Abdomen

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How many spinal nerves are in the cervical spine?

8

What is a Nerve plexus?

A fusion, bifurcation and rejoining in a complex fashion

What dermatomes are responsible for the shoulders?

C6, C7 and C8

Where are the two spinal cord enlargements?

Cervical (C4-T1) Lumbar enlargement (L2-S3)

Why are there 8 cervical nerves and 7 cervical vertebrae

Cervical spinal nerves exit above their respective vertebrae

Which vertebral rami form a plexus?

Cervical, lumbar, sacral and brachial

What is the Dorsal Root Ganglion

Collection of nerve cell bodies located in the intervertebral foramen

Which ribs are the easiest to fracture? And why?

Floating ribs because they are the smallest, weakest, closest to ground

Where does the spinal cord span to?

Foramen magnum to L1 & L2

What is the function of the thoracic wall?

Framework and protection for the thoracic viscera (heart, lungs, etc)

Primary causes for diastasis recti

Giving birth (being over 35 y/o, multiple births, small stature)

What is the cauda equina

Horse hair-like structures below conus medullaris

Which nerve sends sensation to mons pubis/ upper groin?

Illioguinal nerve

Rectus abdominus m get blood from?

Inferior epigastic artery

Where do rectus abdominis mm attach?

-Costal cartilage of ribs 5-8 -Sternum -Pubic crest -Pubic symphysis

What are the differences between Direct hernias and indirect hernias

-Direct are acquired through heavy lifting and indirect are congenital -Direct emerge medial to the inferior epigastric a., direct are lateral -Direct- Abdominal contents travel thought the superficial ring only, indirect- travel through both deep and superficial rings

Which abdominal muscles flex and rotate the trunk?

-External oblique -Internal oblique

What structures are inside the inguinal canal

-Ilioinguinal nerve (L1) -Spermatic cord (male) -Round ligament of the uterus (female)

What muscles make up the Anterolateral abdominal wall?

-R/L rectus abdominis mm -External obliques -Internal obliques -Transverse abdominis mm

What muscle/s are innervated by ventral (anterior) rami of 77-T12 and L1

-Rectus abdominis -External obliques -Internal obliques -Transverse abdominis

What muscles are innervated by the Thoracoabdominal nn

-Rectus abdominous -External obliques -Internal obliques -Transverse abdominous

Layers of the anterolateral abdominal wall

-Skin -Superficial facia -External oblique m -Internal oblique muscle -Transversus abdmonis -Transveralis facia -Parietal peritoneum

What are the functions of abdominal wall muscles

-Stabilize the trunk (posture) -Flexion -Lateral flexion -Torsion -Abdominal compression (Valsalva maneuver)

When below the arcuate line which layers are below the rectus?

-Transversal facia -Parietal peritoneum

How many intercostal spaces do intercostal muscles span?

1

How are the ribs numbered?

12 pairs of ribs are numbered consecutively from superiorly to inferiorly

Where is McBurney's point

2/3 of the way from umbilicus to ASIS

what does bursae do

avoids friction, facilitates gliding

Does the spinal nerve have motor or sensory modalities?

both

what is a synovial sheath

bursae surrounding a tendon, running through a tunnel (tendon sheath)

Which spinal nerves exit above their respective vertebrae

cervical

what is bursae

cleft of CT between muscles, tendons and/or bones

what are ligaments made of

connective tissue

Where is the dorsal primary ramus?

deep back

Which rib does the inferior costal facet of the thoracic vertebra articulate with?

different rib

What are somatic sensory fibers from the periphery to the CNS

dorsal root

what does the vertebral canal contain (4)

epidural/extradural fat, internal vertebral venous plexus, meninges and spinal cord

What anchors the spinal cord

filum terminale

where does the vertebral canal span from

foramen magnum to entire vertebral column

The body of a thoracic vertebra has what shape?

heart

Where is gray matter located on the spinal cord

inner region

What part of the ischium do we sit on?

ischial tuberosity

What is the blood supply of serratus anterior?

lateral thoracic artery

What creates the medial line down your 6 pack abs?

linea alba

Lateral margin of rectus abdominis

linea semilunaris

What is the innervation of serratus anterior?

long thoracic nerve

What is white matter composed of

myelinated axons

what do ligaments do

permit some movements and yield applied forces

Just the body of rib 7 is touching which rib?

rib 8

The body and transverse process of T8 is touching which rib?

rib 8

where does serratus anterior attach

ribs 1-9 and anterior and medial border of scapula and inferior angle

The vertebral foramen of a thoracic vertebrae is what shape?

round

Opening created by ligaments through which nerovasculature and muscles pass though the ischium

sciatic foramen

Concavities formed from contours of the coxal bone

sciatic notches

Are dorsal rami segmental or in a plexus?

segmental

what is the function of adipose tissue (4)

stores energy, insulate, secretes hormones, GF, cytokines, leptin and cushions/protects body

what is a Ganglion cyst

swollen or inflamed synovial sheath

What part of the rib is the weakest/ most likely to fracture?

the angle

What part of the rib articulates with vertebral bodies?

the head

Which rib does the superior costal facet of the thoracic vertebra articulate with?

the same rib

Which rib does the transverse costal facet of the thoracic vertebra articulate with?

the same rib

Which direction do the internal intercostal muscles go in?

towards the chin

What is the function of white matter

transmits messages

Which way do innermost intercostal muscles go to?

transverse

Which flank muscle does not contribute to the inguinal canal?

transversus abdominis

What two structures for to create the spinal nerve

ventral and dorsal root

What is the function of anterior (ventral) horn gray matter

Innervate skeletal muscles

Which nerves supply segmental motor and sensory innervation to the abdominal wall

Intercostal/subcostal/L1 nerves

Which intercostal muscles are insufficient posteriorly?

Internal intercostal mm Inner most intercostal mm

Where does venous drainage of the thoracic cavity occur?

Into the venae comitantes anteriorly, brachiocephalic vv, azygoes vv

Where is the conus medullaris ?

L2

Intercostal arteries and lumbar arteries supply blood to where?

Lateral wall (flank) muscles

What are the 3 parts of the sternum?

Manubrium Body Xiphoid Process

What is gray matter composed of

Neuronal and glial cell bodies

Where is white matter located on the spinal cord

Outer region

What are the two types of gray matter

Posterior (dorsal) horn - receive sensory info and Anterior (ventral) horn- somatic motor nn that innervate skeletal mm

What is the function of the serratus anterior?

Protraction of scapula (Draws scapula forward) Cranial rotation of glenoid fossa

What is the function of posterior (dorsal) horn gray matter?

Receive sensory info

Which abdominal muscle stabilizes and controls tilt of the pelvis?

Rectus abdominis

Which muscles do you see when somebody has a 6 pac?

Rectus abdominis muscle

What is the function of the great radicular artery

Reinforce blood supply to lumbosacral enlargement

What are the 3 regions above the transphyloric plane

Right hypochondriac, Epigastric, Left hypochondriac

What are the 3 regions below the transtubercular plane

Right inguinal, Hypogastric, Left inguinal

What are the 3 regions in the middle

Right lumber Umbilical Left lumbar

how are ribs numbered in relation to vertebrae

Same number as the vertebrae they touch twice

What does the posterior intercostal aa branch into

Segmental spinal aa

What is the sensory pathway of the spinal cord and spinal nerve?

Sensation occurs from dorsal and ventral ramus, travels down dorsal root ganglion, to through the dorsal rot then into the dorsal horn, dorsal horn sends signal to thalamus then to brain

What does the segmental spinal aa branch into

Several radicular aa- follow nerve root to cord and (8-10)Segmental medullary aa- reinforce longitudinal vessels

What would happen if the great radicular artery is occluded

Spinal cord infarction, spinal cord ischemia then potential paralysis of pelvis and lower limbs

What is the purpose of intercrural fibers?

Strengthen and prevent "banana peeling"

Which nerve is located just below the ribs?

Subcostal nerve

Which parts of the thoracic vertebrae articulate with the ribs

Superior costal facet, Transverse costal facet, Inferior costal facet

Rectus abdominus m gets its blood supply from which artery?

Superior epigastric artery

What are spinal ganglia lacking?

Synapses

Which dermatomes are responsible for the thorax?

T1-T12

Which ventral (anterior) rami create the thoracoabdominal nerves?

T7-T12 and L1

What creates the horizontal lines to your 6 pac abs?

Tendinous intersection

Why can the veins in the internal vertebral venous plexus flow both ways

They lack valves

Which vertebral rami are segmental?

Thoracic (T2-T11)

What structures make up the thoracic wall?

Thoracic vertebrae, Sternum, Ribs

Which spinal nerves exit below their respective vertebrae

Thoracic, lumbar, sacral, coccygeal

What happens if there's too much blood in spinal cord?

Too much pressure

Which plane is across the inferior border of the 10th costal cartilage and the body of L1 vertebra

Transpyloric (subcostal) plane

Which plane is across the iliac tubercles

Transtubercular plane

When above the arcuate line, what layers are below the rectus?

Transvers abdominis, Transversal facia, Parietal peritoneum

What are the layers of the superficial inguinal canal?

Transversalis facia Internal oblique external oblique

Which abdominal muscle stabilizes and maintains intraabdominal pressure

Transverse Abdominis

What are the 3 different type of ribs?

True Ribs (vertebrosternal) 1-7 False ribs (vertebrocostal) 8-10 Floating Ribs (vertebral) 11-12

Which part of the rib articulated with the transverse processes of the vertebrae?

Tubercle

What happens with trunk torsion?

Twist towards contracted internal obliques

What causes pain of the round ligament of the uterus?

When the uterus stretches during pregnancy, the ligament cannot stretch

Where do ribs attach/articulate

With the vertebrae posteriorly articulate with the body and transverse process of vertebra of the same number and with the body of the vertebrae directly superior

Which direction do the external intercostal muscles go in?

X, medial and inferior

Which abdominal muscles compress and support abdominal viscera?

All 4! Rectus abdominis, external/internal obliques and transverse abdominis

What veins drain into the internal vertebral venous plexus

Anterior and posterior spinal veins

Where is the transumbilical plane

At the level of T10 and umbilicus

Where are spinal taps preformed

Between L3 and L4, in the cauda equina

What is the separation or right and left rectus abdominis muscles due to linea alba stretching?

Diastatsis Recti

Which type of hernial protrusion recedes when patient lays down?

Direct inguinal hernia

What is the function of the internal vertebral venous plexus

Drains the vertebral column

Which intercostal muscles are insufficient anteriorly?

External intercostal mm and Inner most intercostal mm

What are the 3 types of intercostal muscles?

External intercostal muscles Internal intercostal muscles Innermost intercostal muscles

Which of the flank muscles attach to the ribs?

External obliques (ribs 5-12)

Order of flank muscles superficial to deep

External obliques, Internal obliques, Transverse abdominis

Which muscles work together to perform the Valsalva maneuver?

Flank and rectus abdominous mm

Where would you feel pain if your appendix ruptures?

Mcburneys point, Accute and sharp pain

Which plane bisects the clavicles halfway between

Midclavicular planes (L/R)

Where is the arcuate line?

Midway point between umbilicus and pubic symphysis

What is the Dorsal Primary Ramus?

Mixed motor and sensory fibers innervating epaxial muscles and overlying skin

What is the Ventral primary Ramus?

Mixed motor and sensory fibers that innervate hypaxial muscles and overlying skin

What makes abs visible to the naked eye?

Muscle bellies of rectus abdominis muscles are well developed and low amounts of Camper's facia

Which part of the rib houses the nerves, arteries and veins

The Costal Groove

Where does rib 2 articulate with the manubrium and body of sternum?

The Sternal Angle

What is a dermatome?

The dorsal and ventral rami or each spinal nerve that are responsible for innervating Strip of skin

Which facet of the thoracic vertebra does not articulate with the same rib?

The inferior costal facet

What are the 4 quadrants of the anterolateral abdominal wall

Upper right Upper left Lower right Lower left

What is used clinically to check for inguinal hernia, prolapsed uterus or bladder, varicoceles...

Valsalva Maneuver

What maneuver is creating an increase in intra-abdominal pressure by breathing in, contracting abdominal mm and attempting to exhale

Valsalva maneuver

Innervation of rectus abdominis muscles

Ventral (anterior) rami T7-T12 and L1

What is the motor pathway for the spinal cord and spinal nerve?

Ventral Horn releases a signal, travels down dorsal root, to the spinal nerve, sends it to both the dorsal ramus and ventral ramus

Where are the motor fibers that innovate somatic muscles?

Ventral Root

What happens with lateral trunk flexion?

You bend towards the contracted side


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