Anatomy: Abdominal Wall and Diaphragm

• The rectus sheath is a fibrous enclosure for the rectus abdominis and pyramidalis muscles.
• It is formed by the aponeuroses of the external oblique, internal oblique, and transversus abdominis muscles.
• The rectus sheath's composition changes from the xiphoid process to the pubic symphysis.

Abdominal Muscles

• External Oblique: Know attachments, actions, functions, and innervations.
• Internal Abdominal Oblique: Know attachments, actions, functions, and innervations.
• Transversus Abdominis: Know attachments, actions, functions, and innervations.
• Rectus Abdominis: Know attachments, actions, functions, and innervations.

Somatosensory Pathways

• Understand the pathways from the skin of the anterior and lateral abdominal wall to the central nervous system (CNS).

Diaphragm

• Identify structures passing from the thoracic cavity to the abdominal cavity via the diaphragm.
• Know at which vertebral level each of these structures passes through the diaphragm.

Peritoneum

• Understand the layers of the peritoneum.
• Mesentery: Describe and understand it in a developmental context.
• Know the specific mesenteries of the abdomen.
• Mesentery Functions: Understand their roles.
• Intraperitoneal Structures: Know which abdominal structures are intraperitoneal Structures, primary retroperitoneal, and secondary retroperitoneal and understand what these terms mean.

Abdominal Viscera

• Understand the morphology and internal structure of abdominal viscera.
• Be able to trace food through the digestive system.
• Identify all abdominal viscera and know their general functions.
• Gut Tube Structures: Know which structures are part of the continuous gut tube and which are derivatives.
• Thoroughly understand the relationships of the abdominal organs
• Foregut, Midgut, Hindgut: Know the structures and anatomical boundaries of each.
• Quadrants: Know which organs are in which quadrants.
• Colic Flexures: Understand their relationships.
• Spleen: Know which organs are related to the spleen.
• Duodenum: Know which organs and vessels have relationships to the duodenum.
• Pylorus: Identify a major structure posterior to it.
• Pancreas Neck: Identify a major structure posterior to it.
• Spleen and Liver: Understand their positions relative to the rib cage.

Clinical Associations

• Understand any clinical associations of the abdominal structures.

Abdominal Vasculature

• Paired vs. Unpaired Branches: Understand the difference between paired and unpaired branches off the abdominal aorta.
• Arterial Branches: Name the arterial branches off the abdominal aorta (both paired and unpaired) and their distribution areas.
• Celiac Trunk: Identify and state the distribution area of its named branches.
• Portal System: Understand what a portal system is, especially the hepatic portal system and its function.
• Distinguish veins/organs that drain into the hepatic portal system from those draining directly into systemic veins.
• Trace how blood from the hepatic portal system returns to systemic circulation.
• Spatial Relationships: Understand the spatial relationship between arteries and veins (e.g., IVC and abdominal aorta, renal arteries/veins, etc.).
• Left vs. Right Renal Vein: Know how the tributaries of the left renal vein differ from those of the right.
• Arterial Anastomoses: Understand anastomoses (e.g., along the stomach's curvatures, between celiac trunk and superior mesenteric artery branches, between superior and inferior mesenteric artery branches).

Innervation

• Visceromotor Innervation: Describe the sympathetic and parasympathetic motor innervation of abdominal structures.
• Understand the effects of each autonomic nervous system division on specific abdominal viscera.
• Trace pathways from pre-ganglionic neurons in the CNS to abdominal target organs, including synapses with post-ganglionic neurons.
• Prevertebral Ganglia: Know their relation to the foregut, midgut, and hindgut.
• Post-ganglionic Sympathetic Axons: Understand how they reach target organs from prevertebral ganglia.

Pelvic Skeleton

• Os Coxae: Understand the fusion locations/spatial relationships of its three bones.
• Know when these bones completely ossify.
• Bony Landmarks: Know the pelvic bony landmarks.
• Ligaments: Understand the ligaments associated with the bony pelvis (attachments) and the foramen they create.

Pelvic Body Wall

• Understand what structures form the walls of the pelvic cavity (muscles, vertebrae, pelvic bones, etc.).

Pelvic Diaphragm

• Levator Ani & Coccygeus Muscles: Know their attachments, actions, functions, and innervations.
• Somatomotor Pathway: Understand the pathway from the ventral horn of the spinal cord to the pelvic diaphragm's skeletal muscles.
• Pelvic Diaphragm Muscle Type: What type of skeletal muscle comprises it?

Inguinal Canal

• Understand the inguinal canal, what it is a passageway through.
• Know what passes through the inguinal canal in males and females.

Spermatic Cord

• Know the layers of the spermatic cord surrounding the testes (superficial to deep and vice versa).
• Know the abdominal wall structures from which these layers are derived.
• Testes Layers: Know which layer surrounding the testes that is not part of the spermatic cord, and its abdominal origin.
• Spermatic Cord Contents: Understand the structures found within.
• Gonad Descent: Understand the structures involved and the process.
• Know how this relates to the inguinal canal in males and females.

Pelvic Viscera

• Understand the morphology, layers, and internal structure of pelvic viscera (gut tube, urinary structures, male/female internal reproductive structures).
• Identify all pelvic viscera and know their functions.
• Bladder, Uterus, Rectum: Understand their relationships (in females).
• Ductus Deferens: Know its pathway after entering the pelvic cavity.
• Glands Spatial Relationships: Know the spatial relationships of various glands to pelvic viscera and muscles.
• Pelvic Viscera and Skeleton: Understand their relationship.
• Cross-Sectional Anatomy: Identify pelvic structures in cross-sections, sagittal sections, and frontal sections.
• Clinical Associations: Understand any clinical associations of the pelvic structures.

Pelvic Vasculature

• Know what becomes of the abdominal aorta as it enters the pelvis.
• Name subsequent arteries/veins and what they supply/drain.

Pelvic Innervation

• Visceromotor Innervation: Describe the sympathetic and parasympathetic motor innervation of smooth pelvic structures.
• Understand the effects of each autonomic nervous system division on specific viscera (internal sphincters, gut tube, etc.).
• Trace sympathetic and parasympathetic pathways from pre-ganglionic neurons in the CNS to pelvic target organs, including synapses with post-ganglionic neurons.
• Post-ganglionic Sympathetic Axons: Understand how they reach target organs from prevertebral ganglia.

Perineum Location

• Know location of the perineum relative to the pelvis.
• Know the location of perineum muscles relative to the pelvic diaphragm muscles.

Perineal Triangles

• Know the two triangles of the perineum and their boundaries.
• Know which pelvic structures pass through the triangles (males and females).

Perineal Muscles

• Transverse Perineal, External Urethral Sphincter, External Anal Sphincter, Ischiocavernosus, Bulbospongiosus Muscles: Know their attachments, actions, functions, and innervations.
• Somatomotor Pathways: Understand the pathways from the ventral horn of the spinal cord to perineal skeletal muscles.
• Perineum Muscle Type: Which type of skeletal muscle comprises the perineum?
• Pudendal Nerve: Know its origin and how it reaches the perineum.

Perineal Viscera

• Understand the morphology, layers, and internal structure of perineal viscera (gut tube, urinary structures, male/female external reproductive structures).
• Identify all perineal viscera and know their general functions.
• Erectile Tissues: What are the erectile tissues and the specific regions of erectile tissue in males and females?
• Glands Spatial Relationships: Know the spatial relationships of various glands/erectile tissues in males and females.
• Pelvic Structures: Which pelvic structures pass through into the perineum?
• Vestibule: What is the vestibule in the female and what structures are associated with the vestibule?
• Ischiorectal Fossa: Know the boundaries and contents of the ischiorectal fossa.
• Cross-Sectional Anatomy: Identify perineal structures in cross-sections, sagittal selections, and frontal sections.

Reproductive Homologs

• What are reproductive homologs? Why do they exist?
• Know all corresponding male and female reproductive homologs.
• Clinical Associations: Understand any clinical associations of the perineal structures.

Perineal Vasculature

• Know which artery off the internal iliac artery supplies the perineum.
• Know its pathway to exit the pelvis and enter the perineum.(same for veins)

Perineal Innervation

• Visceromotor Innervation: Describe the sympathetic and parasympathetic motor innervation of perineal structures.
• Understand the effects of each autonomic nervous system division on specific viscera (erectile tissues, gut tube, etc.).
• Trace sympathetic and parasympathetic pathways from pre-ganglionic neurons in the CNS to perineal target organs, including synapses with post-ganglionic neurons.
• Post-ganglionic Sympathetic Axons: Understand how they reach perineal structures from prevertebral ganglia.