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