6 Abdominal wall, inguinal region and hernias 1 Flashcards
What structures are beneath the 4 quadrants of the abdomen?
- RUQ: Liver and gall bladder
- RLQ: Ileum, caecum, appendix
- LUQ: Jejunum
- LLQ: Sigmoid colon
Which 2 lines are used to determine the 4 quadrants of the abdomen? And where do they lie or pass through?
- Transumbilical plane - lies at the level of the umbilicus corresponding to the L3/4 intervertebral disc
- Median plane -
passes through the xiphoid process & pubic symphysis
Which 4 lines are used to determine the 9 regions of the abdomen? And where do they lie or pass through?
- Midclavicular Lines (2)
- passes through midpoint of clavicle - Subcostal Plane -
lies at L3 vertebra level uniting the lowest point of the costal margins - level of the 10th CCs - Transtubercular/ intertubercular plane -
lies at the level of the L5 vertebra uniting the two iliac tubercles
What is the umbilicus?
A scar representing the site of attachment of the umbilical cord in the foetus
How is the superficial fascia of the abdominal wall divided?
- Superficial fatty layer - Camper’s fascia
2. Deep membranous layer - Scarpa’s fascia
What is fascia?
- “Packing tissue” allowing movement of structures in relation to each other but without being restrictive
- Some provides muscle attachment
What is the composition of the internal fascia in the abdominal wall?
- There are very thin, negligible layers of fascia between the muscles
- Deep to the muscles (but outside the peritoneum), there is a layer of endo-abdominal or transversalis fascia
- Variable extraperitoneal fascia which is immediately external to the peritoneum
What are the 2 layers of the superficial fascia/ subcutaneous tissue of the perineum?
- Superficial fatty layer -Camper’s fascia
2. Deep membranous layer - Colles’/perineal fascia
What are Scarpa’s fascia and Camper’s fascia continuous with in the perineum?
• Scarpa’s fascia is continuous with Colles’/perineal fascia
• Camper’s fascia is continuous with the superficial fatty layer of the
superficial fascia/subcutaneous tissue of the perineum
In the abdomen, what fascia layers are found deep to the muscle layer?
- Transversalis fascia
2. Extraperitoneal fascia
Where does thoracolumbar fascia pass from and to? What does it give origins to? What may be at risk?
Passes from the iliac crest –> 12th rib in 3 layers (anterior, middle & posterior) that surround the back muscles & fuse together to give origin to the transversus abdominis & internal oblique muscles but not external oblique (free edge posteriorly - lumbar hernia)
What does transversus abdomens and internal oblique arise from?
Thoracolumbar fascia
What is transversals fascia (undo-abdominal fascia)?
Thin layer of fascia (connective tissue)
• lines the transversus abdominis muscle
• continuous with a similar layer lining the diaphragm & the iliacus muscle
What is extraperitoneal fascia?
Thin layer of fascia (connective tissue)
• contains a variable amount of fat
• lies between the transversalis fascia & the parietal peritoneum
What lines the walls of the abdomen?
Parietal peritoneum -
thin serous membrane that encloses peritoneal cavity
What are the layers in the abdomen?
- Skin
- Superficial fascia:
• Fatty layer (Camper’s)
• Membranous layer (Scarpa’s) - External oblique m
- Internal oblique m
- Transversus abdominis m
- Transversals fascia
- Exztraperitoneal fascia
- Parietal peritoneum
What are the anterior abdominal wall muscles? (4)
3 broad, thin sheets (sup to deep): 1. External oblique 2. Internal oblique 3. Transversum abdominis
A vertical muscle:
4. Rectus Abdominis (and Pyramidalis)
What are the functions of the anterior abdominal wall muscles?
- Support abdominal contents and raise intra-abdominal pressure, withstanding pressure from descent of the diaphragm
- Support vertebral column, flexing, laterally flexing and rotating the trunk against resistance
- Respiration
What 2 points are on the same coronal plane on a pelvis?
- Anterior superior iliac spine
2. Pubic tubercle
Where does the arcuate line continue from?
Pectineal line