pelvic diaphragm function?
provides support for pelvic viscera and resists increase in intra-abdominal pressure
coccygeus location?
parallel to sacrospinous ligament (runs from inferior sacrum to coccyx)
levator ani location?
has 3 components (large-ish); attaches to pubic bones, ischial spines, and to tendinous arch of obturator internus muscle
abdominal wall - innervation?
iliohypogastric and ilioinguinal nerves
quadratus lumborum and psoas major - innervation?
direct branches of T12-L4
iliacus - innervation?
femoral nerve
muscular walls and floor of pelvic cavity - innervation?
obturator internus - L5-S2piriformis - S1-S2pelvic diaphragm - S4-S5 and coccygeal plexus
perineum - innervation?
branches of pudendal nerve
all body cavity viscera inferior to thoracic diaphragm - innervation?
autonomic nerve fibers of pre-aortic and inferior hypogastric plexuses (its subplexuses are names after location and viscera they innervate)
hypogastric nerves
moves sympathetic fibers from pre-aortic plexus to inferior hypogastric plexusfrom inferior hypogastric plexus to pelvic cavity AND from pelvic splanchnic to inferior mesenteric artery
nodes involved in spread of pathology from pelvic organs, perineum, and gonads?
nodes at origins of gonadal arteries from abdominal aorta
Valsalva maneuver?
contraction of abdominal wall w diaphragm fixed and laryngeal glottis closed --> increases intra-abdominal pressure (helps w childbirth and excreting urine and feces)
layers of anterolateral abdominal wall?
-skin-superficial fascia (Camper's and Scarpa's)-deep fascia-muscular layer and investing fascia (anterolateral: external oblique, internal oblique, transversus abdominis; anterior abdominal wall is just rectus abdominis)-internal fasciaparietal peritoneum
linea alba
separates L and R of rectus abdominis; formed by aponeurosis of all 3 muscles from anterolateral abdomen
rectus sheath - superior vs inferior to arcuate line
free inferior edge of posterior rectus sheath marks location of change in relationship of aponeurosis to rectus abdominis
rectus abdominis aponeuroses
BELOW ARCUATE LINE - all 3 layers pass ANTERIOR to rectus abdominis ABOVE ARCUATE LINE: external oblique aponeurosis passes ANTERIOR to rectus abdoministransversus abdominis aponeurosis passes POSTERIOR to rectus abdominisinternal oblique aponeurosis splits and half goes anterior and other half goes posterior to rectus abdominis
transversalis fascia
between parietal peritoneum and deep investing fascia on posterior surface of rectus abdominis
surface landmarks of T6, T10, and L1 dermatomes?
T6 - xiphoid process (siX and Xiphoid)T10 - umbilicus (belly button)L1 0 - inguinal ligament (inguinal L1gament)
umbilical folds formed by?
median - urachusmedial - umbilical ligamentlateral - inferior epigastric vessels
greater sac of peritoneal cavity
supracolic compartment (liver, gallbladder, stomach, spleen)infracolic compartment - all remaining viscera of GI tract and is separated into L and R infracolic spaces by mesentery proper
lesser sac of peritoneal cavity
posterior to stomach and lesser omentum, which connected stomach to liverthis is just as space!
mesentery
how viscera is suspended from posterior abdominal wallhow intraperitoneal organs receive neurvascular supply from abdominal aorta and pre-aortic plexus (also get lymphatic vessels and lymph nodes fat this way)
intraperitoneal organs?
in peritoneal cavity AND suspended by mesentery; connected to abdominal wall or other intraperitoneal organs via mesenteries (double layers of peritoneum that connect viscera to posterior abdominal wall) and peritoneal ligaments (double layers of peritoneum that connect intraperitoneal organs to one another or body wall)SALTD SPRSS:-stomach (omentum)-appendix (and cecum) (mesoappendix and mesocecum)-liver and gallbladder (falciform and coronary ligaments)-transverse colon (transverse mesocolon)-duodenum (1st part)-small intestine (jejunum and ileum) (mesentery proper)-pancreas (only tail) --> so lowkey doesn't really count)-rectum (upper 3rd)-spleen (splenorenal ligament)-sigmoid colon (sigmoid mesocolon)
retroperitoneal organs
posterior to peritoneum; within retroperitoneal space; have peritoneum on anterior side ONLY, not suspended by mesentery; lie between parietal peritoneum and abdominal wallSAD PUCKER:-suprarenal glands-aorta/IVC-duodenum (2nd-4th parts)-pancreas (head, neck, body)-ureters-colon (ascending and descending)-kidneys-esophagus-rectum (distal 2/3)LOWKEY THOUGH IT IS ONLY THE KIDNEYS
secondarily retroperitoneal organs
begin as intraperitoneal structures and as the develop, will attach to posterior abdominal wall AND reside in retroperitoneal spaceDADP:-duodenum (most of it)-ascending colon-descending colon-pancreas (all but tail)
supine position - fluid build up?
hepatorenal recess
erect position - fluid build up?
rectovesical (male) and rectouterine (female) pouches
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