Term
umbilicus located at
indicated level of what dermatome?
location of iliac crest |
|
Definition
|
|
Term
linea alba extends from
made from |
|
Definition
xiphoid to public symphysis
aponeurosis of EP/IO/TA |
|
|
Term
| extension of semilunar lines |
|
Definition
| 9th costal cartilages to pubic tubercles (forward projecting bony nodule of pelvis) |
|
|
Term
left upper quadrant
left lower quadrant
what's in? |
|
Definition
|
|
Term
right upper quadrant
right lower quad
what's in? |
|
Definition
right lobe of liver
appendix, cecum |
|
|
Term
| referred pain of appendix, where? |
|
Definition
| epigastric region (under sternum) |
|
|
Term
caput medusae
what?
cause?
pt usually has what problem? |
|
Definition
protruding veins around umbilicus
obstruction of portal vein
venous anatomoses disrupted, cause portal hypertension causing blood to be shunted to umbilical veins (dilated)
caused by cirrhotic liver (hardened) |
|
|
Term
|
Definition
| umbilical, incisional, inguinal, epigastric, semilunar |
|
|
Term
umbilical hernia, why?
incisional hernia, why
epigastric hernia, why |
|
Definition
UH: babies have underdeveloped ab walls
IH: ab wall made weak by surgery
EH: obesity |
|
|
Term
rectus diastasis
what?
result?
commonly in who? |
|
Definition
separation of the rectus abdominis muscle into right and left halves
bulge will protrude when pt tries to sit up.
newborns, eldery, preggers |
|
|
Term
|
Definition
| top layer, fatty filled with blood vessels |
|
|
Term
scarpa's fascia
characteristics in relation to campers?
continuous with? |
|
Definition
membraneous layer underneath camper's.
denser/tougher. * surgeons will use as suture material
continuous with penile fascia, scrotal fascia (dartos) |
|
|
Term
| if urethra ruptured, would urine go to abdominal cavity? leg? why/why not? |
|
Definition
No, leg. scarpa's fuses with fascia lata lining of thigh creating a barrier.
Yes, abdomen. |
|
|
Term
| largest muscle in abdominal cavity |
|
Definition
|
|
Term
|
Definition
O:Outer surface of Ribs 5 – 12
I: Aponeurosis at linea alba, illiac crest
n: ventral rami of lower 6 thoracic nerrves
function: flex, rotate trunk, compress, assist movt/posture |
|
|
Term
| direction of EO muscle fibers? |
|
Definition
| DOWN towards pubis (infromedially) |
|
|
Term
|
Definition
crescent shaped line at which anterior and posterior rectus sheaths merge and run superficially to RA.
So, inferior to this line RA is NOT covered posteriorly,
below umbilicus |
|
|
Term
inguinal ligament
composed of?
location?
function? |
|
Definition
folded lower border of EO aponeurosis
superior iliac spine to pubic tubercle
floor of inguinal canal; reinforcement of abdominal wall |
|
|
Term
Internal Oblique
o/i
inn
function |
|
Definition
O:thoracolombar fascia in back
I:ribs 10-12, LA, xiphoid, iliac crest
n:ventral rami of lower 6 thoracic nerves and L1 (note, L1 not in EO)
functions: flex, compress, rotate (same as EO) |
|
|
Term
|
Definition
| UPWARD, towards xiphoid. (superomedially) |
|
|
Term
conjoint tendon (inguinalis falx)
made by what?
location? |
|
Definition
formed by aponeurosis of internal oblique/transversus
extends from posterior border of rectus sheath to pectin pubis, contributes some to posterior border of inguinal canal
strengthens posterior wall of medial half of inguinal canal |
|
|
Term
| pecten pubis or pectineal line |
|
Definition
|
|
Term
Result of damage to L1
potential problem? |
|
Definition
weakenss in IO/TA
increased likelihood of hernias under conjoint tendon |
|
|
Term
transversus abdominis
i/o
inn
function |
|
Definition
O: thoracolombar fascia, iliac crest, costal cart 7-12
I: linea alba, pubic crest, pectin pubis
inn: vent. rami of 6 lower thoracic nerves and L1
f: compress, support trunk |
|
|
Term
|
Definition
| formed by fusion of the aponeuroses of EO/IO/TA |
|
|
Term
rectus abdominis
o/i
inn
function |
|
Definition
o:pubic symphysis and crest
i: xiphoid
inn: vent. rami of lower thoracic nerves (lower intercostal nerves)
fun: main flexor of trunk |
|
|
Term
|
Definition
| becomes thicker, stronger, narrower |
|
|
Term
pyramidalis m.
o/i
inn
fun
shape?
location? |
|
Definition
o: pubic symphysis & crest
i:linea alba
subcostal nerve T12
tenses linea alba.
triangular; right behind ant. rectus sheath |
|
|
Term
transversalis fascia
what?
where?
function? |
|
Definition
layer of fascia that lines entire abdominopelvic cavity
between parietal peritoneum and posterior layer of rectus sheath
makes up opening for deep inguinal ring
superior to arcuate line |
|
|
Term
above arcuate line
EO/IO/TA? |
|
Definition
EO anterior
IO ant/post
TA post |
|
|
Term
below arcuate line
EO/IO/TA? |
|
Definition
EO ant
IO ant
TA ant
Nothing post except transversalis fascia |
|
|
Term
| primary blood supply of ab wall |
|
Definition
| superior & inferior epigastric arteries |
|
|
Term
| superior epigastric a/v branches from what? |
|
Definition
|
|
Term
| inferior epigastric a/v branch from what? |
|
Definition
|
|
Term
venous circulation in camper's fascia
- - - - |
|
Definition
superficial epigastric v
superficial external pudendal v
superficial circumflex iliac v
thoracoepigastric v (to axillaryv) |
|
|
Term
| Below umbilicus, lymph drains where? |
|
Definition
| superficial inguinal nodes |
|
|
Term
| above umbilicus, lymph drains where? |
|
Definition
| axillary/parasternal nodes |
|
|
Term
umbilical folds
names?
why there? |
|
Definition
lateral, median, medial
leftovers from fetal times |
|
|
Term
lateral umbilical fold
-contents
-location |
|
Definition
covers inf. epigastric vessels
central, posterior, left side (medial to deep inguinal ring) |
|
|
Term
median umbilical fold
contents
location |
|
Definition
inferior, central.
covers median umbilical ligament, a remnant of the primitive urachusn (canal of urinary bladder) |
|
|
Term
medial umbilical fold
location
contents |
|
Definition
covers medial umbilical ligament, remnant of umbilical arteries.
inferior, central but to left of median fold. |
|
|
Term
layering of abdominal muscles
top to bottom |
|
Definition
|
|
Term
inguinal ring
function (m/f)
composed of
divides what from what |
|
Definition
to transport the spermatic cord (m), the round ligament (f)
composed of aponeurosis of EO
thigh from anterolateral abbdominal wall
canal - 4cm long |
|
|
Term
inguinal ligament
describe |
|
Definition
aponeurosis of EO thins out making a border between the thigh and abdomen. this is the floor of the canal, upon which the spermatic cord lies. it travels down to the superior ramus of the pubis. the fibers that attach to this are called ' lacunar ligament'.
Note: as floor of canal forms a half pipe for cord. |
|
|
Term
deep inguinal ring
composed of?
general location |
|
Definition
transversalis fascia, opening midway along ligament
lateral to infer epigastric artery, right before spermatic cord ducts under TA |
|
|
Term
superficial ring
composed of? |
|
Definition
| an opening formed by the aponeurosis of EO |
|
|
Term
bounderies of canal
ant/post/inf/sup |
|
Definition
ant: apon of EO
post: Transversalis fascia (little contribution from conjoint lig)
inf: ligament
sup: arching fibers of IO/TA |
|
|
Term
| if superficial ring slit open, what see? |
|
Definition
spermatic cord covered in cremastric muscle, a continualtion of IO
ilioinguinal n. on cord |
|
|
Term
|
Definition
that the spermatic cord inserts right below transversus abdominis in transversalis fascia
see cord covered in internal spermatic fascia (no IO) |
|
|
Term
ilioinguinal nerve
which ring goes through?
how sits in relation of spermatic cord? |
|
Definition
ONLY superficial
lateral to cord |
|
|
Term
spermetic cord
contents
coverings |
|
Definition
| testicular veins/artery, cremasteric artery, ductus deferens (van deferens) artery, nerves (genitofemoral), pampiniform plexus, vans deferens lymph vessels |
|
|
Term
pampiniform plexus
what is it?
join to create what |
|
Definition
8-12 veins that act as cooling device similar to radiator, cooling arterial blood to keep testis cool
join to creae LEFT testicular vein which drains into Left RENAL vein |
|
|
Term
coverings of spermatic cord
(3)
each derived from where? |
|
Definition
| cremasteric fascia (IO), internal spermatic fascia (TF), external spermatic fascia (Apon of EO) |
|
|
Term
cremasteric muscle
function?
inneervation? |
|
Definition
elevates testis in response to cremasteric reflex (ilioinguinal sens nerves stimulated. synapse with motor fibers of genital branch of glenofemoral nerve and get cremesteric muscle to elevate
genital branch of glenofemoral n (L1,L2) |
|
|
Term
| 90% of hernias are what kind? |
|
Definition
|
|
Term
inguinal hernia
what happens
two kinds |
|
Definition
above inguinal ligament
intestines/fat get into inguinal canal
direct/indirect |
|
|
Term
Direct hernias
-% common
-located where in relation to inf epigastric a
predominantly in
passes through what rings?
path to outside (2)
how affects spermatic cord |
|
Definition
25%
medial/inferior to infEGa
predominately females
ONLY THROUGH SUPERFICIAL RING
will go through abdominal wall or slip under conjoint tendon
doesnt affect Spermcord, just joins it exiting the superficial ring |
|
|
Term
hesselbach's triangle
borders
importance |
|
Definition
medially: RA
inferiorly: inguinal ligament
superior/laterally: inf. epigastric artery
location of direct hernia protrusion. |
|
|
Term
|
Definition
L1 innervates IO/TA. predisposed to have direct inguinal hernias
this way, hernia has to go through muscle. in indirect hernia, just goes through TFascia |
|
|
Term
Indirect Hernia
-% common
-located where in relation to inf epigastric a
predominantly in
passes through what rings?
path to outside (2)
in or outside of spermatic cord layers?
congenital?
how far does hernia go? |
|
Definition
75%
lateral to inf epigastric artery
predom males
deep and superficial rings
through transversalis fascia
passes inside all layers of spermatic cord (internal spermatic fascia is Tfascia.)
congential with patent processus vaginalis
usually goes to scrotal sac |
|
|
Term
| which type of hernia tends to be caused by obesity and present in babies? |
|
Definition
|
|
Term
|
Definition
for regulating temperature
skin
dartos fascia (continuous with campers) smooth muscle that contracts to wrinke scrot and preserve heat. |
|
|
Term
| scrotal innervations (3) and direction |
|
Definition
ant: ilioinguinal
post: pudendal
inf: post femoral cutaneous |
|
|
Term
testis
function
coverings
where originally housed? |
|
Definition
produces spermatozoa/testosterone
tunica vaginalis, tunica albuginea
originally from abdomen, when descended brought peritoneal lining with it |
|
|
Term
tunica vaginalis
- two layers |
|
Definition
outer covering
parietal layer and visceral layer with space inbetween that has some fluid. |
|
|
Term
| patent processus vaginalis |
|
Definition
embryonic developmental outpouching of peritoneum. it is supposed to close in testis.
becomes tunica vaginalis.
if doesnt close then there is an opening leading straight from abdominal cavity to balls |
|
|
Term
gubernaculum
what is?
function? |
|
Definition
fibrous cord
that aids descent of testes from abdomen to scrotal sac. as descend, cord becomes shorter. |
|
|
Term
undescended testes
potential problems?
when should be descended?
when fix?
% occurence |
|
Definition
infertility (sperm cannot survive)
predosposition to test. cancer
should descend by 3 mo.
fixed by 5 yrs
3% full term
30% preemies |
|
|
Term
|
Definition
testis to
epididymis body
epididymis tail
vas deferens |
|
|
Term
|
Definition
| skin, dartos, external spermatic (EO), cremaster (IO), internal spermatic (TF), Tunica Vag parietal and tunica vag visceral (peritoneum), tunica albunigea |
|
|
Term
variocele
what?
potential problem?
presentation
due to? |
|
Definition
dilation of pampiniform plexus
tortuous mass on scrotal surface
due to malfunction of venous VALVES or renal problems
infertility. dilated veins cannot thermoregulate and sperm get too hot |
|
|
Term
| where do left and right testicular veins drain to? |
|
Definition
Left - left renal vein
right - IFC |
|
|
Term
Hydrocele
what?
due to?
how diagnosed? |
|
Definition
accumulate of serous, clear fluid between parietal and visceral layers of tunica vaginalis
drainage or renal problems
common cause of enlarged testicles
light test, see red. |
|
|
Term
| if no light shines through balls what are possible prognosi (3) |
|
Definition
| testicular mass (cancer), hematoma (blood filled sac, infection |
|
|
Term
Testicular cancer
common between what ages
why not do biopsy?
how fast grows
risk factors? |
|
Definition
males 15-35
slow growing
no biopsy to reduce mets, alot of abdominal lymphatic association. entire testis removed instead
risks: undescended testicles, mumps, hernia, family history
risks: |
|
|
Term
lymphatics of testis
lymphatics of scrotal
extension? |
|
Definition
testes: to lumbar area (quickly mets)
scrotum: say in superficial inguinal nodes |
|
|
Term
| posterior to rectus sheath what are layers? |
|
Definition
| transversalis fascia, extraperitoneal fat, parietal peritoneum |
|
|
Term
peritoneum
what?
layers
peritoneal cavity includes what? |
|
Definition
membraneous lining of peritoneal cavity
parietal/visceral
abdomen and pelvis |
|
|
Term
parietal peritoneum
lines what
shares blood/lymp/n with what
sensitive/insensitive?
describe pain |
|
Definition
lines internal wall of peritoneal cavity
share blood, et al with the abdominopelvic wall it covers
sensitive to pain/press/temp
pain well localized |
|
|
Term
visceral peritoneum
cover what
shares blood with
sen/insenstive?
describe pain |
|
Definition
covers organs of interperitoneal cavity
shares blood/n/lymp with organs it covers
insensitive
pain referred to dermatomes |
|
|
Term
peritoneal cavity
what is it
open/closed in f/m
compartments
what organs? |
|
Definition
fluid filled space between parietal and visceral peritoneal layers
males: closed // females:open
greater sac, lesser sac
NO ORGANS |
|
|
Term
greater sac (of peritoneal cavity)
lesser sac (omental bursa) |
|
Definition
everywhere but posterior stomach/lesser omentum
post to stomach/lesser omentum |
|
|
Term
| omental foramen (epiplotic foramen of Winslow) what does it form? function location |
|
Definition
allows communication between greater and less sacs posterior to the free edge of the lesser omentum forms hepatoduodenal ligament
[image][image] |
|
|
Term
Mesentary
composition
function |
|
Definition
double layer of peritoneum, occurs as a result of organ invaginating into peritoneum, continuity of visceral/parietal pleura
[image]
supports viscera, stores fat, route for lymph/nerves/vessels to go to and from gut |
|
|
Term
greater omentum
also called
location
three parts
function |
|
Definition
policeman of abdomen
extends from greater curvature of stomach inferiorly (as gastrocolic ligament), laterally (as gastrosplenic ligament) and superiorly from fundus (as gastrophrenic ligament)
adheres/separates injured structures from rest of cavity |
|
|
Term
lesser omentum
location
two parts (ligaments)
function* |
|
Definition
extends superiorly from the lesser curvature of stomach to liver
hepatogastric ligament (liver to stomach)
hepatoduodenal ligament (duodenum to liver)
conducts portal triad (portal vein, hepatic artery, bile duct) |
|
|
Term
| Peritoneal recesses, names? locations? |
|
Definition
subphrenic space (sup recess of lesser sac): between diaphragm and liver
hepatorenal recess (inf recess of lesser sac): between liver and right kidney
[image]
|
|
|
Term
Paracolic gutters
4, locations
(medial two actually called paramesenteric gutters) |
|
Definition
right lateral
left lateral
right medial(paramesenteric)
left medial (paramesenteric) |
|
|
Term
Hepatorenal reecess
what's important? |
|
Definition
rich in lymphatics
fluid accumulates here when supine (most posterior recess!)
infections spread easily here with interperitoneal fluid and lymphatics |
|
|
Term
Paracolic gutters
4
location
where does fluid move? |
|
Definition
right lateral/medial
left lateral/medial
located on either side of ascending/descending colon
move fluid superiorly, esp when lying down.
actually* the medial once are called paramesenteric gutters |
|
|
Term
| why is right lateral paracolic recess so importnat |
|
Definition
connects pelvic cavity to hepatorenal recess.
so if appendix ruptures or abcess in pelvis it can spread superiorly easily |
|
|
Term
|
Definition
| esophagus, esophagogastric junction/inferior esophageal sphincter, stomach, pyloric sphincter, duodenum, jejunum, ileum, cecum, ascending colon, right colic flexure, transverse colon, left colic (splenic) flexure, descending colon, sigmoid colon, rectum, anus |
|
|
Term
| Diaphragm structures and nerves |
|
Definition
I 8 10 EGGs AT 12
- at T8 - IVC
- at T10 - EsophaGus, vaGus
- at T12 - Azygous, Thoracic duct |
|
|
Term
| right or left colic flexure. which one higher? |
|
Definition
| left higher, liver sitting on right |
|
|
Term
| what connects liver to anterior abdominal wall? |
|
Definition
falciform ligament
[image] |
|
|
Term
|
Definition
underneath liver
contacts abdominal wall al linea semilunaris |
|
|
Term
|
Definition
| behind stomach, tail ends at spleen |
|
|
Term
spleen
part of what system?
function
location?
where lobulated? |
|
Definition
lymph system!
phagacytes celluar debris, breaks down RBC, recylces iron/heme, immune response to foreign stuff, stores small quantity of RBC
posterior to mix-axillary line, along 10th rib
enlarged anteriorly
lobulated anteriorly and superiorly. (colic and gastric side) |
|
|
Term
|
Definition
cardiac (meets esophagus)
fundus (superior part under diaphragm)
body (major part)
pyloric (funnel shaped) |
|
|
Term
| fundus usually filled with what |
|
Definition
|
|
Term
pyloric region of stomach
- 2 parts, characteristics/funct |
|
Definition
antrum & canal
antrum - where food collects first
(pyloric) canal - contains pyloric sphincter, narrower than antrum |
|
|
Term
rugal folds
what?
function? |
|
Definition
mucousal folds running longitudinally inside EMPTY stomach. diappear when full.
allow expansion, direct liquids towards, run toward pyloric canal |
|
|
Term
Duodenum
some functions?
muscular arrangement? |
|
Definition
BEGINS DIGESTIONS, some absorption. mucus for production, receives and neutralized acidified chyme (releases bicarb)
bile released to breakdown fat
enzymes released
muscles: outer longitudinal, inner circular |
|
|
Term
| sections of duodenum (4) and muscle types |
|
Definition
1st: superior/horizonal cap/bulb - smooth 2nd: descending/vertical - plica circulara 3rd: horizontal - plica circulara 4th: ascending - plicaC +kink
[image] |
|
|
Term
| which duodenal section most prone to ulcerations? |
|
Definition
|
|
Term
| which duodenal region has entrance of pancreatic ducts and bile duct |
|
Definition
|
|
Term
plica circulara
what?
function? |
|
Definition
| circular folds that dont expand |
|
|
Term
| what duodenal region has superior mesenteric vessels that travel anterior to it? |
|
Definition
|
|
Term
|
Definition
| nipple like stucture in 2rd (descening) duodenum from which the common bile duct and pancreatic duct perforate. |
|
|
Term
| suspensory ligament of Treitz |
|
Definition
| connects duodenum to diaphragm. attaches to the duodenal/jejunal junction, causing kink in duodenum in 4th region |
|
|
Term
how long is small intestine
what suspends jejunum and ileum to post wall? |
|
Definition
|
|
Term
| length of jejunum/ileum in comparison to one another |
|
Definition
jejunum 2/5th
ileum 3/5ths |
|
|
Term
| characteristics of jejunum |
|
Definition
larger diameter, thicker (plicaC)
feathery on xray
less encroaching fat
more vascular (pinker)
simpler arterial arcades
long vasa recti |
|
|
Term
|
Definition
smaller, thinnner wall
peyers patches (lymph patches)
snaky sausage on xray
short vasa recti
more encroaching fat
less vascular, less pink
meckel's diverticulum |
|
|
Term
meckel's diverticulum
what is it?
presentation?
(2s) |
|
Definition
remnant of yolk sac
outpouching of ileum
2 inches
2% of pop
2 ft from IC junction
2x in males |
|
|
Term
ileo-cecal junction
what valve is there
what else is here? |
|
Definition
ileocolic valve, through which watery contents empties into cecum
appendix |
|
|
Term
| large intestine, how much watery shit in, how much out |
|
Definition
|
|
Term
| tenia coli what? function? location? |
|
Definition
3 longitudinal bands of SMOOTH muscle that converge at the base of appendix and run length of large instestine. draw intestine into haustra
[image] |
|
|
Term
orientation of appendix.
two kinds, which more common? by how much? |
|
Definition
retrocecal appendix (2/3)
pelvic appendix (1/3) |
|
|
Term
| which two stuctures are completely covered by tenia coli? |
|
Definition
|
|
Term
McBurney's point
what is it? |
|
Definition
approximates location of appendix.
1/3 of way from anterior superior iliac spine (ASIS) to umbilicus.
if appendix inflamed, point of palpation that causes maximum discomfort |
|
|
Term
plica semilunaris
- where
- what |
|
Definition
inside large intensine.
semilunar folds that run transversely |
|
|
Term
|
Definition
| fat hanging off colon, usually between haustra |
|
|
Term
sigmoid colon
- characteristcs |
|
Definition
S shaped
continuous with rectum
fairly mobile, this can be problem though |
|
|
Term
|
Definition
| mesentary that connects sigmoid colon to post wall |
|
|
Term
|
Definition
| bowel obstruction formed when colon twists upon itself (signmoid mesocolon too long!) |
|
|
Term
rectum
also called
characteristics |
|
Definition
'straight gut'
smooth mucousa
3 semicircular rectal folds/valves that help SUPPORT fecal material |
|
|
Term
Ulcer
- what is?
- other related problems |
|
Definition
inflamm. erosion of duodenal wall (usually within 3 cm of pyloric sphincter)
can perforate wall, contents gets into peri cavity causing peritonitis
if liver/gallbladder adhered to wall of ulcer can be ulcerate as well |
|
|
Term
stenosis of pyloric sphincter
-what?
- congenital? |
|
Definition
| can be congen or due to hpertrophy of muscles surrounding opening or scarring |
|
|
Term
|
Definition
caused by bact infection/trauma
inflammed peritoneal layers can adhere /interfere with movt of viscera |
|
|
Term
diverticulitis
what
where
what kind of pain? |
|
Definition
inflamm of diverticulum in sigmoid colon (sig colon is part of LI with smallest diamtere)
produced pain mimiking appendicitis |
|
|
Term
pancreas
-parts
function
location? |
|
Definition
tail, body, neck, head, unicate
secretes bicarb, amylases, lipases, proteases as well as hormones such as insulin/glucagon.
head lies in the C of the duodenum. just posterior to stomach. spleen on left |
|
|
Term
|
Definition
| general cavity of abdomen |
|
|
Term
|
Definition
| cavity formed by greater and lesser omentum |
|
|
Term
| ligaments attached to spleen |
|
Definition
Gastrolieneal ligament
Lienorenal ligament |
|
|
Term
Lienorenal ligament
where?
conducts what? |
|
Definition
where greater sac and lesser sac meet, between spleen and kidney
tail of pancreas, splenic vessels |
|
|
Term
Gastrolieneal ligament
where?
conducts what? |
|
Definition
where greater sac meets lesser sac, between greater curve of stomach and spleen
left epiploic and short gastric |
|
|
Term
greater omentum
extends from what to what? |
|
Definition
| stomach to transverse colon |
|
|
