Create
Learn
Share

Abdomen

rename
pinkpanther's version from 2016-12-24 09:29

Section 1

Question Answer
Where is the abdominal cavitybetween diaphragm and pelvic girdle, may extend into 4th intercostal space
What marks the superior abdominal apectureT12 vertebrae, rib 12, distal end of rib 11, costal margin and xiphoid process
What makes up the posterior abdominal wall (bones + muscles)L1-L5 vertebra, quadratus lumborum, psoas major, iliacus
What makes up the lateral abdominal wall (bones + muscles)External and internal oblique, transverse abdominis
What makes up the anterior abdominal wall (bones + muscles)Rectus abdominis
What are the planes dividing the 4 quadrantsTransumbilical plane and median plane
Why is the umbilicus a poor landmarkIt shifts downwards during pregnancy or obesity
What are the planes dividing the 9 quadrants1. Subcostal plane (Or transpyloric plane) 2. Midclavicular planes (Or linea semilunaris) 3. Transtubercular plane
What does each plane crossMidclavicular: Midclavicular to mid-inguinal point (midpoint of ASIS and pubic symp), Transpyloric (L1): halfway between jugular notch and pubic symphosis, through pylorus @ rib 9), Subcostal (L3): through inferior border of 10th costal cartilage, Transtubercular (L5): through iliac tubercles
What are the 9 quadrantsRight and left hypochondrium, Epigastric, Right and left lumbar, Umbilical, Right and left inguinal, Pubic
What encloses the abdominal cavityPeritoneum, ventral mesentry for proximal regions of gut, dorsal mesentry along entire length of system
memorize

Section 2

Question Answer
Superficial to deep of abdominal regionSkin, superficial fascia (camper's fascia - superficial fatty, and scarpa's fascia - deep membranous), external oblique, internal oblique, transversus abdominis (rectus abdominis + pyramaidalis), transversalis fascia, extraperitoneal fascia, parietal peritoneum, visceral peritoneum.
memorize
MUSCLES
Question Answer
Difference between linea alba and linea semilunarisLinea alba is the line in the center, linea semilunaris is the two linse at each side
Where is the neurovascular plane locatedBetween internal oblique and transversus abdominis (2nd and 3rd layer, just like in thorax)
Fibre direction, origin, insertion and action of: External obliqueForward and down // lower 8 ribs // Linea alba, iliac crest // Compress abdomen and flex trunk
Internal obliqueBehind and down // Anterior 2/3 of iliac crest, laterial 2/3 of inguinal lig // Linea alba, lower 3 ribs, pubic crest, pectineal line // Compress abd + flex trunk
Transversus abdominisTransverse // Costal cartilage, ribs 7-12, iliac crest, lateral 1/3 of inguinal lig // Linea alba, pubic crest, pectineal line // Compress abdomen
Rectus abdominisSuperior to inferior // Pubic crest, tubercle, symphysis // Xiphoid process, costal cartilage 5-7 // Compress abdomen, flex trunk
Muscles compress abdominal viscera to maintain/ increase intra-abdominal pressure in which 5 processesMicturition. defecation. childbirth, sneezing/coughing, forced expiration
What does flexing the trunk doMaintain posture and prevents lordosis - excessive side-side swaying
What forms the inguinal ligamentLower border of aponeurosis of external oblique, which folds backwards on itself and attaches to pubic tubercle. Upper border attaches to ASIS
Attachment of lacunar ligamentCrescent shaped extension from medial end of inguinal ligament to pecten pubis on superior ramus of pubic bone
Attachment of pectineal (cooper's) ligamentExtends from lacunar ligament along pecten pubis
memorize

 

RECTUS SHEATH
Question Answer
What is the arcuate line= linea semi-circularis, midway between the umbilicus and pubic symphysis, marks the point where the inferior epigastric artery perforates and supplies the rectus abdominis
Layers above the arcuate line (Superficial to Deep)External oblique aponeurosis, anterior lamma of internal oblique, rectus abdominis, posterior lamma of internal oblique, transversus abdominis, transversalis fascia, parietal peritoneum
memorize
Layers below the arcuate line: External oblique aponeurosis, anterior and posterior lamma of internal oblique, rectus abdominis, transversus abdominis, transversalis fascia, (medial and median umbilical ligaments), parietal peritoneum

 

FASCIA
Question Answer
What does the superficial fascia split into below the umbilicusCamper's fascia (superfical and fatty) and Scarpa's fascia (deep and membranous). Scarpa's fascia is continous with Colles' fascia at perineum.
Camper's fascia in menloses fat at penis and fuses with Scarpa's fascia, continues into scrotum as Dartos fascia (contains smooth muscle)
memorize
Camper's fascia in women: retains fat and forms labia majora
Question Answer
SummaryAnterior abdomen = Scarpa's fascia, Perineum = Colle's fascia, Scrotum = Dartos fascia, all continuous with one another
memorize

 

NERVE SUPPLY + BLOOD SUPPLY
Refer to notes

 

SURGICAL INCISIONS
Question Answer
Should muscles be split in the direction of their fibres or transectedSplit in the direction of their fibres, except for rectus abdominis
memorize
Transverse incision of rectus abdominis: Can be done as a new transverse band orms when segments are rejoined but transections at tendinous intersections endangers cutaneous nerves and superior epigastric vessels.
Question Answer
Should muscles and viscera be retracted towards or away from their neurovascular supplyTowards
From where to where is the most common large abdominal incisionFrom xiphoid process to pubic symphysis
Where is McBurney's point and what is the significance of itIt is 1/3 distance from ASIS to umbilicus (from lateral) and it is for appendectomy, the surgical removal of the appendix
memorize

 

TESTES AND SCROTUM
Question Answer
Describe the embryology of the testesThe testes develop in the superior lumbar region in the posterior abdominal wall and descend into the scrotum through what becomes the inguinal canal. It carries the spermatic cord and blood supply from the abdomen with it. An extra-abdominal portion of the gubernaculum outgrows, pulling the testis along. Processus vaginalis, a peritoneal diverticulum (sac), outpouches to enter the testes, carrying muscular and fascial layers before it. During its descent, it forms the inguinal canal together with musculofascial layers of the abdominal wall. Processus vaginalis obliterates at birth or shortly after. Hence, the testes is ensheathed by the musculofascial outpouching of the anterolateral abdominal wall, ie the scrotum.
Describe the embryology of the ovariesThe ovaries develop in a similiar region but do not descend all the way through the inguinal canal. Only the round ligament, which develops from the gubernaculum, descends all the way.
Layers acquired from superficial to deepExternal oblique, Internal oblique, Transversalis fascia. Transversus abdominis not acquired.
Layers covering testes from superficial to deepSkin of scrotum, Dartos fascia and muscle (from subcutaneous fascia), External spermatic fascia (from external oblique aponeurosis), Cremasteric fascia and muscle (from internal oblique muscle), Internal spermatic fascia (from transversalis fascia), Parietal and visceral layer of tunica vaginalis
Clinical conditions Cryptorchism and HydroceleCryptorchism - undescended testes cannot produce sperm and has malignancy risk. Hydrocele - unoblierated processus vaginalis lets peritoneal fluid enter scrotum.
Why is temperature regulation by scrotum importantSpermatogenesis requires a constant temperature cooler than core temperature
How does the scrotum regulate temperatureCold - Cremaster and dartos muscles contract to draw testes superiorly into the scrotum. Warm - They relax to allow testes to descend deeply into scrotum
Innervation of cremaster and dartos muscleCremaster muscle is skeletal, innervated by genital branch of genitofemoral nerve (L1-L2). Dartos muscle is smooth.
memorize