Abdomen

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scarpa's fascia on scrotum (_______) on deep fascia of thigh (_______)
dartos fascia; fascia lata
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o and i external oblique m
rib 5 to linea alba, form inguinal ligament
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fx external oblique m and internal
flex trunk, same side bend
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O and I internal obliques
9-12 ribs, lateral inguinal ligament
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innervation internal oblique m
intercostal nerves (T7-T11), the subcostal nerve (T12), the iliohypogastric nerve (L1), and the ilioinguinal nerve (L1).
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innervation external oblique m
thoracic spinal nerves (T7-T12) and the iliohypogastric nerve (L1).
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O and I transverse abdominus
lower 6 ribs to inguinal ligament tp linea alba
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fx transverse abdominus
compress abdominal contents
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O and I rectus abdominus
costal cartilage to pubic sympjysis
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fx rectus abdominus
flex vertebral column
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innervation rectus abdominus
anterior rami of the thoracic spinal nerves, specifically T6-T12
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innervation transverse abdominus
intercostal nerves (T7-T11), the iliohypogastric nerve (L1), and the ilioinguinal nerve (L1).
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these muscles all attach to the thick aponeurotc sheet medially forming the rectus sheath
external and internal oblique
transversus abdominus
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star
superficial inguinal ring
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blue dotted line
semilunar line
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PrS
posterior rectus sheath
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ARS
anterior rectus sheath
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a weakened area in the abdominal wall located in the groin, bounded by the rectus abdominis muscle medially, the inguinal ligament inferiorly, and the inferior epigastric vessels laterally; herniation can occur here
hesselbach's triangle
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a triangular depression of the peritoneum on the inner abdominal wall, above the bladder, formed by the peritoneal fold covering the bladder's surface.
supravesical fossa
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this innervates the skin above the pubic bone
iliohypgastric n (L1)
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spermatic to and give cutaneous inn. To anterior scrotum
ilioinguinal n
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the internal thoracic a. branches into ____________ which runs deep to rectus abdominus and meets with ___________ which is from the external iliac a
superior epigastric a; inferior epigastric a
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This vein connects the superficial epigastric v to lateral thoracic v
thoracoepigastric v
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what does the thoracoepigastric v drain into
SVC via axillary v and IVC via femoral v
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pathway of the paraumbilical veins
the superficial epigastric vein, which then flows into the femoral vein and subsequently into the external iliac vein and inferior vena cava
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what drains the superficia abdomen wall (lymph); deep
axillary and superficial inguinal
deep: external iliac or lumbar nodes
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what passes through the inguinal canal
spermatic cord OR round ligament of uterus
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an extension of the fibers of the internal oblique muscle. The fibers of this muscle are innervated by the genital branch of the genitofemoral nerve.
reflex: an involuntary muscle contraction that elevates the testicle on the same side of the body
cremaster
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what is at risk of injury in triangle of pain
genitofemoral, femoral, and lateral femoral cutaneous at risk of injury
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what is at risk of injury in triangle od doom
external iliac vessels
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direct or indirect inhuinal hernia: is covered by parietal peritoneum and transversalis fascia
direct
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drect or indirect inguinal hernia: does not traverse the entire inhuinal canal
direct
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direct/indirect inguinal hernia: is outside of the spermatic cord
direct
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dorect/indrect inguinal hernia: emerges from the seuperficial ring
direct
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direct/indirect inguinal hernia: pass drectly through hesselbach's triangle
dorect
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dorect/indirect inguinal hernia: goes indirectly through the inguinal canal
indirect
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dorect/indirect inguinal hernia: is the most common type
indirect
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dorect/indirect inguinal hernia: leaves the abdominal cavty lateral to the epigastric vessels through a congenitally patent deep ring
indirect
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dorect/indirect inguinal hernia: traverse the entire inguinal cana;
indirect
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dorect/indirect inguinal hernia: has the same coverings of the spermatic cord
indirect
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dorect/indirect inguinal hernia: commonly enters the scrotum
imdirect
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this mesentery/peritoneum holds the liver to the body wall
visceral peritoneum
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suspends most digestive organs (other than liver) to the body wall
dorsal mesentery
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digestive organ term for the digestive organs that have lost their mesentery during developent
retroperitoneal
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The stomach is attached to the dorsal and ventral mesenteries. Rotation of the stomach pulls the dorsal mesentery to the left forming ...
omental bursa
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this is the only entrance to the omental bursa
epiploic foramen of winslow
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this continues to lengthen and then fuses to form the greater omentum
dorsal mesentery
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what is the fx of the greater omentum; what does it extend from
encapsulate organs, encapsulate infection, tumors, etc that enter the cavity;
extends from the greater curvature of the stomach
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this connects the liver to the stomach via the hepatoduodenal and hepatogastrix ligaments
lesser omentum
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what ligaments/folds make up the lesser omentum
hepatogastric and hepatoduodenal
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this connects the greater and lesser sacs and is the only communication point between them
omental foramen=epiploic foramen
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what makes up the portal triad? (x3) where is itcontained?
hepatic artery proper, bile duct, portal vein
lies within the hepatoduodenal ligament
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this ligament of the liver is the former L umbilical v
ligamentum teres
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is the liver peritoneal or retroperitoneal
retroperitoneal
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O and I quadratus lumborum
O: Transverse process L1-L5
I: Iliac Crest
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fx of the quadratus lumborum
stabilize ribs
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what are the visceral branches of the abdominal aorta
-celiac, SMA, IMA
-middle suprarenal
-renal
-testicular/ovarian
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what are the parietal braches of the abdominal aorta
inferior phrenic, lumbar, middle sacral
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what are the terminal branches of the abdominal aorta
common iliac
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what are the tributaries of the IVC
-lumbar
-right testicular/ovarian
-renal
-suprarenal
-inferior phrenic
-hepatic
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what ribs when they fracture can hurt the kidneys
Ribs 11 and 12
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what is used to find the appendix
McBurney point
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what is the liver in contact with
bare area in contact with diaphragm
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what is this?
gallstones
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what does the portal triad include
bild duct, hepatic artery proper, portal vein
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branches of SMA
middle colic a, ileocolic a, right colic a, intestinal a
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iliocolic a
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blood supply to descending colon
left colic a
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blood supply to sigmoid colon
sigmoid a
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branches of IMA
left colic a, sigmoidal a, superior rectal a
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this artery connects IMA to SMA
marginal artery
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what are the IMP porto caval anastomosis points
L gastric to esophageal
superor rectal with middle and inferior rectal
paraumbilical vv with superior epigastric v
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a clinical sign characterized by swollen, snake-like veins radiating from the navel, caused by portal hypertension, a dangerous increase in blood pressure in the portal vein
caput medusae
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a condition where blood is present in the urine
hematuria
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a genetic disorder characterized by the growth of numerous fluid-filled cysts in the kidneys. These cysts gradually enlarge, damaging the kidney tissue and leading to progressive kidney failure.
polycystic kidney disease
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a condition where the kidney drops below its normal position when standing up, often without causing symptoms. However, if it causes issues, symptoms can include abdominal or flank pain relieved by lying down, blood in the urine, and repeated infections.
nephroptosis
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what nerve is responsible for the cremaster reflex?
genital branch of genitofemoral n. and ilioingional n.
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where the superior mesenteric a compresses the left renal artery= causes verocele in testicular v
nutcracker syndrome
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what does this show?
renal stones in the ureters
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what are the most common sites of anatomical constriction in the ureters
1) ureter passes over inferior renal pole
2) ureter crosses over external iliac vessels
3) ureter transverses the bladder wall
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what leaves through the lateral accurate ligament
subcostal n
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what leaves through the medial arcuate ligament
iliolinguinal n
iliohypogastric n
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pulsatile lump in ulbilical region. Imaging shown
abdominal aortic aneurism
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what is the structure of a parasympathetic neuron?
long preganglionic fiber; innervate more than one ganglion cell
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this is the sympathetics to the foregut
celiac
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this is the sympathetics pre aortic ganglia to the midgut
superior mesenteric
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sympathetics pre aorticic ganglia renal
aorticorenal
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sympathetcs pre aortica ganglia hindgut
inferior mesenteric
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what does the greater splantnic n supply
celiac an superior mesenteric
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what does the lesser splantnic n supply
superior mesenteric and aorticorenal
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what does the least splantnic n supply
aorticorenal
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what does the lumbar splantnic supply
inferior mesenteric
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what travels through the hypogastric plexus and nerves
lumbar splanchnics and pelvic splanchnics
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location of preganglionic GVE sympathetic cell bodies abdominal
IML
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where does the sympathetic GVA cell body reside in abdominal autonomics
posterior root ganglion
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where do the abdominal lymphatics drain?
corresponding pattern to cisterna chyli to thoracic duct to left jugular venous plexys
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lymph: what drains the foregut
celiac
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lymphatics: what drains the midgut?
superior mesenteric
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lymphatics: what drains the kidneys and testes
lumbar
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lymphatics: what drains the hindgut and superior rectum
inferior mesenteric
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enlarged lymph node on neck; sign of gastric, hepatic, or pancreatic cancer
virchow's node
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what drains the bare area of the liver
phrenic nodes
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what drains the falciform ligament of liver
parasternal
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what drains the round ligament ofd the liver
periumbilical node
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enlarged nodule of the anterior abdomen; sign of stomach cancer
Sister mary joseph node
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what runs through the deep inguinal ring?
iliohypogastric n
ilioinguinal n
gen branch of genitofemoral n
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what is this? what ligament?
testicular torsion; scrotal ligament twisted cutting off blood supply
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what is this?
hydrocele: no blood; blood accumulates between the two layers of the tunica vaginalis
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what layers are cut in a vasectomy?
skin, dartos fascia, external spermatic fascia, cremasteric m and fascia, internal spermatic fascia, parietal layerof tunica vaginalis
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what is cutemoved in a vasectomy?
vas deferens
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what structure are most at risk of injury in a vasectomt
testicular a most at risk; ilioingional n and genital branch of genitalfemoral also at risk
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What does the cremaster reflex test?
L1-2 spinal cord level
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How is the cremaster reflex elicited?
Stroking the medial aspect of the upper thigh
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What is absent with spinal cord injuries above T5-6?
Abdominal reflex
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What vessel most commonly causes rectus sheath hematoma?
Inferior epigastric artery
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What layer is fat removed from during liposuction?
Subcutaneous tissue (superficial fascia)
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What nerves, arteries, and veins are most at risk in liposuction?
Cutaneous nerves, superficial arteries, superficial veins
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What abdominal incision is at risk of injuring the inferior epigastric vessels?
Transverse incisions
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Which layer must always be sutured during closure of the abdominal wall?
Fascia
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What are the two main types of inguinal hernias?
Direct and indirect inguinal hernias
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Which hernia is medial to the inferior epigastric vessels?
Direct inguinal hernia
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Which hernia traverses the inguinal canal and often enters the scrotum?
Indirect inguinal hernia
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What is Amyand’s hernia?
An inguinal hernia that contains the appendix
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What is the triangle of pain?
A region bound by the inguinal ligament and testicular vessels, containing key nerves
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What is the triangle of doom?
A region bound by the vas deferens and testicular vessels, containing major vessels
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What is an epigastric hernia?
Hernia through the midline between xiphoid and umbilicus
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Where does a femoral hernia protrude?
Through the femoral ring, inferolateral to the pubic tubercle
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What surgery removes part of the ductus deferens?
Vasectomy
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What is at risk of iatrogenic injury in vasectomy?
Genital branch of genitofemoral nerve, testicular artery
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What happens in torsion of the testes?
Rotation and twisting of the spermatic cord, causing vascular compromise
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What is a hydrocele?
Fluid accumulation in the tunica vaginalis of the testes
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What is a hematocele?
Blood collection in the tunica vaginalis of the testes
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Where does the lymph from the testes drain?
Lumbar (para-aortic) lymph nodes
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Where does the lymph from the scrotum drain?
Superficial inguinal lymph nodes
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Name a peritoneal ligament between spleen and kidney.
Splenorenal (lienorenal) ligament
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What is the epiploic foramen of Winslow?
Entry to the lesser sac, bordered by portal triad anteriorly
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What recess accumulates fluid in the supine position?
Morrison’s pouch (hepatorenal recess)
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What is volvulus?
Twisting of an organ with mesentery, leading to obstruction and ischemia
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What is paracentesis?
Removal of ascitic fluid from the peritoneal cavity
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What is the main complication of peritoneal adhesions?
Intestinal obstruction or chronic pain

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