1. Anterior Abdominal Wall Flashcards
Which aponeuroses are anterior / posterior to rectus abdominis below the arcuate line?
Anterior: external oblique, internal oblique, transversus abdominis
Posterior: transversalis fascia
Into which other nodes do the external iliac nodes drain?
The external iliac notes drain into the common iliac nodes, which drain into the lumbar (caval/aortic) nodes.
What anterior abdominal wall fossa is of the site of direct inguinal hernias?
The medial inguinal fossa
Which fold of the internal surface of the abdominal wall is a remnant of the urachus?
The median umbilical fold
What is the function of the illioinguinal nerve?
Provide sensation through the inguinal canal.
Passes into the anterior scrotum / labia majora.
Cutaneous sensation to the medial thigh.
Why might a midline incision through the linea alba have a long recovery time?
Because of contraction of the muscles pulling apart, and lack of a dedicated blood supply.
What are the risks of a subcostal incision?
Cutting the intercostal nerves, and possibly the superior epigastric artery.
(Note: subcostal incisions typically avoid the musculophrenic artery and subcostal nerve)
To what vertebra and rib does the transpyloric plane correspond?
L1
Rib 9
Where is the trans-tubercular plane found, and to which vertebra does it correspond?
The trans-tubercular plane is found at the widest part of the hips.
It corresponds with L5
Where is the neurovasculature of the abdominal compartment located?
Between the internal oblique muscle and the transversus abdominis muscle.
What root gives rise to the illiohypogastric and illioinguinal nerves?
L1
What rib and vertebra is associated with the xiphisternal plane?
Rib 7
T9
What roots make up the thoraco-abdominal nerves?
The anterior rami of T7-T11
(Same as the intercostal roots)
What are the dangers of a paramedian incision (along the linea semilunaris)?
Very large potential to cut the thoraco-abdominal nerves, eliminating control of the rectus abdominis and other abdominal muscles.
What are the eight layers of the anterior abdominal wall in order from superficial to deep (not including skin)?
Camper’s fascia
Scarpa’s fascia
External oblique muscle
Internal oblique muscle
Transversus abdominis
Transversalis fascia
Extra peritoneal fat
Parietal peritoneum
Where are epigastric hernias likely to occur?
In the linea alba
What is the function of the illiohypogastric nerve?
Provides cutaneous sensation to the upper inguinal region and the superior hypogastric region.
What do we call Scarpa’s fascia when it enters the scrotum?
Dartos fascia
Where does the superior epigastric artery run?
Behind rectus abdominis, between rectus abdominis and the posterior rectus sheath.
Where does the deep circumflex iliac artery run?
From the external iliac artery medially up the inguinal ligament.
What major artery and gives rise to the inferior epigastric artery?
The external iliac artery
The medial umbilical fold is the remnant of what structure?
The obliterated umbilical artery
There is an unnamed plane at the eighth rib – to what vertebra does it correspond?
T11
What landmark and vertebra defines the supracristal plane?
Top the iliac crest
L4
What is a Spigelian hernia?
A rare hernia occurring in the linea semilunaris
To what rib and vertebra does the subcostal plane correspond?
The base of rib 10
L3
Where is the medial inguinal fossa found?
Medial to the inferior epigastric vessels / the lateral umbilical fold.
Lymph close to the center of the abdomen just above the umbilicus travels to which lymph nodes?
Anterior diaphragmatic lymph nodes – then to the parasternal lymph nodes
Where does lymph superior to the trans-umbilical plane travel?
Axillary lymph nodes (pectoral, central, apical, clavicular)
What two branches of the internal thoracic artery supply the abdominal cavity?
The musculophrenic and superior epigastric
Where does lymph inferior to the trans-umbilical plane in the abdominal cavity travel?
Superficial inguinal lymph nodes (same as the scrotum)
Where are the supravesical fossae of the anterior abdominal wall found?
Lateral to the superior margin of the bladder, but medial to the edge of the medial umbilical fold
What nerve root innervates the umbilicus?
T10
Which aponeuroses are anterior / posterior to rectus abdominis above the arcuate line?
Anterior: external oblique, internal oblique
Posterior: internal oblique, transversus abdominis, transversalis fascia
What anterior abdominal wall fossa is the location of indirect inguinal hernias?
The lateral inguinal fossa (lateral to the inferior epigastric vessels)
What is the lateral umbilical fold?
A fold of tissue covering the inferior epigastric vessels
