The Abdomen Anatomy, zones, muscles and blood supply

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form pages 71-85 of our Gross Anatomy Lecture book. some references were cited form the Gross Anatomy Lab book.

Abdominal Regions. The abdomen is divided into Horizontal Planes. Describe them.

a) TRANSPYLORIC (TPP) it is midway between the umbilicus and the xyphosternal joint. The plane passses through the tips of the 9th costal cartilage anteriorly and the lower border of the L1 vertebral body posteriorly.
*Note: subcostal plane often replaces the transpyloric plane, it passes the tip of the 10th costal cartilage anteriorly and the superior part of the body L3 vertebra.
b) TRANSTUBERCULAR (TPP) - it passes throught th iliac tubercles and crosses the body of the L5 vertebra.

Abdominal Regions. Describe the Sagittal (lateral) planes.

a. Lateral (right and left) - these two vertical lines extend downward from the mid-point of the clavicles to the mid-point of the inguinal ligaments.

Describe the Epigastric Zone

Above the transpyloric plane between the 2 lateral lines.

Hypocondriac (right and left) zone

superior to the transpyloric plane and lateral to the right and left lateal lines.

Umbilical Zone

the median region of the middle zone, between the two horizontal and two vertical lines.

Lumbar (right and left) zone

lateral to the umbilical zone, between the two horizontal planes and lateral to the vertical lines.

Hypogastric zone

Below the transtubercular plane, between the vertical lines.

Ilica or Inguinal (right and left)

lateral to the hypogastric zone, below the transtubercular plane and lateral to the vertical lines.

Name major viscera of the Epigastric Zone

stomach liver

Name major viscera of the Hypochondriac (right) zone

liver, gallbladder

Name major viscera of the Hypochondriac (left) zone

stomach, spleen, splenich flexure, transverse colon, descending colon

name the major viscera of the Umbilical Zone

stomach, duodenum, pancreas, small intestines (jejunum), transverse colon

name the viscera of the Lumbar (right) zone

ascending colon, hepatic flexure, transverse colon, kidney (right)

Name the viscera of the Lumbar (left) zone

descending colon, transverse colon, kidney (left)

Name the viscera of the Hypogastric zone.

sigmoid, rectum, bladder, small intestine (ileum)

name the viscera of the Iliac (right)

cecum, appendix

name the viscera of the Iliac (left)

sigmoid

Innervation of the anterior abdominal wall.

a) lower six (intercostal) nerves
2) first lumbar nerves

Arteries of the anterior abdominal wall

1) superior epigastric artery a branch of the internal thoracic artery
2) inferior epigastric artery
3) and the deep circumflex artery branches of the external iliac just above the inguinal ligament.
page 77.

The muscles of the anterior abdominal wall consists of how many large thin muscular sheets?

"The muscles of the anterior abdominal wall consists of four large thin muscular sheets. page 74.

Functions of the anterior abdominal muscles?

"support and protect the abdominal viscera; compress abdomen during breathing, coughing, vomiting, sneezing, urination and flex and lateral rotate the trunk." page 74

What is the largest and most superficial muscle of the abdominal wall?

External Obliques. page 74

External Oblique (O/I, Nerve, Action)

Origin: Lower 8 ribs
Insertion: Iliac creast, pubic tubercle and linea alba
Innervation: lower six intercostal nerves and subcostal nerve
Action:Compresses abdomen, flexes and rotates trunk

Name the structure or ring that is formed by the aponeurosis of the external oblique muscles

superficial inguinal ring

Internal Oblique

It is the intermediate muscle of the abdominal wall and its fibers run supermedially at right angles to the fibers of the external oblique.

Internal Oblique (O/I, nerves, Action)

ORIGIN: Lateral half of the inguinal ligament, anterior 2/3 of the iliac crest and thoraco lumbar fascia.

INSERTION: Lower border of 10th to 12th ribs, linea alba, pubis

INNERVATION: lower six intercostal nerves and first lumbar nerves (iliohypogastric and ilioinguinal)

ACTION: compress abdomen and flex and rotate trunk

Transverus Abdominis

it is deep to the internal oblique and its fibers run horizontally

Transversus Abdominis (O/I, nerves, action)

ORIGIN: lower six costal cartilage, thoraco lumbar fascia, iliac crest, and lateral thrid of the inguinal ligament

INSERTION: linea alba, pubis and pectineal line

INNERVATION: lower six intercostal nerves and first lumbar nerves

ACTION: compresses the support abdominal viscera

Rectus Abdominis (O/I, Nerve, Action)

O: pubic symphysis and pubic crest

Insert: xiphoid process and 5th to 7th costal cartilage

Innervation: lower six intercostal nerves

Action: Comresses abdomen and flexes trunk

Pyramidalis (describe)

It is a triangular muscle anterior to the lower part of the rectus abdominis.

True or false. "The Pyramidalis is often absent"

TRUE

Pyramidalis (O/I, Nerve, Action)

O: pubis

Insertion: linea alba

Innervation: subcostal nerve

Action: tenses the linea alba

Rectus Sheath. What sheaths make up the Rectus Sheath?

1. Anterior Rectus Sheath

2. Posterior Rectus Sheath

Anterior Rectus Sheath. Describe it.

It is formed by the aponeurosis of the exteranl oblique and the ventral fibers of the internal oblique aponeurosis.

Posterior Rectus Sheath. Describe it.

It is formed by the aponeurosis of the transversus abdominis and the posterior fibers of the internal oblique aponeurosis.

Arcuate Line. True or false, "It is a line on the dorsal wall of the rectus sheath."

True page 76

Linea Alba- describe it.

It is an intermexiture of anterior and posterior rectus sheaths extending from xiphoid process tothe symphsis pubis.

Transversalis Fascia. True or false the Transversalis Fascia forms the the deep inguinal ring?

True page 76

Tranversalis Fascia. Describe it.

It is a thing layer of fascia covering the deep surface of the tranversus abdominus muscle and its aponeurosis and is continuous with a similar layer lining the diaphragm, iliacus muscle, psoas muscle and inguinal canal. It forms the deep inguinal ring.

Preperitoneal Connective Tissue. Describe the type of tissue and location of it.

It is an areaolar tissue and fat between the peritonueum and the general fascia lining the abdominal and pelvic cavities.

What is lined by the parietal peritoneum?

The abdominal wall is lined with the parietal peritoneum.

Peritoneum. Describe.

It is a thin serous membrane, lining the abdomen and extended over the viscera. It has two layers with space in between.

Parietal peritoneum lines what?

It lines the abdominal wall.

Visceral peritoneum lines what?

It forms the outer lining of the visceral.

Peritoneal cavity-

the space between the two layers of the peritoneum. It contains serous fluid for lubrication. It consists of greater sac and lesser sac.

Messentery

Broad fanlike double fold of pertoneum suspending the jejunum and ileum from the posterior abdominal wall.

Omentum

It is double layer of peritoneum connecting stomach with certain abdominal viscera (diaphragm, liver, spleen and tranverse colon).

Greater Omentum (gastrocolic)

it is a double layer of peritoneum, folded on itself to make four layers. It hangs from greater curvature of the stomach, crosses transverse colon, and descends in front of the abdominal viscera. It contains fat and fixed macrophages. It aids in keeping abdominal viscera warm, prevents friction and localizes infection.

Lesser Omentum (gastrohepatic)

it is a double layer of peritoneum connecting the lesser curvature of the stomach and the first 2 cms of the duodenum with the liver. It consists of two ligaments:

1. Hepatogastric ligament
2. heptoduodenal ligament

Omental Bursa (lesser sac)

it is a diverticulum from the main cavity, behind stomach, liver adn lesser omentum.

Greater Sac

is is the anterior portion of the peritoneal cavity.

Retroperitoneal

it is referred to the organ that is located behind the peritoneum and outside the peritoneal cavity. The peritoneum covers anterior aspect of organ e.g. kidney, pancreas, ascending and descending colon, rectum, and duodenum (except superior part)

Intraperitoneal

It is referred to the organ that is located within the peritoneal cavity (e.g. stomach, spleen, appendix, small intestines, sigmoid, transverse colon, and superior part of duodenum)

Clinical Anatomy page 79. What is Peritonitis?

An inflammation of the the peritoneum as a result of infection, may cause an adhesion which interfere with the normal movements of viscera.

Abdominal Aorta, it begins at the aoritic hiatus of the diaphragm, It is anterior to which thoracic vertebra?

T12.

Where does the abdominal Aorta Bifurcate into right and left common iliac arteries?
d. L4

L4 thats right you are so smart!

for a million trillion godzillion dollars, which side does the aorta lie on?

The left side of the lumbar bodies.

Abdominal Aorta. From superior to inferior name 10 branches of the abdominal Aorta.

1. Inferior Phrenic Arteries
2. Celiac Artery (trunk)
3. Middle Suprarenal Arteries
4. Superior Mesenteric Artery
5. Renal Arteries
6. Testicular/Ovarian Arteries
7. Inferior Messenteric Artery
8. Lumbar Arteries
9. Median Sacral Artery
10. Common Iliac Arteries

This branch of the abdominal aorta, arises from the lateral aspect of the abdominal aorta at the level of the first lumbar supplying the diaphragm.

Inferior Phrenic Arteries

This abdominal aorta branch arises from ventral aspect of the aorta at the level of L1, supplying the spleen, stomach, liver, pancreas and duodenum.

Celiac Artery (trunk)

This branch arises from the lateral aspect of the aorta at the level of L1, supplying the suprarenal gland.

Middle Suprarenal Arteries

This abdominal aorta branch arises from the ventral aspect of th eaorta at the level of L1, supplying small intesting and part of colon.

Superior Mesenteric Artery

This aspect of the abdominal aorta arises from the lateral aspect of the aorta at the level of L1-L2, supplying kidneys.

Renal Arteries.

This branch of the abdominal aorta arise from the lateral aspect of the aorta at the level of L2, supplying testes/ovaries

Testicular/Ovarian Artery

This branch of the aorta arises from the ventral aspect of aorta at the level of L3, supplying part of colon and part of rectum.

Inferior Mesenteric Artery

This branch of the abdominal aorta has 4 pairs, arising from the dorsal aspect of aorta at the level of L1-L4. They supply the dorsal muscles, joints and skin as well as the spinal cord, cuada equina and meninges.`

Lumbar arteries

This branch of the abdominal aorta arises from the dorsal aspect of th eaorta above its bifurcation (L4), supplying the sacrum.

Median Sacral Artery

This branch of the abdominal aorta bifurcates at the level of the fourth lumbar vertebral body, into the left nad right common iliac arteries, supplying teh lower limbs, pelvic wall and viscera, gluteal region and sacro-illiac joint.

Common Iliac Arteries.

For all the Rice in China, name 3 branches or arteries associted with the Celiac Trunk!

1. Left Gastric Artery
2. Splenich Artery
3. Common Hepatic Artery

The left gastric artery supplies what?
Choose the correct answer from below.
a. gall bladder
b. greater curvature of stomach
c. Lesser curvature of stomach

c. Lesser curvature of stomach

did you know the left gastric anastomoses with the right gastric artery , a branch of the common hepatic ?

Well now you do.

What is the largest branch of the celiac trunk?
a. left gastric
b. Splenich Artery
c. Common Hepatic Artery

suprise suprise suprise! The answer is b. Splenich Artery page 81.

The short gastric artery is a branch of what? Choose the correct answer!
a. left gastric artery
b. splenich artery
c. common hepatic portal

b. Splenich Artery page 81

Do you need to redeem yourself try again. The left gastroepiploic artery is a branch of what? Choose the correct answer.
a. Common hepatic artery
b. Splenich Artery
c. Left Gastric Artery

b. Splenich Artery page 81.

The splenich artery supplies what? Choose the correct answer.

spleen, pancreas, fundus of stomach, greater curvature of stomach

name two branches of the splenich artery

1. Short gastric artery
2. Left gastroepiploic artery

Short Gastric Artery supplies what?

fundus of the stomach and superior margin of the greater curvature.

Left gastroepiploic artery

It runs along the greater curvature and anastomes with the right gastroepiploic artery, branch of hepatic artery to supply the greater curvature of stomach.

Name three branches of the Common Hepatic Artery.

a. Right Gastric Artery
b. Gastroduodenal Artery
c. Proper Hepatic Arter

Right Gastric Artery, Describe it

Branch of the Common Hepatic Artery. it anastomeses with left gastric artery to supply the lesser curvature of the stomach.

Gastroduodenal Artery, describe it.

Supraduodenal Artery to superior part of the duodenum. Two terminal branches: Superior Pancreaticoduodenal aa anterior and posterior branches to duodenum and pancreas. (<-- from lab book p29). (from lect. book p 82 -->) It runs behind 1st part of duodenum and divides into two branches.
(from Wikipedia -->) It divides into Right Gastroepiploic and Superior Pancreaticoduodenal Artery.

Right Gastroepiploic Artery

It goes to greater curvature of stomach. Right portion anastomoses with left Gastroepiploic artery from splenich artery.

Superior Pancreaticoduodenal Artery

It supplies the duodenum and the head of the pancreas. It anastomoses with the inferior pancreaticoduodenal, a branch of superior mesenteric artery.

Supraduodenal Artery describe it.

It may arise from the gastroduodenal, right gastric, or the hepatic artery (common or proper)

Proper Hepatic Artery

It gives rise to two branches which supply the liver.

What are the two arteries that Arise from the Proper Hepatic Artery?

1) Left Hepatic Artery
2) Right Hepatic Artery- It gives rise to cystic artery which supplies the gallbladder.

Superior Mesenteric Artery has 5 Branches. Name them.

1. Middle Colic Artery
2. Right Colic Artery
3. Ileocolic Artery
4. Jejunal and Ileal Branches (Small Intestinal Arteries)
*5. Inferior Pancreaticoduodenal Artery. Usually not visible.

Superior Mesenteric Artery

It arises from anterior surface of the Aorta about 1.25 cm below the Celiac A. at the level of L1

Middle Colic Artery. Where does it go?

Transverse colon.

Right colic Artery. Where does it go?

Ascending Colon

Ileocolic Artery. Where does it go?

to the Ileocolic junction.

Jejunal and Ilieal Branches go where?

to the jejunum and ileum.

Describe the Middle Colic Artery.

Highest branch from the right side. It supplies the transverse colon. Divides into 2 branches.
a. right branch: anastomes with the right colic artery.
b. left branch: anastomes with the left colic artery.

Describe the Right Colic Artery

Arises from the right side and supplies the ascending colon and right colic flexure.

Ileocolic Artery. Describe it. You can do it!

Lowest of branches from right side, supplies cecum and appendix. Divides into 2 branches.
a. Superior (colic)
b. Inferior (ileal)

Jejunal and Ilieal Branches

Arise from the left side of the superior mesentaric. There are 12-15.

Inderior Pancreaticoduodenal. Describe it.

Anastomes with superior pancreaticoduodenal and supplies lower portion of duodenum and head of the pancreas.

Inferior Mesentarich Artery is at what vertebral level?

L3

What general location does the Inferior Mesentarich Artery supply

it supplies the hindgut, (primarily left-sided structures)

List three branches of the Inferior Mesentaric Artery

1. Left Colic: Supplies transverse and descending colon, anastomoses with middle colic.
2. Sigmoid Arteries (inferior to left colic): Supply lower part of descending colon and the sigmoid colon.

3. Superior Rectal: Continuation of the inferior mesentaric artery and supplies the rectum.

Inferior Vena Cava (I will tell you about it)

It begins at level L5 and ascends superiorly on the right of the aorta to level T8. It enters the thoracic cavity through the vena cava hiatus of the diaphragm. It forms from the union of the right and left common iliac veins.

Inferior Vena Cava. Name the tributaries from Superior to Inferior. on page 84 there are 7 main tributaries.

1. Three hepatic veins
2. left renal veins (long), a. Left suprarenal
3. Right renal vein (short)
4. Suprarenal (inferior, middle, and superior) veins.
5. Inferior phrenic veins (to left renal vein)
6. 4 paired lumbar veins
7. Testicular/Ovarian (gonadal) veins
a. right: joins IVC directy at an oblique angle
b. left: joins with the left renal vein at a right angle.

Hepatic Portal System

It includes all veins collecting blood for the abdominal part of the digestive tube and spleen, pancreas, and gall bladder. From these viscera, blood is conveyed into the liver by the portal vein.

Portal Vein (of Hepatic Portal system)
where does it start in relation to vertebra>

Starts at level of L2 where superior mesentaric vein and splenic vein joine.

Portal Vein, what does it run with?

It runs with the hepatic artery and the common bile duct and divides into right and left stems.

Portal Vein...

Blood enters the liver through the portal vein and continues through the sinusoids to reach central veins wich are beginning of the hepatic vein system.

Splenich Vein.... (part of Hepatic Portal System). Where does the splenich vein recieve its tributaries from?

Speen pancreas, stomach, and colon, p 84.

Spenich Vein. It has 4 tributaries listed on page 85. Can You name them? Yes you can!

1. Short gastric vein
2. Left gastroepiploic vein
3. Pancreatic vein
4. Inferior mesentaric vein

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