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WEEK 3:
Introduction to retroperitoneal structures, posterior body wll and diaphragm:
| Question | Answer |
|---|---|
| functions of anterolateral abdominal wall (4) | Protection /support viscera, Stabilises vertebral column, Movement of trunk(Anterior & lateral flexion and rotatory movements) and Increase intra-abdominal pressure (force for defecation, micturition, vomiting, parturition) |
| contents of the rectus sheath (5) | Rectus abdominis, Pyramidalis, Sup and inf epigastric vessels, Lymphatics and Terminal section of T7-T12 nerves |
| functions of the rectus sheath (3) | Protect the muscles/ vessels which it encloses, Keeps the rectus abdominis and pyramidalis muscle together and Provides maximal compression/support to viscera |
| walls of the rectus sheath | anterior and posterior wall composed of a fusion of the aponeuroses of the external oblique, internal oblique and transversus abdominis muscles |
| mid inguinal point lies between | ASIS and pubic symphysis |
| inguinal canal extends from | deep inguinal ring to the superficial inguinal ring |
| inguinal ligament importance to inguinal canal | inguinal ligament makes the inferior floor for inguinal canal |
| differences between direct and indirect inguinal hernia | inferior epigastric vessels |
| femoral hernia | protrusion into the femoral ring |
| inguinal hernia | protrusion of parietal peritoneum and viscera through a normal or abnormal opening from abdominal cavity (more common in biological males and indirect being more common) |
| female inguinal canal contents | round ligament of uterus, ilioinguinal nerve, and blood and lymphatic vessels |
| male inguinal canal contents | spermatic cord, ilioinguinal nerve, blood and lymphatic vessels |
| indirect hernia v direct hernia | direct goes through abdominal wall (Hesselbach's triangle) but indirect bypasses by going through deep ring to superficial ring (inguinal canal) |
| indirect hernia occurs where | lateral to inferior epigastric vessels |
| hernia meaning | any viscera and its parietal membrane leaving normal anatomical boundary |
| direct inguinal hernia | protrusion of abdominal contents through transversalis fascia within Hesselbach's triangle medial to inferior epigastric vessels |
| boarders of Hesselbach's triangle | inferior epigastric vessels (superolaterally), rectus sheath (medially), inguinal ligament (inferiorly) |
| superolateral boundary of Hesselbach's triangle | inferior epigastric vessels |
| medial boundary of Hesselbach's triangle | rectus sheath |
| inferior boundary of Hesselbach's triangle | inguinal ligament |
| descent of the testes involves going through | inguinal canal |
| peritoneum in the retroperitoneum | parietal, visceral layers mesentery/ligaments/omentum |
| intraperitoneal viscera are surrounded by | peritoneum |
| retroperitoneal viscera are positioned where | outside peritoneum |
| types of retroperitoneal viscera | primary/ secondary and related to the dorsal abdominal wall |
| retroperitoneum is bounded by | posterior parietal peritoneum anteriorly and the lumbar spine posteriorly |
| retroperitoneum extends from | diaphragm superiorly through to the pelvic peritoneal attachments inferiorly and encompasses the lumbar and iliac regions |
| retroperitoneal space contains what | kidneys, adrenal glands, pancreas (except tail), nerve roots, lymph nodes, abdominal aorta, and IVC |
| blood supply in kidneys | renal arteries |
| blood supply in ureter (5) | Renal aa, Gonadal aa, Abdominal aorta, Common iliac aa and Internal iliac aa |
| blood supply in adrenal/ supra-renal glands (3) | Superior (inferior phrenic arteries) Middle (Abdominal aorta) Inferior (renal aa) |
| superior blood supply in adrenal/ supra-renal glands | inferior phrenic arteries |
| middle blood supply in adrenal/ supra-renal glands | abdominal aorta |
| inferior blood supply in adrenal/ supra-renal glands | renal artery |
| kidney innervation | renal plexus - sympathetic and parasympathetic and visceral afferent fibres |
| ureter innervation | renal plexus, aortic and superior hypogastric pl- sympathetic and parasympathetic and visceral afferent fibres, visceral afferent for pain follow sympathetic fibres to T11-12 |
| level kidneys are at | T12-13 (right kidney being more inferior compared with left) |
| kidney transplantation where | iliac fossa, renal vessels are joined to external iliac vessels and ureter sutured into bladder |
| where are the natural constrictions of the ureter | junction of renal pelvis and ureter which then crosses pelvic brim (iliac vessels) and enters bladder |
| ligaments in the diaphragm (3) | median arcuate, medial arcuate, and lateral arcuate ligaments |
| parts of the diaphragm (3) | sternal, costal (forms domes), and lumbar |
| structures which enter and leave at IV disc bw T8-9 | |
| structures which enter and leave at T10 | |
| structures which enter and leave at C12 | |
| what type of supply to diaphragm | sensory |
| irritation of diaphragmatic pleura and D. peritoneum refers to pain where | shoulder |
| shoulder is supplied by | C3-C5 (which also gives anterior rami for phrenic nerve) |
| irritation of peripheral regions of diaphragm innervated by | inferior intercostal nerves (more localised pain) with referred to skin over the costal margins of anterior lateral abdominal wall |
| lumbar plexus | |
| lumbar plexus includes |
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22tango
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