ryan anatomy exam 2

quadrant, regions

what are the two methods for dividing the abdominal wall into smaller regions?

divided into four quadrants using two planes

describe the quadrant region

median and transumbilical

what are the two planes used in the quadrant method?

RUQ, RLQ, LUQ, LLQ

what regions does the quadrant method divide the body into?

liver, gallbladder, head of pancreas, and part of kidney, colon, stomach

list structures found in the RUQ

spleen, stomach and part of kidney, pancreas, and colon

list structures found in LUQ

Right kidney, colon, small intestine, major artery and vein of right leg, ureter, appendix

list structures found in RLQ

L kidney, colon, small intestine, major artery and vein to the left leg, ureter

list structures found in LLQ

nine

how many regions are formed by using the region method?

subcostal and transtubercular planes and midclavicular lines

the region method forms 9 regions that are bounded by what planes/lines?

epigastric region, umbilical or periumbilical region, hypogastric or pubic region, L and R hypochondriac regions, L and R lateral or lumbar regions, L and R inguinal or iliac regions

list the regions formed via the region method

liver, gallbladder, small intestine, ascending and transverse colon, R kidney

list structure(s) found in R hypochondriac region

spleen, stomach, tail of pancreas, L kidney, small intestine (part of), transverse and descending colon

list structure(s) found in L hypochondriac region

esophagus, stomach, liver, spleen, pancreas, R and L kidneys, R and L ureters, small intestine, transverse colon

list structure(s) found in epigastric region

ascending colon, gallbladder, small intestine, liver, R kidney

list structure(s) found in R lateral or lumbar region

descending colon, stomach, small intestine, L kidney

list structure(s) found in L lateral or lumbar region

stomach, pancreas, small intestine, transverse colon, R and L ureters, cisterna chyli

list structure(s) found umbilical or periumbilical region

descending colon, sigmoid colon, small intestine (part of), L ovary and uterine tube in F

list structure(s) found in L inguinal/iliac region

small intestine, appendix, cecum, ascending colon, R ovary and uterine tube in F

list structure(s) found in R inguinal/iliac region

small intestine, sigmoid colon, rectum, urinary bladder, R and L ureters, uterus and R and L uterine tubes if F, ductus deferens, seminal vesicles, and prostate if M

list structure(s) found in hypogastric or pubic region

umbilicus

what is also known as the navel or "belly-button"?

L3-L4

the umbilicus lies at the ___ level in someone who is lean

pubic symphysis

what is the point at which two pubic bones join?

pubic symphysis to pubic tubercle

the pubic crest is a bony ridge running laterally from the ___ to ___

small, rounded elevation to which the inguinal ligament attaches

what is the pubic tubercle?

posteriorly from ASIS

the iliac crest is a bony ridge that extends...

the most anterior end of iliac crest

what is the anterior superior iliac spine (ASIS)?

thickened portion of iliac spine located approximately 6 cm posterior to ASIS

what is the iliac tubercle?

abdomen and thigh

what does the inguinal groove mark the division between?

inguinal ligament

what is the inguinal groove the site of?

yes

is the inguinal ligament palpable throughout its length?

from ASIS to pubic tubercle

where does the inguinal ligament extend from and to?

epigastric fossa

what is the term for the "pit of the stomach"?

just inferior to xiphoid process

the epigastric fossa is a depression located where?

white lines formed by the fusion of the fascial planes that surround abdominal mm

what is the linea alba?

xiphoid process to pubic symphysis

the linea alba extends from the ___ to the ___

medial border of the rectus abdominis m

what does the linea alba mark the location of?

curved groove (convex laterally) that extends from ninth costal cartilage to pubic tubercle

what is the linea semilunaris?

lateral borders of rectus abdominis mm

what does the linea semilunaris mark the location of?

midpoint of line extending from ASIS to pubic symphysis

what is the midinguinal point?

linea nigra

what is the darkened vertical line due to increased melanin production during pregnancy?

four

how many muscles come together to form the linea alba?

right and left costal margins

what is the superior border of the abdominal wall?

horizontal line connecting the ASIS

what is the inferior border of the abdominal wall?

vertical line extending through ASIS

what are the lateral borders of the abdominal wall?

four horizontal planes and 3 vertical planes

what planes are typically used to subdivide and navigate the anterior abdominal wall?

transpyloric, subcostal, transumbilical, and transtubercular planes

list the horizontal planes of the abdominal wall from superior to inferior

L1 level

at what is the level is the transpyloric plane found?

midway between the suprasternal notch and pubic symphysis, passes through pylorus of stomach

where is the transpyloric plane located?

L3

at what level is the subcostal plane located?

passes through the most inferior point of ribcage

describe the location of the subcostal plane

L3/L4 level

at what level is the transumbilical plane located?

passes through umbilicus

describe the location of the transumbilical plane

L5 level

at what level is the transtubercular plane located?

passes through the iliac tubercles

describe the location of the transtubercular plane

median or midsagittal plane and midclavicular lines

what are the sagittal or vertical planes of the abdominal wall?

midclavicular point to midinguinal point

the midclavicular lines extend from the ___ to the ___

skin, superficial fascia (two layers), muscles (3 flat and 1 strap) with associated aponeuroses, transversalis fascia, extraperitoneal fat, parietal peritoneum

list layers of abdominal wall from superficial to deep

camper's and scarpa's fascia

what are the two layers of superficial fascia?

rectus abdominis, external oblique, internal oblique, transversus abdominis

what are the muscles of the abdominal wall from superficial to deep

superficial fascia

what is composed of two layers and is distinct from the fascia surrounding the abdominal musculature?

fatty superficial layer found just below the skin

what is camper's fascia?

deep, membraneous layer that will blend with fascia lata

what is scarpa's fascia?

fascia lata

what is the deep fascia of the thigh that fuses with scarpa's fascia called?

external oblique

the aponeurosis of what muscle forms the inguinal ligament?

three

how many tendinous intersections are within the belly of rectus abdominis m?

rectus sheath

what is the rectus abdominis covered by both anteriorly and posteriorly?

aponeuroses of external abdominal oblique and internal abdominal oblique mm fused together

what is the anterior wall of the rectus sheath formed by above the arcuate line?

aponeurosis of the internal abdominal oblique and transversus abdominis mm fused together

what is the posterior wall of the rectus sheath formed by above the arcuate line?

linea alba

what did the anterior and posterior walls of the rectus sheath fuse bilaterally to form?

a condition where the two halves of the rectus abdominis m separate

what is diastasis recti?

PT, surgery with sutures, mesh, or coils

what is the tx for diastasis recti?

pregnant women, anyone who has rapidly gained weight

what is the patient population for diastasis recti?

posterior wall of the rectus sheath between the umbilicus and the pubic rami

where is the arcuate line located?

the internal abdominal oblique and transversus abdominis mm aponeuroses travel anteriorly and fuse with the anterior rectus sheath

the arcuate line is an arched line that is formed as...

single very thin CT layer, transversalis fascia

what remains below the arcuate line?

fused aponeurosis of all three flat abdominal mm

what is the anterior wall of the rectus sheath inferior to arcuate line?

transversalis fascia

what is the posterior wall of the rectus sheath inferior to arcuate line?

ribs 5-12

origin: external abdominal oblique m

via aponeurosis to linea alba, pubic crest, and iliac crest

insertion: external abdominal oblique m

ventral rami of lower 6 thoracic spinal nn, iliohypogastric n, and ilioinguinal n (e)

innervation: external abdominal oblique m

support and compress abdominal contents, assist flexion and rotation of trunk

action: external abdominal oblique m

lumbar fascia, iliac crest, lateral 2/3 of inguinal ligament

origin: internal abdominal oblique m

via aponeurosis onto ribs 10-12, xiphoid process, linea alba, pubic symphysis

insertion: internal abdominal oblique m

ventral rami of lower 6 thoracic spinal nn, iliohypogastric n, and ilioinguinal n

innervation: internal abdominal oblique m

support and compress abdominal contents, assists flexion and rotation of trunk

action: internal abdominal oblique m

ribs 7-12, lumbar fascia, iliac crest, lateral 1/3 of inguinal ligament

origin: transversus abdominis m

xiphoid process, linea alba, pubic symphysis

insertion: transversus abdominis m

ventral rami of lower 6 thoracic spinal nn, iliohypogastric n, ilioinguinal n

innervation: transversus abdominis m

support and compress abdominal viscera, acts as a girdle for abdominal cavity

action: transversus abdominis m

public symphysis, pubic crest

origin: rectus abdominis m

xiphoid process and costal cartilage of ribs 5-7

insertion: rectus abdominis m

ventral rami of lower 6 thoracic spinal nn

innervation: rectus abdominis m

flex trunk, support and compress abdominal contents

action: rectus abdominis m

external oblique aponeurosis as it reflects inwards

what is the inguinal ligament formed by?

ASIS

what is the inguinal ligament attached to laterally?

pubic tubercle

what does the inguinal ligament attach to medially?

lacunar ligament

what is another reflection of the external abdominal oblique aponeurosis besides the inguinal ligament?

pectineal ligament and pectineal line of the innominate bone

what does the lacunar ligament connect the inguinal ligament to?

crescent shaped

describe the shape of the free margin of the lacunar ligament