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83 Cards in this Set

  • Front
  • Back
what are the attachments of the diaphragm?
crura attached to lumbar vertebrae (2 left, and 3 right)
xiphoid process
inner surfaces of lower 6 ribs
arcuate ligaments

central tendon
where is the only part of the diaphragm which is not covered by peritoneum?
bare area of liver
what innervates the diaphragm?
C3, 4, 5
what happens during contraction and relaxation of the diaphragm?
contraction - thorax volume increases; abdominal volume decreases

relaxation - thorax volume decreases; abdominal volume increases
what happens if the diaphragm contracts at the same time as the abdominal muscles?
abdominal pressure increases (vomiting, defecation)
at what level is the umbilicus?
at what dermatome is the xiphoid process?
T6 dermatome
at what dermatome is the umbilicus?
T10 dermatome
at what dermatome is the pubic symphysis?
L1 dermatome
the median umbilical ligament is a remnant of what?
allantois (urachus)
medial umbilical ligaments are remnants of what?
umbilical arteries
ligamentum teres is a remnant of what?
umbilical vein
what are considered the lateral umbilical ligaments?
inferior epigastric arteries
describe the superficial fascia above the umbilicus
contains fat and connective tissue as a single layer
describe the superficial fascia below the umbilicus
subcutaneous Camper's fascia
deeper membranous Scarpa's fascia
--continuous with superficial perineal fascia (Colle's fascia) and attaches to fascia lata
what is the superficial perineal fascia?
with what is it continuous?
Colle's fascia

continuous with Scarpa's fascia
what is the great flexor of the trunk?
rectus abdominis
what are the actions of the rectus abdominis?
flexes trunk

fixes rib cage for neck muscles to lift head

fixes pelvis for hip flexors to raise legs from bed
what innervates the rectus abdominis?
segmental innervation from T6-T12
what are the attachments of the rectus abdominis?
superior - anterior surface of xiphoid process and adjacent 5-7 costal cartilages

inferior - pubic crest and symphysis
what separates the two recti abdominis?
linea alba

(avascular insertion of aponeuroses of 3 flat anterior abdominal muscles)
what is the deep fascia infesting the superficial and deep layers of the three flat abdominal muscles and rectus abdominis (depending on the level)?
rectus sheath
what fascia is on what side of the rectus abdominis above the umbilicus?
anterior - fascia of external oblique and fascia of anterior surface of internal oblique

posterior - fascia of posterior surface of internal oblique and fascia of transversus abdominis
what fascia is on what side of the rectus abdominis below the umbilicus?
anterior - fascia of external oblique, fascia of internal oblique, fascia of transversus abdominis

posterior - just parietal peritoneum
what arteries supply the rectus abdominis?
inferior epigastric artery
superior epigastric artery
where does the inferior epigastric artery anastomose with the superior epigastric artery?
near the level of the costal cartilage of rib 8
where is an incision made during abdominal surgery?
in the anterior rectus sheath, on the medial side

the muscle should be retracted laterally

posterior aspect of rectus sheath is incised
where are motor nerves and arteries found for the flat abdominal muscles?
between the second and third layers of muscle
what are the attachments of the external oblique?
external aspects of lower 8 ribs

superior 1/2 - anterior aspect of rectus sheath & linea alba
inferior 1/2 - iliac crest, tubercle, asis, inguinal ligament, and pubic bone
lowermost - external lip of iliac crest
what makes the inguinal ligament?
the free inferior border of the external oblique muscle between the anterior superior iliac spine and the pubic tubercle
what is the lacunar ligament?
reflection of the inguinal ligament onto pectineal line of pubic bone
what is the superficial inguinal ring?
opening in external oblique aponeurosis close to the pubic tubercle
what direction are the fibers directed for the internal and external obliques?
external - from superior posteriorly to inferior anteriorly

internal - from inferior posteriorly to superior anteriorly
what are the attachments of the internal oblique?
intermediate line of iliac crest
lateral 1/2 of inguinal ligament

rectus sheath and linea alba
what is the conjoint tendon?
aka falx inguinalis

insertion of internal oblique fibers into pubic tubercle and pectineal line of pubis, combined with attachment of transversus abdominis

reinforces the wall posterior to the superficial inguinal ring
what are the attachments of the transversus abdominis?
lower 6CC
aponeurosis from lumbar vertebrae
inner lip of iliac crest
lateral 1/2 of inguinal ligament

linea alba
from what is the cremaster muscle derived?
muscle fibers of the internal oblique that arch over the spermatic cord within the inguinal canal
what is the function of the cremaster muscle?
elevate testes in the scrotum
what is the innervation of the cremaster muscle?
genitofemoral nerve (L1,2)

what innervates the anterior abdominal wall?
anterior rami of T7-T12

(mixed nerves running between the internal oblique and transversus abdominis)
what are the layers in the walls of the abdomen?
1. skin
2. supficial fascia (Camper's, Scarpa's)
3. external oblique
4. internal oblique
5. transversus abdominis
6. fascia transversalis
7. extraperitoneal fat
8. peritoneum
what are the layers in the walls of the scrotum?
1. skin
2. dartos muscle and fascia
3. external spermatic fascia
4&5. cremaster muscle
6. internal spermatic fascia
7. areolar tissue
8. processus vaginalis
what forms the internal spermatic fascia?
fascia transversalis
what forms the cremaster muscle and its cremasteric fascia?
internal oblique and its fascia
what forms the external spermatic fascia?
external oblique aponeurosis
with what is the superficial inguinal ring at the pubic tubercle continuous?
external spermatic fascia
(from external oblique aponeurosis)
what forms the barriers of the inguinal canal?
anterior wall - external oblique aponeurosis
floor - external oblique aponeurosis
posterior wall - fascia transversalis
roof - internal oblique and transversus abdominis
what reinforces the deep and superficial inguinal rings?
deep - internal oblique muscle and aponeurosis of external oblique

superficial - conjoint tendon
what is an indirect inguinal hernia?
gastrointestinal organs enter the deep inguinal ring

lies lateral to the inferior epigastric artery and invested in internal spermatic fascia
what is a direct inguinal hernia?
gastrointestinal organs protrude through the superficial inguinal ring, caused by failure of the conjoint tendon

lies medial to the inferior epigastric
artery covered by external spermatic fascia
what nerve must be blocked for a vasectomy?
ilioinguinal nerve (L1)

provides sensory innervation to scrotum
how does the ilioinguinal nerve enter the inguinal canal?
pierces internal oblique

leaves via superficial inguinal ring
where is the iliohypogastric nerve sensory?
after it pierces the external oblique aponeurosis above the superficial inguinal ring
what nerve gives motor innervation to the cremaster muscle?
genital branch of genitofemoral
what is the cremasteric reflex?
rub inside of thigh, and cremaster muscle retracts scrotum
what does the gubernaculum connect in prenatal life?
inferior pole of the developing gonad

skin of developing scrotum (labium majus)
what is drawn into the inguinal canal by the gubernaculum?
processus vaginalis
vas deferens
when does the gonad descend into the iliac fossa?

when does the gonad traverse the inguinal canal?
3rd month

7th month

(reaches bottom of scrotum after birth)
what is the female equivalent of the gubernaculum testis?
round ligament of the ovary
round ligament of the uterus

(attach inferior pole of ovary to labium majus)
where is the dartos muscle?
wall of the scrotum
what innervates the dartos muscle?
sympathetic nerves
what is the function of the scrotum?
contains testes and keeps them at a below-body temperature
what innervates the scrotum (labium majus)?
anterior - ilioinguinal nerve (L1)
posterior - S2, 3, 4
what arteries suply the scrotum?
external pudendal artery & vein
internal pudendal artery & vein
from where does the external pudendal artery branch?
femoral artery
from where does the internal pudendal artery branch?
internal iliac artery
where does the lymphatic drainage of the scrotum go?
from the penis?
scrotum and testes - superficial inguinal nodes
(superior horizontal nodes)

testes - lymph nodes between common iliac and renal vessels
where does the lymphatic drainage of the testes go?
follows testicular arteries and veins along the spermatic cord to abdominal lymph nodes

(end in nodes between the common iliac and renal vessels)
what fasciae make up the spermatic cord?
external spermatic fascia
cremasteric fascia
internal spermatic fascia
what is contained within the spermatic cord?
processus vaginalis (from parietal peritoneum)
loose connective tissue continuous with extraperitoneal loose connective tissue
vas deferens (spermatic duct)
testicular artery and sympathetic nerves
pampiniform plexus of veins
artery of ductus deferens
genital branch of genitofemoral nerve
what happens to the processus vaginalis?
processus vaginalis is an extension of the parietal peritoneum into the scrotum

where it sits through the inguinal canal, is obliterated, but the inferior portion becomes the tunica vaginalis
what is formed in the abdomen from the pampiniform plexus of veins?
single testicular vein on each side
where is the only place that the tunica vaginalis is not covering the testis?
around epididymis
entrance of spermatic cord into testis
what is the outer covering of the testis?
tunica albuginea
what is the mediastinum testis?
posterior portion of tunica albuginea
what is the sequence of ducts from the testes?
seminiferous tubules
straight tubules
rete testis
efferent ductules
ductus epididymis
ductus deferens
what are the divisions of the epididymis?
from where does the testicular artery arise?
from abdominal aorta

(at L2)
with what does the testicular artery anastomose?
artery of the vas deferens
(from inferior vesical branch of internal iliac artery)

cremasteric artery
(from inferior epigastric artery)
where do the testicular veins drain?
right - inferior vena cava
left - left renal vein

***have valves***
what is a varicocele?
abnormal enlargement of testicular veins

treated with catheter-directed embolization
what innervates the testis?
sympathetic innervation from T6-T10 vasomotor fibers

afferent fibers from T8-T10 dermatomes
(pit of the stomach)
what innervates the ductus deferens?
sympathetic innervation from inferior hypogastric plexus

(T11, T12, L1)