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abdomen
FORM GRAYS ANATOMY FOR STUDENTS
89
Anatomy
Professional
10/04/2008

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Cards

Term
Describe the parameters of the abdominal cavity?
Definition
The major part of the abdominopelvic cavity
• Located between the diaphragm and the pelvic inlet.
  Separated from (he rhoracic cavity by the thoracic diaphragm
• Continuous inferiorly with the pelvic cavity
• Under cover of the thoracic cage superiorly
• Supported and partially protected inferiorly by the greater
  pelvis
• The space surrounded by the multilayered abdominal
   walls
  The location of most digestive organs, the spleen, kidneys,
  and most of the ureters.
Term
What are the Abdominal Viscrea
Definition
Abdominal viscera include:
  • major elements of the gastrointestinal system-the caudal end of the esophagus, stomach, small and large intestines, liver, pancreas, and gallbladder;
  • the spleen;
  • components of the urinary system-kidneys and ureters;
  • the suprarenal glands;
  • major neurovascular structures.
Term

What  does the Abdomen House?

 

Definition

Houses and protects major Viscera:Much of the liver, gallbladder, stomach, and spleen, and parts of the colon are under the domes of the diaphragm, which project superiorly above the costal margin of the thoracic wall, and as a result these abdominal viscera are protected by the thoracic wall. The superior poles of the kidneys are deep to the lower ribs.Viscera not under the domes of the diaphragm are supported and protected predominantly by the muscular walls of the abdomen.

 

Term
How does the abdominal wall facilitate breathing?
Definition
  • it relaxes during inspiration to accommodate expansion of the thoracic cavity and the inferior displacement of abdominal viscera during contraction of the diaphragm
  • during expiration, it contracts to assist in elevating the domes of the diaphragm thus reducing thoracic volume
  • Contraction of abdominal wall muscles can dramatically increase intra-abdominal pressure when the diaphragm is in a fixed position (Fig. Air is retained in the lungs by closing valves in the larynx of the neck. Increased intra-abdominal pressure assists in voiding the contents of the bladder and rectum and in giving birth
Term
What are the skeletal elements of the abdominal wall?
Definition
  • the five lumbar vertebrae and their intervening intervertebral discs;
  • the superior expanded parts of the pelvic bones;
  • bony components of the inferior thoracic wall including the costal margin, rib XII, the end of rib XI and the xiphoid process
Term
What are the Muscular Parts of thwe Abdominal Wall?
Definition
  • lateral to the vertebral column, the quadratus lumborum, psoas major, and iliacus muscles reinforce the posterior aspect of the wall-the distal ends of the psoas and iliacus muscles pass into the thigh and are major flexors of the hip joint;
  • lateral parts of the abdominal wall are predominantly formed by three layers of muscles, which are similar in orientation to the intercostal muscles of the thorax-transversus abdominis, internal oblique, and external oblique;
  • anteriorly, a segmented muscle (the rectus abdominis) on each side spans the distance between the inferior thoracic wall and the pelvis.
Term
What provides continuation between the posterior, lateral, and anterior parts of the abdominal wall?
Definition
  • thick fascia posteriorly and by flat tendinous sheets (aponeuroses) derived from muscles of the lateral wall
  • A fascial layer of varying thickness separates the abdominal wall from the peritoneum, which lines the abdominal cavity
Term

What holds the gastrointestinal sytem within the abdominal walls?

 What are exceptions to this rule?

Definition

Gastrointestinal system is suspended from the posterior abdominal wall and partly from the anterior abdominal wall by thin sheets of tissue (mesenteries)

  •  a ventral (anterior) mesentery for proximal regions of the gut tube;
  • a dorsal (posterior) mesentery along the entire length of the system
Major viscera, such as the kidneys, that are not suspended in the abdominal cavity by mesenteries are associated with the abdominal wall

 

Term
What is the peritonium?
Definition

Consists of an epithelial-like single layer of cells (the mesothelium) together with a supportive layer of connective tissue.

Peritoneum reflects off the abdominal wall to become a component of the mesenteries that suspend the viscera:

  • parietal peritoneum lines the abdominal wall;
  • visceral peritoneum covers suspended organs
Term
How are abdominal viscera described within the peritonium?
Definition
Abdominal viscera are either intraperitoneal or retroperitoneal:
  • intraperitoneal structures, such as elements of the gastrointestinal system, are suspended from the abdominal wall by mesenteries;
  • structures that are not suspended in the abdominal cavity by a mesentery and that lie between the parietal peritoneum and abdominal wall are retroperitoneal in position.
Retroperitoneal structures include the kidneys and ureters, which develop in the region between the peritoneum and the abdominal wall and remain in this position in the adult
Term

What holds the diaphram to the anterolateral surface of the vertebral column?

What holds the diaphram to the costal margin posteriorly?

 

Definition
A muscular extension (crus) firmly anchors the diaphragm to the anterolateral surface of the vertebral column as far down as vertebra LIII on the right and vertebra LII on the left
Costal margin is not complete posteriorly, the diaphragm is anchored to arch-shaped (arcuate) ligaments, which span the distance between available bony points and the intervening soft tissues:
  • medial and lateral arcuate ligaments cross muscles of the posterior abdominal wall and attach to vertebrae, the transverse processes of vertebra LI and rib XII, respectively;
  • a median arcuate ligament crosses the aorta and is continuous with the crus on each side

The posterior attachment of the diaphragm extends much farther inferiorly than the anterior attachment. Consequently, the diaphragm is an important component of the posterior abdominal wall, to which a number of viscera are related

Term
What constitutes the pelvic inlet?
Definition

The abdominal wall is continuous with the pelvic wall at the pelvic inlet, and the abdominal cavity is continuous with the pelvic cavity

The circular margin of the pelvic inlet is formed entirely by bone:

  • posteriorly by the sacrum;
  • anteriorly by the pubic symphysis;
  • laterally, on each side, by a distinct bony rim on the pelvic bone.
Term

How does the abdomen communicate with the lowe limbs?

What are the structures that are involed in this communication?

Definition
Abdomen communicates directly with the thigh through an aperture formed anteriorly between the inferior margin of the abdominal wall (marked by the inguinal ligament) and the pelvic bone.
 
Structures that pass through this aperture are:
  • the major artery and vein of the lower limb;
  • the femoral nerve, which innervates the quadriceps femoris muscle, which extends the knee;
  • lymphatics;
  • the distal ends of psoas major and iliacus muscles, which flex the thigh at the hip joint.
Term
What does the primitive gut consist of?
Definition
The primitive gut tube consists of the foregut, the midgut, and the hindgut. Massive longitudinal growth of the gut tube, rotation of selected parts of the tube, and secondary fusion of some viscera and their associated mesenteries to the body wall participate in generating the adult arrangement of abdominal organs
Term
What does the foregut give rise to?
Definition
In abdominal regions, the foregut gives rise to the distal end of the esophagus, the stomach, and the proximal part of the duodenum. The foregut is the only part of the gut tube suspended from the wall by both the ventral and dorsal mesenteries
 
Term
What is the embryology of the structures found in the forgut?
Definition

  • A diverticulum from the anterior aspect of the foregut grows into the ventral mesentery, giving rise to the liver and gallbladder, and ultimately, to the ventral part of the pancreas
  • The dorsal part of the pancreas develops from an outgrowth of the foregut into the dorsal mesentery. The spleen develops in the dorsal mesentery in the region between the body wall and presumptive stomach

    In the foregut, the developing stomach rotates clockwise and the associated dorsal mesentery, containing the spleen, moves to the left and greatly expands. During this process, part of the mesentery becomes associated with, and secondarily fuses with, the left side of the body wall

    At the same time, the duodenum, together with its dorsal mesentery and an appreciable part of the pancreas, swings to the right and fuses to the body wall

     

  •  
Term
What bounds the anterolateral abdominal walls
Definition

The anterolateral abdominal walls are bounded by:

  • Superiorly by the cartilage of the 7th through 10th ribs and the Xiphoid process of the sternum (breast bone)
  • Inferiorly by the inguinal ligament and the pelvic bone.
Term
What are the three muscles of the antherolateral wall?
Definition
The the flat muscle of the anterolateral abdominal wall are the:
External oblique, the superficial muscle arising from the iddle and lower ribs by muscular slips that interdigitate ith those of the serratus anterior, a pectoral muscle; the fibers of the external oblique pass inferomedially
Internal oblique, the intermediate muscle whose fibers run horizontally at the level of the anterior superior,iliac spine,the fibers run obliquely upward superior to this level and obliquely downward inferior to it
Transverse abdominal, the innermost muscle whose fibers, except for the most inferior ones, run more or less transversomedially.
Term
What is the Lina alba
Definition
  • Is a tendinous median raphe between the two rectus abdominis muscles, extending from the xiphoid process to the pubic symphysis.
  • Is formed by the fusion of the aponeuroses of the external oblique, internal oblique, and transverse muscles of the abdomen
  • The aponeuroses of these muscles interlace at the linea alba (L. white line) with their fellows of the opposite side to form the tough, aponeurotic, tendinous sheath of the rectus muscle-the rectus sheath
Term
What are the two vertical muscles of the abdominal wall referred to as?
Definition
The two vertical muscles of the anterolateral abdominal wall are within the rectus sheath:
• Rectus abdominis
• Pyramidalis.
Term
Where is the transpyloric planeand what are its features?
Definition
A horizontal plane that transects the body through the lower aspect of vertebra LI. It:
  • is about midway between the jugular notch and the pubic symphysis, and crosses the costal margin on each side at roughly the ninth costal cartilage;
  • crosses through the opening of the stomach into the duodenum (the pyloric orifice), which is just to the right of the body of LI-the duodenum then makes a characteristic C-shaped loop on the posterior abdominal wall and crosses the midline to open into the jejunum just to the left of the body of vertebra LII, while the head of the pancreas is enclosed by the loop of the duodenum, and the body of the pancreas extends across the midline to the left;
  • crosses through the body of the pancreas;
  • approximates the position of the hila of the kidneys, though because the left kidney is slightly higher than the right, the transpyloric plane crosses through the inferior aspect of the left hilum and the superior part of the right hilum
Term
What are the 3 arteries that supply the Gut and where do they arise from?
Definition
  • the celiac artery, which branches from the abdominal aorta at the upper border of vertebra LI and supplies the foregut;
  • the superior mesenteric artery, which arises from the abdominal aorta at the lower border of vertebra LI and supplies the midgut;
  • the inferior mesenteric artery, which branches from the abdominal aorta at approximately vertebral level LIII and supplies the hindgut
Term
What vein drains the abdomen?
Definition
IVC
Vessels that drain into the IVC include:
  • one of the most significant is the left renal vein, which drains the kidney, suprarenal gland, and gonad on the same side;
  • another is the left common iliac vein, which crosses the midline at approximately vertebral level LV to join with its partner on the right to form the inferior vena cava-these veins drain the lower limbs, the pelvis, the perineum, and parts of the abdominal wall.
  • other vessels crossing the midline include the left lumbar veins, which drain the back and posterior abdominal wall on the left side.
Term
What is the path of the IVC
Definition
The inferior vena cava lies to the right of the vertebral column and penetrates the central tendon of the diaphragm at approximately vertebral level TVIII
Term

What are the important points that the portal mand caval system overlap?

What are the other regions where these system interconnect?

Definition
  • around the inferior end of the esophagus;
  • around the inferior part of the rectum

Other regions where portal and caval systems interconnect include:
  • where the liver is in direct contact with the diaphragm (the bare area of the liver);
  • where the wall of the gastrointestinal tract is in direct contact with the posterior abdominal wall (retroperitoneal areas of the large and small intestine);
  • the posterior surface of the pancreas (much of the pancreas is secondarily retroperitoneal).
Term
Describe innervation of the Abdominal Viscera?
Definition
Innervation of the abdominal viscera is derived from a large prevertebral plexus associated mainly with the anterior and lateral surfaces of the aorta. Branches are distributed to target tissues along vessels that originate from the abdominal aorta.
Body_ID: P004101
The prevertebral plexus contains sympathetic, parasympathetic, and visceral sensory components:
  • sympathetic components originate from spinal cord levels T5 to L2;
  • parasympathetic components are from the vagus nerve [X] and spinal cord levels S2 to S4;
  • visceral sensory fibers generally parallel the motor pathways.
Term
Describe the divisions of the Abdomen?
Definition
  • Is divided topographically by two transverse and two longitudinal planes into nine regions: right and left hypochondriac, epigastric, right and left lumbar, umbilical, right and left inguinal (iliac), and hypogastric (pubic).
  • Is also divided by vertical and horizontal planes through the umbilicus into four quadrants: right and left upper quadrants and right and left lower quadrants. The umbilicus lies at the level of the intervertebral disk between the third and fourth lumbar vertebrae. Its region is innervated by the tenth thoracic nerve.
Term
What are the horizontal planes used in dividing the abdomen in the 9  regions?
Definition
  • the superior horizontal plane (the subcostal plane) is immediately inferior to the costal margins, which places it at the lower border of the costal cartilage of rib X and passes posteriorly through the body of vertebra LIII (note, however, that sometimes the transpyloric plane halfway between the jugular notch and the symphysis pubis or halfway between the umbilicus and the inferior end of the body of the sternum, passing posteriorly through the lower border of vertebrae LI and intersecting with the costal margin at the ends of the ninth costal cartilages is used instead);
  • the inferior horizontal plane (the intertubercular plane) connects the tubercles of the iliac crests, which are palpable structures 5 cm posterior to the anterior superior iliac spines, and passes through the upper part of the body of vertebra LV;
Term
Describe the superficial fascia?
Definition

The superficial fascia of the abdominal wall (subcutaneous tissue of abdomen) is a layer of fatty connective tissue. It is usually a single layer similar to, and continuous with, the superficial fascia throughout other regions of the body. However, in the lower region of the anterior part of the abdominal wall, below the umbilicus, it forms two layers:

  • a superficial fatty layer 
  • a deeper membranous layer
Term
Describe the superficial layer of the superficial fascia?
Definition

AKA Camper's Fascia

  • Continues over the inguinal ligament to merge with the superficial fascia of the thigh.
  • Continues over the pubis and perineum as the superficial layer of the superficial perineal fascia.

 

Term
Describe the deep layer of the superficial fascia?
Definition

AKA Scarpa's Fascia

  • Is attached to the fascia lata (deep fascia of the thigh) just below the inguinal ligament.
  • In the midline, it is firmly attached to the linea alba and the symphysis pubis
  • Continues over the pubis and perineum as the membranous layer (Colles' fascia) of the superficial perineal fascia.It is firmly attached to the ischiopubic rami and to the posterior margin of the perineal membrane
  • Continues over the penis as the superficial fascia of the penis and over the scrotum as the tunica dartos, which contains smooth muscle.

 

Term
Lacunar Ligament
Definition
  • Represents the medial triangular expansion of the inguinal ligament to the pectineal line of the superior ramus of the pubic bone .
  • Forms the medial border of the femoral ring and the floor of the inguinal canal
Term
Pectineal (Cooper's) ligament.
Definition
Is a strong fibrous band that extends laterally from the lacunar ligament along the pectineal line of the pubis
Term
Transversalis Fascia
Definition
  • Abdominal Fascia that is layer deep to the transversus abdominis muscle.
  • a continuous layer of fascia that lines the abdominal cavity and continues into the pelvic cavity.
  • crosses the midline anteriorly, associating with the transversalis fascia of the opposite side, and is continuous with the fascia on the inferior surface of the diaphragm.
  •  It is continuous posteriorly with the deep fascia covering the muscles of the posterior abdominal wall and attaches to the thoracolumbar fascia. 
Term
Extraperitoneal fascia
Definition
  • Deep to the transversalis fascia
  • Separates the transversalis fascia from the peritoneum
  • Contains varying amounts of fat, this layer not only lines the abdominal cavity, but is also continuous with a similar layer lining the pelvic cavity.
  • It is abundant on the posterior abdominal wall, especially around the kidneys, continues over organs covered by peritoneal reflections, and, as the vasculature is located in this layer, extends into mesenteries with the blood vessels.
  •  Viscera in the extraperitoneal fascia are referred to as retroperitoneal
Term

Peritoneum

What are its layers, describe them?

Definition
  • Is a serous membrane lined by mesothelial cells.
  • Consists of the parietal peritoneum and the visceral peritoneum
  • Parietal peritonium lines the abdominal and pelvic walls and the inferior surface of the diaphragm and is innervated by the somatic nerves such as the phrenic, lower intercostal, subcostal, iliohypogastric, and ilioinguinal nerves.
  • Visceral peritonium covers the viscera, is innervated by visceral nerves, and is insensitive to pain.
Term
What nerves supply the adbominal wall?
Definition
  • skin and muscles of the anterolateral abdominal wall are supplied by T7 to T12 and L1 spinal nerves.
  • The anterior rami of these spinal nerves pass around the body, from posterior to anterior, in an inferomedial direction
  • As they proceed, they give off a lateral cutaneous branch and end as an anterior cutaneous branch
Term
Describe the path of the Intercostal nerves that innervate the Abdomen
Definition
  • T7 to T11 leave their intercostal spaces, passing deep to the costal cartilages, and continue onto the anterolateral abdominal wall between the internal oblique and transversus abdominis muscles 
  • Reaching the lateral edge of the rectus sheath, they enter the rectus sheath and pass posterior to the lateral aspect of the rectus abdominis muscle.
  • Approaching the midline, an anterior cutaneous branch passes through the rectus abdominis muscle and the anterior wall of the rectus sheath to supply the skin
  • Spinal nerve T12 (the subcostal nerve) follows a similar course as the intercostals
Term
What do the brances of nerves T7 to T12 and L1 supply?
Definition
  • nerves T7 to T9 supply the skin from the xiphoid process to just above the umbilicus;
  • T10 supplies the skin around the umbilicus;
  • T11, T12, and L1 supply the skin from just below the umbilicus to, and including, the pubic region,
  • additionally, the ilio-inguinal nerve (a branch of L1) supplies the anterior surface of the scrotum or labia majora, and sends a small cutaneous branch to the thigh
Term
What arteries supply the Superficial Abdominal walls?
Definition
  • the superior part of the wall is supplied by branches from the musculophrenic artery, a terminal branch of the internal thoracic artery;
  • the inferior part of the wall is supplied by the medially placed superficial epigastric artery and the laterally placed superficial circumflex iliac artery, both branches of the femoral artery
Term
What arteries supply the anterolateral Abdominal wall  deeply?
Definition
  • the superior part of the wall is supplied by the superior epigastric artery, a terminal branch of the internal thoracic artery;
  • the lateral part of the wall is supplied by branches of the tenth and eleventh intercostal arteries and the subcostal artery;
  • the inferior part of the wall is supplied by the medially placed inferior epigastric artery and the laterally placed deep circumflex iliac artery, both branches of the external iliac artery
Term
Describe
Lymphatic drainage of the anterolateral abdominal wall?
Definition
  • superficial lymphatics above the umbilicus pass in a superior direction to the axillary nodes, while drainage below the umbilicus passes in an inferior direction to the superficial inguinal nodes;
  • deep lymphatic drainage follows the deep arteries back to parasternal nodes along the internal thoracic artery, lumbar nodes along the abdominal aorta, and external iliac nodes along the external iliac artery
Term
Superior epigastric artery
Definition
  • Arises from the internal thoracic artery, enters the rectus sheath, and descends on the posterior surface of the rectus abdominis.
  • Anastomoses with the inferior epigastric artery within the rectus abdominis
Term
Inferior epigastric artery
Definition
  • Arises from the external iliac artery above the inguinal ligament, enters the rectus sheath, and ascends between the rectus abdominis and the posterior layer of the rectus sheath.
  • Anastomoses with the superior epigastric artery, providing collateral circulation between the subclavian and external iliac arteries.
  • Gives rise to the cremasteric artery, which accompanies the spermatic cord
Term
Deep circumflex iliac artery
Definition
  • Arises from the external iliac artery and runs laterally along the inguinal ligament and the iliac crest between the transverse and internal oblique muscles.
  • Forms an ascending branch that anastomoses with the musculophrenic artery
Term
Superficial epigastric arteries
Definition
  • Arise from the femoral artery and run superiorly toward the umbilicus over the inguinal ligament.
  • Anastomose with branches of the inferior epigastric artery
Term
uperficial circumflex iliac artery
Definition
  • Arises from the femoral artery and runs laterally upward, parallel to the inguinal ligament.
  • Anastomoses with the deep circumflex iliac and lateral femoral circumflex arteries
Term
Superficial (external) pudendal arteries
Definition
Arise from the femoral artery, pierce the cribriform fascia, and run medially to supply the skin above the pubis
Term
Thoracoepigastric veins
Definition
  • Are longitudinal venous connections between the lateral thoracic vein and the superficial epigastric vein.
  • Provide a collateral route for venous return if a caval or portal obstruction occurs
Term
Inguinal canal
Definition
  • slit-like passage that extends in a downward and medial direction, just above and parallel to the lower half of the inguinal ligament
  • Begins at the deep inguinal ring and terminates at the superficial ring
  • Transmits the spermatic cord or the round ligament of the uterus and the genital branch of the genitofemoral nerve, both of which also run through the deep inguinal ring and the inguinal canal. An indirect inguinal hernia (if present) also passes through this canal. Although the ilioinguinal nerve runs through part of the inguinal canal and the superficial inguinal ring, it does not pass through the deep inguinal ring.
  1. Anterior wall: aponeuroses of the external oblique and internal oblique muscles. 
  2. Posterior wall: aponeurosis of the transverse abdominal muscle and transversalis fascia.
  3. Superior wall (roof): arching fibers of the internal oblique and transverse muscles.
  4. Inferior wall (floor): inguinal and lacunar ligament
Term
Deep inguinal ring
Definition
  • is the beginning of the inguinal canal and is at a point midway between the anterior superior iliac spine and the pubic symphysis.
  • It is just above the inguinal ligament and immediately lateral to the inferior epigastric vessels. It is the beginning of the tubular evagination of transversalis fascia that forms one of the coverings (the internal spermatic fascia) of the spermatic cord in men or the round ligament of the uterus in women.
Term
Superficial inguinal ring
Definition
  • It is the end of the inguinal canal and is superior to the pubic tubercle.
  • It is a triangle-shaped opening in the aponeurosis of the external oblique, with its apex pointing superolaterally and its base formed by the pubic crest. The two remaining sides of the triangle (the medial crus and the lateral crus) are attached to the pubic symphysis and the pubic tubercle, respectively. At the apex of the triangle the two crura are held together by crossing (intercrural) fibers, which prevent further widening of the superficial ring
  • It is actually the beginning of the tubular evagination of the aponeurosis of the external oblique onto the structures traversing the inguinal canal and emerging from the superficial inguinal ring. This continuation of tissue over the spermatic cord is the external spermatic fascia
Term
What are the structures of the Spermatic cord?
Definition
  • the ductus deferens;
  • the artery to ductus deferens (from the inferior vesical artery);
  • the testicular artery (from the abdominal aorta);
  • the pampiniform plexus of veins (testicular veins);
  • the cremasteric artery and vein (small vessels associated with the cremasteric fascia);
  • the genital branch of the genitofemoral nerve (innervation to the cremasteric muscle);
  • sympathetic and visceral afferent nerve fibers;
  • lymphatics;
  • remnants of the processus vaginalis
Term
What fascias enclose the contents of the spermatic cord?
Definition
  • the internal spermatic fascia, which is the deepest layer, arises from the transversalis fascia, and is attached to the margins of the deep inguinal ring.
  • the cremasteric fascia with the associated cremasteric muscle, which is the middle fascial layer and arises from the internal oblique muscle;
  • the external spermatic fascia, which is the most superficial covering of the spermatic cord, arises from the aponeurosis of the external oblique muscle, and is attached to the margins of the superficial inguinal ring
Term

What is an inguinal hernia?

How many types  are there?

Definition
Inguinal hernia is the protrusion or passage of a peritoneal sac, with or without abdominal contents, through a weakened part of the abdominal wall in the groin. It occurs because the peritoneal sac enters the inguinal canal either:
  • indirectly, through the deep inguinal ring;
  • directly, through the posterior wall of the inguinal canal
Term
Describe the Indirect inguinal hernias
Definition
  • passes through the deep inguinal ring, inguinal canal, and superficial inguinal ring and descends into the scrotum.
  • lies lateral to the inferior epigastric vessels. 
  • is found more commonly on the right side in men and is more common than direct inguinal hernia.
  • It is congenital (present at birth), associated with the persistence of the processus vaginalis,
  • is covered by the peritoneum and the coverings of the spermatic cor
Term
Direcct Inguinal Hernia
Definition
  • occurs directly through a weakened area of the abdominal wall muscles (posterior wall of the inguinal canal), lateral to the edge of the conjoint tendon, in the inguinal triangle but does not descend into the scrotum.
  • The hernia lies medial to the inferior epigastric vessels and protrudes forward to (rarely through) the superficial inguinal ring.
  • It is acquired (develops after birth), associated with weakness in the posterior wall of the inguinal canal lateral to the falx inguinalis
  • it has a sac that is formed by the peritoneum and occasionally the transversalis fascia
  • The bulging occurs medial to the inferior epigastric vessels in the inguinal triangle(Hesselbach's triangle
Term
What are the boarders of the inguinal triangle (Hesselbach's triangle)
Definition
  • laterally by the inferior epigastric artery;
  • medially by the rectus abdominis muscle;
  • inferiorly by the inguinal ligament
Term

What is the peritoneal cavity and is it closed or open in males and females?

What are its divisions?

Definition
  • Is a potential space between the parietal and visceral peritoneum.
  • Contains a film of fluid that lubricates the surface of the peritoneum and facilitates free movements of the viscera.
  • Is a completely closed sac in the male but is open in the female through the uterine tubes, uterus, and vagina.
  • Is divided into the lesser and greater sacs
Term
Describe the lesser sac of the peritoneal cavity?
Definition
  • Is an irregular space that lies behind the liver, lesser omentum, stomach, and upper anterior part of the greater omentum.
  • Is a closed sac, except for its communication with the greater sac through the epiploic (omental) foramen.
  • Presents three recesses: (a) superior recess, which lies behind the stomach, lesser omentum, and left lobe of the liver; (b) inferior recess, which lies behind the stomach, extending into the layers of the greater omentum; and (c) splenic recess, which extends to the left at the hilus of the spleen
Term
Describe the greater sac of the Peritoneal cavity?
Definition
  • Extends across the entire breadth of the abdomen and from the diaphragm to the pelvic floor.
  • Presents numerous recesses into which pus from an abscess may be drained
Term

Omenta

Describe?

How many are there?

Definition
The omenta consist of two layers of peritoneum, which pass from the stomach and the first part of the duodenum to other viscera. There are two:
  • the greater omentum derived from the dorsal mesentery;
  • the lesser omentum derived from the ventral mesentery
Term
Describe the greater omentum
Definition
  • Is derived from the embryonic dorsal mesentery.
  • Two layered
  • Hangs down like an apron from the greater curvature of the stomach, covering the transverse colon and other abdominal viscera.
  • Transmits the right and left gastroepiploic vessels along the greater curvature.
  • There are two arteries and accompanying veins, the right and left gastro-omental vessels, between this double-layered peritoneal apron just inferior to the greater curvature of the stomach
Term
Describe the Lesser Omentum?
Definition
  • Is a double layer of peritoneum extending from the porta hepatis of the liver to the lesser curvature of the stomach and the beginning of the duodenum.
  • Consists of the hepatogastric (which passes between the stomach and liver) and hepatoduodenal ligaments (which passes between the duodenum and liver) and forms the anterior wall of the lesser sac of the peritoneal cavity.
  • Acts as a route for the left and right gastric vessels, which run between its two layers along the lesser curvature.
  • Has a right free margin that contains the proper hepatic artery, bile duct, and portal vein.
Term

Mesenteries

Types?

What do they do?

Definition
Mesenteries are peritoneal folds that attach viscera to the posterior abdominal wall. They allow some movement and provide a conduit for vessels, nerves, and lymphatics to reach the viscera and include:
  • the mesentery-associated with parts of the small intestine;
  • the transverse mesocolon-associated with the transverse colon;
  • the sigmoid mesocolon-associated with the sigmoid colon.
Term
Mesentery of the small intestine?
Definition
  • Is a fan-shaped double fold of peritoneum that suspends the jejunum and ileum from the posterior abdominal wall and transmits nerves and blood vessels to and from the small intestine.
  • Forms a root that extends from the duodenojejunal flexure to the right iliac fossa and is about 15 cm (6 inches) long.
  • Has a free border that encloses the small intestine, which is about 6 m (20 feet) long.
  • Contains the superior mesenteric and intestinal (jejunal and ileal) vessels, nerves, and lymphatics
Term
Transverse Mesocolon
Definition
  • Connects the posterior surface of the transverse colon to the posterior abdominal wall.
  • Its two layers of peritoneum leave the posterior abdominal wall across the anterior surface of the head and body of the pancreas and pass outward to surround the transverse colon
  • Fuses with the greater omentum to form the gastrocolic ligament.
  • Contains the middle colic vessels, nerves, and lymphatics between its layers
Term
Sigmoid mesocolon
Definition
  • is an inverted, V-shaped peritoneal fold that attaches the sigmoid colon to the abdominal wall.
  • The apex of the 'V' is near the division of the left common iliac artery into its internal and external branches, with the left limb of the descending 'V' along the medial border of the left psoas major muscle and the right limb descending into the pelvis to end at the level of vertebra SIII.
  • The sigmoid and superior rectal vessels, along with the nerves and lymphatics associated with the sigmoid colon, pass through this peritoneal fold.
Term
Peritoneal ligaments
Definition
consist of two layers of peritoneum that connect two organs to each other or attach an organ to the body wall, and may form part of an omentum
Term

Abdominal esophagus

Where ddoes it pierce the diaphram?

Definition
  • represents the short distal part of the esophagus located in the abdominal cavity.
  • Emerging through the right crus of the diaphragm, usually at the level of vertebra TX, it passes from the esophageal hiatus to the cardial orifice of the stomach just left of the midline
Term
What is associated with the abdominal oesophaus
Definition
The anterior and posterior vagal trunks:
  • the anterior vagal trunk consists of several smaller trunks whose fibers mostly come from the left vagus nerve-rotation of the gut during development moves these trunks to the anterior surface of the esophagus;
  • similarly, the posterior vagal trunk consists of a single trunk whose fibers mostly come from the right vagus nerve and rotational changes during development move this trunk to the posterior surface of the esophagus.
Term

Stomach

Resting Position?

Blood supply?

Characteristic feature when contracted?

What it produces?

Definition
  • Rests, in the supine position, on the stomach bed, which is formed by the pancreas, spleen, left kidney, left suprarenal gland, transverse colon and its mesocolon, and diaphragm
  • Is covered entirely by peritoneum and is located in the left hypochondriac and epigastric regions of the abdomen
  • Receives blood from the right and left gastric, right and left gastroepiploic, and short gastric arteries.
  • Undergoes contraction, which is characterized by the appearance of longitudinal folds of mucous membrane, the rugae. The gastric canal, a grooved channel along the lesser curvature formed by the rugae, directs fluids toward the pylorus.
  • Produces hydrochloric acid (which destroys many bacteria in food and drink) and a protein-digesting enzyme, pepsin (which converts proteins to polypeptides), in its fundus and body.
  • Produces the hormone gastrin (which stimulates gastric acid secretion) in its pyloric antrum. Parasympathetic fibers in the vagus nerve stimulate gastric secretion.
Term
What are the 4 regions of the stomach?
Definition
  1. cardia, which surrounds the opening of the esophagus into the stomach;
  2. fundus of stomach, which is the area above the level of the cardial orifice;
  3. body of stomach, which is the largest region of the stomach;
  4. pyloric part, which is divided into the pyloric antrumpyloric canal and is the distal end of the stomach
and
Term
What surrounds the pyloric orifice?
Definition
The pyloric orifice is surrounded by the pyloric sphincter, which is a group of thickened circular smooth muscles and controls the rate of discharge of stomach contents into the duodenum. The sphincter is constricted by sympathetic stimulation and relaxed by parasympathetic action
Term
External features of the stomach?
Definition
  1. greater curvature, which is a point of attachment for the gastrosplenic ligament and the greater omentum;
  2. lesser curvature, which is a point of attachment for the lesser omentum;
  3. cardial notch, which is the superior angle created when the esophagus enters the stomach;
  4. angular incisure, which is a bend on the lesser curvature.
Term
small Intestines?
Definition
  • Extends from the pyloric opening to the ileocecal junction.
  • Is the location of complete digestion and absorption of most of the products of digestion and water, electrolytes, and minerals such as calcium and iron.
  • Consists of the duodenum, jejunum, and ileum
Term

Duodenum

Description?

Location?

Blood supply?

Divisions?

Definition
  • Is a C-shaped tube surrounding the head of the pancreas and is the shortest (25 cm [10 inches] long or 12 fingerbreadths in length) but widest part of the small intestine.
  • Is retroperitoneal except for the beginning of the first part, which is connected to the liver by the hepatoduodenal ligament of the lesser omentum.
  • Receives blood from the celiac (foregut) and superior mesenteric (midgut) artery.
  • Is divided into four parts:
1.Superior (first) duodenum
2.Descending (Second) duodenum
3.Transverse (3rd) duodenum
4.Ascending (4th) duodenum
Term

Describe the sections of the duodenum

1st

Definition
  • Superior part (first part) extends from the pyloric orifice of the stomach to the neck of the gallbladder, is just to the right of the body of vertebra LI, and passes anteriorly to the bile duct, gastroduodenal artery, portal vein, and inferior vena cava.Has a mobile or free section, termed the duodenal cap (because of its appearance on radiographs), into which the pylorus invaginates
Term

Describe the parts of the duodenum?

2nd

Definition
  • Right of midline and extends from the neck of the gallbladder to the lower border of vertebra LIII-its anterior surface is crossed by the transverse colon, posterior to it is the right kidney, and medial to it is the head of the pancreas
  • Contains the major duodenal papilla, which is the common entrance for the bile and pancreatic ducts, and the minor duodenal papilla, which is the entrance for the accessory pancreatic duct, and the junction of the foregut and the midgut just below the major duodenal papilla
  • Contains the junction of the foregut and midgut, where the common bile and main pancreatic ducts open
Term
Describe the 3rd part of the duodenum
Definition
  • Is the longest part and crosses the IVC, aorta, and vertebral column to the left.
  • Is crossed anteriorly by the superior mesenteric vessels
Term
Describe the 4th part of the duodenum?
Definition
Ascends to the left of the aorta to the level of the second lumbar vertebra and terminates at the duodenojejunal flexure, which is surrounded by a fold of peritoneum containing muscle fibers called the suspensory muscle (ligament) of duodenum (ligament of Treitz).This fibromuscular band is attached to the right crus of the diaphragm.
Term
Jejunum
Definition
  • Makes up the proximal two fifths of the small intestine (the ileum makes up the distal three fifths).
  • Is emptier, larger in diameter, and thicker walled than the ileum.
  • Has the plicae circulares (circular folds), which are tall and closely packed
  • Contains no Peyer's patches (aggregations of lymphoid tissue).
  • Has translucent areas called windows between the blood vessels of its mesentery.
  • Has less prominent arterial arcades (anastomotic loops) in its mesentery compared with the ileum.
  • Has longer vasa recta (straight arteries, or arteriae rectae) compared with the ileum
Term
Ileum
Definition
  • Makes up the distal three-fifths of the small intestine
  • Is longer than the jejunum and occupies the false pelvis in the right lower quadrant of the abdomen.
  • Is characterized by the presence of Peyer's patches (lower portion), shorter plicae circulares and vasa recta, and more mesenteric fat and arterial arcades when compared with the jejunum.
  • The ileocecal fold:flaps of the ileocecal fold come together at their end forming ridges. Musculature from the ileum continues into each flap, forming a sphincter
Term
Large Intestines
Definition
  • Extends from the ileocecal junction to the anus and is approximately 1.5 m (5 feet) long.
  • Consists of the cecum, appendix, colon, rectum, and anal canal.
  • Functions to convert the liquid contents of the ileum into semisolid feces by absorbing water, salts, and electrolytes. It also stores and lubricates feces with mucus.
Term

Colon

Path?

Blood and Nerve supply?

Location

Definition
  • Has ascending and descending colons that are retroperitoneal and transverse and sigmoid that are surrounded by peritoneum (they have their own mesenteries, the transverse and sigmoid mesocolon respectively)
  • ascending colon -->into the right hypochondrium---> bends to the left, forming the right colic flexure (hepatic flexure) {just below the liver}----> crosses the abdomen as the transverse colon to the left hypochondrium--->the large intestine bends downward {just below the spleen forming the left colic flexure (splenic flexure)-->the descending colon through the left flank and into the left groin.
  • The ascending and transverse colons are supplied by the superior mesenteric artery and the vagus nerve; the descending and sigmoid colons are supplied by the inferior mesenteric artery and the pelvic splanchnic nerves.
Term
What are the characteristics of the Colon?
Definition
  1. Teniae coli: three narrow bands of the outer longitudinal muscular coat.
  2. Sacculations or haustra: produced by the teniae, which are slightly shorter than the gut.
  3. Epiploic appendages: peritoneum-covered sacs of fat, attached in rows along the teniae.
Term
Cecum
Definition
  • first part of the large intestine
  • It is inferior to the ileocecal opening and in the right iliac fossa.
  • It is an intraperitoneal structure because of its mobility not because of its suspension by a mesentery
  • continuous with the ascending colon at the entrance of the ileum and is usually in contact with the anterior abdominal wall.
  • It may cross the pelvic brim to lie in the true pelvis
Term
Appendix
Definition
  • Is a narrow, hollow, muscular tube with large aggregations of lymphoid tissue in its wall.
  • Is suspended from the terminal ileum by a small mesentery, the mesoappendix, which contains the appendicular vessels.
  • point of attachment to the cecum is consistent with the highly visible free taenia leading directly to the base of the appendix
Term
Rectum and anal canal
Definition
Extend from the sigmoid colon to the anus
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