revision of the abdomen

How would you define the region of the abdomen?

Below diaphragm (physical barrier) and above the inlet of the pelvis (space)

At what level is the transpylonic plane?

L1

At what level is the transtubular line?

L5

At what level is the subcostal plane?

L2-3

At what level is the transumbilical plane?

L3/4

At what level is the oesophagus?

C6 - T11

What does the pylorus do?

connects and controls flow between stomach to duodenum

What is the location of the pancreas?

Epigastric and L hypochondriac

posterior to the stomach

Level T1-2

What is the location of the liver?

right upper quadrant (R hypochondriac to L hypochondriac)

What is the location of the kidneys?

retroperitoneal from T12 - L4

** R kidney lower than left

What is the location of the spleen?

LUQ (L yphypochondriac)

Posterior to the stomach and anterior to the left hemidiaphram

Rib 9-11

Where does the abdominal aorta bifurcate?

L4

At what level is the interspinous plane?

Midsacrum

Which organs are intraperitoneal?

• S: Stomach

• A: Appendix

• L: Liver

• T: Transverse colon

• D: First part of the duodenum

• S: Small intestines (jejunum and ileum)

• P: Tail of the pancreas

• R: Upper third of the rectum

• S: Spleen

• S: Sigmoid colon

SALTD SPRSS

Which organs are reteroperitoneal?

• S: Suprarenal (adrenal) glands

• A: Aorta/IVC

• D: Duodenum (except the proximal 2cm, the duodenal cap)

• P: Pancreas (except the tail)

• U: Ureters

• C: Colon (ascending and descending parts)

• K: Kidneys

• E: (O)esophagus

• R: Rectum

  SAD PUCKER

What are Ascites and how are they formed?

Ascites is the build-up of fluid in the space between the lining of the abdomen and abdominal organs.

results from high pressure in certain veins of the liver (portal hypertension) and low blood levels of a albumin

What is an omentm?

a fold of peritoneum connecting the stomach with other abdominal organs

what is a ligament (in the abdomen)

Links organ to organ or organ to abdominal wall

What is an aponeurosis?

A fibrous connective tissue that connected muscle to bone or fibrous tissue

What arteries supply the foregut, midgut and hindgut?

foregut: celiac trunk

midgut: superior mesenteric artery

hindgut: inferior mesenteric artery

What does the greater, lesser and gastrosplenic omenta connect

Stomach to TRANSVERSE COLON

Stomach to LIVER

Stomach to SPLEEN

What does a mesentary do?

Connects intestine wall to posterior abdominal wall

What does the abdominal aorta bifurcate into?

the right and left common iliac arteries

What structures does the foregut give rise to?

oesophagus

stomach

liver

gallbladder

bile ducts

pancreas

proximal duodenum

What structures does the midgut give rise to?

distal duodenum

jejunum

ileum

cecum

appendix

ascending colon

proximal 2/3 of transverse colon

What structures does the hindgut give rise to?

the distal 1/3 of the transverse colon

descending colon

sigmoid colon

upper anal canal

What is the portal triad made up of?

hepatic artery, hepatic portal vein and bile duct

Describe the livers dual blood supply

the hepatic artery delivers oxygenated blood from the general circulation

the hepatic portal vein delivers deoxygenated blood from the small intestine containing nutrients

What planes/ lines/ landmarks make up the 4 quadrants of the abdomen?

Vertical line: midline (line down from jugular notch to the pubic symphysis)

Horizontal line: transumbilical plane

What lines/planes/ landmarks form the lines in the 9 section abdominal model?

Horizontal: Midclavicular line

Vertical superior: subcostal plane L2-3

Vertical inferior: transtubercular plane (supracristal plane) L4 → highest point of iliac crest

A. Transpyloric plane L1

B. Subcostal plane L2-3

C. Transumbilical plane L3/4

D. Transtubercular plane/ supracristal plane L5

E. Interspinous plane: midsacrum

Describe the boundaries of the inguinal canal

Anterior wall – aponeurosis of the external oblique, reinforced by the internal oblique muscle laterally.

Posterior wall – transversalis fascia.

Roof – transversalis fascia, internal oblique, and transversus abdominis.

Floor – inguinal ligament