[1] Anterior Abdominal Wall Flashcards
Function: Anterior Abdominal Wall (5)
- Protect/Support Viscera
- Trunk Movement
- Diagnose Disease (“Mirror”)
- Increase Intra-abdominal Pressure
- Ambulation
Superior Limits of AAW
Costal Margins
Xiphoid Process
Inferior Limits of AAW
ASIS
Inguinal Ligament
Pubic Crest
Symphysis
Lateral Limits of AAW
Vertical plane through ASIS
Best area to cut through during abdominal surgery?
Why?
Linea alba
It is relatively bloodless
Level of Subcostal Plane
L3
Level of Transtubercular Plane
L5
Level of Sagittal Plane
Midpoints of Clavicle and Inguinal Ligament
Level of Transpyloric Plane
L1, L2
Level of Transumbilical Plane
L3, L4
Which superficial fascia is fatty?
Which one is membranous?
Camper’s Fascia: Fatty
Scarpa’s Fascia: Membranous
Layers of the AAW In Order
- Skin
- Superficial Fascia
- Deep Fascia
- Muscles
- Trasversalis Fascia
- Extraperitoneal Fat
- Peritoneum
[External Oblique]
What direction do the fibers project?
Inferomedial
[Intenral Oblique]
What direction do the fibers project?
Superomedially mostly, however the lower layers start projecting inferomedially
Internal Oblique + Transversus Abdominis = ?
Conjoint Tendon
Rectus Sheath has contributions from?
External and Internal Oblique, Transversus Abdominis
Medial Separation of the Rectus Abdominis
Linea Alba
Lateral Separation of the Rectus Abdominis
Linea Semilunaris
Is the posterior rectus sheath complete?
No it is not. It ends inferiorly as the arcuate line/linea semicircularis
Innervation of the Abdominal Wall
Ventral Rami of T5-L1
Terminal Branches of L1
Iliohypogastric
Ilioinguinal
Differentiate Indirect and Direct Hernia
Direct: Medial to the inferior epigastric
Physiologic: Lateral to the interior epigastric as it passes through the inguinal ring
Acronym: LIMD [Lateral Indirect] [Medial Direct]
[Inguinal Canal]
Anterior Wall
External Oblique Aponeurosis
[Inguinal Canal]
Posterior Wall
Transversalis Fascia
[Inguinal Canal]
Roof
Internal Oblique
Transversus Abdominis Muscle
[Inguinal Canal]
Floor
Inguinal Ligament
2 Rings of the Inguinal canal
Superficial
Deep
Where does the superficial inguinal ring open?
External Oblique Aponeurosis
[Inguinal Canal]
Contents (Male + Female)
Spermatic Cord
Round Ligament of the Uterus
Ilioinguinal Nerve
[Spermatic Cord]
Coverings (3)
Internal Spermatic Fascia
Cremaster Muscle
External Spermatic Fascia
[Spermatic Cord]
Contents (3)
Ductus Deferens
Arteries, Nerves, Lymphatic Vessesl
Pampiniform Plexus
[Diaphragm]
What are the 3 Apertures?
Esophagus
Vena Cava
Aorta
At what level are the 3 diaphragmatic apertures found?
IVC: T8
Esophagus: T10
Aorta: T12
8-10-12
Which of the vagal trunks is anterior?
Which one is posterior?
Left: Anterior
Right: Posterior
LARP
Origin of Musculophrenic and Pericardiophrenic Artery?
Internal Thoracic/Mammary Artery
Responsible for the “6-Pack” Formation
Tendinous Intersections
From where to where does the Inguinal Ligament span?
ASIS to Pubic Tubercle
Imaginary horizontal line at the level of the umbilicus?
Transumbilical Plane
The Pyramidalis muscle is present in what % of the population?
80%
Function: EO + IO
Rotation
Function: Transversus Abdominis
Trunk Flexion
Function: EO + IO + TA
Flexion
Function: Rectus Abdominis
Passive contraction and spinal extension
[Vascular Supply]
Branches of External Iliac
Inferior Epigastric
Deep Circumflex Iliac
[Vascular Supply]
Branches of Femoral Artery
Superficial Circumflex Iliac
[Vascular Supply]
Branches of Greater Saphenous Vein
Superior Epigastric
[Vascular Supply]
4 Primary Blood Vessels of the AAW
- Internal Thoracic
- External Iliac
- Greater Saphenous Vein
- Femoral Artery
What supplies blood to the superior part of the rectus abdominis?
Internal Thoracic Artery
What supplies blood to the inferior part of the rectus abdominis?
Inferior Epigastric Artery
[Superficial Lympathics]
Where does lymph drain above the umbilicus?
Axillary Nodes/Cervical Nodes
[Superficial Lympathics]
Where does lymph drain below the umbilicus?
Superficial Inguinal Nodes
[Deep Lymphatics]
What is the convergence o the main lymphatic ducts of the abdomen?
Cisterna Chyli