What are the bones of the pelvic girdle
Sacrum, Coccyx, 2 Os Coxae
What bones compose the os coxae
Ilium, Ishium, Pubis
What is the concave fossa where the femur articulates with the pelvis?
Acetabulum
Which muscle interdigitates with the serratus anterior?
External oblique m.
What is the “white line” down midline of the abdominal cavity?
Linea Alba
What is the line on the lateral aspect of the rectus abdominis?
Linea semilunaris
What creates the “6-pack” look
Tendinous insertions of the rectus abdominis
What bony landmark is the most anterior portion of the iliac spine?
Anterior Superior Illiac Spine
What plane intersects the inferior surface of the rib cage?
Subcostal plane
What is the vertebral level of the sternal notch
T3 body
What is the vertebral level of the Sternal angle of Louis?
T4-T5 disc
What is the vertebral level of the xiphisternal joint?
T9-T10 disc
What is the vertebral level of the subcostal plane?
L3 body
What is the vertebral level of the transumbilical plane?
L4 body
What is the vertebral level of the sacral promontory?
S1
The intersection of what two planes creates the quadrants of the abdomen
The median sternal plane and the transumbilical plane
What planes intersect to create the 9 subdivisions of the abdomen?
Midclavicular lines and the subcostal and intertubercular lines
What structures form the superior boundary of the abdominal wall?
Costal margin, ribs 11-12, xiphoid process, diaphragm
What are the two branches of the Internal Thoracic artery?
Musculophrenic artery and superior epigastric artery
Where in the abdominal wall does the superior epigastric a. course?
Posterior to Rectus abdominis m. within the rectus sheath
What is the source of the external iliac artery?
It is a branch off the bifurcation of the aorta
What are the two branches of the external iliac artery?
Inferior epigastric a., and Deep circumflex iliac a.
What area does the deep circumflex iliac a. supply?
Low, lateral abdominal wall- iliac region lateral to crest
To which vein do upper abdominal veins ultimately drain?
Axillary v.
To which vein do lower abdominal veins ultimately drain?
Femoral v.
What are the primary connecting veins of the abdomen?
Superficial epigastric v. and thoracoepigastric v.
What is the dermatome of the umbilicus
T10
What is the dermatome of the nipples?
T4
What is the dermatome of the suprapubic region
L1
What nerves make up the anterior and lateral cutaneous branches of the thoracoabdominal nn.?
Ventral rami of T7-11 intercostal nn.
What is the name of the anterior division of the T12 spinal n.?
Subscostal nn.
What two nerves are anterior branches of L1?
Iliohypogastric n and Ilioinguinal n.
What is the course of the ilioinguinal n.?
Runs lower than iliohypogastric n, and goes through inguinal canal and innervates skin on the medial side and external genitalia
What are the functions of the abdominal wall
1) Supports and protects abdominal viscera
2) Flex and rotate the trunk, maintain posture
3) Alters
What is the name of the fatty superficial fascial layer
Camper’s fascia
What is the name of the membranous layer of superficial fascia that overlies the muscular layers
Scarpa’s fascia
From superficial to deep, what layers would a surgeon cut through in getting into the peritoneal cavity?
Skin, Camper’s fascia, Scarpa’s fascia, external oblique anterior lamella, external oblique m., internal oblique anterior lamella, internal oblique m., transversus abdominis anterior lamella, transversus abdominis m., posterior lamella, transversalis fascia, extraperitoneal fat,, parietal peritoneum
What is the direction of external oblique m fibers?
Superolateral to inferomedial
What makes up the inguinal ligament?
Inferior free edge of external oblique m. aponeurosis
The inguinal ligament extends from where to where?
The anterior superior iliac spine to the pubic tubercle
External oblique innervation
Thoracoabdominal nn. (T7-T11) and Subcostal n (T12)
What direction do the internal oblique muscle fibers run?
Inferolateral to superomedial
Internal oblique m. innervation
Thoracoabdominal (T7-11), Subcostal nn. (T12), Iliohypogastic and Ilioinguinal nn (L1)
In which direction do the fibers of the Transverse Abdominis muscles run?
Transversely
Transverse Abdominis m. innervation
Thoracoabdominal (T7-11), Subcostal nn. (T12), Iliohypogastic and Ilioinguinal nn (L1)
Rectus Abdominis m innervation
Thoracoabdominal nn (T7-11), Subcostal nn. (T12)
Which abdominal muscle is present in only 80% of pop.
Pyramidalis mm.
Pyramidalis m action
Tense linea alba
Pyramidalis m innervation
Subcostal n. (T12)
What are the layers of the anterior rectus sheath superior to the arcuate line
Aponeurosis of external oblique, anterior lamina of the aponeurosis of the internal oblique
What are the layers of the posterior rectus sheath superior to the arcuate line
Posterior lamina of internal oblique aponeurosis, anterior and posterior fascia layers of transversus abdominis m., transversalis fascia.
What are the layers of the anterior rectus sheath inferior to the arcuate line
Aponeurosis of external and internal oblique mm., aponeurosis of transversus abdominis m.
What are the layers of the anterior rectus sheath posterior to the arcuate line
Transversalis fascia
What is the inferior border of the abdominal cavity
the pelvic inlet
Where is the False Pelvis?
Between iliac crests and the pelvic brim
Where is the true pelvis?
From the pelvic brim to the pelvic diaphragm mm.
What forms the posterior border of the inferior pelvic apeture?
Sacrotuberous ligament
What are the two classifications of organs within the peritoneum? What is the difference?
Intraperitoneal (almost completely enclosed within visceral peritoneum) and extraperitoneal (external to and only partially covered by parietal peritoneum) organs
What are the typical contents of the peritoneal cavity?
Peritoneal fluid
Is the peritoneal cavity closed or open?
Closed in males, open in females
What pouches are created by reflections of the parietal peritoneum
Vesicouterineand rectouterine pouches in females; rectovesical pouch in males
What are the extra-peritoneal organs in the pelvic cavity?
Bladder, uterus, prostate, seminal vesicles, rectum, part of ureters
What is the median umbilical ligament a remnant of?
The obliterated connection from the umbilicus and top of bladder (urachus)
What is the medial umbilical ligament a remnant of
The obliterated umbilical artery
Lateral umbilical ligament is created by what?
Inferior epigastric vessels
What is mesentery
A double layer of peritoneum w/ blood vessels, nerves, fat and lymphatics running in it
What is a peritoneal ligament?
A double layer of peritoneum that connects an organ to an organ or an organ to the abdominal wall
What are the three named peritoneal mesenteries?
Transverse mesocolon, sigmoid mesocolon, mesentary proper
What are the true retro peritoneal structures?
The kidneys and ureters
What are the secondary retroperitoneal structures?
2-4th portion of duodenum, ascending ad descending colon
What connects the Lesser Sac and Greater Sac?
Epiploic foramen/ omental foramen/Foramen of Winslow
What are omenta
Double layered fold of peritoneum that encloses fat
What ligaments does the greater omentum consist of
Gastrosplenic ligament, gastrophrenic ligament, gastrocolic ligament
What are the two ligaments of the lesser omentum
Hepatogastric and hepatoduodenal ligaments
What is the free edge of the lesser omentum called? What does it contain?
Hepatoduodenal ligament—portal triad