Abdominal and Pelvic anatomy
Where do the gonads develop?
(male: testes; female: ovaries) develop at the posterior aspect of the abdominal cavity and descend through development.
What is the lesser omentum?
(ventral mesentery) from lesser curvature of the stomach and proximal duodenum to the liver
How does the gubernaculum function?
). This structure guides the gonads during their descent. The testes descend down to the scrotum and the ovaries down to the pelvic cavity. A remnant of the gubernaculum in females is the round ligament of the uterus (and the ovarian ligament) and in males it is the scrotal ligament.
What are the layers of outpouching caused by process vaginalis?
-Before the gonads begin to descend a peritoneal outpouching (known as the processus vaginalis) protrudes through the abdominal wall forming the inguinal canal and acquires coverings from the various layers its passing through: -Transversalis fascia -Transversus abdominis -Internal oblique muscle -External oblique muscle
What are the contractions of the internal abdominal obliques?
-Bilateral contraction -Unilateral contraction
What types of contraction does the external obliques cause?
-Bilateral contraction -unilateral contraction
What happens during ovulation?
-Burst of estradiol: positive feedback on FSH and LH -FSH and LH surge release of mature ovum -Cervical mucus increases in quantity and changes in quality—to support sperm motility and survival This begins several days before ovulation
What are the two layers of superficial fascia?
-Campers Fascia -Scarpa Fascia
What are the lymphatic nodes called?
-Celiac nodes near celiac trunk -Superior mesenteric nodes near SMA -Inferior mesenteric nodes near IMA
What are the major branches of the abdominal aorta?
-Celiac trunk -superior mesentery -inferior mesentery
What is the bilateral contraction of the rectus abdominis contraction?
-Compress abdominal viscera -Flex trunk
What is the inguinal or groin region defined by?
-Defined by inguinal ligament Formed by external oblique aponeurosis -Marks area where testes (and accompanying nerves and vessels) descend through the abdominal wall to enter scrotum After descent there is a passageway left called the inguinal canal
What is the development of the anal canal?
-Derived from endoderm -Innervated by GVA fibers -Supplied by IMA -Derived from ectoderm -Innervated by GSA fibers -Supplied by branches of internal iliac artery
What is the indirect hernia?
-Described as a congenital hernia -Occurs because of a persistent (open) processus vaginalis (peritoneal sac within layers of spermatic cord) -Frequently occurs in young males -Herniation lateral to inferior epigastric vessels -Will pass through deep and superficial inguinal rings
What is the vitelline fistula?
-Direct opening between ileum and umbilicus -Fecal discharge at umbilicus
What is the developmental stages of the pancreas?
-Dorsal and Ventral pancreatic buds develop in the dorsal and ventral mesentery, respectively. -As the duodenum grows and rotates the buds will join and fuse -Overtime the pancreas will get pushed up against the posterior abdominal wall due to the enlarging abdominal organs -It will loose it's mesentery and become secondarily retroperitoneal (also happens to most of duodenum)
When do organs become secondarily retroperitoneal?
-Dorsal mesenteries persist unless an organ becomes secondarily retroperitoneal
What are the secondary retroperitoneal organs?
-Duodenum (descending, horizontal and ascending) -Pancreas -Ascending and Descending colon and cecum -Rectum (upper 2/3)
Where does the lesser sac communicate with the greater sac?
-Epiploic or omental foramen (foramen of winslow)
what are the four paired muscles of the anterolateral abdominal wall?
-External abdominis obliques, Internal abdominal Obliques and Tranversus abdomnis -Rectus abdominalis and pyramidalis
What is congenital omephalocele caused by?
-Failure of bowl return to body cavity -Failure of the body walls to fuse at the umbilical ring because of defective growth of mesenchyme
What are the branches of Branches of L1 ventral ramus?
-Iliohypogastric -Ilioinguinal nerve
What ligaments are formed by the external abdominis obliques?
-Inguinal ligament -Lacunar ligament -Pectineal (i.e. cooper's) ligament
What is the inguinal triangle?
-Inguinal ligament -lateral border of the rectus abdomis -Inferior epigastric
What are the primary retroperitoneal organs?
-Kidneys and Ureters -Suprarenal glands -Uterine Cervix
What are the arteries of the abdominal wall?
-Musculophrenic a. (branch of internal thoracic) -Superior epigastric a. (branch of internal thoracic) -Lower posterior intercostal aa. (10th and 11th intercostal aa.) Subcostal a. -Inferior epigastric a. (branch of external iliac artery; will anastomose with superior epigastric a. posterior to rectus abdominus m.) -Deep circumflex iliac a. (branch of external iliac artery)
What is the merkel diverticulum?
-Outpouching of ileum (2ft proximal to ileocecal junction) -Vitelline lig from diverticulum to umbilicus -Inflammation can mimic appendicitis
How does the transport of cholesterol into the adrenal cortex happen?
ACTH activates StAR by transporting cholesterol into the mitochondria
What is the regional system of the abdominal region?
Abdomen is divided into 9 regions by vertical and horizontal planes.
What is the quadrant system of the abdomen region?
Abdomen is divided up into 4 quadrants for descriptive purposes and to isolate referred pain from organs Transumbilical plane Median plane
What intercostal rib does the abdomen reach?
Abdomen typically reaches the 5th rib Higher on right side due to liver
What is the abdominopelvic cavity?
Abdominal cavity separated from pelvic cavity by pelvic inlet.
What are the nerves of the thoracic wall?
Anterior and lateral cutaneous branches of intercostal nerves T7-T11 ventral rami (also known as thoraco-abdominal nerves) Anterior and lateral cutaneous branches of subcostal n (T12 ventral ramus) Branches of L1 ventral ramus: iliohypogastric n. and ilioinguinal n.
What forms anterior, posterior and lateral boundaries of the abdominopelvic cavity
Anterior, Posterior and lateral boundaries are formed by musculature and skeletal elements
Where does superficial fascia fuse?
At a point just inferior and parallel to the inguinal ligament.
How are lipids, and steroids transferred in the blood?
Attached to proteins that prevent degradation, the steroid are synthesize when needed but slowly released.
What is the contraction of the transversus abdominis?
Bilateral contraction
What is the rectus abdominis contraction?
Bilateral contraction
How does a steroid hormone work?
Binds to a E domain that is next to the C domain activates the C domain that binds to DNA. this transcribes the DNA forms mRNA that eventually is coded and has a physiological function.
What does the celiac nodes receive from?
Celiac nodes will receive lymph from the superior and inferior mesenteric nodes. Lymph will pass from the celiac nodes to the cisterna chyli and then into the thoracic duct.
What the types of embryo folding?
Cephalic-caudal (head - tail) folding Lateral folding Future gut is divided into a foregut, midgut and hindgut
Where do clefts develop?
Clefts develop in the dorsal mesogastrium (future greater omentum) and it bags out to the left enlarging a space called the omental bursa or lesser peritoneal sac
What are the clusters of the lymphatic ducts?
Clusters of pre-aortic lymph nodes are located near unpaired branches of abdominal aorta.
What is the corpus luteum?
Composed mostly of granulosa and theca cells Also capillaries, fibroblasts Secretes steroid hormones necessary for implantation and maintenance of zygote
What is the bilateral contraction of the transversus abdominis?
Compression of abdominal viscera
What is bilateral contraction internal abdominal obliques?
Compression of abdominal viscera and trunk flexion
What is the motion of the bilateral contraction of the external abdominis obliques?
Compression of abdominal viscera and trunk flexion
what is the entrance and exit of the inguinal canal?
Deep inguinal ring superficial inguinal ring (EXIT)
What is the dermatome and vertebral level of the jugular notch?
Dermatome C4, T2 verterbra
What is the vertebral dermatome Sternal angle?
Dermatome T2 Vertebral level T4
What is the xiphoid vertebral and dermatome?
Dermatome T6 T9 vertebrae
What are the direct hernias?
Described as an acquired hernia Occurs due to a weakness in abdominal muscles Viscera pass "directly" through wall Occurs medial to inferior epigastric vessels and medial to deep inguinal ring Herniation occurs in an area called the inguinal triangle (also Hesselbach's triangle) Will pass through superficial inguinal ring
What are the two types of hernias?
Direct Indirect
What is process vaginalis?
Direct opening from abdominal cavity to area of future scrotum If it persists an individual will be more susceptible to herniation. Processus vaginalis usually disappears but sometimes it does not (especially in males)
Where does each cluster receive lymph from?
Each cluster receives lymph from abdominal viscera: -Celiac nodes from foregut -Superior mesenteric nodes from midgut -Inferior mesenteric nodes from hindgut
What does the aponeurosis form?
Each of these have a broad flat tendon called an aponeurosis that interdigitate in the midsagittal plane (linea alba) with the aponeuroses from the opposite side forming the rectus sheath
What are the two vertical muscles enclosed by?
Enclosed by rectus sheath
What is the ending result GI development from the splanchnopleure
End result of folding: tube within a tube organization
what is the transversalis?
Endo-abdominal fascia lines internal aspect of abdominal wall.
How does the endoderm of the splanchnopleure form?
Endoderm forms epithelial lining of gut tube and gives rise to parenchyma (functional cells of gland or organ)
What is a thrombosis or obstruction of the IVC cause?
Enlarged veins (varices) in the abdominal and thoracic walls facilitate collateral channels of venous drainage.
What is the effect of oxytocin?
Estrogen stimulates oxytoxin in partituation and causes the uterine contractions. Prostaglandins can also cause an increase secretion of oxytocin
what extends to the allantois?
Extending from the anterior portion of the cloaca to the connecting stalk is the allantois
Which of the muscles anterolateral abdominal wall contain aponeurosis?
External abdominis obliques Internal abdominal obliques Transversus abdominis
What are the flat muscles of the anterolateral abdominal wall?
External abdominis obliques, Internal abdominal obliques, Transversus abdominis
How do you distinguish between retroperitoneal and infraperitoneal?
Extraperitoneal organs do not have a mesentery.
What hormones are in the follicular phase?
FSH and LH estradiol Dominant hormone: Estrogen (rising) Estrogen inhibits FSH and LH via negative feedback
What ligament passes between parts of the liver lobe and what ligament does it lead to?
Falciform ligament, which leads to the round ligament of the liver, a remnant of the umbilical vein that passes through the falciform ligament and spans the umbilicus to the liver
What happens if fertilization occurs?
Fertilization of ovum and implantation into endometrium; HCG released (HCG= human chorionic gonadotropin) During first trimester: corpus luteum provides progesterone to support pregnancy 2nd and 3rd trimesters: Placenta takes over progesterone production
What happens in the follicular phase in the ovary?
Follicular recruitment Graafian (dominant) follicle Neighboring follicles become atretic (regress
What are the ligaments of the greater omentum?
Gastrophrenic ligament Gastrosplenic ligament Gastrocolic ligament Splenorenal ligament *
What are 3 ways to describe sex?
Genetic sex Gonadal sex Phenotypic sex
What happens in stage 2 of the oogenenisis?
Granulosa and theca cells proliferate Fluid containing steroid hormones, proteins, FSH accumulates in the follicle (antrum) Granulosa cells directly secrete the steroid hormones Present only in the reproductive period
What cells have FSH receptors?
Granulosa cells are only ovarian cells that have FSH receptors Stimulates growth of granulosa cells in primary follicles Stimulates aromatase for conversion of testosterone to 17β-estradiol 17β-estradiol then supports trophic effect of FSH on follicular cells
What is a function of the greater omentum?
Greater omentum, aka "policeman of the abdomen," has the ability to migrate to an inflamed area of the intestine (intraperitoneal infection) and wall off the inflammation to contain it. When a portion of the bowl gets inflamed the smooth muscle within it ceases peristaltic movement (peristalsis is the mechanism by which the alimentary canal moves substances distally). The remaining non-inflamed intestine continues to move and "massages" the greater omentum to the area of inflammation.
What are the peritoneal subdivisions?
Greater sac Lesser sac (omental bursa
What attaches structures guides the gonads?
Gubernaculum Attaches to inferior aspect of gonad and region of external genitalia
What and why is a site of importance that involves the scarpa fascia?
Hasselbach triangle There is a potential space between the Scarpa's fascia and the deep fascia covering external oblique and rectus abdominis muscles. Blood can accumulate in this space or urine can accumulate if there is a ruptured urethra. Fluid in this potential space will not spread inferiorly into the thigh region because the deep fascia of the thigh is fused to Scarpa's fascia.
What are the 2 ligaments of the lesser omentum?
Hepatoduodenal ligament (Portal triad within) Hepatogastric ligament
Where is the hepatoduodenal ligament found?
Hepatoduodenal ligament is anterior to the epiploic or omental foramen
What is hyperthyroidism?
Hyperthyroidism is when the autoimmune system activates the TSH receptors and collect mucopolysaccharides behind the eyes.
What is a function of abdominal muscles?
Inspiration Expiration
What are infraperitoneal organs mostly, or fully covered with?
Intraperitoneal organs are mostly covered by visceral peritoneum (not always completely covered as the table above indicates but usually more than 2/3rds of the organ is covered) and intraperitoneal organs have a mesentery
Where is the transpyloric plane?
L1
what is the innervation of the inguinal and suprapubic region?
L1 ventral ramus
What does the large slippery area of the peritoneal cavity facilitate?
Large surface area of the peritoneal cavity facilitates the spread of infection or disease throughout the abdomen. The peritoneal cavity will also contain disease to the abdomen. Intraperitoneal infection will be contained to the abdomen below the diaphragm and will not spread to the thoracic cavity.
What happens when intra-abdominal pressure increases?
Laryngeal valve closed; air retained in lungs; fixed diaphragm with contraction of abdominal musculature Urination, vomiting, defecation, flatulence, childbirth
What is the mesoderm lateral aspect?
Lateral plate mesoderm Will split into 2 layers
What superior abdominal organs does the thoracic cage help to protect?
Liver Stomach Spleen Gallbladder Parts of large intestine
How T3 and T4 made?
MIT and DIT are in the colloid of the thyroglobulin and combine to make the T3 and T4.
Where is the estimated location of where the deep inguinal ring is located?
Midway between ASIS and pubic tubercle.
how does I work with the thyroid gland?
Na/I transporter exchanges the molecules and the I reacts with the MIT DIT thryoglobin to form T4 with peroxidase activity then it merges back in to colloid where the lysosome activate.
What is the function of JAK 2?
OJanus Kinase receptor 2 binds a ligand, then autophosphorylates its tyrosine amino acids. Next STAT binds to the phosphorylated tyrosine and then autophosphorylates the STAT. next STAT travels to the nucleus to perform transcription
How is the parietal innervated and how is the pain distributed?
Parietal peritoneum is innervated by somatic sensory (GSA) fibers that are associated with spinal nerve ventral rami of the abdominal wall and activation of these fibers is well localized.
What are the two layers of the peritoneum?
Parietal peritoneum lines the internal surface of the abdominopelvic wall (innervation: GSA) Visceral peritoneum directly invests viscera (innervation: GVA) Between the visceral and parietal peritoneum is the peritoneal cavity
Where are the peritoneal ligaments derived?
Peritoneal ligaments of the spleen are derived from dorsal mesogastrium.
What is congenital omephalocele?
Persistence of herniation of abdominal contents into the proximal part of the umbilical cord
Where do the primarily retro peritoneal organs develop?
Primarily retroperitoneal organs developed behind the parietal peritoneum and have an anterior surface that is covered by parietal peritoneum.
What are the stages of oogenesis?
Primordial primary secondary graafian follical if fertilized then zygote but if not fertilized then corpus albicans
When does the processus vaginalis typically obliterate and what happens obliteration does not occur?
Processus vaginalis typically obliterates in a 1 month old infant but if it remains patent the abdominal wall will be more susceptible to herniation. In other words, a patent processus vaginalis leaves an opening between the abdominopelvic cavity and the scrotum.
WHat happens in stage 3 of oogenesis?
Progression to ovulation Single graafian follicle achieves dominance Ovulation occurs 14 days before menses (day 14 of a 28 day cycle) Dominant follicle ruptures, and oocyte is released
What happens in the proliferative phase in the uterus?
Proliferation of endometrium (Proliferative phase)
What Is the pubic symphysis dermatome and vertebral level?
Pubic Symphysis- T12-L1
What other structure also are found at the same level as the transpyloric plane?
Pylorus of the stomach 1st portion (superior part) of the duodenum Neck of the pancreas Origin of the superior mesenteric artery The hila of both kidneys
What is the embryological germ layers of the abdomen?
Recall the 3 germ layers (trilaminar disc): Ectoderm Mesoderm Endoderm
What are the vertical muscles of anterolateral abdominal wall?
Rectus abdominalis and pyramidalis
What does the dorsal pancreatic bud become?
Rest of head of pancreas, neck, body and tail Distal portion of main pancreatic duct and accessory pancreatic duct
What is unilateral contraction of the external abdominis obliques?
Rotation and lateral bending of trunk Rotation → turns anterior part of abdomen to opposite side
What is the unilateral contraction of the abdominal obliques?
Rotation and lateral bending of trunk Rotation → turns anterior part of abdomen to same side
What does superficial fascia fuse with?
Scarpa's fascia is fused to the deep fascia of the thigh (fascia lata)
What are the differences in structure of the retroperitoneal and infraperitoneal?
Secondarily retroperitoneal organs have a fairly large bare area on their posterior surface. A bare area is defined as such because it is not covered by visceral peritoneum. Side note: the liver has a bare area, but it is categorized as intraperitoneal because it is mostly covered with visceral peritoneum and has a mesentery.
What is the function of the parietal cavity inside substance?
Serous fluids helps lubricate the parietal peritoneum from the visceral organs movements.
Where is the peritoneum found?
Serous membrane found in the abdominopelvic cavity
What are the fascial layers of the abdominal walls?
Skin Superficial fascia Investing layer of deep fascia Endo-abdominal fascia Extraperitoneal Fat Parietal Peritoneum
What is the pyramidal muscles?
Small, triangular muscle Tenses linea alba by drawing it down Sometimes absent
What are some mesenteries called?
Some mesenteries are called an omentum, peritoneal ligament or mesocolon:
What occupies the spot of the inguinal canal in males?
Spermatic cord
what does the splanchnic mesoderm give rise to?
Splanchnic mesoderm gives rise to stroma (connective tissue framework), visceral peritoneum, blood vessels and smooth muscle in gut
What is the spleen considered as?
Spleen is considered part of the foregut but does not develop as an outgrowth of the gut.
what are the peritoneal ligaments?
Splenorenal Gastrosplenic Hepatogastric Falciform
What is the function of T3,T4, calcitonin?
Stimulate skeletal muscle growth, heat production, oxygen consumption
What does LH do?
Stimulates cholesterol desmolase in theca cells for synthesis of testosterone. Initiates ovulation Stimulates formation of corpus luteum (luteinization) Maintains steroid hormone production by the corpus luteum during the luteal phase of the menstrual cycle
What is the function of the LH?
Stimulates the ovulation to the copus lutuem and secretion of progesterone and estrogen
What is the function of thyrotropin-releasing hormone?
Stimulates the thyroid-stimulating hormone
What is the omentum meaning?
Stomach
What are the development steps of the stomach in a embryo?
Stomach Starts to dilate in week 4 Appearance changes due to rapid growth along certain surfaces Greater curvature (original posterior wall) Position changes due to rotation (see next slide)
What is the horizontal plane of the abdominal cavity?
Subcostal (sometimes transpyloric, or L1, instead) plane Intertubercular plane
What is the flow of the blood during a IVC obstruction?
Superficial epigastrics thoracodorsal vein axillary vein
What is the superficial fascia?
Superficial fascia is a layer of fatty connective tissue deep to the skin
Where is the superficial inguinal ring located?
Superficial ring fully visible in external oblique aponeurosis.
What are the boundaries of the abdominopelvic cavity?
Superior: diaphragm Inferior: pelvic inlet
What is the cardiac plexus of the heart?
T1-T4
What is hashimotos disease?
TSH receptors are destroyed.
Why is the allantois important?
The allantois is an evolutionary remnant; in lower vertebrates it is important for storage of nitrogenous wastes (excreted by renal system) Placenta takes care of this in mammals Fibrous remnant of allantois is the urachus → medial umbilical ligament
What does the cranial portion of the diverticulum differentiate into?
The cranial portion of the diverticulum differentiates into the liver and as it enlarges it comes into contact with the diaphragm
How do the livers, gallbladder, and the system of bile ducts develop?
The liver, gallbladder and system of bile ducts develop as a ventral outgrowth from the abdominal foregut known as the hepatic diverticulum
What is the orgin, insertion, and function of the pyramidalis?
The pyramidalis originates on the pubis and pubic symphysis and inserts on the linea alba functioning to tense the linea allba.
What is the rectus sheath formed by?
The pyramidalis originates on the pubis and pubic symphysis and inserts on the linea alba functioning to tense the linea allba.
Which ligament can be discluded from the greater omentum ligaments
The splenorenal ligament is occasionally considered part of the greater omentum, but not always. Since the splenorenal ligament is a remnant of the dorsal mesogastrium, we will consider this ligament as part of the greater omentum in our course.
How does photoreception work?
The stimulus to light causes a conformational change in the rhodopsin further causing the Gprotein transducing and to activate phosphodiesterase to hydrolyze cGMP and lowering the amount of cGMP and causing the channels to close.
What is the insertions of the rectus abdominis?
There are 4 tendinous insertions along the length of each rectus abdominis muscle that attach to the anterior rectus sheath. There are 4 tendinous insertions along the length of each rectus abdominis muscle that attach to the anterior rectus sheath.
What is the significance of the rectus abdominis muscle?
These insertions shorten the length of muscle fibers thereby increasing muscular efficiency. Near it's attachment to the pubis there is a muscle called the pyramidalis (triangular in shape) that is missing in 20% of individuals.
what are the extraperitoneal organs?
These organs either have no mesentery or lost it during development.
What signifies a intraperitoneal organ?
These organs have a mesentery and are completely covered by the peritoneum
How do the gonads descend?
They descend throughout development. Ovaries descend down into the pelvic cavity and testes pass through the abdominopelvic cavity to lie within the scrotum.
What is a the importance of the fusion of superficial fascia and the fascia lata?
This prevents blood or urine from descending into the thigh.
What is the mesocolon?
Transverse colon retains part of dorsal mesentery: now called transverse mesocolon
What does the ventral pancreatic bud become?
Uncinate process Inferior part of head of pancreas Part of main pancreatic duct
What is the ventral mesentery of the foregut?
Ventral mesentery of foregut = falciform lig., hepatogastric lig. and hepatoduodenal lig. falciform ligament has a free inferior margin because the ventral mesentery of the midgut disappears
What is the innervation of Anterior abdominal wall?
Ventral rami of T7-T12
How is the visceral innervated and how is the pain distributed?
Visceral peritoneum is innervated by visceral sensory fibers (GVA) that accompany autonomic nerves and activation of these fibers leads to poorly localized sensation and referred pain.
What is the annular pancreas?
When ventral bud splits to move both anterior and posterior to duodenum: Forms ring around Stenosis (narrowing and constriction) of duodenum
Where is the median umbilical folds and what does it contain?
Where: in the midline extending from the bladder to umbilicus. What: contains the median umbilical ligament or the embryonic urachus.
Where is the lateral umbilical folds and what does it contain?
Where: lateral to medial umbilical fold. What: contains the inferior epigastric vessels.
Where is the medial umbilical folds and what does it contain?
Where: lateral to the median umbilical fold What: obliterated umbilical arteries
What is the femoral hernia?
Will pass inferior to inguinal ligament and through the femoral ring Will pass medial to femoral vessels More common in females due to wider pelvis structure
What is expiration?
abdominal muscles contract and diaphragm relaxes thus reducing volume of thoracic cavity Important in forced expiration: yelling, sneezing, coughing.
What is inspiration?
abdominal muscles relax and diaphragm contracts allowing for expansion of thoracic cavity Inferior displacement of abdominal viscera.
What is structures are herniating in direct, indirect and femoral hernia's?
abdominal viscera covered with peritoneum (serous membrane in abdomen)
What is the precursor molecule to testosterone?
androsteondione
What does L1 innervate?
area above pubic symphysis
What does T10 innervate?
area around umbilicus
WHat is ovulation?
characterized by development and proliferation of ovarian follicles
What is the follicular phase?
characterized by development and proliferation of ovarian follicles
What is the luteal phase>
characterized by transformation of follicular cells into a corpus luteum Unless implantation of a fertilized ovum takes place, the corpus luteum regresses and menses follows
What is the process of making estradiol>
cholesterol (cholesterol desmolase) pregnalone can form progesterone testosterone (aromatase) estradiol
What does the transversalis fascia contribute to the spermatic cord?
contributes the internal spermatic fascia
What does the splanchnic mesoderm contribute?
contributes to splanchnopleure (GVA)
What reactions of cholesterol are in the mitochondria?
corticosterone
What does the illioinguinal nerve innervate?
cutaneous innervation to anterior scrotum (male) or labia majora (female) and medial thigh
What does the illiohypogastric innervate?
cutaneous innervation to suprapubic region
What is Scarpa's fascia?
deep membranous layer
Where does the gubernaculum develop?
develops from the inferior border of the gonad to the labioscrotal swellings (external genitalia).
What is the visceral peritoneum?
directly invests viscera (innervation: GVA)A
What does the transversus contribute to the spermatic cord?
does not contribute anything since it arches above the passing processus vaginalis (see slide illustrating deep inguinal ring)
What is the peritoneal ligament?
double layer of parietal peritoneum from organ to organ or from organ to body wall
Where are the attachment sites of the Lacunar ligament?
extension of inguinal ligament onto pectin pubis
What are the attachment sites of pectineal ligament?
extension of lacunar ligament to edge of pelvic inlet
What happens in stage one of the primordial stage?
follicular cells provide nutrients oocyte with steroids and nutrients
Where are the attachments sites of the inguinal ligament?
from ASIS to pubic tubercle
What does the gubernaculum become in females?
gubernaculum becomes the round ligament of the uterus and ovarian ligament
What is the portal triad?
hepatic artery proper hepatic portal vein the common bile duct
Where is the hepatic diverticulum located?
hepatic diverticulum is located between the layers of the ventral mesogastrium
How are catecholamines, and peptide hormones transferred in the blood?
in vesicles as prohormones, so they can be quickly degraded, after their short effects on the cell.
What is the function of the parathyroid hormone?
increase Ca2+
What happens as the greater omentum expands?
inferiorly over the intestines
What does the stimulation of suckling cause?
inhibition of dopamine release of prolactin inhibition of GnRH
What is the function of the dopamine or prolactin inhibiting factor?
inhibits prolactin
What does somatostatin or the somatostatin inhibiting releasing hormone function?
inhibits the growth hormone
What covers the external surface of abdominal muscles?
investing layer of deep fascia
Where is the deep inguinal ring?
is the beginning of the canal (evagination of transversalis fascia) inferior to arching fibers of transversus abdominis
where is the deep ring?
is the beginning of the canal (evagination of transversalis fascia) inferior to arching fibers of transversus abdominis
What is the superficial ring?
is the end of the canal (opening between fibers of the external oblique aponeurosis)
What nerve fibers is the parietal peritoneum innervated by?
lines the internal surface of the abdominopelvic wall (innervation: GSA)
What is the mesocolon?
mesentery of the large intestine
What is the vertical plane of the abdominal cavity?
midclavicular
Where is the yolk sac incorporated?
midgut; remains connected by way of vitelline duct or yolk stalkmidgut; remains connected by way of vitelline duct or yolk stalk
What does the internal oblique abdominal muscle contribute to spermatic cord?
muscle contributes muscle fibers that make up the cremaster muscle
What do germ cells produce?
oogonia
What is the processus vaginalis?
outpouching of abdominal cavity next to gubernaculum
WHat do theca cells produce>
progesterone and testosterone
What is the prohormone of cortisol?
proopiomelanocortin
What is the growth hormone?
protein synthesis and overall growth
What is the factors that control circulating hormone concentrations?
rate of secretion plasma binding rate of elimination peripheral conversion
What is IGF-1 and 2?
released from the liver and 1 causes systemic growth and 2 has more autonomic release.
What does the gubernaculum become in males?
scrotal ligament
What is found in the parietal peritoneum?
serous membrane in abdomen
What does T7 innervate?
skin below xiphoid process
What does the GI system develop from?
splanchnopleure
What is the function corticotropin-releasing hormone?
stimulates adrenocorticotropins
What does oxytocin?
stimulates milk ejection from the breast and uterine contractions
What is the function of the FSH?
stimulates sperm maturation in sertoli cells stimulates follical development and estrogen synthesis in the ovaries stimulates the leydig cells to secrete testosterone
What is the function of the growth hormone releasing factor?
stimulates the GH
What is the function of gonadotropin releasing hormone?
stimulates the LH or FSH
What does ACTH
stimulates the secretion of the adrenal cortex
What is the function of vasopressin?
stimulates water absorption of the principle cells, and contriction of arterioles
What is Camper's Fascia?
superficial fatty layer
What do granulosa cells produce?
surround oogonia to form oocytes synthesize estradiol together with theca cell
What is the entrance to the omental bursa?
the epiploic or omental foramen
What does the external oblique muscle contribute?
the external spermatic fascia
What does the hindgut supply?
the inferior mesenteric artery (IMA) distal 1/3 of transverse colon, descending colon, sigmoid colon, rectum and anal canal (up to pectinate line)
What occupies the spot of the inguinal canal in females?
the round ligament of the uterus
What does the midgut supply?
the superior mesenteric artery (SMA) Second half of duodenum, jejunum, ileum, cecum, ascending colon, and proximal 2/3 of transverse colon
What does below the arcuate line?
transversalis fascia posterior to rectus abdominis
Why are older people more susceptible to direct hernias?
weakness in the abdominal musculature that develops over time. Therefore, older individuals are more susceptible and causes include raised intraabdominal pressure, nerve damage to the muscles of the abdominal wall (from surgical incisions) and weakening or stretching of the abdominal wall muscles.
Where does the arcuate line marks the point of transition?
where each aponeurosis of the 3 flat muscles passes anterior to the rectus abdominis
What is the development of the gut?
-Recall that midgut is suspended by a dorsal mesentery -This portion of the gut tube communicates with the yolk sac via the vitelline duct or yolk stalk -It undergoes elongation/growth and forms a loop -Herniation into umbilical cord due to rapid growth and limited space -Counterclockwise rotation (90 degrees) about SMA and return to the abdomen at around 10 weeks -Elongation continues during rotation -Jejunum and ileum begin to coil; large intestine just elongates -Once the intestines return to the abdomen they undergo another 180 degree about a AP axis -Mesentery twists around with rotation -Connection with yolk stalk is lost Ascending colon (midgut) and descending colon (hindgut) get pressed against posterior abdominal wall -Both loose their mesentery and become secondarily retroperitoneal
What are the secondarily peritoneal organs?
-Secondarily retroperitoneal organs once had a dorsal mesentery during development but the mesentery was resorbed as the organ was pushed up against the posterior aspect of the abdominal cavity. -Secondarily retroperitoneal organs still have visceral peritoneum covering their surface that is continuous with parietal peritoneum, just no mesentery (see next slide).
What does the lateral plate mesoderm divide into?
-Splanchnic mesoderm (visceral peritoneum) -Somatic mesoderm (parietal peritoneum)
What are the peritoneal ligaments?
-Splenorenal ligament (allows for passage of splenic vessels) -Gastrosplenic ligament
What are the organs of the abdominal peritoneum?
-Stomach -Small intestine (some of the superior part of the Duodenum, jejenum, and ileum) -Spleen -Liver -Gall bladder -Cecum with veniform appendix (portions of variable size may be retroperitoneal)
What is development of hindgut?
-Terminal hindgut enters the cloaca -Cloaca (Latin for sewer) -Is divided by septum: posterior aspect will be the anorectal canal and anterior aspect will develop into urinary and reproductive structures -Cloacal membrane will be separated by septum and becomes anal membrane = future anal opening for hindgut (eventually ruptures) -Marks boundary between ectoderm and endoderm-
How is the gut tube suspended in the abdomen?
-The gut tube is suspended by dorsal and ventral mesenteries in the abdomen -Ventral mesenteries of the midgut and hindgut disappear by the end of the first month of development
What cells are involved in the development of the spleen?
-The spleen develops from mesenchymal cells in the layers of the dorsal mesogastrium
What are the infraperitoneal organs?
-Urinary bladder -Distal ureters -Prostate -Seminal Vesicle -Uterine Cervix -Vagina -Rectum (lower 1/3)
What is pelvic peritoneum?
-Uterus (fundus and body) -Ovaries -Uterine tubes
What branches of the abdominal aorta supply the abdominal gut?
-abdominal foregut, Celiac Trunk -Midgut, Superior mesenteric artery -Hindgut, Inferior mesenteric artery
What does the celiac trunk supply?
-esophagus - stomach -first half of duodenum (liver, gallbladder, bile ducts, and pancreas develop as outgrowths of the abdominal foregut)
What is the linea alba formed by?
-point of fusion in the midline -Completely encloses upper 3/4th portion of rectus abdominis
What is the strangulation of a hernia?
. Strangulation of the hernia can occur where the blood supply to the hernial sac is pinched resulting in ischemia (reduced blood supply to tissues). Note the hernia passing medial to the inferior epigastric vessels through an area known as the inguinal triangle.
What is the mesentery?
A mesentery is a double layer of parietal peritoneum that helps to suspend organs within the abdominopelvic cavity. It is continuous with visceral peritoneum and provides a route for lymphatics, vessels and nerves to reach an organ