anatomy exam 3- abdomen

diaphragm

what is the upper border of the abdomen

pubis bone

what is the lower border of the abdomen

costocartilages of 7-10 ribs and xiphoid process

what is the superior/roof of the anterolateral abdominal wall

ASIS to pubic tubercle (inguinal ligament) and superior pelvis

what is the inferior border of the anterolateral abdominal wall

edges of rectus abdominus

what is the lateral borer of the abdomen

subcutaneous superficial fascia fatty layer, membraneous layer of superficial fascia, investing fascia of three muscles, endoabdominal (transversalis fascia) and parietal peritoneum

what are the layers of the abdominal fascia

greater omentum

large fold of visceral peritoneum that hangs down from stomach to cover the small intestine, and attach to the transverse colon; resides under the parietal peritenium

support, protection of viscera, maintain or increase intra-abdominal pressure and oppose the diaphragm, help maintain posture

what are the functions of the anterolateral abdominal muscles

as it passes through the esophageal hiatus of the diaphragm

when does the vagus nerve splint into anterior (L) and posterior (R) vagal trunks

rectus sheath

fibrous compartment formed by the overlapping sheetlike tendons of the lateral abdominal wall muscles to enclose the rectus abdominis

splits to encase the muscle on both the front and back

how is the rectus sheath oriented around the rectus abdominis superior to the umbilicis

entirety of it is anterior

how is the rectus sheath oriented around the rectus abdominis inferior to the umbilicis

tendinous intersections

the transverse or oblique fibrous bands that cross the rectus abdominis muscle to create the six pack look

pyramidalis

muscle that lies near the pubis bone that tenses linea alba and is a marker for midline incision for surgery; 20% don’t have

spermatic cord or round ligament of uterus and ilioinguinal nerve

what passes through the inguinal canal

subinguinal space

gap beneath the inguinal ligament between the ASIS and pubic tubercle that allows structures like the nerve, artery, and vein to pass through into the lower extremity

psoas fascia of the thoracolumbar fascia

what continues into the diaphragm as the medial arcuate ligament

anterior or quadratis fascia of the thoracolumbar fascia

what continues into the diaphragm as the lateral arcuate ligament

pericardiacophrenic aa and vv, musculophrenic a, and superior phrenic arteries

what are the arteries and veins of the superior surface of the diaphragm derived from

inferior phrenic arteries and veins

what supplies and drains blood from the inferior surface of the diaphragm

inferior phrenic arteries

what is usually the first branches of the abdominal aorta

internal thoracic a/v, external iliac a/v, femoral a/ greater saphenous v, and posterior intercostals (10,11) and anterior branch of subcostal (12)

what are the four primary blood vessels that supply the anterolateral abdominal wall

superior epigastric artery

is a direct continuation of the internal thoracic artery and supplies the superior part of the rectus abdominis

inferior epigastric artery

what does the superior epigastric artery anastomose with in the umbilical region

inferior epigastric artery

branches from the external iliac artery just superior to the inguinal ligament to run superiorly in transversalis fascia to enter the lower rectus abdominis to anastomose with the superior

thoracoepigastric vein

superficial blood vessel that runs along the anterolateral wall of the chest and abdomen to connect the superficial epigastric vein with the axillary vein

either the axillary or femoral vein

what do superficial veins of the abdomen drain into

right and left phrenic nerves

what supplies the entire motor supply and some sensory fibers to the diaphragm

intercostal and subcostal nerves

peripheral parts of the diaphragm receives sensory nerve supply from what

subcostal nerve

supplies the muscles of anterolateral abdominal wall/overlying skin; superior to iliac crest and inferior to the umbilicus

iliohypogastric

supplies the skin overlying the iliac crest, upper inguinal and hypogastric regions; internal oblique and transverse abdominus muscles

ilioinguinal

supplies the skin of the lower inguinal region, medial thigh, inferior most internal oblique, and transverse abdominus

celiac trunk and superior and inferior mesenteric arteries

what are the anterior branches of the descending aorta in the abdominal space

inferior phrenic, subcostal, lumbar, and median sacral artery

what are the posterior branches of the descending aorta in the abdominal space

superior suprarenal, middle suprarenal, renal, and gonadal artery

what are the lateral branches of the descending aorta in the abdominal space

under the inguinal ligament

when does the external iliac artery change into the femoral artery

abdominal aortic aneurysm

localized enlargement of the aorta that can be detected with deep palpation and acute rupture is associated with severe pain in abdomen and back and has a mortality rate of about 90%

iliohypogastric and ilioinguinal nerve

branch off of L1 nerve root and may not split until the ASIS

genitofemoral nerve (L1,2)

pierces the psoas major and runs on the anterior surface to split into branches of this name

lateral femoral cutaneous (L2-3)

cutaneous nerve to the thigh and iliacus

obturator ((L2,3,4)

passes medially to the psoas major and pierces deep to travel into the obturator canal; supplies the medial compartment of the thigh and adductors

femoral (L2,3,4)

runs lateral to the psoas major and above iliacus muscle to travel with the external iliac and continue with them to anterior thigh

intraperitoneal

completely covered with visceral peritoneum

retroperitoneal

partially covered with peritoneum

stomach, 1st part of duodenum, jejunum, ileum, transverse colon, sigmoid colon, liver, sleen

which organs are considered intraperitoneal

kidneys, ureters, suprarenal glands, rectum

which organs are considered retroperitoneal

urinary bladder

which organ is considered subperitaneum

small intestine (jejunum)

what is responsible for most absorption of nutrients

large intestine

what is responsible for reabsorbing water to become formed

cardia

where the esophagus meets the stomach

fundus

dome-shaped upper portion of the stomach just to the left and above the cardia and sits directly beneath the left dome of the diaphragm; dilates when full

pyloric

lower part of the stomach that connects to the duodenum

mesentary

double layer of peritoneum that contains vessels (mesenteric) to supply the intestinal tissue and anchors the small and large intestines to the posterior abdominal wall and itself

celiac trunk

anterior branch of descending aorta that supplies blood to the upper digestive organs (forgut)

superior mesenteric

anterior branch of descending aorta that supplies blood to the small intestine and ascending colon

inferior mesenteric

anterior branch of descending aorta that supplies blood to the large intestine on the left side (descending colon, sigmoid, rectum)

left gastric a, common hepatic a, and splenic

what are the major branches off of the celiac trunk

same veins go into either the superior mesenteric or splenic vein

how is the stomach and intestines drained of blood to first go to the portal vein to be filtered before returning to the IVC

superior mesenteric vein and splenic vein

what meet to form the portal vein

R, L and middle hepatic veins

how does filtered blood from the liver return to the IVC

posterior vagal trunk

what does the right vagus nerve become just past the esophagus

anterior vagal trunk

what does the left vagus nerve become just past the esophagus

gastric

means stomach

hepatic

means liver

renal

means kidney

cholecyst

means gallbladder

cysto

means bladder

abdominopelvic splanchnic nerves

paired visceral autonomic nerves (greater, lesser, and least) that come off the sympathetic ganglia to be the primary sympathetic supply to the stomach and intestines but some still comes from the vagus traveling along the esophagus

vagal trunks

creates nerve plexuses around the esophagus

T5-9

where do the greater splanchnic nerves come from

T10-11

where do the lesser splanchnic nerves come from

T12

where do the least splanchnic nerves come from

sympathetic

has long pre and post ganglionic nerves

parasympathetic

has very long pre-ganglionic put short post

organ pain

is poorly localized and rather radiates out to dermatomal levels

right neck and upper back pain

where does the liver, gallbladder, and duodenum refer pain as a result from irritation of the diaphragm

duodenum, jujunum, ileum

what are the parts of the small intestine from superior to inferior

appendix, cecum, colon (ascending, transverse, descending, sigmoid), rectum, anal canal

what are the parts of the large intestine in order of flow

cecum

what part of the large intestine is not enclosed with mesentary

superior mesenteric artery

what artery supplies the cecum, appendix, ascending colon, and first 1/3 of the transverse colon

inferior mesenteric artery

what artery supplies the second part of the transverse colon, descending colon, sigmoid colon, and rectum

splenic vein

what does the inferior mesenteric vein drain into that eventually joins the superior mesenteric vein to form the portal vein

posterior and anterior vagus and pelvic splanchnic nerves

what provides parasympathetic innervation to the large intestine

superior mesenteric plexus

what provides sympathetic innervation to the cecum, appendix, ascending and transverse colon

inferior mesenteric plexus

what provides sympathetic innervation to the left colic flexure to the rectum

inferior hypogastric plexus

what also supplies sympathetic innervation to the rectum

spleen

on the left side of the body near ribs 9-11 and lies at the head of the pancreas

splenic artery

what branch off of the celiac trunk supplies the spleen

celiac plexus

what supplies the sympathetic innervation to the spleen and is created by the splanchnic nerves synapsing on preaortic ganglia

vagus nerve

what provides parasympathetic innervation directly onto the spleen

pancreas

is positioned at the L1 and 2 level and has exocrine and endocrine functions

maintenance of blood sugar (glucagon and insulin

what is the pancreas’s endocrine function

back

where does the kidney refer pain to

secrete pancreatic juices and digestive enzymes into the duodenum from the common bile duct

what is the pancreas’s exocrine function

the joining of the pancreatic and bile duct from the gall bladder

what forms the ampulla of vater

sympathetic trunk of splanchnic ns that synapse on celiac

what supplies the sympathetic innervation to the pancreas

left sagittal fissure

demarcates the left and right lobes of the liver

right and left sagittal fissures joined by the porta hepatis to form an H

what demarcates the quadrate and caudate lobes of the liver

falciform ligament

connects the anterior surface of the liver to the anterior abdominal wall and inferior surface of diaphragm

lesser omentum

attaches stomach to liver and contains the hepatogastric and hepatoduodenal ligament that encloses the portal triad