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Abdomen
Abdomen
95
Anatomy
Graduate
09/28/2016

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Term
BOUNDARIES of the Abdominal wall
Superior, Inferior, Lateral
Definition
Superior: Costal margins
Inferior: Line connecting ASIS to pubic symphysis
Lateral: Vertical line through ASIS
Term
What are the two layers of subcutaneous tissue (superficial fascia)?
Definition
Camper fascia (superficial fatty layer)
Scarpa fascia (deep membranous layer)
Term
What coves the external aspects of the three flattened muscle layers?
Definition
Investing fascia (deep fascia; epimysium)
Term
Four planes that divide the abdomen into 9 quadrants
Definition
2 Midclavicular planes- Middle of clavicle to midinguinal point (ASIS & PS)
Subcostal plane (L3)- joins the most inferior parts of costal margins (10th rib)
Transtubercular plane (L5)- Through iliac tubercles
Term
Three planes that divide abdomen into 6 quadrants
Definition
Median plane- Xiphoid process-> pubic symphysis
Transumbilical plane- Umbilicus-> IVD between L3 and L4
Transpyloric plane-
Term
Transpyloric plane (helps divide into 6 regions along with median plane and transumbilical plane (IVD between L3 and L4)
Definition
- Midway between jugular notch and pubic symphysis
- midway between umbilicus and xiphersternal joint
- inferior border of L1
- Passes through anterior parts of 9th costal cartilage, duodenojejunal jxn, neck of pancreas, hila of kidneys, pylorus of stomach, pyloroduodenal jxn
Term
What is scarpa's fascia a continuation of?
Definition
Fascia Lata- AKA deep fascia of thigh
Term
What is the purpose of scarpa's fascia?
Definition
Stops urine from going down below the inguinal ligament
Term
What is colles fascia?
Definition
Superficial fascia of the perineum
Term
Fascia that fuses with deep fascia of abdomen
Definition
Scarpa's fascia
Term
External oblique
Definition
-largest, most superficial
- fibers pass inferomedially and slips with serratus anterior
-Aponeurosis turns into inguinal ligament
-Fibers that cross the inguinal ligament cross linea alba to form RELFEX INGUINAL LIGAMENT
-Fleshy part-> anterolateral portion
-Aponeurotic part-> anterior portion
Term
Inguinal ligament
Definition
Formed by aponeurosis inferiorly
Medial part of inguinal ligament reflect horizontally back to attach to pecten pubis and is called LACUNAR ligament
Term
Internal oblique muscle
Definition
-Fibers run superoanteriorly (right angle to EO)
-Inferior fibers arch over spermatic cord in the inguinal canal
-Inferior aponeurotic fibers join aponeurotic fibers of traverse abdomens to form CONJOINT tendon
Term
What two structures are found between EO and IO?
Definition
Ilioinguinal nerve
Iliohypogastric nerve
Term
LAYERS of the abdominal wall
Definition
1) Skin
2) Camper Fascia
3) Scarpa Fascia
4) Investing deep fascia (Superficial, Intermediate, deep)
5) E.O.
6) I.O.
7) Transverse Abdominis muscle
8) Transversalis fascia
9) Extraperitoneal fat
10) Parietal peritoneum
Term
What forms the posterior part of the rectus sheath?
Definition
Formed by aponeurosis of transverses abdominis muscle and posterior part of internal oblique aponeurosis
Term
6 causes of abdominal protrusion
Definition
Food, fluid, fat, feces, flatus, fetus
Term
What is abnormal accumulation of serous fluid in the peritoneal cavity called?
Definition
Ascites
Term
What forms the conjoint tendon?
Definition
Inferior aponeurotic fibers of IO and aponeurotic fibers of transversus abdominus
Term
What does the arcuate line do?
Definition
demarcates the transition between the posterior rectus sheath covering the superior 3 quarters of the rectus abdominis proximally and the transversals fascia covering the inferior quarter.
Term
What does the transversalis fascia fuse with posteriorly?
Definition
Thoracolumbar fascia
It covers deep surface of transverses abdomens and continues from side to side deep to linea alba
Term
4 extensions of the transversalis fascia
Definition
Diaphragmatic, iliac, psoas, pelvic
Term
Transversalis fascia continues as what with the iliac fascia?
Definition
FEMORAL SHEATH
Term
Transversals fascia continues as what as well?
Definition
Internal spermatic fascia- extension into the inguinal canal as it covers the spermatic cord
Term
Falciform ligament
Definition
Superior half of anterior abdominal wall to liver and diaphragm; contains LIGAMENTUM TERES- remnant of umbilical vein
Term
Lateral umbilical fold
Definition
Covers inf epigastric artery; therefore, if cut, bleeds
Term
Medial umbilical fold
Definition
Cover medial umbilical ligaments-formed by fetal umbilical arteries
Term
Median umbilical fold
Definition
Covers median umbilical ligament which is a remnant of the urachius (fetal bladder to umbilicus)
Term
Inferior epigastric artery
Definition
Branch of EIA, enters rectus sheath at arcuate line
Term
Superior epigastric artery
Definition
Enters rectus sheath just inferior to 7th costal cartilage
Term
Deep circumflex iliac arteries
Definition
Runs deepest of abd wall, parallel to inguinal ligament and along iliac crest between transverses abdominis muscle and internal oblique muscle
Term
What forms the inguinal canal?
Definition
Descent of the testes
Term
Interspermatic fascia
Definition
When the testes encounter the transversals fascia, it carries the layer with it; it's a continuation of the transversals fascia
Term
Inguinal canal (4)
Definition
-4 cm long
-Inferior part of anterior abdominal wall
- Runs inferomedially just superior and parallel to medial half of inguinal ligament
-has 2 walls A& P
- 2 openings
- roof and floor
Term
Anterior wall of inguinal canal (most superficial layer of abdomen?)
Definition
EOM aponeurosis; reinforced laterally by IOM and TABD
Term
Posterior wall of inguinal canal (deepest muscle layer of the abdomen?)
Definition
Transversals fascia, reinforced medially by conjoint tendon
Term
Floor of inguinal canal
Definition
Superior surface of inguinal ligament and lacunar ligament
Term
Roof of inguinal canal
Definition
Formed by arching fibers of the IOM and TABDM
Term
Superficial ring of the inguinal canal MEDIAL SIDE
Definition
Aponeurosis that attaches to pubic bone and crest medial to pubic tubercle
Term
Superficial ring LATERAL side
Definition
Part of EO aponeurosis attached to pubic tubercle via inguinal ligament
Term
What lies lateral to the inferior epigastric artery and SUPERIOR to the midpoint of the inguinal ligament and MEDIAL to the origin of the TABDM ?
Definition
Deep inguinal ring
Term
What continues as the internal spermatic fascia?
Definition
Transversals fascia
Term
What forms the cremaster muscle & fascia?
Definition
IOM and TABDM
Term
What forms the external spermatic fascia?
Definition
EOM aponeurosis
Term
Indirect inguinal hernia 2x more common
Definition
-Lateral to inferior epigastric artery
-Transverses deep inguinal ring, inguinal canal, and superficial inguinal ring
-Covered by all 3 layers of spermatic cord
-Hernial sac is the processus vaginalis
Term
Direct inguinal hernia
Definition
-Protrudes wall of inguinal canal
-Lies MEDIAL to inferior epigastric artery
-Passes through inguinal triangle
Term
Where is a potential site for direct inguinal hernias?
Definition
Inguinal triangle
Term
Describe the inguinal triangle
Definition
-Weak
-Lies posterolateral to superficial inguinal ring
-hernial sac is the peritoneum
-includes posterior wall of inguinal canal lined by TF
Term
Spermatic cord
Definition
Begins at deep inguinal ring, lateral to inferior epigastric artery
-passes inguinal canal, emerges at superficial ing ring, and descends within scrotum
Term
What innervates the cremaster muscle and what is it a continuation of?
Definition
Genital branch of genitofemoral nerve and internal oblique
Term
2 Layers of peritoneum
Definition
Parietal and visceral. Visceral organs attach to peritoneum via mesentery
Term
Greater peritoneal sac
Definition
Enters through incision on anterior abdominal wall
Term
Lesser peritoneal sac
Definition
Lies posterior to stomach, omen, and liver
Term
Are there organs in the peritoneal cavity?
Definition
no
Term
What is contained in the greater sac?
Definition
Supramesocolic compartment consisting of greater omentum, transverse colon, and mesocolon
Term
(supramesocolic compartment) What does the falciform ligament of the liver do? Slide #21
Definition
Divides into right and left subphrenic recesses
Divides into hepatorenal recess- between right lobe of liver and right kidney
Term
(inframesocolic compartment) What does the mesentery of small intestine do? Slide #22 Slide #23
Definition
Divides into right and left inframesolic compartments
Divides into right and left parabolic gutters
Term
What is the falciform ligament?
Definition
AKA ligamentum teres
It's a remnant of umbilical vein
Term
Name 4 peritoneal ligaments
Definition
Falciform ligament
Greater omentum
Lesser omentum
others
Term
What does the lesser omentum do?
Definition
Connects lesser curvature of stomach and proximal duodenum to the liver
Term
What does greater omentum do?
Definition
Connects greater curvature of stomach to diaphragm, spleen, and transverse colon
Term
Name 2 ligaments of the lesser omentum because it covers these tructures: DUODENUM AND LESSER CURVATURE OF STOMACH
Definition
Hepatogastic ligament- stomach to liver
Hepatoduodenal ligament- Portal triad
Term
Where does the lesser momentum lie?
Definition
Lies posterior to the left lobe of the liver and is attached to liver liver in the fissure for the ligamentous venous and to porta hepatic
Term
What are the contents of the hepatoduodenal ligament?
Definition
Portal vein- portal triad
hepatic artery- portal triad
common bile duct- portal triad
nerves
lymphatics
Term
What makes the portal triad?
Definition
Hepatic vein
Portal artery
Common bile duct
Term
What are the four layers of the greater omentum because it covers the COLON, SPLEEN, and DIAPHRAGM
Definition
Gastrocolic ligament- stomach to colon
Gastrosplenic ligament- stomach to spleen
Gastrophrenic ligament- covers colon
Term
What is the fourth peritoneal ligament?
Definition
The falciform ligament AKA ligamentum teres.
The ligamentous venous is aka the round ligament of liver is inferior to the falciform ligament
Term
Intraperitoneal vs. retro peritoneal slide #34
Definition
Intraperioneal- invaginating the peritoneal sac from behindhand being suspended from mesentery
Retroperitoneal- located posterior to the peritoneum
Term
3 characteristics of intraperitoneal organs
Definition
-Have visceral peritoneum,
-Peritoneum lining the body wall is parietal peritoneum
- Suspended by a dual layer of peritoneum called mesentery
Term
Where are retroperitoneal organs located?
Definition
Posterior to the parietal peritoneum and located between it and the posterior abdominal wallHomeMy
-Are only PARTIALLY covered by parietal peritoneum
Term
Name the intraperitoneal organs
Definition
Duodenum first part
liver gall bladder
pancreas, tail
stomach
spleen
jejunum
ileum
cecum
appendix
transverse and sigmoid colon
Term
Name the retroperitoneal organs
Definition
Duodenum except first part
ascending/descending colon
pancreas except the trail
Kidneys and suprarenal glands
Abdominal aorta
Inferior vena cava
Term
In portal hypertension, what 3 portacaval anastomoses may enlarge?
Definition
Lower esophagus- esophageal varices
Anal canal- hemorrhoids
Paraumbilical region- Varicose veins radiating outward from umbilicus (caput medusae)
Term
A parasympathetic neuron has:
Definition
LONG myelinated axon to ganglion to SHORT unmyelinated axon
Term
A sympathetic neuron has:
Definition
SHORT myelinated axon to ganglion to LONG unmyelinated axon
Term
sympathetic nervous innervation (slide #60)
Definition
Preganglionic nerve fibers-> prevertebral ganglia thorugh SPLANCHNIC nevers
Postganglionic nerve fibers from cell bodies of PREVERTEBRAL ganglia -> follow arteries to organs
Term
Splanchnic nerves are thoracic splanchnic nerves
Definition
Greater splanchnic nerve (T5-T9)
Lesser Splanchnic nerve (T10-T11)
Least splanchnic nerve (T12)
Lumbar splanchnic nerves (L1-L2/L3
Term
4 Areas where pre vertebral ganglia are located
Definition
Celiac trunk (celiac ganglia)
Superior mesenteric artery (superior mesenteric ganglion)
Inferior mesenteric artery (Inferior mesenteric ganglion)
Renal arteries (aorticorenal ganglia)
Term
What does the thoracic splanchnic nerves supply? (SYMPAPTHETIC)
Definition
Foregut (celiac trunk) and midgut (superior mesenteric artery)
Term
What does the lumbar splanchnic nerves supply? (SYMPATHIC)
Definition
hind gut(inferior mesenteric artery)
Term
What three things occur during sympathetic autonomic input?
Definition
Vasoconstriction of viscera vessels
Reduced glandular secretion
Reduced peristalsis
Term
Vagus nerves innervates and enters what? (PARASYMPATHETIC)
Definition
Foregut and midgut derivatives
-esophageal hiatus
Term
What does pelvic splanchnic nerves (S2-S4) innervate? (PARASYMPATHETIC)
Definition
Handgun derivatives consisting of descending colon, sigmoid colon, rectum, and upper anal canal
Term
Where do vagus nerves enter the abdomen?
Definition
Through ESOPHAGEAL HIATUS of diaphragm and divide as anterior and posterior vagal trunks supplying parasympathetic input
Term
What does the vagus nerve innervate?
Definition
Foregut and mid gut
Term
What does the pelvic splanchnic nerves S2-S4 innervate?
Definition
Hind gut
Term
What does parasympathetic output do?
Definition
Increased glandular secretion
Increase peristalsis
Term
Why is there referred pain to the ipsilateral shoulder during phrenic nerve damage, cholecystitis, or ruptured spleen?
Definition
Because afferent fibers of phrenic nerve (C3, C4, C5) enter the same spinal cord segments as the supraclavicular nerves C3/C4 which supply cutaneous innervation of the shoulder)
Term
Preganglionic parasympathetic innervation involve what two things?
Definition
-Vagus nerve innervating the foregut and midgut
-Pelvic splanchnic innervating the hindgut
Term
What are the foregut derivatives innervated by the celiac ganglia fibers?
Definition
Stomach, proximal duodenum, liver, gall bladder, pancreas
Term
What are the midgut derivatives?
Definition
Distal duodenum, ascending colon, jejunum, ileum, transverse colon
Term
What are the hindgut derivatives?
Definition
Descending colon, sigmoid colon, upper anal canal, rectum
Term
What forms the hepatic portal vein and what drains into that vein? PAGE 198
Definition
The union of the splenic vein and superior mesenteric vein; the inferior mesenteric vein drains into the splenic vein
Term
What does SALTD SPRSS stand for for intraperitoneal organs?
Definition
Stomach, appendix, Liver+gallbladder, transverse colon, duodenum 1st part, small intestine (jejunum, ileum, cecum), pancreas (tail), rectum, sigmoid colon, spleen
Term
What does SADPUCKER stand for for retroperitoneal organs?
Definition
Suprarenal glands, Aorta+ IVC, Duodenum but 1st part, Pancreas but tail, Ureters+ bladder, colon ascending+ descending, kidneys
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