THORAX/ABDOMEN/PELVIS EXAM REVIEW Abdominal Muscles

Muscles
External oblique

Origin
External surfaces of ribs 5-12 Thoracolumbar fascia, anterior 2/3 of iliac crest, and lateral of inguinal ligament Internal surfaces of costal cartilage 7-12, thoracolumbar fascia, iliac crest, and lateral 1/3 of inguinal ligament Pubic symphysis, pubic crest Inferior rectus sheath

Insertion
Lineal alba, pubic tubercle, and anterior half of iliac crest Inferior borders of ribs 10-12, linea alba, and pubis via conjoint tendon Linea alba w/ aponeurosis of internal oblique, public crest, and pecten pubis via conjoint tendon Xiphoid process and costal cartilages 5-7 Linea alba

Innervation Action(s)
Inferior six thoracic nerves and subcostal nerve Anterior rami of inferior 6 thoracic and 1st lumbar nerves Compress and support abdominal viscera; flex and rotate trunk, maintain posture

Other
3 flat muscles of anteriolateral abdominal wall External fibers run inferiomedially, internal fibers run at right angles to external, and transverse fibers run horizontally Aponeurosis of all three fibers forms rectus sheath

Internal oblique

Tranverse abdominal

Compresses and supports abdominal viscera

Rectus abdominus Pyramidal

Anterior rami of inferior 6 thoracic nerves

Flexes trunk and compresses abdominal viscera Triangular muscles that lies in the rectus sheath anterior to the inferior part of the rectus abdominus

Abdominal Nerves
Nerve
Thoracoabdominal (T7-T11)

Origin
Continuation of inferior intercostals nerves Anterior ramus of T12

Course
Run btwn 2nd and 3rd layers of abdominal muscles Runs along inferior border of rib 12

Distribution
Anterior abdominal muscles and overlying skin; periphery of diaphragm Lowest slip of external oblique m. and skin over anterior superior iliac spine and hip Skin of hypogastric region and over iliac crest; internal oblique and transverse abdominal Skin of scrotum/

Other
T7-T9 supply skin superior to umbilicus T10 supplies umbilicus

Subcostal (T12)

Iliohypogastric (L1)

Chiefly from anterior ramus of L1

Ilioinguinal (L1)

Anterior ramus of L1

Pierces transverse abdominal m., branches pierce external oblique aponeurosis Pass btwn 2nd and 3rd

layer of abdominal muscles and passes through ilioinguinal canal

labium majus, mons pubis, and adj. medial aspect of thigh; internal oblique and transverse abdominal

Abdominal Arteries
Artery
Superior epigastric Inferior epigastric

Origin
Internal thoracic a. External iliac a.

Course
Descends in rectus sheath deep to rectus abdominus Runs superiorly and enters rectus sheath; runs deep to rectus abdominus Runs on deep aspect of ant abd wall, parallel to inguinal ligament Runs in superficial fascia along inguinal ligament Runs in superficial fascia toward umbilicus

Distribution
Rectus abdominis and superior part of anterolateral abd wall Rectus abdominis and medial part of anteriolateral abdominal wall Illiacus muscle and inf part of anterolateral abd wall Subcutaneous tissue and skin over inferior portion of anterolateral abd wall Subcutaneous tissue and skin over suprapubic region

Other

Deep circumflex iliac

Superficial circumflex iliac Superficial epigastric

Femoral a.

FETAL/ADULT HOMOLOGS
Fetal Structure
Umbilical vein Ductus venosus Foramen ovule Ductus arteriosus Umbilical arteries Truncus arteriosus Bulbus cordis

Function
Bring oxygen and nutrients from placenta to fetus Shunts most of blood through liver (already processed by mothers liver) Shunts blood from right atrium to left atrum, bypassing nonfunctional lungs Shunts right ventricular blood from pulmonary trunk to aorta, bypassing nonfunctional lungs Returns poorly oxygenated blood and metabolic waste to the placenta

Adult Homolog
Ligamentum teres hepatis Ligamentum venosum Fossa ovalis Ligamentum arteriosum Medial umbilical ligaments (Urachus connects apex of bladder with umbilicus) Aorta, pulmonary trunk Superior 1/3=truncus arteriosus (aorta, pulmonary trunk) Middle 1/3=conus arteriosus (outflow tract) Proximal 1/3=right ventricle Left ventricle Auricles Pectinate muscle walls of L/R atria

Primitive ventricle Primitive atrium

Sinus venosus Gubernaculum Processes vaginalis Medullary cords (male) Cortical cords (female) Genital tubercle Bubble of peritoneum that follows the descending gubernaculum to form the inguinal canal Formed from primitive sex cords

Right atrium Females: round ligament, ligament of the ovary Males: spermatic cord Tunica vaginalis Seminiferous tubules Ovarian tubes Phallus (male) Clitoris (female)

EMBRYOLOGICAL ORIGINS
Endoderm
Bladder Urethra Prostate Trigone (bladder)

Mesoderm
Ureter (mesenephros) (intermed. mesoderm) Kidney (metanephros) (intermed.) Seminal vesicles (intermed.) Trigone (ureteric inlets to bladder) Gonads (testes, ovaries; intermed. mesoderm) Genital ducts (vas deferens, fallopian tubes) External genitalia (penis, scrotum, vagina)

GENITAL DEVELOPMENT
Indifferent stage organ
Primitive sex cords Genital ridge Mesonephric (Wolffian) duct

Male fetal (adult)

*Testis/medullary cords ( seminiferous tubules) *Mesenchyme of genital ridge ( Leydig cells) *Ductuli efferentes ( ductus deferens vas deferens when acquires muscular coat) *epididymis *seminal vesicles Stimulated by testosterone (Leydig cells) Suppressed (MIS of Sertoli cells)

Female fetal (adult)

*Cortical cords ( fallopian tubes) ___ Degenerate (no testosterone)

Paramesonephric (Mullerian) duct

*Uterine canal (cranial 2/3 bilateral uterine tubes, caudal 1/3fusion uterus) *Sinovaginal bulbs (vagina) Egg Round ligament, ligament of the ovary clitoris Labia majora Labia minora

Abdominal wall Primitive sex cells Gubernaculum Genital tubercle Genital swellings Urethral folds

Processus vaginalis ( tunica vaginalis) Sperm Spermatic cord Phallus (penis) Scrotum Fuse urethral plate