Fiber direction of muscles of thoracic and abdominal walls
m. in thorax comparable to rectus abdominis
-extends anteriorly to linea alba, external surface of ribs 5-12, linea alba, pubic tubercle, iliac crest -Intercostoabdominal nerves and subcostal nerve
Inguinal ligament (Poupart's ligament)
Inferior edge of aponeurosis of the external oblique. From Anterior superior iliac spine to pubic tubercle.
1/3 upper fibers as that of internal intercostal, 2/3 lower opposite direction. Attaches to thoracolumbar fascia, anterior 2/3 iliac crest, lateral 1/2 of inguinal ligament, inferior borders of ribs 10-12, linea alba, pecten pubis Intercostoabdominal, subcostal, lumbar nerves
Horizontal fibers. Attaches to internal surfaces of costal cartilages 7-12, thoracolumbar fascia, iliac crest, lateral 1/3 of inguinal ligament, linea alba, pubic crest, pecten pubis Intercostoabdominal, subcostal, lumbar nerves
Pubic symphysis, pubic crest, costal cartilages 5-7, xiphoid process Intercostoabdominal nerves and subcostal nerve
Fibrous sheath of rectus abdominis
Aponeurosis of external, internal oblique & transversalis abdominis. It encloses rectus abdominis, superior & inferior epigastric vessels, lymphatics, nerves.
Location of sheath of rectus abdominis (RA) where pattern of aponeurotic coverings changes (may also be gradual). Superior to line: aponeurosis superficial and deep to RA (between Internal oblique aponeurosis). Inferior to line: only anterior of RA in contact with aponeurosis, posterior with transversalis fascia.
Actions of abdominal muscles -together
Together: compress, support abdominal viscera, stabilize penis, important in respiration, defecation, and parturition (straining), control volume of abdominal cavity
Actions of abdominal muscles-unilaterall or bilaterally
EO, IO (same side)-bend trunk to the same side TA-rotates trunk to same side RA bilaterally-flexes trunk (not hip)
Ventral and dorsal rami of spinal nerves innervate:
skin & muscles of body wall, parietal: pleura, pericardium and peritoneum.
4th week-flat to cylindrical-gut forms due to folding
During the 4th week of development why does the head and tail form?
The developing nervous system grows faster than anything else.
During folding, what becomes the gut?
What does the intraembryonic coelom become?
pericardial, pleural, peritoneal cavitie
Which cavity surrounds the gut?
What are the Gut tube derivatives? (in abdomen and pelvis)
stomach, small & large intestine, appendix, liver, gallbladder, pancreas, rectum, part of anal canal. NOT SPLEEN
double layer of peritoneum, ligament
suspended by a mesentery....so in the beginning GI tract was like this and projected into peritoneal cavity
The gut mesentery is first in a ______ plane and then it rotates to a ______plane.
The cul de sac in respect to the ventral mesentery changes:
From on either side of ventral mesentery to posterior to the ventral mesentery.
Root of the lung
the location through which vessels and nerves have access to the lung
Vessels and nerves have access to GI tract and its derivatives via__________.
Arterial supply of abdominal gut
Foregut: Celiac trunk Midgut: Superior mesenteric artery Hindgut: Inferior mesenteric artery *All these unpaired branches from the aorta
Branches of abdominal aorta: Unparied vs. Paired
Unpaired: celiac, superior mesenteric, inferior mesenteric Paired: Inferior phrenic, suprarenal, renal, lumbar, gonadal (testicular or ovarian) Unpaired: supply GI tract and its derivatives plus spleen Paired: supply body wall and associated organs: kidneys
Blood to gut and its derivatives goes through _______ before returning to heart.
Two capillary beds -portal system
Posterior to parietal peritoneum on the posterior abdominal wall. Ex. GI tract and derivatives go from being intraperitoneal to being secondarily retroperitoneal...only anterior surface is covered with peritoneum.
Vessels and nerves supplying secondarily retroperitoneal organs are _______.
Posterior to parietal peritoneum on posterior wall abdominal wall. Also deep to transversalis (endoabdominal fascia) Kidneys, aorta, inferior vena cava, pancreas, small & large intestine
space between parietal peritoneum and transversalis fascia (retroperitoneal is a subdivision). Ex. umbilical ligaments: extraperitoneal but not retroperitoneal. Ascending colon: extra peritoneal and retroperitoneal
Subdivisions of peritoneal cavity (2)
1. Greater sac: supracolic and infracolic compartments 2. Lesser sac: omental bursa
Omental bursa (AKA lesser sac)
Has an inferior and superior recess *Superior recess posterior to liver *Inferior recess usually obliterated due to fusion of the gastrocolic ligament and transverse mesocolon.
Liver---L & R hepatic ducts, common hepatic duct, bile duct constricted, up cystic duct, gallbladder *When bile duct not constricted bile goes into 2nd part-descending part-duodenum **Pancreatic duct merges with bile duct
2 ligaments associated with spleen and contents
1. gastrosplenic-short gastric vessels (connects stomach with spleen) 2. splenorenal-splenic vessels, tail of pancreas (connects spleen to posterior abdominal wall)
Spleen is _________ and forms in ____________.
intraperitoneal, dorsal mesentery
Secondarily retroperitoneal organs
duodenum, pancreas (except tail which is within splenorenal ligament
Head of pancreas in nestled in __________________.
the curve of the duodenum
The bile duct travels posterior to both the ____ part of ________ and the _____.
1st, duodenum, pancreas
Union of the bile and pancreatic ducts
Most common-join together, hepatopancreatic sphincter of Oddi
25% of the time-remain separate
Pancreas begins as two outgrowths from the _______.
A primarily peritoneal structure is ALWAYS _____ to a secondarily retroperitoneal structure.
Branches of the Superior mesenteric
1. inferior pancreaticoduodenal artery 2. middle colic artery 3. intestinal arteries A. ileocolic artery B. right colic artery
Inferior pancreaticoduodenal artery
Branch remains retroperitoneal. Supplies duodenum distal to entrance to bile duct, head of pancreas, (secondarily retroperitoneal). Bifurcates into anterior and posterior branches and anastomoses with the superior pancreaticoduodenal branches.
Middle colic artery
Supplies proximal 2/3 of transverse colon (intraperitoneal), runs in the transverse mesocolon
distal ileum, appendix, cecum, proximal ascending colon. Branches supplying ileum and appendix are within "the" mesentery or the mesoappendix respectively while branches to the ascending colon are retroperitoneal.
from a common stem off the superior mesenteric artery.
Derivatives of the hindgut are supplied by the _______ ______ artery.
Branches of the inferior mesenteric artery
left colic artery four branches that supply sigmoid colon superior rectal artery
Left colic artery
descending colon (secondaritly retroperitoneal) and distal part of the transverse colon. Therefore the initial part of the artery is retroperitoneal but the branches to the transverse colon run in the transverse mesocolon
4 branches to the sigmoid colon
sigmoid colon is intraperitoneal so sigmoidal branches run in the transverse mesocolon.
superior rectal artery
superior part of rectum (secondarily retroperitoneal), branch remains retroperitoneal.
Anastomosis between SM and IM
Middle colic artery and left colic artery.
What is unique about the lymphatic drainage of the abdominal viscera
The lymphatic vessels follow ARTERIES (celiac, SM, IM branches) and NOT VEINS.
lymphatic vessels form an intestinal trunk, empties into chyle cystern (adjacent to celiac trunk), drains into thoracic duct, empties into venous system at or near junction of internal jugular and subclavian veins
malignant cells carried in the veins of the abdominal viscera to the portal vein and liver, liver metastases in colon cancer.
The IM vein is usually a tributary of the ____ vein.
Veins of the body wall are called:
1. esophageal branch of left gastric and esophageal tributaries of the azygos Result: esophageal varices 2. superior rectal vein and middle/inferior rectal veins hemorrhoids 3. paraumbilical veins and superficial epigastric veins of anterior abdominal wall caput medusai (dilated veins on anterior abdominal wall) 4. veins of secondarily retroperitoneal organs and veins of posterior abdominal wall
T or F. The abdominal viscera are composed of smooth muscle and glands and are therefore innervated by the autonomic nervous system.
The splanchnic nerves are paired nerves that contribute to the innervation of the viscera, carrying fibers of the autonomic nervous system (visceral efferent fibers) as well as sensory fibers from the organs (visceral afferent fibers). All carry sympathetic fibers except for the pelvic splanchnic nerves, which carry parasympathetic fibers.
Greater, lesser, and least splanchnic nerves pierce the _______.
crura of the diaphraghm
Vagal trunks go through______.
Significance of medial arcuate ligament
fascia covering the psoas major. The sympathetic chain enters the abdominal cavity by going under it.
Where do the axons within the greater, lesser, least, and lumbar splanchnic nerves synapse?
In prevertebral (preaortic) ganglia within the abdomen.
Which is the largest of the pretervebral ganglia?
Celiac ganglia, can be seen macroscopally
Where do axons on vagal trunks synapse?
Axons in vagal trunks synapse in, on , or near their targets.
provide parasympathetic innervation to abdominal viscera. They pass through hypogastric nerves and superior hypogastric plexus to reach their targets.
the left kidney is usually higher than the right kidney.
Kidneys are held in place by a
fascial sheath, atrophy can lead to increase mobility of kidney, "floating kidney", may interfere with renal blood flow, and/or urinary outflow and may cause pain
Surgery of the kidneys is best done by a ____ approach.
posterior (anterior,,increase risk of peritonitis)
Kidneys are anterior to which ribs:
11 and 12, lateral to psoas major
There are _____ renal arteries because _______.
multiple, kidneys developed in pelvis and then ascended to posterior abdominal wall. As kidneys ascend new arteries form and former ones degenerate.
inferior poles of kidneys are fused-full ascent does not occur due to prevention by IMA. Suprarenal glands and kidneys are not adjacent.
Urine journey through kidney
minor calyce, major calyce, renal pelvis, ureter, each minor calyce is attached to a renal pyramid
Ureters are intra, retro peritoneal?
descend, pass anterior to psoas major, posterior to gonadal vessels,, enter pelvis by crossing anterior to bifurcation of common iliacs.
not usually a problem when inside the kidney but once in ureter, there is much chain which changes over time since ureters are innervated by multiple sources as they descend. Mid-back pian and move to inguinal region with time.
Mesentery of uterus, made up of 2 layers of parietal peritoneum. Parts: mesometrium, mesosalpinx, mesovarium
Ovarian vein L/R
Right-drains into IVC Left-drains into Renal vein
muscular floor of the pelvic cavity-made up of levator ani muscle and coccygeus muscle
How does the urethra, vagina, and anal canal pass through midline openings in the pelvic diaphragm ______.
urogenital hiatus, anal hiatus
Suspensory ligament of the ovary contains
T/F the vaginal artery is entirely subperitoneal
T/F there are end to end anastomoes of branches of the uterine, ovarian, and vaginal arteries.
Ureter passes _____- to the uterine artery.
inferior, bridge over water
Normal position of uterus
Anterverted and anteflexed
Uterus falls out of place. In complete prolapse, bladder cannot completely empty so women will be prone urinary tract infections.
Why does prolapse occur?
Women who have uterus in a retroverted position are more prone to prolapse. Also childbirth can cause weakness of the pelvic diaphragm and fascia.
Ovary releases oocyte into ____.
Ovulation involves breaking thorugh ___ _____ and may be painful.
Lacunar ligament (gimbernat's ligament)
Formed by deep fibers of the inguinal ligament that attach to the pectinal line of the hip bone. Parat of it that attaches to pectineal lines is called pectineal ligament (Cooper's ligament).
Relation of deep and superficial ring of inguinal canal to inferior epigastric aretery.
oblique passage through the anterior abdominal wall from the deep inguinal ring to the superficial inguinal ring
ovarian ligament and round ligament
outpocketing of the parietal peritoneum into the future scrotum that provides continuity between the abdominopelvic cavity and the scrotum.
Testis travel down into the scrotal sac through the ____.
inguinal canal. Ductus deferens, blood supply, and innvervation, descend and are contianed within the spermatic cord.
Remnant of male gubernaculum
What happens to the processus vaginalis
Largely degenerates but a remnant remains in the scrotal sac, the tuinca vaginalis
Failure of a testis to descend down into the scrotum
In spermatic cord, skeletal, innervated by the genital branch of genitofemoral nerve.
Sites of hernias
Inguinal canal, femoral ring, umbilicus, and linea alba
What is the most common kind of hernia
inguinal (5% of population)
Hernias can lead to
Reduction of blood supply-ischemia-necrosis fecal obstruction
Indirect inguinal hernia
2/3 of hernias, young males, due to patent processus vaginalis, part of gut enters spermatic cord, through inguinal canal , enter scrotum, covered by parietal peritoneum
Direct Inguinal hernia
Less common than the indirect ones. Males over 40 years of age.Section of gut pushes through abdominal wall in the medial 1/3 of the inguinal canal, does NOT enter the spermatic cord. covered with parietal peritoneum...can exit superficial inguinal ring but DOES NOT enter scrotum
Differences between direct/indirect hernias
indirect-young males, into spermatic cord, scrotum direct-old males, DOES NOT ENTER 2 structures above
Inguinal (Hesselbach's triangle)
Triangle through which direct hernias go through. Bounded by inferior epigastric vessels, rectus abdominis, and inguinal ligament
What forms the boundary between the abdomen and pelvis?
The iliac crests
What divides the false (greater) and trues (lesser) pelvis?
The pelvic brim
area between thighs
Roof of perineum?
Vasculature and nerves ______ go directly to and from the pelvis and perineum because they ____ perforate the pelvic diaphragm.
do not, do not
What structures go through the pelvic diaphraghm?
urethra, vagina, GI tract
Name hiatuses on pelvic diaphraghm
1. urogenital 2. anal
pelvic brin is AKA
Narrowest fixed distance through which a baby's head must pass during vaginal delivery?
Anteroposterior diameter between pubic symphysis and sacral promontory
Greater Sciatic foramen
Periformis goes through, connects pelvis with the gluteal region
Lesser sciatic foramen
Obturator internus goes through, covered up by LA, connects gluteal region to perineum
Tendinous arch of levator ani
Fascial attachment of the levator ani, thickening of the obturator internus fascia.
covered up by obturator membrane...lil opening is the obturatora canal
superior portion in pelvic cavity inferior portion in perineum
pericardial cavity lies in part behind sternum, between which ribs?
Want to see the other 242 Flashcards in Anatomy?JOIN TODAY FOR FREE!