1- Anterior Abdominal Wall Flashcards by Staci Thomas

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What are the transverse planes of the abdomen?

Transpyloric Plane (L1)
Subcostal Plane (L3)
Transtubercle Plane (L5)
Interspinous Plane (S2)

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This transverse plane of the abdomen is at the level of the gall bladder fundus, pylorus, pancreatic neck, SMA origin, hepatic portal vein, root of transverse mesocolon, and hila of kidneys.

Transpyloric Plane (L1)

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This transverse plane of the abdomen passes the inferior border of the 10th costal cartilage. It is at the level of the transverse colon.

Subcostal Plane (L3)

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This transverse plane of the abdomen passes between the iliac tubercles at the level of the iliocecal junction.

Transtubercle Plane (L5)

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This transverse plane of the abdomen is between the ASIS at the level of the appendix and sigmoid colon.

Interspinous Plane (S2)

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The abdominopelvic cavity includes the abdomen and pelvis. This cavity lies between what?

Thoracic Diaphragm
Pelvic Diaphragm

***The Abdominal Cavity and Pelvic Cavity collectively make up the Abdominopelvic Cavity

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The abdominopelvic cavity can extend as high as what intercostal space?

4th

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The abdomen is separated from the pelvis by the imaginary border of the ________ _________.

Pelvic Inlet

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What lines the Abdominopelvic Cavity?

Peritoneum

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The anteriolateral abdominal wall is made up of mostly…

Muscle and Aponeurosis

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What are the boundaries of the anteriolateral abdominal wall?

Upper 7-10 costal cartilages

Lower inguinal ligament and pelvic bones

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What is the outer layer of the anteriolateral abdominal wall?

Skin, Camper’s Fascia, and Scarpa’s Fascia

Aponeurosis

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The aponeurosis is tough and relatively thick because it’s made of several layers. It overlies/envelopes the rectus abdominis, forming the ________ ________.

Rectus Sheath

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This is the fatty layer of superficial fascia in the anteriolateral abdominal wall.

Camper’s Fascia

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This is the membranous underlying CT layer of superficial fascia in the anteriolateral abdominal wall.

Scarpa’s Fascia

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Scarpa’s Fascia is continuous with _______ _______ of the perineum but fused with _______ _______ of the lower limb.

Colle’s Fascia
Fascia Lata

***Fluid cannot go from abdominal wall into leg but could flow into or out of superficial perineum!

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This abdominal muscle runs in a downward medial direction and interdigitates with Serratus Anterior.

External Oblique M.

***Hands in pockets!

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What is the origin of the External Oblique M.?

Outer surface of lower 6 ribs

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What is the insertion of the External Oblique M.?

Aponeurosis and Linea Alba

Anterior Iliac Crest and Pubic Tubercle

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The lower portion of the External Oblique M. is rolled under to make the _________ _________ that is attacked to the ASIS and Pubic Tubercle.

Inguinal Ligament

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The lower portion of the External Oblique M. also makes the opening of the superficial _______ _______, and some is reflected under to make the _______ _______.

Inguinal Ring

Lacunar Ligament

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What innervates the External Oblique M.?

Ventral Rami T7-12 of Intercostal Ns.

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What are the actions of the External Oblique M.?

Compress abdomen
Increase intra-abdominal pressure
Move trunk
Retain posture

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This muscle runs 90˚ from the External Oblique M.

Internal Oblique M. ***Hands in prayer!

What is the origin of the Internal Oblique M.?

Iliac Crest and some of Thoracolumbar Fascia

What is the insertion of the Internal Oblique M.?

``` Lower 10-12 ribs Aponeurosis Linea Alba Pubic Crest Lower part makes part of conjoint tendon (inguinal falx) ```

The Internal Oblique M. has some fibers that follow the spermatic cord to make the...

Cremasteric M.

For the Internal Oblique M., the _________ part splits to encompass the Rectus M. in the upper 3/4s. Otherwise, it all goes in from in the lower 4th.

Aponeurosis

What innervates the Internal Oblique M.?

T7-12 and L1

What are the actions of the Internal Oblique M.?

Compresses and supports viscera | Laterally flexes and rotates trunk

This muscle runs transverso-medially except for some running toward the pubic crest (to contribute to conjoint tendon).

Transversus Abdominis M.

What is the origin of the Transversus Abdominis M.?

Lower 7-12 ribs Thoracolumbar Fascia Iliac Crest Some off upper Inguinal L.

What is the insertion of the Transversus Abdominis M.?

Linea Alba Pecten Pubis Pubic Crest

The aponeurosis of the Transversus Abdominis M. contributes to what?

Rectus Sheath

What innervates the Transversus Abdominis M.?

T7-L1

What are the actions of the Transversus Abdominis M.?

Compress and supports viscera

This is a paired muscle of the anterior abdominal wall that is wider at the top than the bottom.

Rectus Abdominis M.

What is the origin of the Rectus Abdominis M.?

Pubic Symphysis | Pubic Crest

What is the insertion of the Rectus Abdominis M.?

Xiphoid Process | Outer surface of 5th-7th intercostal cartilages

The Rectus Abdominis M. has _________ intersections that form part of the rectus sheath at the umbilical, xiphoid, and midway levels.

Tendinous

What innervates the Rectus Abdominis M.?

T7-T12

What are the actions of the Rectus Abdominis M.?

Flexes and compresses abdomen

This is the lateral border of the Rectus Abdominis M.

Linea Semilunaris

At the very bottom of the Rectus Abdominis M. there is another muscle present, but is missing in 20% of people. What is this muscle?

Pyramidis M.

This is made of fascia and aponeurosis of muscles encompassing the Rectus Abdominis M.

Rectus Sheath

This aponeurosis is always anterior on the Rectus Sheath.

External Oblique aponeurosis

This aponeurosis splits in the upper 3/4s but is all anterior in the lower 1/4 of the Rectus Sheath.

Internal Oblique aponeurosis

This aponeurosis is posterior except in the lower 1/4 of the Rectus Sheath.

Transversus Abdominis aponeurosis

This is the sharp transition where all EO, IO, and TA aponeuroses become anterior to Rectus Abdominis M.

Arcuate Line

Below the Arcuate Line, the Rectus Abdominis M. is in contact with the...

Transversalis Fascia

These nerves are a continuation of the Intercostal Ns. and run between TA and IO ms. Both motor and sensory.

Thoracoabdominal Ns. (T7-T11)

This nerve runs along the inferior 12th rib and is motor, the sensory portion is superior to the Iliac Crest.

Subcostal N. (T12)

This nerve runs between the 2nd and 3rd muscle layers. They are motor to IO and TA, and sensory to upper inguinal and hypogastric region.

Iliohypogastric N. (L1)

This nerve provides motor to lower IO and TA, and sensory to lower inguinal, anterior scrotum/labia, and near medial thigh.

Ilioinguinal N. (L1)

These abdominal wall arteries come off the abdominal aorta.

Lumbar As.

What abdominal wall arteries come off the Femoral A.?

Superficial Epigastric A. | Superficial Circumflex Iliac A. (runs along Inguinal L.)

What abdominal wall arteries come off the External Iliac A.?

Deep Circumflex Iliac A. (runs deep along Inguinal L.) Inferior Epigastric A. (runs posterior to RA m.) ***Inferior Epigastric anastomoses with Superior Epigastric

This abdominal wall artery is a terminal branch of the Internal Thoracic A.

Superior Epigastric A.

This artery runs anterior to the posterior Rectus Sheath.

Inferior Epigastric A.

This fold is formed due to the obliterated urachus.

Median Umbilical Fold

This fold is formed due to obliterated umbilical arteries.

Medial Umbilical Fold

This fold is formed due to the Inferior Epigastric A.

Lateral Umbilical Fold

This is the gutter on either side of the upper bladder.

Supravesicular Fossa ***Lateral to Median Umbilical Fold

This is the gutter lateral to the Medial Umbilical Folds.

Medial Inguinal Fossa

This gutter is lateral to the Lateral Umbilical Folds.

Lateral Inguinal Fossa

Superficial vessels superior to the umbilicus drain into what lymph nodes?

Axillary Nodes | Some go to Parasternal Nodes

Superficial vessels below the umbilicus drain to what lymph nodes?

Superficial Inguinal Nodes

Deep lymph vessels accompany what other vessel of the abdominal wall?

Deep veins (i.e., External and Internal Iliac Vs.)

This type of incision is 2.5 cm inferior from the margin, and gives access to the gall bladder and biliary tract and spleen.

Subcostal

This type of incision can be made rapidly because it has few blood vessels or nerves.

Midline

This type of incision opens the anterior sheath and pushes the RA muscle aside laterally to enter the peritoneum.

Paramedian

This type of incision is muscle splitting and is typical of an appendectomy.

Gridline (McBurney's Point)

This type of incision is used most in gynecological/obstetrical surgeries.

Suprapubic

What are the 9 abdominal areas?

Top = Right Hypochondriac; Epigastric; Left Hypochondriac Middle = Right Flank; Umbilical; Left Flank Bottom = Right Inguinal; Pubic; Left Inguinal