut pain
- Aortic aneurysm
- Pancreatitis
- Ulcer
- Gastritis
- Reflux
- MI
- Pericarditis
What pain may refer to the Right Flank/Lumbar
- Ascending colitis
- Nephrolithiasis
- Pyelonephritis
What pain may refer to the left flank lumbar?
- Descending colitis
- Nephroliothiasis
- Pyelonephritis
What pain may refer to the umbilical region?
- Midgut pain
- Enteritis
- Intestinal obstruction
- Mesenteric occlusion
What pain may refer to the Right Iliac Fossa?
- Appendicitis
- Gonadal pathology
- Gastroenteritis
- Inguinal hernia
What pain may refer to the left iliac fossa?
- Diverticulitis
- Colitis
- Gonadal pathology
- Inguinal hernia
- Ulcerative colitis
What pain may refer to the pubic region?
- Hindgut pain
- Uterine pathology
- UTI/ UT obstruction
- Endometriosis
- Pelvic Inflammatory disease
Define Hernia
Protrusion of tissue / organ through a retaining tissue
What may predispose a person to hernia?
- Surgery
- Pregnancy
- Congenital defects
- Lifting
- Obesity
- Family history
- Chronic coughing
How do you find the:
a) Transpyloric plane
b) Subcostal plance
c) Supracristal plane
d) Transtubercular?
a) Halfway between jugular notch + pubic symphsis. Passes through tips 9th CC
b) Immediately inferior to 10th CC. At lowest anterior point of costal margin
c) Highest point of Iliac crest
d) Tubrcles of iliac crest. (Palpable 5-7cm posterior to ASIS)
What are the layers from skin to parietal peritoneun?
- Skin
- Superficial fascia (Campers/ Scarpers below umbilicus)
- Rectus Abdominus (if in centre)
- External obliques
- Internal obliques
- Transversus abdominus
- Transversalis fascia
- Parietal peritoneum
What is the
a) loaction + muscle fibre direction
b) function
c) innervation
External obliques?
a) Immediately deep to superficial fascia
Laterally placed muscle
Fibres inferomedial direction
- Origin:* Outter surfaces ribs 5-12
- Insertion:* Lateral lip iliac crest
Large aponeurotic compnent covers anterior abdo wall as aproaches midline formes linea alba
b) Compress abdominal contents
Flex trunk
Each muscle bend trunk to same side turning anterior part of abdomen to opposite side
c) Anterior rami T7-T12
What is the
a) loaction + muscle fibre direction
b) function
c) innervation
* INTERNAL OBLIQUES?*
a) Deep to internal obliques
Superomedial direction
- Origin*: Thoracolumbar fascia, iliac creset between origins of external + transversus. Lateral 2/3 inguinal ligament
- Insertion:* Boarder lower 3/4 ribs (ribs 8-9)
Aponeurosis ending in linea alba anteriorly
Pubic crest + pectineal line
b) Compress abdo contents
Flex trunk
Each muscle bends trunk + turns anterior part of abdomen to same side
c) Anterior rami of T7-L1
What is the
a) loaction + muscle fibre direction
b) function
c) innervation
Transversus abdominus?
a) Deep to internal obliques
Transverse running fibres
Origin: Thorocolumbar fascia
Medial lip iliac crest
Lateral 1/3 inguinal ligament
CC ribs 8-12
Insertion: Aponeurosis ending in linea alba
Pubic crest + Pectineal line
b) Compress abdominal contents
c) Anterior rami T7-L1
What is the
a) loaction + muscle fibre direction
b) function
c) innervation
Rectus Abdominus?
a) Origin = Pubic: crest, tubercle + symphesis
* Insertion:* CC ribs 5-7
Xiphoid process
Extends length anterior abdo wall separated by linea alba @ midline
Intersected by tendinous intersection
b) Compress abdominal contents
Flex vertebral column
Tense abdominal wall
c) Anterior rami T7-T12
What is the rectus sheath?
What happens to the position of rectus abdominis during pregnancy?
What else does it contain?
a) Encloses rectus abdominus
Formed by aponeuroses of flat abdo wall muscles
Above arcuate line (midway between umbilicus + pubis symphysis): sheath completely encloses RA
Anteriorly–> EO apn + 1/2 IO apn
Posteriorly –> 1/2 IOapn + TA apn
Below arcuate line: All aponeuroses move to anterior wall rectus sheath
RA in contact with transversalis fascia posterially
b) Stretches + moves apart from linea alba
c) Inferior epigastric artery + vein
How does the anterior abdominal wall get is NV supply?
What are the dermatomal regions?
Name the 2 important arteries, where they meet + their role
b) Travels around the abdominal wall from the vertebral column toward the anterior midline
* T7- L1 spinal nerves:* supply skin, muscle + parietal peritoneum of anterior abdo wall
Anterior rami pass around body posterior to anterior in an inferomedial direction. Give off lateral cutaneous branches + end as anterior cutaneous branches- which pass through rectus abdominus muscle + anterior wall of rectus sheath to supply the skin
- Intercostal nerves T7-T11:* leave intercostal spaces continue onto anterolateral abdominal wall between internal obliques + transversus abdominus muscle. Enter rectus sheath + pass posterior to lateral aspect of RA muscle
c) T7-T9: Xiphoid process –> just above umbilicus
T10: Umbilicus
T11-L1: Below umbilicus including pubic region
d) Superior + inferior epigastric arteries anastmoses in rectus sheath
Unite subclavian + external iliac artery providing arterial shunt if aorta narrowed
Name + draw location of the 5 incisions.
1) Median/ Midline
2) Paramedian
3) Gridiron (muscle splitting) @ McBurney Point
4) Pfannenstiel (suprapubic)
5) Subcostal (Kocher)
What is the role of the parietal + visceral peritoneum?
Label the diagram
Line future abdominal wall and surround and support the organs
