Abdomen I
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| Origin and insertion of rectus abdominus | origin: pubic symphysis and crest --> insert at xiphoid and 5th-7th costal cartilages
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| Origin and insertion of external oblique | External surfaces of 5th – 12th ribs insert at Linea alba, pubic tubercle, anterior ½ of iliac crest
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| Origin and insertion of internal oblique | Thoacolumbar fascia, anterior 2/3 of iliac crest, lateral 1/3 of inguinal ligament insert at inf. Border of 10th-12th ribs, linea alba, and pecten pubis via conjoined tendon
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| Origin and insertion of transversus abdominus | Internal surfaces of 7th-12th costal cartilages, thoracolumbar fascia, iliac crest, lateral 1/3 of inguinal ligament insert at linea alba, pecten pubis via conjoined tendon
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| Name the layers of the abdomen from outside in | Skin, Camper's fascia, Scarpa's Fascia, external oblique, internal oblique, transversus abdominus, transversalis fascia, pre-pertioneal fat, parietal peritoneum
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| Name the muscles used to twist the torso | external oblique, internal oblique, transversus abdominus
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| Name the order of the abdomen examination | Inspection, Auscultation, Percussion, Palpation
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| Name the area above the appendix | McBurney's Point; 2/3 from umbilicus to anterior iliac spine
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| What is located 1/3 below umbilicus and marks the end of the posterior sheath? | Arcuate Line; 3/4 of rectus located above this point, important when making and closing incisions
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| The superior epigastric arteries are the continuation of which arteries? | internal mammary (thoracic) artery. They travel posterior to rectus muscle within posterior rectus sheath
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| Where do the inferior epigastric arteries originate? | the last branch of the external iliac artery anastomoses with the superior
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| Where are the deep circumflex iliac arteries located? | In the lower abdomen
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| Superficial areas above the umbilicus drain to which lymphatic region? | Axillary
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| Superficial areas below the umbilicus drain to which lymphatic region? | Inguinal
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| Deep areas above the umbilicus drain to which lymphatic region? | Para-aortic nodes, internal mammary nodes
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| Deep areas below the umbilicus drain to which lymphatic region? | inguinal, external iliac, common iliac
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| Which nerves innervate the xiphoid? | T5-6
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| Which nerve innervates the umbilicus? | T10
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| Which nerve innervates the pubis? | L1
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| A spinal cord transection from a car accident causes cutaneous loss of sensation where? | Xiphoid
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| Name the function of the psoas muscle | Flexes the spine; hip
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| Name the function of the iliacus | Flexes the hip/thigh
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| Where do the ileopsoas muscles (psoas major, psoas minor, iliacus) originate and insert? | Originates at ileac fossa and lumbar spine and inserts into the lesser trochanter of the femur.
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| Which muscle group will be inflammed in appendicitis? | Ileopsoas muscles
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| Which muscle extends and laterally flexes the spine? | Quadratus lumborum; spans from iliac crest to lowest rib and to vertebrae
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| Which muscle runs laterally around the appendix? | Psoas muscle; Psoas Test: Patient in supine position tries to flex right hip against resistance; pain in pelvis during this maneuver is a positive test
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| List the attachments of the diaphragm | Sternal: posterior aspect of xiphoidCostal: last 6 costal cartilagesLumbar: L1-L3 (crura)
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| Name the three structures pass through the central tendon of the diaphragm | IVC: T8Esophagus: T10(Vagus nerve also passes through with esophagus)Aorta: T12
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| In what position is the diaphragm lowest? | Standing
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| CDH | Congental Diaphragmatic Hernia; Failure of the diaphragm to fuse during fetal developmentUnilateral with pulmonary hypoplasiaOccurs in approximately 1/2200 live births50% mortalitySurgical correction
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| Which structures can herniate in an abdominal hernia? | extraperitoneal fat, peritoneum, omentum, bowel, or other viscera through a defect in the transversalis fascia
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| Name the structures that go through the inguinal canal. | Contains spermatic cord(M)/round ligament of uterus(F) and ilioinguinal nerve (M+F)
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| Name the boundaries of the inguinal canal. | Floor: top of inguinal ligamentCeiling: aponeurosis of internal oblique and transverse abdominal musclesAnterior: external obliquePosterior: transversalis fascia
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| Name the origin and insertion of the inguinal ligament | anterior-superior iliac spine to the pubic tubercle
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| Which structure pulls the testes into the scrotum and at what point of development does this occur? | Gabernaculum; 7 months in utero
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| Where does an indirect hernia occur? | Through the process vaginalis
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| Where does a direct hernia penetrate? | Through a weakness in the wall
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| This is a fascial defect lateral to inferior epigastric vessels through which the testes pass by means of the process vaginalis into the scrotum | Internal (deep) inguinal ring
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| Name the borders of Hesselbach's triangle. | bounded by the inguinal ligament inferiorly, the lateral border of the rectus muscle medially and the inferior epigastric vessels laterally; direct hernia's occur within the triangle
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| This type of hernia passes lateral to the inferior epigastrics, is congenital and more common, enters the inguinal canal through the deep ring. | Indiret hernia
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| Passes medial to epigastrics ( in Hesselbach’s triangle)Aquired weakness in abdominal wallUsually in adults | Direct hernia
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| List the contents of the spermatic cord. | Vas DeferensTesticular artery- a branch of the abdominal aortaCremasteric artery-a branch of the inferior epigastric arteryArtery of the vas deferens- a branch of the inferior vessicle arteryPampiniform Plexus of VeinsCremasteric MuscleSympathetic nerve f
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| Name the hernia that is inferior to the inguinal ligament and which occur 70% of the time in women | Femoral hernia
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