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Anatomy of Abdomen

Soft Tissue Anatomy of the Abdomen-WVSOM Class of 2012

QuestionAnswer
what is the potential space between visceral and parietal peritoneum? peritoneal cavity
what fluid can exist in the peritoneal cavity? ascites
cavity that would exist if all viscera were removed from the abdomen? abdominal space
what fascia comprise the abdominal space? transversalis and inferior phrenic
an organ entirely or almost entirely surrounded by peritoneum and is suspended by mesentery? peritoneal or intraperitoneal organ
organs in this category have no free mesentery and have little mobility; only partially covered by peritoneum? retroperitoneal organ
double layer of peritoneum that connects viscus to body wall? mesentery
double layer of peritoneum that links viscus to body wall or to another organ? peritoneal ligament
cutaneous layers of abdomen are innervated by what nerves? lateral and anterior cutaneous nerves
where to lateral and cutaneous nerves of the abdomen originate? thoracic region
first lumbar contribution of lateral and anterior cutaneous nerves happens where? which nerves are involved? inguinal canal; iliohypogastric and ilioinguinal nerves
what veins exist in fascia near the inguinal canaL? thoraco-epigastric veins
when the IVC is compromised, what venous system can provide collateral circulation? thoraco-epigastric veins
thoraco-epigastric veins communicate with the portal systen where? umbilicus
in cases of portal blockage, thoraco-epigastric veins can become dilated; what is this termed? caput medusa
camper's fascia is consistend with what other fascia? superficial fascia of thorax and thigh
scarpa's fascia blends with what superiorly and inferiorly? superiorly: aponeurosis of external abdominal oblique; inferiorly: fascia lata 3cm distal to inguinal ligament
between what layers will urine be found in cases of urethral rupture? scarpa's fascia and abdominal wall
where does external abdominal oblique arise from superiorly and inferiorly? superiorly: from costal cartilage of lower 8 ribs; inferiorly: lateral margin of thoraco-lumbar fascia
what two places will the external abdominal oblique attach to? linea alba and inguinal ligament
inguinal ligament is portion of external abdominal oblique that is found between what two bony landmarks? ASIS and pubis
what is the sharp, medial margin of femoral ring, medial to lymphatics of thigh? lacunar ligament
medial end of inguinal ligament attaches where? superior pubic ramus
fibers of the lacunar ligament continue along pubic ramus and are called what? pectineal ligament
spermatic cord exits from abdominal wall where? medial end of inguinal ligament
what is the gap in the aponeurosis of the external oblique near the medial end of the inguinal ligament? what nerve emerges from here? superficial inguinal ring; ilioinginal nerve
superficial inguinal ring is bounded superiorly by what? inferiorly by what? medial crus; lateral crus
what passes between the medial and lateral crura, reinforcing the superolateral portion of superficial ring? intercrural fibers
what two things are attached to the posterior body wall at the end of the 2nd month of development? testis and mesonephros
what is the condensation of mesenchyme that extends from caudal pole of testis to inguinal region? gubernaculum testis
testes will descend along what structure? gubernaculum
the peritoneum evaginates into abdominal wall along course of gubernaculum into scrotal swellings forming what? processes vaginalis
in females, descent of ovary into labium does not occur. what happens to gubernaculum? it becomes the ligamentum teres uteri
what forms the inferior portion of the inguinal canal? inguinal ligament
what layer splits to form the cremaster muscle and cremasteric fascia of spermatic cord? internal abdominal oblique
conjoint tendon is formed from what two aponeuroses? internal abdominal oblique and transversus abdominis
what forms the posterior wall of the inguinal canal? inguinal falx (conjoint tendon)
where does the inguinal falx attach? between pubic crest and pectineal line
inguinal falx reinforces what? how? superficial inguinal ring from behind
deep inguinal ring is reinforced by what? external abdominal oblique
contraction of what two muscles will reduce potential for hernia by compressing spermatic cord against inguinal ligament? internal abdominal oblique and transversus abdominis
what artery reaches deep surface of rectus abdominis at the arcuate line? inferior epigastric artery
what forms the inguinal triangle? lateral border:inferior epigastric a.; inferior border: inguinal ligament; medial border: rectus abdominis muscle
what passes across the inguinal triangle? where does it attach? conjoint tendon; attaches to pubic crest and pectin pubis
define direct inguinal hernia? indirect? direct is when gut is pushed directly through the superficial ring; indirect is when it goes through entire inguinal canal
cremaster and fascia are derived from what abdominal layer? internal abdominal oblique
internal spermatic fascia corresponds to what abdominal layer? transversalis fascia
what artery and vein pass in the spermatic cord? testicular
what structure serves as a countercurrent heat exchange mechanism to lower blood temperature to testes? pampiniform plexus
what nerve is located at the deep inguinal ring? genitofemoral nerve
what nerve passes through inguinal canal, supplying scrotal sckin through anterior scrotal nerves? genital branch of genitofemoral nerve
femoral branch of genitofemoral nerve exits pelvis along with what artery? what does it supply? external iliac artery; skin on medial thigh
what nerve passes through the superficial inguinal ring and supplies skin of anterior superior scrotum through anterior scrotal nerves? iliolinguinal nerve
in testicular cancer, metastasis is to which nodes first? para-aortic lymph nodes
tunica vaginalis has what two layers? parietal and visceral layers
what is the duct system of the testis? epididymis
what is the visceral layer that covers the connective tissue capsule of the testis? tunica albuginea
3 parts of epididymis? head, body, and tail
tail of epididymis becomes what structure? ductus deferens
laterally, epididymis is separated from the testis by what? sinus epididymis
the round ligament of the uterus connects with what structure internally? ovarian ligament
what does the genital branch of the genitofemoral nerve supply in females? labia majora
what are the origins of the internal abdominal oblique? posterior layer of thoracolumbar fascia, iliac crest, and lateral 2/3 of inguinal ligament
cranial fibers of internal abdominal obliques insert where? caudal? costal margin and linea alba; linea alba and pecten pubis
transversus abdominis originates where? costal margin, thoracolumbar fascia, iliac crest, and lateral 2/3 of inguinal ligament
direction of cranial fibers of transversus abdominis? caudal fibers? transverse to abdomen; parallel to internal abdominal oblique
insertion of superior and inferior fibers of transversus abdominis? superior: linea alba; inferior: linea alba, forms conjoint tendon, inserts on pecten pubis
origin of rectus abdominis muscle? pubic symphysis and crest
insertion of rectus abdominis muscle? costal cartilage of 5-7 ribs and xyphoid process
what biomechanics can be seen in the abdominal muscles when twisting? right external abdominal oblique with left internal abdominal oblique will twist to the left
what arteries are on the deep surface of inferior and superior rectus abdominis muscles? what do these form from that is superior? inferior and superior epigastric arteries; internal thoracic arteries
arcuate line also known as what? linea semicircularis
round ligament of liver is remnant of what structure? umbilical vein
falciform ligament is remnant of what structure? ventral mesentery
falciform ligament and round ligament of the liver run from where to where? liver to umbilicus
a patent round ligament of the liver can be used for what? injection site
median umbilical fold is formed from what structure? where is it found? urachus; between umbilicus and bladder
medial umbilical fold is formed from what structure? where is it found? umbilical arteries; between umbilicus and common iliac arteries
lateral umbilical fold is formed from what structure? inferior epigastric vessels passing from external iliac vessels to rectus abdominis muscle
urachus once formed connection between what two structures? bladder and allantois
what is the most anterior structure of the peritoneal cavity? greater omentum
what 4 organs are in the epigastric region? liver, gallbladder, stomach, transverse colon
hypochondriac regions are lateral to what region? epigastric region
liver margins ventrally? 6th costal cartilage on left to 10th rib on right
how can liver hemorrhage be controlled? pinching hepatoduodenal ligament of lesser omentum
left lobe of liver contacts cardiac stomach where? left midclavicular line
what two structures meet up superiorly to liver? falciform and coronary ligaments
what forms the bare area of the liver? right portion of coronary ligament meets up with right triangular ligament; large separation leaves superior surface without peritoneum
what is the lesser omentum? mesenteric connection between liver and stomach
what lies in the lesser omentum? common hepatic duct, hepatic artery proper, and portal vein
what are the 3 borders of the quadrate lobe of liver? gallbladder, round ligament, and lesser omentum
hepatoduodenal ligament is what exactly? what is within it? lesser omentum presents a free margin on the right; common bile duct, hepatic artery proper, and portal vein
opening deep to the hepatoduodenal ligament is what? what does this opening lead to? where exactly does this lie? omental foramen; omental bursa (lesser sac); space between stomach and pancreas
in hollow viscera, what does fundus refer to? portion furthest from entrance of the organ
hepatogastric ligament runs between what structures? lesser curvature of the stomach and the liver
greater omentum is made up of how many layers of peritoneum? 4
very short portion between stomach and colon is what? this is actually just part of what? gastrocolic ligament; greater omentum
posterior gastric ulcer will cause stomach contents to enter what structure? eventually it will irritate where? referred pain to where? lesser sac; underside of diphragm; left shoulder pain
left colic flexure is what relation to spleen? inferior
gastrosplenic ligament lies between where and where? greater curvature of stomach and lower pole of spleen
what vessels travel within the gastrosplenic ligament? short gastric arteries
second part of duodenum's relationship to the transverse colon? transverse colon is anterior to second part of duodenum
foregut develops into what structures? esophagus, trachea, lung buds, stomach, and duodenum (up to the bile duct)
proximal duodenum gives rise to what structures embryonically? liver, biliary system, and pancreas
how do the left and right vagal trunks become anterior and posterior vagal trunks in adult? rotation so that left stomach becomes anterior, right stomach becomes posterior
pancreas originally developed as what? dorsal and ventral pancreatic bud
longitudinal columns of muscle on external surface of colon? tenia coli
sacculations of the colon are: haustra
small pouches of fat-filled peritoneum hanging from surface of colon? omental appendges
tenia coli meet up where? vermiform appendix
appendix sits in what recess? retrocecal recess
appendix is suspended by what? mesoappendix (mesentery of ileum)
ascending colon is fixed to the posterior wall, making it what? retroperitoneal
transverse colon is what kind of peritoneal organ? intraperitoneal
what connects the colon to the diaphragm? where is this at ? phrenicocolic ligament; inferior to spleen at left colic flexure
descending colon is what kind of peritoneal organ? retroperitoneal
transverse colon mobile or not? mobile
portion of small intestine that connects to cecum? what is name of juncture? ileum; ileocecal junction
ileum vs. jejunum? which has long vasa recta? jejunum
point where mesentery meets posterior wall? root of mesentery
what is the course of the third part of the duodenum? crosses midline inferior to superior mesenteric artery in root of mesentery, can be palpated through peritoneum
as duodenum emerges from retroperitoneal location, it becomes what? what is this called? jejunum; duodeno-jejunal flexure
what is the structure that suspends the duodeno-jejunal junction? suspensory ligament of the duodenum
majority of adult gut tube derived from what? what organs are included? midgut; most of duodenum, small intestine, appendix, cecum, colon up to 2/3 of transverse portion
what happens to small intestine during development? it is herniated out through umbilicus, then retracted and rotated 270 degrees around the superior mesenteric artery
what happens to the ascending colon during development? falls back on posterior wall, loses free mesentery and becomes retroperitoneal
what forms the boundary of the greater and lesser sacs? attachment of transverse mesocolon to posterior wall
what suspends the sigmoid colon? sigmoid mesocolon
where does sigmoid colon become rectum? at the pelvic inlet
what organs arise from the hindgut? 1/3 of transverse colon, sigmoid colon, rectum, and superior portion of anal canal
what is the inferior portion of anal canal formed from? ectoderm
what innervates inferior portion of anal canal? internal pudendal nerve
where is the pyloric sphincter palpated? 6-7 cm superior to umbilicus
where is sphincter of oddi palpated? 5-6 cm superior and right of umbilicus
where is duodeno-jejunal juncture palpated? 5-6 cm superior and to left of umbilicus
where is ileocecal valve palpated? 2-3 cm inferior to mcburney's point
where is mcburney's point? 1-2 inches superomedially to ASIS
relationship of common bile duct, hepatic artery proper, and portal vein? duct is to right of artery; duct and artery are anterior to vein
cystic artery usually arises from what vessel? right hepatic artery
celiac trunk conveys what nerves to the organs it supplies with blood? what nerves travel along with these? postganglionic sympathetic fibers from greater splanchnic nerves; preganglionic parasympathetic fibers to the stomach
what nerves are found on either side of the celiac trunk? what is this all called? celiac ganglia; celiac plexus
what nerve trunk meets up with the celiac plexus and is distributed with it? where is thie located? posterior vagal trunk; gastro-esophageal junction
what trunk does not enter the celiac plexus but instead runs to the liver and stomach? where does it travel? anterior vagal trunk; travels along lesser curvature of stomach
esophageal branches originate from what vessel? where? left gastric artery; near gastro-esophageal junction
what vessel drains the lesser curvature of the stomach and the inferior portion of esophagus? left gastric (coronary)vein
esophageal branches of left gastric veins connect to what other esophageal branches? why are these important? azygous-hemiazygous system; when portal vein is blocked, these are used as a shunt and can become enlarged and burst
anterior and posterior superior pancreatico-duodenal artery anastomose with arteries from what? superior mesenteric artery
in general, what does the superior mesenteric artery supply? intestine from duodenum to left colic flexure
superior mesenteric ganglia make up what? superior mesenteric plexus
how do nerves run to the superior mesenteric ganglia? receive preganglionic fibers from the lesser splanchnic nerves and distribute postganglionic fibers along superior mesenteric artery and inferiorly along aorta
in addition to receiving preganglionic lesser splanchnic nerves, the superior mesenteric plexus also receives fibers from where? lumbar splanchnic nerves
first branch of the superior mesenteric artery is usually what? inferior pancratico-duodenal artery
describe artery flow to jejunum and ileum? jejunal arteries->arcades->vasa recta
what arteries from the superior mesenteric artery supply the proximal colon? ileocolic and right colic arteries
what are the 4 branches of the ileocolic artery? anterior and posterior cecal branches, appendicular, and ileal branches (direct to ileum, no arcades)
through what structure does the middle colic artery travel? transverse mesocolon
inferior mesenteric artery supplies what structures in general? what is the embryological portion this refers to? left colic flexure to rectum; hind gut
left colic artery supplies what structure? descending colon
the marginal artery is most likely to be compromised at what portions? left colic flexure and cecum
the further distally on the small intestine, what two things occur? number of arcades increase, vasa recta are shorter
superior mesenteric vein drains what structures? distal duodenum, jejunum, ileum, ascending colon, transverse colon
inferior mesenteric vein drains what structures? descending and sigmoid colons and superior rectum
inferior mesenteric vein empties into either of which two veins? superior mesenteric or splenic veins
portal vein is formed at what point? splenic and superior mesenteric veins join together
portal vein branches into right and left portal veins at what point? porta hepatis
the liver drains through what veins? these enter what vessel? where? right and left hepatic veins; IVC; as it passes through the thoracic diaphragm
what are the 4 places that portal and systemic venous systems communicate? gastric and esophageal veins; umbilical and epigastric veins; superior rectal and middle rectal veins; between veins draining a viscus lying against a body wall and the veins of the body wall
Created by: mhassan