PA 509 Unit 14 Anterior Abdomen
Abdominal viscera not protected by the diaphragm are protected mostly by which structures?
The muscular walls of the abdomen
Where is the abdomen located
The region that extends between the thorax and the pelvis
The lower ribs protect which abdominal structures?
The superior poles of the kidneys
What is the significance of topographical divisions of the abdomen?
Topographical divisions of the abdomen are used to describe the location of abdominal organs and the location of pain associated with abdominal problems
the superficial circumflex iliac artery is a branch off of the ______________ artery that travels in the superficial fascia along the _________ ligament to supply the __________ __________ region of the anterolateral abdominal wall
femoral artery inguinal ligament
what is the finial event in the developmental process of the inguinal canal in males and females?
males - descent of testes into the scrotum females - descent and lateral displacement of ovaries into the pelvic cavity
after piercing the IAo the iliohypogastric nerve supplies the skin of the ___________ area of the __________
medial area of the groin
During inspiration the anterior abdominal wall ___________ to accommodate the expansion of the thoracic cavity due to the descent of the _________ and subsequent inferior displacement of the abdominal viscera
relaxes; diaphragm
What structures does the RUQ contain?
right portion of the liver (most of the liver), gal bladder, right kidney/adrenal gland, stomach, small bowel, pylorus, doudenum, head of pancreas, hepatic flexure of colon, portions of ascending and descending transverse colon
in women the inguinal canal contains what structure?
round ligament of the uterus
the fibers of the external abdominal oblique interdigitate or overlap with the muscle fibers of which muscle?
seratus anterior
in the upper abdominal region the superficial fascia contains a ______________ that is called the ________________ or __________________
single strata; superficial fatty layer; Camper's fascia
the layers of the abdominal wall consist of :
skin superficial fascia (subcutaneous tissue) muscles and their associated deep fascias transversalis facia extraperitoneal fascia parietal peritoneum
what are the borders of the pelvic inlet?
slants forward and inferiorly from the sacral promontory to the superior aspect of the pubic symphisis bound by the: sacral promontory arcuate lines pectineal lines pubic symphisis
guarding is initiated by reflex spasms caused by the excitation of __________ __________ ______ in segments of the ________ ___________ to guard the underlying viscera from pressure
somatic pain afferents parietal peritoneum
in men the inguinal canal contains what structure?
spermatic cord
after piercing the IAO the ilioinginal nerve accompanies the ________ in males or the ______ in females in the inguinal canal to supply the skin of the anterior surface of the ________ in males or the ______ in females and in both sexes sends a small cutaneous branch to the _________
spermatic cord round ligament scrotum labia majora thigh
in the upper 3/4 of the abdomen, this structure splits into anterior and posterior layers and passes around both sides of the rectus abdominis
the aponeurosis of the IAO
in the upper 3/4 of the abdomen this structure passes posterior to the rectus abdominis
the aponeurosis of the transversus abdominis
in the lower 1/4 of the abdomen this structure passes anterior to the rectus abdominis
the aponeurosis of transversus abdominis
anterior cutaneous nerve branches from the thoracoabdominal nerves at spinal nerve level T10 supplies cutaneous innervation to what area?
the area at the level of the umbilicus
anterior cutaneous nerve branches from the thoracoabdominal nerves at spinal nerve level T11 supplies cutaneous innervation to what area?
the area just below the umbilicus
the inguinal region is defined as
the area of junction between the anterior abdominal wall and thigh
this is a long flat muscle that extends the entire length of the anterior abdominal wall
rectus abdominis
this muscle arises from the pubic crest, tubercle and symphisis as a short tendon
rectus abdominis
the anterior layer of the internal abdominal oblique passes anterior to the _________ muscle along with the aponeurosis of the _________ muscle
rectus abdominis external abdominal oblique muscle
this structure is formed by the aponeuroses of the three flat muscles (EAO, IAO and TA) of the anterolateral abdominal wall and surrounds the rectus abdominis muscles and the pyramidalis muscles if present
rectus sheath
this ligament is a minor extension off the medial end of the inguinal ligament that travels from the pubic tubercle upward to the linea alba
reflected inguinal ligament
the skin and muscles of the anteriolateral abdominal wall are innervated by the ______ through ______ and ______ spinal nerves
T7-T12 and L1
the anterior wall of the inguinal canal is formed by these two structures
1. EAO aponeurosis over the entire length of the canal 2. IAO muscle on the lateral 1/3 of the inguinal canal
these two structures form the roof of the inguinal canal
1. arched fibers of the TA over the lateral 1/3 2. arched fibers of the IAO and the TQA over the middle and medial 1/3
These two structures account for the stability of the posterior abdominal wall:
1. bodies and discs of the lumbar vertebrae 2. alae of the iliac portion of the innominate bones
What are the five processes involved in the coughing mechanism?
1. deep inspiration 2. closure of the glottis 3. Contraction of the chest wall musculature and abdominal muscles to increase intra-thracic and intra-abdominal pressure 4. opening of glottis 5. forceful expulsion of air
what three anteriolateral abdominal wall muscles tilt the pelvis posteriorly as their closed chain action?
1. external abdominal oblique 2. internal abdominal oblique 3. rectus abdominis
What are two ways that material can be expelled from the airways?
1. forced expiration through activation and contraction of the abdominal muscles 2. coughing and sneezing (physiological mechanisms)
What are two methods of splinting a coughing patient after abdominal or thoracic surgery?
1. hold a pillow or cushion firmly but gently against the incision to make coughing less painful 2. patient can provide counter pressure by using the pillow or cushion to make the cough more effective
these two nerves are branches off the ventral rami of L1 and are the most distal nerve supply to the anterolateral abdominal wall
1. iliohypogastric nerve 2. ilioinguinal nerve
the rectus sheath has an anterior and posterior _________ laminae that fuse with each other in these two locations
1. in the midline along the linea alba 2. laterally along the left and right linea semilunaris
the inferior part of the anteriolateral abdominal wall is supplied by these four arteries
1. inferior epigastric artery 2. deep circuflex iliac artery 3. superficial epigastric artery 4. superficial circumflex iliac artery
these two muscles are innervated by the ventral rami of T7-T12 and L1 spinal nerves
1. internal abdominal obliques 2. transversus abdominis
what are the three ligaments that form from extensions off the medial end of the inguinal ligament?
1. lacunar ligament 2. pectineal (cooper's) ligament 3. reflected inguinal ligament
venous blood from the anterolateral abdominal wall drains to the inferior vena cava from these three locations
1. lumbar veins (directly or through the ascending lumbar veins) 2. inferior epigastric and deep circumflex iliac veins which drain into the external iliac vein 3. superficial epigastric vein and superficial circumflex iliac veins which drain into the femoral veins
these two structures form the floor of the inguinal canal
1. medial 1/2 of the inguinal ligament 2. the lacunar ligament
the internal abdominal oblique muscles and the transversus abdominis muscles are supplied by what four arteries?
1. medial branches off the musculophrenic artery 2. deep circumflex iliac artery 3. superficial epigastric artery 4. superficial circumflex iliac artery
the weakening of the EAO in due to the evagination of the superficial inguinal ring is reinforced by these three crural fibers
1. medial crus - superior margin of the superficial inguinal ring 2. lateral crus - inferior margin of the superficial inguinal ring 3. intercrural fibers - lateral margins of the superficial inguinal ring; binds together the proximal ends of the medial and lateral crura and give the superficial inguinal ring a rounded appearance when well defined
the external abdominal oblique muscles get their blood supply from which 3 major arteries?
1. musculophrenic artery medial branches 2. superficial epigasteric artery 3. superficial circumflex iliac artery
These three pairs of muscles increase the bulk of the posterior abdominal wall:
1. quadratus lumborum 2. psoas major 3. iliacus
what are the two vertical muscles in the anterolateral group of abdominal wall muscles that sit near midline?
1. rectus abdominis 2. pyramidalis
Together the anterolateral abdominal wall musculature has several important functions. what are these five functions?
1. strong expandable support for anteriorlateral abdominal wall 2. protect abdominal viscera 3. compress abdominal contents to maintan or increase intraabdominal pressure by opposing the diaphragm to aid in forced expiration, childbirth, micturition (urination) defecation 4. maintain posture 5. stabilize L spine
the rectus abdominis is supplied by these two arteries:
1. superior epigastric 2. inferior epigastric
venous blood from the anterolateral abdominal wall drains to the superior vena cava from these two locations
1. the lower intercostal and subcostal veins through the azygous and hemiazygous veins 2. the superior epigastric veins through the internal thoracic veins to the brachiocephalic veins
deep lymphatic drainage of the anterolateral abdominal wall follows the deep arteries back to these three locations
1. the parasternal nodes along the internal thoracic artery 2. lumbar nodes along the abdominal aorta 3. external iliac nodes along the external iliac artery
in the lower abdomen, the superficial fascia is defined by two strata:
1. the superficial fatty layer or Camper's fascia 2. A thin deeper membranous layer called Scarpa's fascia
the posterior wall of the inguinal canal is formed by these three structures
1. transversalis fascia throughout the entire length 2. conjoint tendon along the medial 1/3 (with transversalis fascia on its deep surface) 3. reflected inguinal ligament anterior to the conjoint tendon
Laterally the abdomen is enclosed by these three concentric layers of sheet like muscles and their aponeuroses
1. transversus abdominis 2. internal abdominal oblique 3. external abdominal oblique
The rectus abdominis and pyramidalis muscles are enclosed within a tendinous sheath formed by the aponeurosis of which three muscles from both side of the anteriolateral abdominal wall?
1. transversus abdominis 2. internal abdominal oblique 3. external abdominal oblique
what are the three flat muscles in the anteriolateral group of abdominal wall muscles?
1. transversus abdominis 2. internal abdominal oblique 3. external abdominal oblique
what are the five muscles found in the anterolateral group of abdominal wall muscles?
1. transversus abdominis 2. internal abdominal oblique 3. external abdominal oblique 4. rectus abdominis 5. pyramidalis
Fibrous bands of the endoabdominal fascia blend with the epimysium of the abdominal wall muscles increasing the thickness of the deep fascia forming distinct membrane- like fascia over the inner surface of these three muscle groups
1. transversus abdominis and its aponeurosis (transversalis fascia) 2. psoas muscle (psoas fascia) 3. iliacus muscles (ilacus fascia)
these two muscles get their blood supply from the medial branches off the musculophrenic artery, deep circumflex iliac artery, superficial epigastric artery and superficial circumflex iliac artery
1.. internal abdominal oblique 2. transversus abdominis
the distal attachment of the internal abdominal obliques are the inferior border of the lower ______ or _____ ribs (ribs ______ through _______) and their ____________; by aponeuosis to the _______, __________, and __________
3 or 4 ribs (ribs 9-12) and their costal cartilages by aponeurosis to the linea alba, pubic crest, and pectineal line
the _________ divides the anteriolateral abdominal wall into a superior _______ and a inferior _________
3/4 1/4
in the lower 1/4 of the abdomen this structure passes anterior to the rectus abdominis along with the aponeurosis of the EAO
the aponeurosis of the IAO
What is the valsalva maneuver?
A forceful exhalation against a closed airway (glottis closed and contraction of the anterior abdominal wall) that increases pressure in the thoracic cavity and results in decreased venous return. important in bowel voiding and emptying contents of the bladder Main mechanism of childbirth
the deep inguinal ring is located between the ________ and the ________ just above the _________ immediately lateral to the _________ _______ _______
ASIS pubic symphisis inguinal ligamet inferior epigastric artery
the inguinal ligament forms a reinforced trough that extends from the ____________ to the ____________
ASIS; pubic tubercle
How does the anterior abdominal wall effect intra-abdominal pressure?
Contraction of the abdominal wall muscles increases intra-abdominal pressure when the diaphragm is in a fixed position Air is retained in the lungs by the closure of the glottis
In women the ________________ retains some of its fat and is a component of the ____________
Camper's fascia ; labia majora
the gubernacular bulb attaches to the fascia between the developing __________ and __________ muscles in the region of the ______________ _____________
EAO and IAO labiocrotal swelling
What are the three vertical lines on the anterior abdominal wall that are related to the rectus abdominis muscle?
Linea alba (midline) and the left and right linea semilunaris
What structures does the RLQ contain?
Small bowel, cecum and appendix, portions of ascending colon, lower pole of right kidney, right ureter
What structures does the LUQ contain?
Small bowel, left lobe of liver, spleen, stomach, body of pancreas, splenic flexure of colon, portions of transverse and descending colon, left adrenal land, and left kidney
What structures does the LLQ contain?
Small bowel, sigmoid colon, portion of descending colon, lower pole of left kidney, left ureter
the lower abdominal reflexes are supplied by nerve roots _________
T11-T12
the upper abdominal reflexes are supplied by nerve roots __________
T7-T10
the external abdominal oblique muscles are innervated by the ventral rami of ______ to ______ spinal nerves
T7-T12
the internal abdominal obliques and the transversus abdominis muscles are innervated by the _______ rami of _________ and _______ spinal nerves
T7-T12 and L1
guarding as it pertains to the anteriolateral abdominal wall is defined as
a sustained involuntary contraction of segments of the abdominal musculature provoked by local peritoneal inflammation
Where is the umbilicus located
anterior midline at vertebral level L3 and L4
the term "abdominal wall" is used by clinicians an anatomists to refer to the _____________ only
anterolateral abdominal wall diaphragm transverse abdominis internal abdominal oblique external abdominal oblique
the posterior surface of the lower 1/4 of the rectus abdominis is in direct contact with the transversalis fascia nd is demarcated by a line of transition called the _____________
arcuate line
What is the function of increased intra-abdominal pressure?
assist in voiding the contents of the rectum, bladder, and giving birth in females
superficial lymphatic drainage of the anterolateral abdominal wall above the umbilicus passes superiorly to the ______________ nodes
axillary nodes
what is the deep inguinal ring?
beginning of the inguinal canal evagination of the transversalis fascia forming the innermost covering of th structures passing through the inguinal canal
the distal attachment of the transversus abdominis is by aponeurosis to the ________, _______ and ___________
by aponeurosis to the linea alba, pubic crest, and pectineal line
bilaterally the transversus abdominis muscles ____________ abdominal viscera and ____________
compress abdominal viscera and aid in expiration
The superior and anterior portions of the abdomen proper are surrounded by ____________ and _____________ walls, whereas the posterior abdominal wall is _______________ and _____________
contractile; distensible stable; bulky
During expiration the anterior abdominal wall ____________ to assist in the elevation of the ____________ decreasing thoracic volume
contracts; diaphragm
the distal attachment of the rectus abdominis muscle are the costal cartilages of ribs ________ through ________ and the _________ process
costal cartilages of ribs 5-7 and the costal cartilages
In men, Camper's fascia looses its fat and fuses with Scarpa's fascia and continues into the scrotum to form a specialized fascial layer containing smooth muscle called __________________.
dartos fascia
What is the name for the thin connective tissue membrane that is firmly attached to the muscles of the anterior abdominal wall and their aponeuroses?
deep (investing) fascia
the inguinal canal begins at the ______ _______ ______ and continues for _____ cm ending at the _____ _____ ______
deep inguinal ring 4cm superficial inguinal ring
superiorly the endoabdominal fascia lines the interior surface of the _______________
diaphragm
what is the function of the pelvic inlet?
divides the abdominopelvic cavity into the abdominal cavity proper (peritoneal cavity) and the pelvic cavity
The loose areolar tissue that lines the entire abdominal cavity is called the
endoabdominal fascia
inferiorly the endoabdominal fascia is continuous with the ______________
endopelvic fascia
the most superficial of the three flat muscles in the anteriolateral abdominal wall musculature is the ______________________.
external abdominal oblique
the inferior epigastric artery is a branch off of the __________ that ascends within the rectus sheath deep to the rectus abdominis to supply the inferior part of the anteriolateral abdominal wall
external iliac artery
the deep circumflex iliac artery is a branch off of the _______________ that runs parallel to the ___________ ligament to supply the inferiolateral region of the anteriolateral abdominal wall
external iliac artery inguinal ligament
The ___________________ may become laden with fat especially posteriorly where it surrounds the kidneys
extraperitoneal connective tissue
the superficial fascia of the thigh is referred to as the _____________
fascia lata
Where are the left and right linea semilunaris located?
fascial lines lateral to the two rectus abdominis muscles
the superficial epigastric artery is a branch off of the ___________ artery that travels in the superficial fascia towards the ______________ to supply the ______________ ___________ region of the anteriolateral abdominal wall
femoral artery towards the umbilicus superficial inferomedial region
bilaterally the external abdominal obliques, internal abdominal obliques and the rectus abdominis ________ the trunk, ________the abdominal viscera and ______________
flex the trunk compress the abdominal viscera aid in expiration
What forms the linea alba of the anterior abdominal wall?
formed by several layers of aponeurosis between the two rectus abdominis muscles
What are the two most commonly used schemes for the topographical division of the abdomen?
four quadrant pattern and nine region pattern
anterior cutaneous nerve branches from the thoracoabdominal nerves at spinal nerve levels T7-T9 supply cutaneous innervation segmentally to what area?
from xiphoid process to just superior to the umbilicus
the superior end of the gubernaculum attaches to the _______
gonad
the expanded end of the gubernaculum is refered to as the
gubernacular bulb
during development both the testes and ovaries depend on a ligamentous cord called the _____________ that is formed during the ______ week of development within the _________ fascia
gubernaculum 7th extraperitoneal fascia
at the level of the ASIS the muscle fibers of the internal abdominal oblique run in an __________ direction
horizontal
the fibers of the transversus abdominis muscle are mostly ____________ (superior to the ASIS) and end in an aponeurosis at the ____________
horizontal linea alba
these two nerves are branches off the L1 ventral rami that originate from the lumbar plexus
iliohypogastric nerve ilioinguinal nerve
these two nerves pass over the posterior abdominal wall muscles within the abdominal cavity and enter the neurovascular plane by piercing the transversus abdominisn just before they reach the ASIS
iliohypogastric nerve ilioinguinal nerve
in both sexes the ________ nerve passes through part of the inguinal canal and exits through the _________ _______ _______
ilioinguinal nerve superficial inguinal ring
the external abdominal obliques insert into the anterior 1/2 of the outer lip of the ____________, the __________ and by aponeurosis ending the ___________(a midline raphe)
illiac crest; ASIS; linea alba
unilaterally both the external abdominal obliques and the internal abdominal obliques actions are _____________ side bend and ______________ rotation of the trunk
ipsilateral sidebend contralateral rotation of the trunk
unilaterally the rectus abdominis may aid in what action?
ipsilateral sidebend of the trunk
In surgical patients, general anesthesia leads to the following:
impaired FRC due to decreased intercostal and diaphragmatic tone, pleural pressure>>>atmospheric pressure in dependent lung regions causing atelectasis of small airways and subsequent hypoxia, CNS respiratory centers are depressed increasing hypoxia, altered composition of surfactant, increased viscosity of tracheal mucus, and dehydration of respiratory epithelium impairing mucocilliary clearance
what is the difference between males and females in the formation of the inguinal canal during development
in males the inguinal canal extends into the scrotum and transmits the descending testis in females a complete inguinal canal also forms but does not play a role in genital formation
in both males and females the processus vaginalis normally degenerates. when it remains patent the inguinal canal can become a site for a ______________
indirect inguinal hernia
post surgical pain with resultant splinting, diaphragmatic dysfunction, and narcotics for analgesia all reduce the patients respiratory drive and effort leading to....
ineffective coughing, reduced tidal volumes, increased respiratory rate, and absence of sighing
the subcostal nerve pierces the _______ aspect of the lateral border of the __________ sheath and passes posterior to the ___________ muscle innervating it
inferior aspect of the lateral border of the rectus sheath passes posterior to the rectus abdominis muscle
in the nine region abdominal pattern the transtubercular line is the
inferior horizontal plane between the tubercles of the two illiac crests (2 inches posterior to the ASIS) and passes through the body of the L5 posteriorly
What is the superior border of the abdomen?
inferior thoracic aperture (xiphisternal joint and the costal margins) closed by the respiratory diaphragm
the ______________ is enclosed by the ______________ and separates the abdominopelvic cavity from the thoracic cage superiorly
inferior thoracic aperture; diaphragm
the muscle fibers of the external abdominal oblique pass in an ________________ diretion
inferomedial
inferior to the ASIS the muscle fibers of the internal abdominal oblique pass in a ____________ direction
inferomedial (obliquely downwards) hands in pockets (same direction as the external abdominal obliques
inferior to the ASIS the fibers of the transversus abdominis muscle travel _____________ similar to the fibers of the __________ muscle in this region
inferomedially (hands in pockets) internal abdominal oblique
the anterolateral abdominal wall is weakened in the inguinal areal leaving it prone to _____________ (diverticulum protruding through it)
inguinal hernia
the free edge of the external abdominal oblique aponeurosis rolls/folds under itself to form the ________________
inguinal ligament
the lacunar ligament extends from the medial aspect of the ________________ ligament to attach to the __________________ on the superior ramus of the ____________ bone
inguinal ligament pectin pubis pubic bone
Laterally and inferiorly the Camper's and Scarpa's fascia continues into the thigh. At about a finger's breath below the _____________ the Scarpa's fascia fuses to the _____________ (deep fascia of the thigh)
inguinal ligament; fascia lata
the ventral rami of T6 - T11 are the continuation of __________ nerves
intercostal nerves
this muscle lies deep to the external abdominal obliques and is the intermediate muscle of the flat muscle found in the anteriolateral abdominal wall muscle group
internal abdominal oblique
What is the anterior border of the abdomen?
internal surface of the anterolateral abdominal wall
What is the posterior border of the abdomen?
internal surface of the lumbar paravertebral musculature
to each side of the midline the Camper's and Scarpa's fascia descend into the perineum where it firmly attaches into the _____________ and to the posterior margin of the ______________________ where it is referred to as the ____________________ or _________________
ischiopubic rami; posterior margin of the perineal membrane; superficial perineal fascia; Colle's fascia
anterior cutaneous branches from the subcostal nerve supply the skin in this area
just superior to the inguinal ligament on the anterolateral abdominal wall
in females the Camper's fascia retains some fat and with the Scarpa's fascia continues into the _______________
labia majora
this ligament is a crescent shaped extension off the medial end of the inguinal ligament that passes backward to attach to the pectin pubis on the superior ramus of the pubic bone:
lacunar ligament
the thoracoabdominal nerves pierce the posterior rectus sheath at the ___________ border and pass __________ to the _________ muscle innervating it
lateral border posterior to the rectus abdominis muscle
in females, the superior portion of the gubernaculum forms the ____________ and the inferior portion forms the ______________
ligament of the ovaries round ligament of the uterus
how do you test abdominal reflexes
lightly stroke the abdominal wall diagonally towards the umbilicus
In midline Scarpa's fascial (the membranous layer of the superficial fascia) is attached to the _______________
linea alba
the paired rectus abdominis muscles are divided in midline by a raphe called the ____________
linea alba
the aponeurotic portion of the external abdominla oblique covers the anterior portion of the abdominal wall to the midline and forms the ___________________ which passes from the __________________ superiorly to the ____________________ inferiorly
linea alba xiphoid process; pubic symphisis
the convex lateral borders of the rectus abdominis muscles are indicated by two shallow grooves called the left and right ____________
linea semilunaris
Which abdominal structures are protected by the diaphragm and the lower thoracic cage?
liver, gal bladder, stomach, spleen and portions of the colon
Impaired muccociliary clearance and immobility fosters pooling of pulmonary secretions placing the patient at greater risk for....
lower respiratory infections
the superior part of the anteriolateral abdominal wall is supplied from the ___________ branches off the _____________ artery a terminal branch of the _____________ _________ artery and the __________ _____________ artery a terminal branch of the ______________ __________ artery that descends the rectus sheath deep to the rectus abdominis
medial branches off the musculophrenic artery a terminal branch off the internal thoracic artery and the superior epigastric artery a terminal branch off the internal thoracic artery
Within the peritoneal/abdominal cavity, abdominal viscera are either suspended by ________________ or positioned between the cavity and the musculoskeletal wall (aka ______________)
mesenteries; retroperitoneal
In the nine region abdominal pattern the left and right midclavicular lines run from
midclavicle to the inguinal ligament on each side
the fibers of the external abdominal obliques originate as ________________ from the external surface and inferior border of the lower ______ ribs (aka ribs _________ to ________)
muscular slips; lower 8 ribs; ribs 5-12
the _______________ forms the dome shaped roof of the abdomen proper
musculotendious diaphragm
segmental nerves and blood vessels of the body wall travel in the __________________ plane
neurovascular
the endoabdominal fascia attaches the _____________ to the _______________
parietal peritoneum; abdominal wall;
define the inguinal canal
passage that extends in an inferomedial direction just superior and parallel tot he lower 1/2 of the inguinal ligament
the more superior portion of the internal abdominal oblique aponeurosis splits into an anterior and posterior layer along the lateral edge of which muscle?
rectus abdominis
the superior and inferior epigastric arteries provide the blood supply to which muscle?
rectus abdominis
this ligament extends off the medial end of the inguinal ligament across the pectin pubis of the pelvic brim (posterior to the pubic symphisis)
pectineal (cooper's) ligament
this ligament is often used as an attachment site for bladder suspension surgery (to raise a prolapsed bladder)
pectineal (cooper's) ligament
the ______________ separates the abdominopelvic cavity from the ____________ inferiorly
pelvic floor/diaphragm; perineum
what is the closed chain action of the external abdominal obliques
posterior tilt of the pelvis
the three flat muscles of the anteriolatearal abdominal wall begin ____________ and form aponeuroses _____________ as the muscles approach midline that form a tendinous sheath enclosing the _________ and _________ muscles
posteriorly; anteriorly rectus abdominis; pyramidalis
during the 8th week of gestation, a slight invagination of the peritoneum called the __________ __________ develops immediately anterior to the ____________ within the developing inguinal canal and initiates its development
processus vaginalis (vaginal process) gubernaculum
the function of reflex abdominal contractions is to ___________
protect the viscera
What is the clinical significance of the linea alba?
provide extensive access to the abdominal cavity without alot of bleeding, but is slow to heal because this tissue is not highly vascularized/may result in weakening of the anterior abdominal wall
the conjoint tendon (inguinal faux) attaches to the ___________ and the __________
pubic crest pectin pubis
the proximal attachment of the rectus abdominis muscle are the ___________, the ___________ of the ___________ and the ____________
pubic crest, tubercle of the pubic crest and the pubic symphisis
What is the inferior border of the abdomen
pubic symphisis, inguinal folds and illiac crests
the reflected inguinal ligament is a minor extension off the medial end of the inguinal ligament that travels from the ____________ upward to the ____________
pubic tubercle linea alba
this is a small triangular shaped muscle that overlaps the anterior surface of the rectus abdominis muscle just above the pubis and resides within the rectus sheath
pyramidalis
Anteriorly, the abdomen is enclosed by this pair of segmented muscles that span the distance between the thorax and the pelvis
rectus abdominis
the conjoint tendon (inguinal faux) frmed by the fusion of the aponeurosis of the internal abdominal oblique and the transversus abdominis passes anteriorly to the ____________ muscle
rectus abdominis
the subcostal nerves leave the ______________ within the abdominal cavity and cross over the posterior abdominal wall muscles
subcostal groove
the ventral rami of T12 are the continuation of __________ nerves
subcostal nerves
define the abdominal reflex
sudden, momentary contraction of the abdominal muscles upon skin stimulation superficial abdominal reflex
superficial lymphatic drainage of the anterolateral abdominal wall below the umbilicus passes superiorly to the ______________ __________nodes
superficial inguinal nodes
over the penis the Camper's fascia fuses with the Scarpa's fascia and invests the penis as the _____________ and surrounds the scrotum as the ________________
superficial penile fascia; dartos fascia
the rectus sheath completely encloses the superior_________ of the rectus abdominis and covers the anterior surface of _____ the rectus abdominis muscle
superior 3/4 inferior 1/4
in the nine region abdominal pattern the subcostal plane is the
superior horizontal plane that passes immediately inferior to the costal cartilage of rib 10 anteriorly and through the body of L3 posteriorly
superior to the ASIS the muscle fibers of the internal abdominal oblique pass in a ________________direction
superomedial (obliquely upwards) teepee
in men the superficial fascia forms a midline septum in the region above the pubis that extends onto the dorsum of the penis that is called the ___________ or ___________ ligament of the penis
suspensory; fundiform
If in the postoperative period following use of general anesthesia, the FRC continues to decrease, the patient...
takes on a restrictive pattern of pulmonary function
the rectus abdominis muscle is divided transversely into segments by by three ______________
tendinous intersections
when the pyramidalis muscle is present, its action is to:
tense the linea alba
this structure passes anterior to the rectus abdominis throughout its length
the aponeurosis of the EAO
segmental nerves and blood vessels of the body wall travel in the neurovascular plane and distribute their cutaneous and muscular branches by piercing adjacent muscle layers. Describe the location of the neurovacular plane
the areolar tissue between the internal abdominal oblique (intermediate) and transversus abdominis muscles (deepest)
these two arteries branch off the external iliac artery
the deep circumflex iliac artery the inferior epigastric artery
these two arteries travel along the inguinal ligament
the deep circumflex iliac artery the superficial circumflex iliac artery
what is the superficial inguinal ring?
the end of the inguinal canal located superior to the pubic tubercle resembles an obliquely oriented triangle beginning of the tubular evagination of hte aponeurosis of the EAO forming the outermost covering of the structures passing through the inguinal canal
what is the only remaining structure passing through the inguinal canal in females once the inguinal canal is fully developed?
the inferior portion of the gubernaculum which forms the round ligament of the uterus
the neurovascular plane is defined by the areolar tissue between which two muscles
the internal abdominal oblique muscle and the transversus abdominis muscles
these two arteries branch off of the femoral artery
the superficial epigastric artery the superficial circumflex iliac artery
close to midline an anterior cutaneous nerve branches off the _____________ and pierces through the ________ muscle and the anterior _____________ to supply cutaneous innervation
thoracoabdominal nerve rectus abdominis muscle anterior rectus sheath
the intercostal nerves pass deep to the costal cartilages and enter the neurovascular plane (between the IAO and the TA) and are now called the __________
thoracoabdominal nerves
the internal abdominal obliques proximal attachments are the ______________ fascia, the __________________of the iliac crest (anterior 2/3 of the ilac crest between the attachment sites of the _________________ and the ________________) and the lateral 2/3 of the ___________________
thoracolumbar fascia intermediate line of the iliac crest (anterior 2/3 between the attachment sites of the external abdominal oblique and the transversus abdominis lateral 2/3 of the inguinal ligament
the proximal attachment of the transversus abdominis is the ____________ fascia between the __________ rib and the _____________, the lateral 1/3 of the ____________, the ___________ of the iliac crest, and the _________ surface of the lower ___________ costal cartilages
thoracolumbar fascia between the 12th rib and the iliac crest the lateral 1/3 of the inguinal ligament the medial lip of the iliac crest internal surface of the lower 6 costal cartilages
on the surface of the trunk the extent of the abdominal wall corresponds to the region of the trunk between the _______________ and the _____________________
thorax; superior margin of the pelvis and lower limb
In the abdominal quadrants topographical scheme for dividing the anterior abdominal wall the horizontal plane is called the _________________ and travels _________________.
transumbilical line/plane; through the intervertebral discs of L3 and L4 dividing the abdomen into upper and lower halves
this muscle is the deepest (innermost) layer of the three flat muscles in the anterolateral abdominal wall
transversus abdominis
below the level of the umbilicus, the aponeurosis of the internal abdominal oblique fuses with the aponeurosis of the _____________ muscle to form the ___________ or inguinal faux
transversus abdominis conjoint ligament
the posterior layer of the internal abdominal oblique remains fused with the aponeurosis of the _____________ muscle to pass behind the ___________muscle
transversus abdominis rectus abdominis
the subcostal nerves enter the neurovascular plane of the abdominal wall by piercing the ______________ at its origin at the _____________fascia
transversus abdominis thoracolumbar fascia
reflex contractions of the abdominal wall are absent in _________ __________ neuron lesions above the segmental level and also in patients who have had __________ that interrupt the nerves. theyre also absent in normal people _________% of the time and in __________ patients
upper motor neuron lesions surgical operations absent in normal people 15% of the time obese patients
the rectus abdominis muscles are innervated by the ________ rami of spinal nerves ________ through _______ and the _________ and _________ nerves
ventral rami of spinal nerves T7-T12 and the intercostal and subcostal nerves
In the abdominal quadrants topographical scheme for dividing the anterior abdominal wall the midline travels from the ______________________
xiphoid process to the pubic symphisis dividing the abdomen into right and left halves
