What is the superior border of the abdominal wall?
Right and and left costal margins, xiphisteranal joint
What is the inferior abdominal border?
An invisible line running from either ASIS to the pubic symphysis
What is the lateral bodred or the abdominal cavity?
Lateral lines ascending from the ASIS on each side
What is the pesterior border of the abdominal wall?
The paravertebral musculature
How many planes is the abdomen divided into? regions? What are they used for?
- The are four planes (subcostal, Transtubercular, Sagittal) and nine regions.
- They are used in helping to describe clinical pain, swelling and visceral locations.
Decribe the subcostal plane.
A line that passes through the most inferior pointsof the costal caritlage, 10th costal cartilage and passes throughth the body of the L3 vertebrae
Describe the Transtubercular Plane
Passes through the tubercles of the ilium (iliac tubercles) and the level of the L5 vertebra.
Describe the Sagittal plane.
Mid-clavicular line. Runs from the midclavicle inferiorly to the mid-inguinal point.
Which planes are divided to form the nine regions? What are the 9 formed regions?
- The subcostal plane, the sagittal plane, and the transtubercular plane
- The upper region: Right hypochondriac, epigastric, left hypochondriac
- The middle region: Right lumbar, gastric, left lumbar
- The lower region: the right inguinal, the hypogastric, left inguinal
The stomach is sometimes divided into 4 quadrants, what are they? Which planes form these quadrants? The median plane and the trans-umbilical palne
- RUQ: Right upper quadrant
- LUQ: Left upper quadrant
- RLQ: Right lower Quadrant
- LLQ: Left upper quadrant
- The median plane and the trans-umbilical plane
What are the contecnts of the RUQ?
- Gall bladder
- Ascending colon: superior part
- Right kidney
- Right suprarenal gland
What are the contents of the LUQ?
- Pancrease -body and tail
- Left Kidney - left surparenal gland
- Transvers colon (left half)
- Descending colon (superior part)
What are the contents of the RLQ?
- Ascending colon (inferior half)
- Veriform appendix
- Right ovary
- Right ureter
- Most of the ileum
- Right spermatic cord
What are the contents of the LLQ?
- Sigmoid colon
- Descending colon (inferior part)
- Left ovray
- Left ureter
- Left Spermatic cord
Extrenal Oblique OINA
- O: External Surface of ribs 5-13
- I: Linea alba, pubic crest, iliac crest, pubic symphysis
- N: Inferior 5 thoracic nerves, subcostal (T12) nerve, and iliohypogastric
- A: Flex and rotate trunk, laterally rotate trunk, compress abdominal content
Internal abdominal oblique OINA
- O: Thoracolumbar fascia, anterior iliac crest, lateral half of inguinal ligament
- I: Linea alba, pubic crest, ribs 10-12 inferior surface
- N: Lower 5 thorasic nerves, subcostal (T12) iliohypogastric
- A: Flex and rotate the trunk, laterally rotate the trunk, compress the abdominal cavity
What is interesting about the N and A for the Ex/In obliques?
- THEY ARE THE SAME
- N for both: Inferior 5 thoracic nerves, subcostal 12, and the iliohypogastric
- A for both: Flex and rotate the trunk, laterally flex the trunk, compress abdominal contents
Transverse Abdominis OINA
- O: Thoracolumbar fascia, iliac crest, lateral one third of the inguinal ligament, internal surface of costal cartilages 7-12
- I: Linea alba, pubic crest, pubic symphysis
- N: Lower thoracic nerves, subcostal (T12), iliohypogastric (same as the the ex/in oblique)
- A: compress and support abdominal viscera
Rectus Abdominis OINA
- O: pubic symphysis, pubic rest
- I: Xiphoid process, 5th and 7th costal cartilages
- N: Lower 5 thoracic nerves, subcostal (T12), iliohypogastric
- A: flexes trunk and tenses anbterior abdominal wall
What is the rectus sheath? What forms it?
- It is a fascial sheath that encases the rectus abdominus. There is an anterior posterior aspect of it.
- It is formed by the fusion of the aponeuroses of the abdominal muscles.
Describe the Rectus sheath above the umbilicus line and what composes the anterior and posterior sheath.
- Anterior: The ex. obl. aponeurosis and half of the int. obl. aponeurosis.
- Posterior: the other half of the internal olb. aponeurosis and the xvers abdominus aponeurosis
What do we call the structure where the anterior and posteroir walls meet?
The linea alba. It is in the anterior median line.
We knoe what when dealing with the rectus abdominus and the rectus sheath, there is a differencebelow nad above the umbilicus. Describe the inferior portion.
- Anerior is made up of the ex/in ob aponeu and the xverse aponeu. This creates a line called the arcuate line.
- Posterior there is a thin film that protects the rectus abdominus from rubbing on the abdominal contents.
So what is the arcuate line?
It is the point of transition where all three aponeurosis meet aneriorly.
Explain the innervation of the abdominal wall. Which nerves innervate it?
- It is segementaly arranged.
- T10-Umbilicus (like the hole in the ten it represents the belly button)
- T7-Zyphoid process (7 can almost look like a Z it just needs that underscore)
- L1-pubic (L1, where there shines no sun) :)
- Ventral primary rami of T6-T11, and T12 or subcostal nerve, the iliohypogastric that comes off of the lumbar plexus and the ilioinguinal which also comes off of the lumbar plexus, those two also come off of the ventral primary rami of L1.
The verntral primary rami of T6-T11 and the iliohypogastric and ilioinguinal inneravate which structure?
- They innervate the anterior abdominal wall. The basic sections are divided like this:
- T7 at the Zyphoid region
- T10 at the umbilicus region
- L1 at the pubic area
What innervates the anterior abdominal wall?
- Superior: Seprior epigastric-a branch of the internal thoracic off of the subclavian arterys
- Inferior: Inferior epigastric - a branch of the external iliac a.
- They both enter the rectus sheath posterior at the rectus abdominus nad anatomoses with the rectus muscle.
- Posterior intercostal arteries that accompany the intercostal nerves also contribute to the anterior abdominal wall.
- Additional supply comes directly form branches off of the aorta nad lubar arteries.
In a nutshell. what are the 4 supplies of blood for the ant. abdominal wall?
The sup/inf epigastric. The subcostal arteries. Branches off of the lumbar and aorta.
What is the inguinal canal? What forms it?
- It is a passage from the abdominal cavity. Some parts need to be outside of the abdominal cavity.
- Thick folds in the external oblique aponeurosis (thick fibrous tissues)
What is the inguinal ligament?
It is a fibrous band that extends from the anterior superior iliac spine to the pubic tubercle
What begins and ends the inguinal canal?
The superficial and deep inguinal rings
What structures pass through the inguinal canal?
- spermatic cord in males
- round ligamnet of the uterus in females
- Inguinal nerve
- Blood and lymphatic vessels