3.3 Anterior abdominal wall and Inguinal region

Question 1

Name the 8 layers of the anterior abdominal wall

Answer 1

Skin, superficial fascia, external oblique, internal oblique, transversus abdominus, transversalis fascia, extra peritoneal fascia and parietal peritoneum

Question 2

What are the borders of the abdomen

Answer 2

Costal margins, iliac crest, ASIS, pubic tubercle

Question 3

Describe the External oblique muscle and its origins

Answer 3

Fron pocket muscle, attaches to ASIS and pubic crest with a free inferior edge. It overlaps costal margin on top of the ribs.

Question 4

What is a linea alba?

Answer 4

2 aponeuroses meeting together from each side

Question 5

Describe Internal oblique muscles and its origins

Answer 5

Back pocket muscles, attach at costal margins, iliac crest, ASIS and pubic crest. Lowermost fibers arise from lat 2/3 of inguinal ligament, no meeting at linea alba but instead arch over then down to pubic crest

Question 6

From where do internal oblique muscle fibers arise from?

Answer 6

From the lateral 2/3 of inguinal ligament

Question 7

Describe Transversus abdominus and its origins

Answer 7

Attach under costal margin and is continuous with diaphragm. Lowermost fibers arise from lateral 1/2 of inguinal ligament, arches to insert into pubic crest with internal oblique

Question 8

Describe Rectus abdominus and its origins

Answer 8

Overlaps costal margin 5, 6, 7, vertical muscle, 3 tendinous insertions makes muscle stronger. It has a rectus sheath from aponeurosis of ext. oblique, int. oblique and transversalis abdominus. (Upper rectus sheath and Lower rectus sheath)

Question 9

Describe the Upper rectus sheath

Answer 9

3 layers of muscle spread over rectus abdominus with ext. oblique in front, int. oblique half front and back and transversalis at the back

Question 10

Describe the Lower rectus sheath

Answer 10

All 3 muscles pass in front of rectus abdominus

Question 11

Describe the arteries of the abdomen

Answer 11

Ascending aorta, internal thoracic artery, musculophrenic artery, superior epigastric artery, inferior epigastric artery, superficial epigastric artery

Question 12

Where is the Musculophrenic artery?

Answer 12

Along the costal margin

Question 13

Where is the Superior epigastric artery?

Answer 13

In rectus sheath, branch of the internal thoracic artery

Question 14

Where is the superficial epigastric artery?

Answer 14

In superficial fascia, arising from the front of the femoral artery just below the inguinal ligament. It turns up in front of the inguinal ligament moving up through the superficial fascia of the abdominal wall to the umbilicus
It supplies the inferior superficial abdominal wall

Question 15

Describe the veins of the abdomen

Answer 15

There are both superficial and deep veins with superficial veins with epigastric arteries draining to the Hepatic Portal and Systemic system

Question 16

What is the Lacunar ligament?

Answer 16

It is an inward extension of the inguinal ligament onto the pectineal line

Question 17

What is the Pectineal ligament

Answer 17

It is an extension of the inguinal ligament medially

Question 18

What is the Deep inguinal ring?

Answer 18

It is the door to the inguinal canal as it is a deficiency in fascia transversalis

Question 19

What is the Superficial inguinal ring?

Answer 19

It is the exit in ext. oblique in the form of a triangular slit near the pubic crest

Question 20

How do the testes descend?

Answer 20

They start in extra peritoneal fat and descend taking its neurovascular structures with it, descending through the inguinal canal and into the scrotum. This is possible due to the arch formed by the int. and ext. oblique muscles

Question 21

What is a bilateral indirect inguinal hernia?

Answer 21

A protrusion through the deep ring into inguinal canal- it arises from incomplete closure of processus vaginalis thus contents move into the scrotum and labia

Question 22

What is a bilateral direct inguinal hernia?

Answer 22

A protrusion froward into inguinal canal that does not continue into the scrotum but bulges forward

Question 23

What is a rectus sheath on Rectus Abdominus?

Answer 23

The aponeurosis of the three muscles ext. oblique, int. oblique and transversus abdominus