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Functions of the abdomen wall.
1. Supports and protects the abdominal viscera
2. Compress the abdomen viscera to increase intraabdominal pressure for: coughing, burping, yelling, & forced expiration
3. Produces the force required for: defecation, urination, vomiting, & childbirth
4. Movement of the trunk: flexing, twisting, lateral bending
5. Maintain Posture
outer layer fascia
inner membraneous fascia
3 flat muscles are?
1. External Abdominal Oblique Muscle
2. Internal Abdominal Oblique Muscle
3. Transverse Abdominal Muscle
Describe Rectus Abdominis Muscle.
is enclosed by the rectus sheath
** formed by the aponeuroses of the 3 flat abdominal muscles!
All 3 flat abdominal muscles end...
Anteriorly as an Aponeurosis.
terminal branches of L1
Serratous anterior innervated by?
why is it special
long thoracic nerve
runs OUTSIDE of the muscle
What is the LINEA ALBA?
tendinous median line found in between the rectus abdominis muscle
Bloody supply to the muscles of the anterolateral abdominal wall?
1. musculophrenic artery
2.anterior intercostal artery
3. inferior epigastric artery
-pasageway through the inferior abdominal wall
-area between the anterior superior iliac spine and public tubercle
-region where structues exit and enter the abdominal cavity
-clinically significant: potential site for inguinal hernias
- oblique tunnel through aponeuroses
-of abdominal muscles
- -main occupant is SPERMATIC CORD IN MALES
- & ROUND LIGAMENT IN FEMALES
proturison of PERITONEUM & VISCERA through a normal or abnormal opening in the abdominal cavity
Layers of the Abdominal Wall (superficial to deep)
- 1. Skin
- 2. Superficial Fascia
- - Camper's fascia= fatty later
- - Scarpa's fascia= membranous layer
- 3.External Oblique
- 4. Internal Oblique
- 5. Transversus
- 6. Fascia Transversalis
- 7. Extraperitoneal Fatty Tissue
- 8. Peritoneum
Periotoneum= serous layer (same set up as the pleural & pericardial cavity)
= lines or covers the viscera
=lines the cavity
=potential space between the viscera and parietal peritoneum
Double layers of the Peritoeum are?
What is Peritonitis?
-inflammation of the peritoneum, cause adhesions
Whati is Ascites?
fluid accumulation in peritoneal cavity
What is Paracentesis?
-surgical puncture of peritoneal cavity drainage of fluid
connects stomach to adjacent viscera
comvey blood vessels, lymphatics, and nerves
connects abdominal wall to organ or organ to organ
potential spae between parietal and visceral perioteum
male= CLOSED CAVITY
- female= OPEN CAVITY by uterine tubes, uterine cavity and vagina
- **potential area for infection
Intraperitoneal organs are?
almost completely covered by peritoneum (stomach)
Retroperitoneal organs are?
covered by periotoneum on the anterior surface (kidney)
Greater omentum is?
-double layer of peritoneum that connects THE GREATER CURVUTURE OF THE STOMACH to the TRANSVERSE COLON
Lesser omentum is?
double layer of perioteum that CONNECTS THE LESSSER CURVUTURE OF THE STOMACH and DUODENUM to the LIVER
double layer of perioteum that conveys vessels, nerves, and lymphatics
Barium Swallow of the Upper GI:
-fill the esophagus, stomach, & small intestines with barium to visualize the anatomy
**reveals ulcers, tumors, hiatal hernia, scarring, blockage, and abnormalities in the muscular wall
Barrium in Lower GI
-fill the large intestine (colon) and rectum using a barium enema to visualize the anatomy
inflammation or rupturing of the outpouches
Blood Supply of the GI tract
- -3 unpaired vesslels
- -branch off the aorta
- 1. Celiac artery
- 2. Superior mesenteric artery
- 3.Inferior mesenteric artery
Blood supply of the foregut?
Blood supply of the midgut?
superior mesenteric artery
Bloody supply of the hindgut?
inferior mesenteric artery
Structures in the foregut?
- -duodenum (primal)
- -part of pancreas
Structures in the midgut?
- -remainder of duodenu and pancreas
- -ascending colon
- -2/3 transverse colon
Structures in the hindgut?
- -1/3 of transverse colon
- -descending and sigmoid colons
- -upper 1/2 anal canal
Branches off the Celiac Trunk?
- 1. Left Gastric
- 2. Splenic
- 3. Common hepatic
- 4. Hepatic proper
- 5. Right gastric
- 6. Gastroduodenal
Branches off Superior Mesenteric Artery?
- 1. Intestinal
- 2. Illeocoloic
- 3.Right colic
- 4. Middle colic
Branches off Inferior Mesenteric Artery?
- 1. Left colic
- 2. Sigmoid
- 3. Superior rectal
Duodenal ulcers are?
-most common in the posteiror wall of the 1st part of the duodenum
-preforate the duodenal wall permitting contents to enter periotoneal cavity and cause PERIONITIS
What vessel would most likely cause bleeding into cavity because of duodenal ulcer type and why?
**because damge to grastroduodenal artery puts blood into this cavity
Portal Venous System does what?
drains GI tract into the liver
- -main channel of the portal venous system
- -collects poorly O2 & nutrient rich blood
Portal-Systemic drains specifically?
Portal-Systemic Anastomes is?
-where portal venous system communicated with systemic venous system
Normal Blood flow through the liver?
Portal Vein (drains GI tract) to Hepatic Vein (drains into systemic circulation)
Obstructed blood flow through the liver?
-makes blood flow in opposite direction beacause NO VALVES!!
Fibrosis of the liver blockage leads to..?
**blood flow from portal to systemic sites of Anastomoses become ENGORGED
Esophageal varices are?
VERY VERY DANGEROUS IF THEY RUPTURE
How are nodes named?
named according to vessels or locations
where are nodes located?
along the artieries or organs
If cancer is in that one specific spot in stomach the blood supply would go?
- 1. celiac artery
- 2.common hepatic artery
- 3. gastroduodenal artery
If cancer was in that one specific spot, LYMPHATIC DRAINAGE would occur how?
IN OPPOSITE DIRECTION
- -gastrodeunal nodes
- -common hepatic nodes
- -celiac nodes
- -preaortic nodes
- -thorasic duct
HINT HINT: where does everything else drain?
Name the structures contained in the pelvis.
- 1. urinary bladder
- 2. ureters
- 3. rectum
- 4. reproductive organs
- 5. nerves, blood, and lymph vessels
What helps to elevate the rectal/anus muscles so you can defocate?
(pubococcygeus muscle & illiococcugeus muscle)
When the external anal sphincter RELAXES you?
What does the Bulbospongiosus Muscle do for males?
can contract to release last couple drops of semen/urine
-in females it acts as a SUPPORTING MUSCLE
Perineal Body is relevant during childbirth how?
if it tears it can cause long term fecal content (something happens)
What help provide nourishment PH balance to sperm?
what stores sperm?
what are the 3 parts of the penis?
- 1. shaft
- 2. glans penis
- 3. prepuce (aka foreskin)
sac that contains testes
External genitalia of the male is?
- -Penis (and its 3 parts)
What are the accessory glands of a male? (3)
- -seminal vesicles
- -prostate gland
- -bulborethral gland (aka Cowper's gland)
Some other parts of male reproductive tract?
- -ductus defrens (aka vas deferens)
In LAB, where it isn't curly anymore and is straight it is...
the Ductus Deferens
when its curly its the: epididymis
What produce and store the sperm?
The pathway of Ductus Deferens.
- -starts at proximal end of epididymis
- -passes through the inguinal canal
- -enters the pelvic cavity
- -arches over urinary bladder
- -ends in ejaculatory duct
travels in SPERMATIC CORD with (3)?
- -blood vessels
- -cremaster muscle
Sperm propelled by?
In the male embryo the Wolffian Duct turns into?
At 4 months , in the male embryo what occurs?
testis moves closer toward deep inguinal ring
At 8 months, the male embryo ...what occurs?
-this the last month of gestation, the testis descend through the inguinal canal
What are the 3 parts of the male urethra?
- 1. prostatic
- 2. membranous
- 3. spongy/penile
During ejaculation, the INTERNAL URETHRAL SPHINCTER CLOSES in order to... (2)?
- 1. prevent urine from entering urethra
- 2. prevent sperm from entering bladder
Describe SEMINAL VESICLES.
- -duct join ductus deferens to form ejaculatory duct
Describe Prostate Gland.
- -surrounds prostatic urethra
- -several ducts into urethra
- -located anterior to rectum
Describe the Bulbourethral glands.
- - pea sized
- -inferior to prostate gland
It is unlikely you will see _____ in cadaver.
What are the 2 erectile tissue found i the shaft of the penis?
1. corpus cavernosum (paired)
2. corupus spongiosum (surrounds urethra)
What occurs at a slightly lower temperature than our body temperature (male process)?
The scrotum (divided sac) mainatains?
temperature regulation of tests for sperm production assisted by CREMASTER MUSCLE
method of birth control in males, prevents sperm from traveling out
In undescended testes where is the sperm?
it is still inside the inguinal canal & body wall because they don't descend
Describe medulla & cortex.
Medulla= contains blood supply
- cortex= where everything occurs!!
Which follicle is destined for ovulation?
vesicular aka Graafian or ovulatory
-bleeding from cells that are left behind
-progesterone secreting structure that lasts until pregnanacy occurs
If pregnancy does not occure, Corpus Luteum regresses & what is formed?
The ovary is covered with?
tunica albuginea (just like the testes)
What you should NOT HAVE is ovatory follicles present at the same times as ____.
Describe the Fimbriae.
- -partially surround the ovary
- -"wave like" currents
Usual site of fertilization ?
Describe the Uterine Tubes.
- -not attached to ovary
- -ampulla: usual site of fertilization
Fundus is located where? (uterus)
near entrance of uterine tubes
Uterus is located?
between urinary bladder & rectum
outlet protruding into vagina
the 3 layers of uterine walls are?
1. perimetrium (outermost layer)
2. myometrium (middle muscular layer, most of uterus is this)
3. endometrium (proliferated layer)
Which layer is the site of implantation of an embryo?
site of impantation=?
site of fertilization=?
site of implantation= endometrium
site of fertilization= ampulla
- - 8-10 cm long
- -musculomembranous tube
- -extends from cervix to exterior of body (vestibule)
- -hymen= membrane over vaginal opening
Uterine artery runs how?
- comes off int. iliac aa & crosses over the ureter
"water under the bridge"
Pelvic Inflammatory Disease?
-occurs bc uterine tube is open into pelvis and bacteria can travel inside and settle in pelvic cavity
uterus can fall through vaginal opening
can occur within the uterine tube, implantation occurs on endometrial wall instead of inside
when you inject dye inside uterus to look for blockages inside uterine tube
Anatomical relationships of organs are shifted during pregancy in order to?
make room for the growing fetus
What are some common pregnancy relared synotoms that are primarily due to anatomical changes?
- 1. frequent urination
- 2. back or leg discomfort/pain if lying on back
- 3. "waddle" when walk (late term)
Why must you be careful not to have a pregnant woman recline too far back in the chair during a dental exam?
descending arota will put pressure on veins & vesseks & caN DEPRESS AA'S THAT ARE SUPPLYING FETUS IF YOU recline back too far
Pregnancy Related Anatomical Changes:
- -abdominal organs displaced (superiorly)
- -bladder compressed; stress incontinence
- -lumbar curvuture increased
Describe the kidney.
- -bean shaped
- -along posterior abdominal wall, between vertebral leverls T12 & L3
- -surround by ADIPOSE CAPSULE
- -right kidney slightly lower than left
Why is the right kidney lower than the left?
-it is lower because of the liver
Why is the adipose capsule important?
protects the kidney from moving around, cushions it if hit
Adrenal glands sit on what surface of kidneys?
*** NOT PART OF URINARY SYSTEM
in path of kidney blood flow there are no?
-no lobar or segmental veins
Know path of kidney blood flow chart.
Wall composed of?
Urine moves by?
Valve like folds of bladder mucosa over openins PREVENT..?
prevents retrograde flow of urine
- -from renal hilus
- -to posterior aspect of bladder
Volume when moderately full?
wall contains__ layers of smooth muscle
-lined with TRANSITIONAL EPITHELIUM
- volume about 500 ml when moderately full
-wall contains 3 laters smooth muscle
3 opening of urinary bladder
- -thin walled tube
- -urine carried by peristalis
- -2sphincters: internal urethral sphincter & external urethral sphincter
Internal urethral sphincer?
- -bladder to urethra junction
- -smooth muscle
- -involuntary control
External urethral sphincter?
- -at passage of urethra through pelvic floor
- -skeletal muscle
- -voluntary control
In which region of the male urethra is the external urethral sphincter located?
Sex Differences in Urethra?
Name Male & Female.
- relatively long about 20cm
- opens at tip of penis
- 3 named regions: prostatic, membranous, spongy
- relatively short 3-4 cm long (women more susceptible to UTIS due to short distance)
- external orifice anterior to vaginal opening
Micturition (process of urination)
- 1. Stretch receptors in bladder activated
- 2. Nerve impulsed sent via splahnic nerves
- 3. Bladder contracts (reflex)
- 4. Internal urethral sphincter relaxes (opens)
- 5. Urine flow into urethra stimulates urge to void
- 6. External urethral sphincter relaxes to void (voluntary control)
most common narrowest part and most painful when going through the ureter
- <2yrs old, normal development of voluntary control
- older children sleep too deeply to sense stimulus to void ("bed wetters")
- -post operarively following general anesthesis
- -prostatic hyperplasia