1
Q
body muscles lying dorsal to the vertebral column form the _______ muscles.
A
Epaxial
2
Q
muscles lying ventral to the vertebral column form the _______ muscles.
A
Hypaxial
3
Q
How many layers of muscle are there in the body wall? name them.
A
Outer (superficial)
Intermediate (middle)
Inner (inner)
4
Q
The inner muscle layer attaches to the _________ via a fascial layer.
A
Mesothelium
5
Q
What is the Coelomic cavity? What mature remenants of this will develop?
A
It is the primitive anterior body cavity.
In the thorax it will become pleura. (via the endothoracic fascia)
In the mediastinum it will become the pericardium. (via the endothoracic fascia)
In the abdominal it will become peritoneum (via the transversalis fascia)
6
Q
What cavities sit above and below the thoracic diaphragm?
A
Above: Thoracic cavity
below: Abdominopelvic cavity
7
Q
What is the “flooring” for the abdominopelvic cavity?
A
The pelvic diaphragm (AKA the pelvic floor)
8
Q
What are the 4 differentiations for VENTRAL myotomes? What GROUPS of muscles will each category make up?
A
Cervical Hypomeres: prevertebral neck muscles
Thoracic Hypomeres: Thoracic AND Abdominal muscles
Lumbar Hypomeres: Prevertebral lumbar muscles
Sacral Hypomeres: Pelvic Floor muscles
9
Q
What muscles make up the outer, intermediate and inner layers of the thoracic body wall?
A
Outer: External Intercostals
Intermediate: Internal intercostals
Inner: innermost intercostals, Transversus thoracis, Subcostals
10
Q
The neurovascular plane sits between what two muscles?
A
Internal intercostals and innermost intercostals.
11
Q
For the External Intercostals explain:
- The attachments
- The Fibre direction
- The muscle layer itself
A
- They extend (span) from rib tubercles (posteriorly on the rib) to costal cartilage (Anteriorly on the rib), With superior and inferior attachments of the rib above and below. (There are 12 ribs, therefore there are 11 of these INTERcostal muscles)
- The fibres slope inferomedially (from anterior view)
- Muscle layer is incomplete anteriorly and becomes the external intercostal membrane.
12
Q
For the Internal Intercostals explain:
- The attachments
- The Fibre direction
- The muscle layer itself
A
- Extend from the lateral sternal border (anteriorly) to the costal angles (posteriorly). And as the name suggests, these are intercostal muscles so there are 11 of them spanning from the rib above to the rib below.
- Fibres slope inferolaterally (from anterior view)
- Muscle layer is incomplete posteriorly and becomes internal intercostal membrane. (will cover the gap created at the posterior margin between costal angle and the vertebrae)
13
Q
What are the muscles of forced inspiration? (give the SPECIFIC garry answer not the ISAP answer)
A
FIBRE DIRECTION IS KEY:
- Scalenes
- Thoracic Diaphragm
- External Intercostals
- Parasternal (interchondral) internal intercostals
- Sternocleidomastoids
(remember this by S.T.E.P.S)
14
Q
What are the muscles of forced Expiration? (give the SPECIFIC garry answer not the ISAP answer)
A
FIBRE DIRECTION IS KEY:
- Interosseous (section) internal intercostals
- Abdominal muscles: Rectus Abdominus, Internal and external obliques and also the transversus abdominus.
WEAKLY aided (but im gonna say it cause garry does mention it in his slides): Transversus thoracis, now this is mainly due to it being active based on the fact it has the same neural recruitment as the abdominals during F.E.
15
Q
For the Transversus Thoracis, Explain:
- Where it arises from
- Where it inserts
- Its action
A
- Arises from the posterior surface of the sternum
- Inserts on the costal cartilages (posterior aspect)
- Involved in forced expiration as it helps to depress the ribs HOWEVER is really just there to help the other F.E. muscles. Also thought to provide proprioceptive information.
16
Q
For the innermost intermostals explain:
- The location
- The fibre direction
- Pleura connection
A
- Deep to the Internal intercostal muscles, only on the lateral aspect of the rib cage and seperated by the neurovascular bundle.
- Fibres slope inferolaterally (same as Internal IC’s)
- Connected to the parietal pleura via the endothoracic fascia
17
Q
For the subcostales explain:
- The attachment
- The Rib distribution
- The Action
A
- Attach to internal surface near rib angles
- Span 2 or 3 ribs before insertion
- Assists rib depression in forced expiration
18
Q
How does the abdominal body wall differ from the thoracic wall?
A
The abdominal wall has less bony support (i.e. no sternum, no ribs), therefore there will be less places for muscles to attach to resulting in muscle layers in the abdomen being thicker and there will be for fascia and aponeuroses.
19
Q
Explain the fascial support of the abdominal body wall
A
Supported posteriorly and laterally by the thoracolumbar fascia, and anteriorly by the rectus sheath (a psuedosternum: it acts like the sternum for the abdominal wall)
20
Q
In the abdominal body wall what two muscles does the neurovascular plane sit between?
A
The internal obliques (intermediate layer)
and
The Transversus abdominus (Inner layer)
21
Q
For the External Abdominal oblique muscles:
- What are they are continuation of?
- what is the origin?
- What is the insertion?
- What does it contribute to?
- Where do they become aponeurotic?
- what is the Direction of the fascicles?
A
- Continuation of the External Intercostals
- O: Lower 8 ribs
- Linea Alba, iliac crest, inguinal ligament, pubic tubercle
- Contributes to the rectus sheath
- Becomes aponeurotic at the Mid Clavicular Line (anteriorly)
- Same as external intercostals: Inferomedially
22
Q
For the Internal Abdominal Oblique muscles:
- What are they deep to?
- What is the origin
- What is the insertion?
- Where do they become aponeurotic?
- What do they contribute to?
- What is the direction of the fascicles?
A
- Deep to External Abdominal Intercostals
- O: Thoracolumbar fascia, Illiac crest, Inguinal Ligament
- Lower four ribs, linea alba and pubic crest via conjoint tendon
- Becomes aponeurotic in the Mid Clavicular Line
- Contributes to the rectus sheath and the cremaster muscle
- Same as internal intercostals: Inferolaterally
23
Q
For the Transversus abdominus:
- Explain its position in the abdominal muscle wall
- What does it lie deep to?
- What is the Origin?
- What is the Insertion?
- Where does it become aponeurotic?
- What does it contribute to?
- What is the fascicle direction?
A
- Deepest part of the lateral abdominal wall
- Lies deep to the neurovascular structures
- O: Thoracolumbar fascia, costal margin, illiac crest, inguinal lig.
- Linea alba and pubic crest via conjoint tendon
- Becomes aponeurotic in Mid Clavicular line
- Contributes to rectus sheath
- Fascicles are transversely orientated
24
Q
For the Rectus Abdominus:
- State the origin
- State the insertion
- Explain the muscle fibre direction
A
- O: Pubic Symphysis are crest
- I: Xiphoid process and costal cartilage (Runs the entire length of the anterior abdnominal wall)
- Muscle fibres are vertical BUT must be noted that they are interupted by tendinous intersections
25
For the Pyramidalis:
1. What is the percentage of presence?
2. What does it lie within? and how?
3. What doe it tense?
1. Present in 80% of people
2. Lies within the rectus sheath just anteriorly to inferior fibres of rectus abdominus
3. Tenses linea alba
26
What is the rectus sheath formed by? What doe it contain? And what is its midline?
Formed by the union of the External Abdominal obliques, Internal Abdominal Obliques and the Transversus Abdominus Aponeuroses.
Contains the rectus abdominus, pyramidalis, superior and inferior epigastic arteries and veins, lymph vessels and some nerves
Midline is the linea alba (a fibrous white line)
27
For the 5 peritoneal folds below the umbilicus:
1. What are they all formed by?
2. What each fold contains?
1. All formed by parietal peritoneum
2.
- Median umbilical fold: Contains median umbilical ligament. Obliterated Urachus: Fibrous remnant of canal connecting fetal bladder to umbilicus.
- Medial Ubilical Folds (R + L) Contain medial umbilical ligaments which are remenants of umbilical arteries.
- Lateral Umbilical Folds (R + L) Contain inferior epigastric artery (branch of external Iliac)
(Black = Median, Green= Medial, Red = Lateral)
28
Out of the following abdominal body wall muscles:
EAO, IAO, TA, RA.
Explain their contribution to:
1. Flexion
2. Extension
3. Rotation
4. Abdominal Compression
1. EAO = Assist, IAO = Assist, TA = No, RA = Yes
2. None of them do you fucking idiot, they are all hypaxial ffs
3. EAO: Controlaterall contribution to rotation (EAO on one side and IAO on otherside work together to produce rotation), IAO = Ipsilateral Contribution to rotation. TA and RA do not contribute.
4. All of them do
29
For the Conjoint Tendon:
1. Formed from union of what muscles?
2. Attaches to what?
3. What is its function?
1. Formed from union of Transversus Abdominus and Internal Abdominal Obliques.
2. Attaches to the pubic crest
3. Strengthens the Inguinal canal
30
For the Inguinal Ligament:
1. What space does it form?
2. Not a true ligament. Explain?
3. Attachment points
1. Forms the Subinguinal Space
2. Not a true ligament but a fold in the aponeurosis of the External Abdominal Obliques
3. Arises from ASIS and attaches to the pubic tubercle
31
What travels through the subinguinal space?
Illiacus, psoas major and pectineus
Neurovascular structures (femoral N, V and A)
32
For the Inguinal Canal:
1. What the fuck is it?
2. What is it bordered by?
3. What does it contain?
4. is it larger in males or females? why?
1. A hiatus in the anterior abdominal wall
2. Bordered by the inguinal rings (superficial and deep)
3. Spermatic cord in males, round ligament of the uterus in females, Illiolinguinal nerve in both Males and Females (branch of the genitofemoral Nerve)
4. Larger in males because of testes
33
What do the following abdominal wall structures continue as in relation to spermatic cord structures:
1. Parietal peritoneum
2. Transversalis Fascia
3. Transverse abdominus
4. Internal Abdominal Oblique
5. External Abdominal Oblique
1. Tunica Vaginalis
2. Internal spermatic fascia
3. Nothing
4. Cremaster muscle
5. External Spermatic fascia
34
Explain how the female inguinal canal is different to males? What does it contain?
- Narrower than in males
- Contains the round ligament from lateral border of the uterus to the subcutaneous tissue of the labia majora
35
For the thoracic diaphragm:
1. What body cavities does it seperate?
2. What is it composed of?
3. What is it covered by superiorly and inferiorly?
4. What is its innervation?
1. Seperates the abdominal cavity from the thoracic cavity
2. Composed of skeletal musclle and connective tissue
3. Covered superiorly with parietal pleura and pericardium. Covered inferiorly with parietal peritoneum.
4. Innervated by the phrenic nerve (ventral rami of C3, C4, C5)
36
What are the two domes of the thoracic diaphragm connected by?
A U-Shaped tendon known as the Central Tendon.
(Highlighted Red)
37
What are the attachments for the Thoracic diaphragm (yes name them all)
Anteriorly: Xiphoid process
Laterally: Inferior 6 costal cartilages
Posteriorly: Medial and lateral Arcuate ligaments
Inferiorly: Lumbar vertebral bodies via crura and the median articulate ligament.
38
What are the attachments for the central tendon? What radiates our from it?
Superiorly: to fibrous pericardium
Inferiorly: To ligaments of the liver (coronary ligament)
Skeletal muscle fibres radiate out from central tendon down to inferior thoracic aperture attachment points.
(central tendon highlighted in red)
39
What does the median arcuate ligament arch over? What is the name of this "space"? What two structures does this ligament unite?
arches over The Aorta
formes the "roof" of the Aortic Hiatus
Unites the Left and right crus
40
What structures pass through the space posterior to the medial and lateral arcuate ligaments?
Medial: Psoas major
Lateral: Quadratus lumborum
41
The left crus attaches to the bodies of which vertebrae?
L1 and L2
42
The right crus attaches to the vertebral bodies of which vertebrae?
L1, L2 and L3
43
What are the attachment points for the medial and lateral arcuate ligaments?
Medial: V.B of L1/L2 to L1 Transverse process (arches over psoas)
Lateral: Transverse process of L1 to Tip of the 12th Rib (arches over Quadratus Lumborum)
44
What is the name of the space within OR surrounding the diaphragm for the following structures? Explain them a little bit and include the vertebral levels each is at.
1. Inferior Vena Cava
2. Oesophagus
3. Aorta
1. Vena Caval Aperture (peirces on the right side through central tendon) T8
2. Oesophageal hiatus (in the loop created by the right crus) T10
3. Aortic Hiatus (Between vertebral body and median arcuate ligament) T12
45
Explain the functions of the thoracic diaphragm. (basic answer)
**- Containment**
**- Changes pressure within thoracic and abdominal cavities**
**- Respiration**
**- Circulation** (helps venous return to the right atrium by loweing the pressue in the thoracic cavity, therefore increasing the pressure in the abdominal cavity resulting in blood wanting to move to a lesser pressure (within the heart)
**- Generation of pressure** (e.g. Sneezing, Coughing, Crying....)
46
Explain how the thoracic diaphragm helps to create a pressure gradient between the thoracic and abdominal cavities.
As the thoracic diaphragm contracts, domes of the diaphragm DESCEND, which will increase the volume of the thoracic cavity and deceases the abdominopelvic cavity resulting in pressure changes to both cavities.
47
Explain the attachents for the Obturator Internus? What cavity border does it contribute to?
Pelvic Surface of illium and ischium
to
Greater Trochanter
Contributes to Pelvic Wall
(Highlighted in blue)
48
Explain the attachements for the piriformis? What cavity border does it contribute to?
Pelvic surface of sacrum
to
Greater Trochanter
Contributes to Pelvic Wall
(highlighted in red)
49
What muscles contribute to the pelvic floor? (be specific)
Coccygeus (highlighted Red)
Levator Ani: (3 parts of this bish)
- Puborectalis (Highted Green)
- Pubococcygeus (Highlighted Blue)
- Illiococcygeus (highlighted Yellow)
50
Explain the Attachments of the 3 components of the Levator Ani.
Puborectalis: Post. Body of Pubic bone, Forms U-Shape muscle that slings around anorectal hiatus.
Pubococcygeus: Post. Body of pubic bone (lateral to rectalis), and heads posteriorly to attach to coccyx.
Illiococcygeus: (most lateral) Arises from ischial spine and attaches onto coccyx.
51
For the Urogenital Hiatus:
1. What muscle is it the anterior gap to?
2. What is it covered by?
3. What is it the opening passage for?
1. Anterior gap between the medial borders of the puborectalis.
2. Covered with the perineal membrane
3. Opening for the passage of the urethra (for males and females) and the vagina (for females)
(highlighted in green)
52
For the Anorectal Hiatus:
1. What muscle does it create a posterior gap in between?
2. What does it create a passage for?
1. Posterior gap in the puborectalis
2. Allows for the passage of the anal canal
(highlighted in blue)
53
For the Perineum:
1. What is it?
2. What shape does it make up? (explain)
3. How is this shape bordered?
4. What does this shape contain?
1. Area between the legs bounded by the inferior pelvic aperture. It is the external surface area AND a shallow compartment in which the pelvic diaphragm is the roof.
2. It is diamond shaped with two triangles
3. bordered Anteriorly by the pubic symphysis, laterally by the ischial tuberosities and posterioly by the coccyx
4. The diamond contains two triangles; one known as the urogenital triangle (more anteriorly) closed by the perineal membrane, perforated by the urethra (male and female), and vagina (for females). And the other triangle is known as the Anal triangle which contains the anal canal.
54
E ( Trunk )
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