Gross Anatomy: Exam 3 Pages 99-115

vertical planes which extend inferiorly from the midpoints of the clavicles to the midpoints of lines joining the ASIS to the pubic symphysis.

Mid-clavicular planes

a horizontal plane joining the lowest point of the costal margin on each side. It lies at the inferior margin of rib 10.

Subcostal plane

a horizontal plane which joins the tubercles of the iliac crests

Transtubercular plane

What lies in the right hypochondrium and epigastric region.

Liver

The spleen and the fundus and body of the stomach are found in the ?

Left hypochondrium

(TQ) The umbilicus is a variable landmark which lies between what two vertebral levels?

L2-L5

(TQ) What are the MC layers of the anterior abdominal wall?

Superficial (camper's fascia) and Deep (scarpa's fascia) layer of superficial fascia, deep (investing) fascia

A thin fatty layer of fascia which is continuous with the superficial fascia of the perineum and thigh.

Superficial Layer (camper's fascia)

A membranous layer of fascia which is firmly fastened to the fascia latae of the thigh, just below the inguinal ligament.

Deep layer (Scarpa's fascia)

(TQ, know layers-->) Between the deep layer of superficial fascia (scarpas fascia) and deep fascia of the abdomen there is a potential space, where fluid can accumulate. Rupture of the spongy urethra allows accumulation of urine within this space. Spreads superiorly, almost always exclusive to males.

Extravasation of Urine

A median tendinous raphe which extends from the xiphoid process to the pubic symphysis. Anterior abdominal wall muscles insert into this raphe via their aponeuroses.

Linea Alba

What are the anterolateral muscles of the abdominal wall?

External/Internal oblique, and transverse abdominis muscles

What is the muscles not mentioned previously that is on the anterior wall of the abdomen and is split by the linea alba?

Rectus abdominis

The curved line along the lateral border of the rectus abdominis muscle is called?

Linea Semilunaris

3 bundles of connective tissue which run transversely across the rectus abdominis muscle and which fuse with the rectus sheath. Appears in fit people.

Tendinous intersections

What are two instances where forced expiration would impact the anterior abdominal muscles.

Coughing, sneezing

What is formed by the aponeuroses of the external oblique, internal oblique, and transversus abdominis muscle?

Rectus sheath

(KNOW) the rectus sheath encloses what?

Rectus abdominis and pyramidalis muscles, Superior/inferior epigastric A. and V., and Anterior primary rami of lower 6 thoracic nerves

a crescent shaped line in the posterior layer of the rectus sheath located midway between umbilicus and pubic crest.

Arcuate Line

What is included ABOVE the arcuate line?

Anterior/Posterior layer of rectus sheath

The anterior superior (above arcuate line) layer of rectus sheath is composed of aponeuroses of the _____________ and _____________ _____________ muscles.

External, internal oblique

The posterior superior (Above arcuate line) layer of rectus sheath is composed of aponeuroses of the _____________ ________________ and _______________ ________________ muscles.

Internal oblique, transversus abdominis

Above the arcuate line, the aponeurosis of what muscle splits to enclose the rectus abdominis?

Internal oblique muscle

What is included BELOW the arcuate line?

Anterior/Posterior layer of rectus sheath (same as above)

The anterior inferior (below arcuate line) layer of rectus sheath is composed of the aponeuroses of?

All 3 muscles (external, internal, transversus)

The posterior inferior (below arcuate line) layer of the rectus sheath is formed by?

transversalis fascia

(know fold & what it contains) The Median Umbilical fold extends from the apex of the bladder to the umbilicus and contains the ___________.

urachus

The Medial Umbilical fold extends from the side of the bladder to the umbilicus and contains the ________________ _____________ _________.

Obliterated umbilical artery

The lateral umbilical fold extends from the deep inguinal ring to the arcuate line and contains the ___________ _____________ _________.

Inferior epigastric vessels

This lies above the umbilicus and contains the obliterated umbilical vein. It is the free edge of the falciform ligament, which is attached to the liver.

Ligamentum Teres

These nerves run b/t the internal oblique and transversus abdominis muscles

Lower 6 thoracic nerves

This ligament is formed by the lower edge of the external oblique aponeurosis. It extends from ASIS to the pubic tubercle.

Inguinal ligament

This ligament is the most medial fibers of the inguinal ligament which are inserted into the superior pubic ramus.

Lacunar ligament

This ligament is a lateral extension of the lacunar ligament along the pecten pubis (pectineal line).

Pectineal ligament

(TQ) The inguinal canal is an oblique passage ___ to ___ cm in length through the anterior abdominal wall.

3 to 5

The inguinal canal is much larger in which gender?

Male

Inguinal canal contains ?

Spermatic cord (in males), Round ligament (in females) and ilioinguinal nerve (both sexes)

What tendon prevents inguinal hernia from occurring?

conjoint tendon

(TQ) formed by the fusion of the aponeuroses of the internal oblique and transversus abdominis muscles as they insert into the pubic crest and pecten pubis deep to the inguinal ligament. The tendon strengthens the posterior wall of the medial half of the inguinal canal.

Conjoint tendon

The boundaries of the inguinal canal include:

Anterior/posterior wall, roof, and floor

Which boundary is formed by the conjoint tendon and transversalis fascia?

Posterior wall

Which boundary is formed by the aponeurosis of the external oblique muscle.

Anterior wall

Which boundary is formed by the arching fibers of the internal oblique and transversus abdominis muscles?

Roof

Which boundary is formed by the inguinal and lacunar ligaments?

Floor

What structure transmits the spermatic cord in the male, the round ligament in the female, and the ilioinguinal nerve in both sexes.

Superficial Inguinal ring

The superficial inguinal ring is formed by the splitting of the external oblique aponeurosis into two crura: ??

Lateral and Medial crura

inserts into the pubic tubercle.

Lateral crus

inserts into the pubic crest.

Medial crus

strengthens the apex of the superficial inguinal ring.

Intercrural fibers

What is the opening within the transversalis fascia?

Deep inguinal ring

The Inguinal triangle's boundaries include --> ____________: bounded by lateral edge of the rectus abdominis muscle, ___________: bounded by the inferior epigastric vessels, _____________ : bounded by the inguinal ligament

medial, lateral, inferior

What is an area of potential weakness in the anterior abdominal wall where direct inguinal hernias occur?

Inguinal triangle

Contraction of the muscles of the anterior abdominal wall during coughing and straining elevates intra-abdominal pressure, potentially forcing what into the inguinal canal?

abdominal contents

(TQ) Paradoxically, the same muscles which ____________ intra-abdominal pressure (promoting hernia) also ___________ the inguinal canal (preventing hernia).

increase, narrow

This tendon reinforces the posterior wall of the inguinal canal and is also called inguinal falx.

Conjoint tendon

Which gender is more susceptible to inguinal hernias?

Males

Why is the male gender more susceptible to these hernias?

scrotum (creates large potential space) and larger diameter of canal (for passage of spermatic cord)

What, in the female, is homologous to the scrotum of the male?

Labia majora (mostly filled with fat, not a potential space)

This type of hernia passes through the superficial/deep inguinal ring and inguinal canal before descending into scrotum (or labia majora). May be congenital. Passes laterally to the inferior epigastric vessels. Accounts for 75% of inguinal hernias.

Indirect inguinal hernia

This type of hernia punches directly through the posterior wall of the inguinal canal, bypassing the deep inguinal ring. Causes a general bulging of the anterior abdominal wall (DOES NOT descend into scrotum) Passes medially to the inferior epigastric vessels through inguinal triangle. IS ALWAYS ACQUIRED (later in life). Accounts for 25% of inguinal hernias.

Direct inguinal hernia

What two subluxations may impact anterior abdominal muscles, which can increase the risk of inguinal hernia.

Lower T and Upper L

This hernia passes through the femoral canal, occurs inferior to the inguinal ligament, more common in females than males.

Femoral Hernia

This hernia usually results from incomplete closure of the anterior abdominal wall after ligation of the umbilicus at birth, can also occur due to defects in the linea alba.

Umbilical Hernia

This structure begins at the DEEP inguinal ring and ends at the testis (not found in abdominal pelvic cavity)

Spermatic cord

What are the three concentric layers of fascia derived from the anterior abdominal wall?

External/Internal spermatic fascia and Cremasteric fascia

Which fascia is derived from the internal oblique aponeurosis and is collectively referred to as the cremaster muscle?

Cremasteric fascia

(T/F) The cremaster muscle is derived from the external oblique muscle

False (internal)

(TQ) The spermatic cord contains 9 structures. But the top 5 are the most important that Duray whats you to know. Name the 5 important structures.

- Ductus Deferens, Artery to the ductus deferens, Cremasteric and Testicular arteries, Pampiniform plexus of veins (other 4: Genital branch of genitofemoral nerve, remnant of processus vaginalis, autonomic nerves, lymphatics)

(TQ) This nerve runs through the inguinal canal and superficial inguinal ring. It accompanies the spermatic cord but is not apart of it.

Ilioinguinal nerve

(TQ) The ilioinguinal nerve has two branches: ???

Femoral branch and Anterior scrotal (or anterior labial) nerve

(TQ) The anterior abdominal wall layer of subcutaneous tissue, superficial and deep fascia turns into what for the scrotum?

Dartos Muscle

External oblique muscle turns to what in the scrotum?

External spermatic fascia

Internal oblique muscle turns to what in the scrotum?

Cremasteric muscle (or fascia)

(TQ) Transversus Abdominis M turns into what in the scrotum?

No Continuation

Extraperitoeal fascia (Fat) turns into what in the scrotum?

No Continuation

This muscle contains smooth muscle fibers which are firmly adherent to the skin of the scrotum. The muscle functions in thermoregulation.

Dartos muscle

Accumulation of fluid in cavity of tunica vaginalis?

Hydrocele

(TQ) The testes are paired, mobile organs in the scrotum. They have two functions -->

produce spermatozoa, secret androgens

The fibrous outer covering of the testis. It lies deep to the visceral layer of the tunica vaginalis, which is the deepest layer of the scrotum.

Tunica Albuginea

A fibrous compartment in the posterior part of the testis where the septa converge.

Mediastinum Testis

Step 1: functional, sperm producing portion of the testis. Each lobule contains 2 or 3 of these.

Seminiferous tubules

Step 2: Seminiferous tubules unite to form straight tubules and drain into an elaborate network of canals located within the mediastinum testis into which the straight tubules empty.

Rete Testis

Ducts which connect the rete testis to the head of the epididymis.

Efferent ductules

A C-shaped structure attached to the superior and posterior aspect of the testis. Main function is to store sperm until they mature.

Epididymis

Epididymis consists of 3 parts:

Head (connected to superior surface of testis by efferent ductules), body (located on posterior surface of testis), tail (ends in the ductus deferens)

The testis drains into the lumbar nodes and the scrotum drains into the superficial inguinal nodes describes what process?

Lymphatic drainage

(TQ) Where do the testes develop inside the abdominal cavity?

Lumbar region

Condition where testes are undescended at birth (baby's balls didn't drop), most commonly found in the inguinal canal, usually unilateral, administration of testosterone is used to treat condition

Cryptorchidism

Lines the abdominal walls

Parietal peritoneum

covers abdominal organs

Visceral peritoneum

Peritoneal infection may occur in 1 of 2 ways -->

immunocompromised women, parturition in unsanitary conditions

(TQ) Dye introduced into the uterus normally enters the uterine tubes and then the peritoneal cavity. If it does not, there is an obstruction.

Test for Patency (openess) of uterine tubes

Lie posterior to the peritoneum and are covered by peritoneum only on their anterior surface (kidney for example)

Retroperitoneal organs

(NBE/TQ) Accumulation of fluid within the peritoneal cavity, MC worldwide cause: malnutrition, MC in USA: Congestive heart failure

Ascites

Inflammation of the peritoneum. Usually results from infection.

Peritonitis

In peritonitis, what nerve may refer pain to the shoulder

Phrenic nerve

(TQ) The parietal peritoneum is supplied by the nerves of the adjacent body wall including the: (P. I. S. Igas. Igui.)

Phrenic, Intercostal, Subcostal, iliohypogastric, ilioinguinal nerves

The parietal peritoneum is very sensitive to ?

Pain

A broad, apronlike reflection of peritoneum. There are two within abdominal cavity.

Greater/Lesser omentum

(TQ) The greater omentum is very mobile and often adheres to areas of inflammation, wrapping itself around inflamed organs and restricting the spread of infection. It is referred to as?

Abdominal policeman