What are the 4 quadrants of the abdomen?
Right upper /lower
Left upper/lower
What are the 9 regions of the abdomen?
Left hypochondrium Epigastrium Right hypochondrium Umbilical Left lumber Right lumbar Hypogastrium Left iliac region Right iliac region
What planes divide the abdomen into 4?
Mid-sagittal (median) plane
Transunbilical plane
What are the planes which divide the abdomen into 9?
Midclavicular plane
Transpyloric plane
Transtubercular plane
What are the 3 flat muscles of the anterior abdominal wall?
External
Internal oblique
Tranversus abdominis
What is the innervation of the external oblique?
T7-T12
What is the innervation of the internal oblique?
T7-T12 (L1)
What is the innervation of the transversus abdominis?
T7-T12 (L1)
What is action of the oblique muscles?
Flex & rotate trunk
What is the action of transversus abdominis?
Compress & support abdominal viscera
What are names of the vertical anterior abdominal wall muscles?
Rectus Abdominis
Pyramidalis
What is the action of rectus abdominis?
Flexes trunk & increases intra-abdominal pressure
What is the innervation of rectus abdominis?
T7-T11
What is the action of pyramidalis?
Tenses linea alba
What is the innervation of the pyramidalis?
T12
What is the rectus sheath?
Aponeurosis formed from the 3 flat muscles of the anterior abdominal wall
What is an aponeurosis?
Flat tendinous sheet
What level is the umbilicus?
L4
What is the dermatome at the nipples?
T4
What is the dermatome at the umbilicus?
T10
What is the dermatome at the groin?
L1
What is the linea alba?
A fibrous line which runs down the midline, dividing the rectus abdominis into 2
What is the inguinal ligament an extension of?
Aponeurosis of external oblique muscle
Which bony points is the inguinal ligament attached to?
Anterior superior iliac spine
Pubic tubercle
What is the anterior wall of the inguinal canal composed of?
Aponeurosis of external oblique
What is the posterior wall of the inguinal canal composed of?
Transversalis fascia
What is the floor of the inguinal canal composed of?
Inguinal ligament
What is the roof of the inguinal canal composed of?
Transversalis fascia
Transversus abdominis
Internal oblique
In which layer of the AA wall muscles does the deep inguinal ring occur?
Transversalis fascia
In which layer of the AA wall muscles does the superficial inguinal ring occur?
External oblique
What is the contents of the inguinal canal in males?
Spermatic cord
Ilioinguinal nerve
Lymph vessels
What is the contents of the inguinal canal in females?
Round ligament of uterus
Ilioinguinal nerve
Lymph vessels
What types of inguinal hernia can occur?
Direct
Indirect
Which type of inguinal hernia is most common?
Indirect (congenital resulting in peritoneal sac moving out of inguinal canal into scrotum)
What is the cause of direct inguinal hernia?
Weakened abdominal wall
What is the superior epigastric vessel a branch of?
Internal thoracid artery
What is the inferior epigastric a branch of?
External iliac artery
What are the 4 basic mucous types of the GI tract?
Protective
Secretory
Absorptive
Absorptive/Protective
Where is protective mucosa found?
Mouth, oesophagus, anal canal
Where is secretory mucosa found?
Seen only in the stomach
Where is absorptive mucosa found?
Small intestine
Where is absorptive/protective mucosa found?
Large intestine
What vertebral level is the transpyloric plane in?
L1
What vertebral plane is the subcostal plane?
L3
What vertebral plane is the transtubercular plane?
L5
What cells compose the peritoneum and produce peritoneal fluid?
Mesothelial cells
What are the 2 subdivisions of the peritoneum?
Visceral peritoneum
Parietal peritoneum
What are the 2 divisions of the peritoneum, forming sacs?
Greater sac
Lesser sac
Through which foramen do the 2 sacs of the peritoneal cavity communicate?
Epiploic foramen (omental foramen)
What does intraperitonised mean?
Organ is completely covered in visceral peritoneum
What does retroperitonised mean?
Organ is covered on anterior surface by parietal peritoneum, attached to posterior wall
What organs are intraperitonised?
Stomach Jejunum Ileum Caecum Sigmoid colon Spleen Liver Transverse colon
What organs are retroperitonsied?
Suprarenal glands Aorta (IVC) Duodenum (2nd half) Pancreas Ureters Colon (ascending/descending) Kidneys E(Oesophagus) Rectum
What is mesentery formed from?
2 layers of visceral peritoneum
What layer of peritoneum is most sensitive to pain, pressure, temperature?
Parietal peritoneum
What are the attachments for the greater omentum?
Greater curvature of stomach
Transverse colon
What are the attachments for the lesser omentum?
Lesser curvature of stomach
Liver
What ligaments compose the lesser omentum?
Hepatogastric
Hepatoduodenal
What is the greater omentum composed of? What is its function?
4 layers of visceral peritoneum
Localises site of infection within abdomen
What is the innervation of the parietal peritoneum?
T7-T12 + L1
What are the 3 hiatuses of the diaphragm for?
IVC (T8)
Oesophagus (T10)
Aorta (T12)
What are the 3 main branches of the aorta which supply the gut?
Coeliac trunk
Superior mesenteric artery
Inferior mesenteric artery
At what level are the common iliac arteries formed?
L4
At which vertebral level is the celiac trunk formed?
T12
At which vertebral level is the SMA formed?
L1
At which vertebral level is the IMA formed?
L3
What is the portal system?
Delivers nutrient rich blood from the gut to the liver for processing.
What forms the hepatic portal vein?
Splenic vein
SM vein
What are the 3 branches of the celiac trunk?
Splenic artery
Left gastric artery
Hepatic artery
Where are the sites of porto-systemic anastomoses?
Anorectal junction
Gastroesophageal junction
Paraumbilical veins
Which level do the kidneys lie at?
T12-L3
What is the order anterior to posterior that vessels leave the renal pelvis?
Renal vein
Renal artery
Renal pelvis
Where are the 3 constrictions of the ureters found?
Pelviureteric junction
Pelvic brim
Vesicoureteric junction
What structures enter the abdominal cavity through the oesophageal cavity?
Oesophagus
Vagus nerve (X)
Oesophageal branch of left gastric artery
What are the 2 orifices of the stomach?
Cardiac
Pyloric
What are the 2 curvatures of the stomach?
Lesser & greater
What layer of tissue is the pyloric sphincter composed of?
Circular smooth muscle
What tissue layer composes the rugae?
Mucosal layer
Where are rugae most prevalent in the stomach?
Greater curvature
Pyloric area
Where does the right gastric artery arise from?
Hepatic artery
Where does the left gastro-omental artery arise from?
Splenic artery
Where does the right gastro-omental artery arise from?
Common hepatic artery
Which common group of lymph nodes do the stomach drain to?
Coeliac trunk
What does the coeliac trunk supply?
Stomach
Spleen
Liver
Duodenum (1st part)
What are the different areas of the small intestine?
Duodenum
Jejunum
Ileum
What part of the small intestine receives the bile & pancreatic duct?
2nd part
Where is the foregut/ midgut boundary?
Hepatopancreatic ampulla (Major duodenal papilla)
What is the shortest, widest & most fixed area of the SMALL INTESTINE?
Duodenum
Which area of the small intestine is red & highly vascularised?
Jejunum
Which area of the small intestine has many arcades but short vasa recta?
Ileum
What are the anatomical features of the large intestine which distinguish it?
Haustra
Omental appendices
Teniae coli
How is the caecum peritonised?
Intraperitonised
Where is the boundary of the midgut/hindgut?
2/3rd along transverse colon
What 2 structures enter into the caecum?
Ileum
Appendix
What is identified at McBurneys point?
The base of the appendix
What is the blood supply of the superior rectum?
Superior rectal artery
How is the superior/middle/inferior rectum peritonised?
Retroperitoneal
Anteriorly peritonised
Subperitoneal
What is the blood supply of the inferior rectum?
Middle rectal artery
What is the parasympathetic supply to the rectum?
S2-4 pelvic splanchnic nerves
Where does the falciform ligament attach?
Liver to anterior abdominal wall
What lies at the free edge of the falciform ligament? What is it a remnant of?
Ligamentum teres
Umbilical vein
Where are the parabolic gutters located? What are the susceptible to?
Lateral to ascending/ descending colon
Infection
What type of epithelium is found in the oesophagus?
Stratified squamous epithelium
What type of tissue is found in muscarlaris mucosae?
Smooth muscle
What is another name for circular folds? Where in the GI tract are they found?
Plicae circularis
Small intestine
What is the surface marking for the transpyloric plane?
9th costal cartilage
What internal structures are found in the transpyloric plane?
Pylorus of stomach Duodenum Neck of pancreas Fundus of gallbladder Kidneys
What is the function of the spleen?
Filters blood and produces immune cells
How is the spleen peritonised?
Intraperitonised
What other organ is in contact with the spleen?
Tail of pancreas
What are the 4 parts of the pancreas?
Head
Neck
Body
Tail
What vein forms posterior to pancreas neck?
Superior mesenteric vein
What are the different lobes of the liver?
Right/Left
Caudate
Quadrate
What structures are in the porta hepatis?
Hepatic artery
Hepatic portal vein
Common hepatic duct
What is the liver bare of?
Peritoneum
What fold of peritoneum covers the structures of the porta hepatis?
Lesser omentum
What is the surface anatomy for the Gallbladder?
9th costal cartilage (R) MIDCLAVICULAR LINE
What is the surface anatomy for the spleen?
9-11th ribs
What is the name of the triangle found in relation to the gallbladder?
Calot’s triangle