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GASTRO > 6: Abdominal Wall & Surgery > Flashcards

6: Abdominal Wall & Surgery Flashcards

1
Q

What are the 2 subdivisions of the Abdominal Wall?

A
  1. Anterolateral wall
  2. Posterior wall
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2
Q

What is the Anterolateral Abdominal Wall bounded by? (4 things)

A
  1. Superiorly by:
  • 7th & 10th rib cartilages
  • Xiphoid process of sternum
  1. Inferiorly by;
  • Inguinal ligament
  • Pelvic girdle
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3
Q

What are the layers of the Anterolateral Abdominal Wall? (6 layers) (Superficial → Deep)

A
  1. Skin
  2. Subcutaneous tissue
  3. Muscles
  4. Deep fascia
  5. Extraperineal fat
  6. Parietal perineum

Sexy Sexy My Dagger Enters Punani

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4
Q

What are these Common landmarks of the abdominal wall?

A
  1. Umbilicus
  2. Epigastric Fossa
  3. Linea Alba
  4. Pubic Crest & Symphysis
  5. Inguinal Groove
  6. Semilunar Lines
  7. Tendinous Intersections of Rectus Abdominis
  8. Arcuate Line (Douglas Line)
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5
Q

What spinal level is the umbilicus at?

A

L3

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6
Q

What are the 5 pairs of muscles of the Anterolateral Abdominal Wall?

A

Flat Muscles:

  1. External Oblique
  2. Internal Oblique
  3. Transverus Abdominis

Vertical Muscles:

  1. Rectus Abdominis
  2. Pyramidalis
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7
Q

What are the Vertical muscles of the Anterolateral abdominal wall maintained within?

A

Rectus sheath

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8
Q

What is the Rectus Sheath? (4 points)

A
  1. Tough, aponeurotic, tendinous sheath
  2. The 3 Flat muscles of the Anterolateral abdominal wall
  3. Formed within mid-clavicular and midline
  4. Encloses rectus abdominis
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9
Q

What is the Linea Alba made up from?

A

Flat muscles aponeuroses from rectus sheath → interweave with fellows from opposite side → linea alba

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10
Q

What must surgical incisions of the abdomenal wall be? (3 things)

A
  1. Closeable
  2. Provide long lasting strength
  3. Minimise incidence of incisional herniae
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11
Q

What are common surgical incisions of the abdominal wall? (3 things)

A
  1. Midline incision
    * Suture linea alba together → strong closure
  2. Transverse incision
    * Suture external oblique aponeuroses together → strong closure
  3. Appendicectomy
    * Incision @ McBurrey’s point (2/3rd of distance between umbilicus and asis)

Pic shows McBurrey’s point labelled: 1

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12
Q

What are some consequents of development defects of the abdominal wall? (4 things)

A
  1. Gastroschisis
  2. Patent urachus
  3. Vitelline duct (persists)
  4. Ophalacoele

GPOV

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13
Q

What is Patent Urachus?

A

Opening between bladder and umbilicus

Urine can leak out of umbilicus

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14
Q

What are the different issues of a persisting Vitelline duct? (3 things)

A
  1. Meckel’s diverticulum
  2. Vitelline cyst
  3. Vitelline fistula
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15
Q

What are the main sites of hernia in the abdominal wall? (3 things)

A
  1. Inguinal (inguinal canal)
  2. Femoral (femoral ring)
  3. Umbilical
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16
Q

Where does the Inguinal canal extend to and from?

A

Interior Inguinal Ring → Exterior Inguinal Ring

4cm long

17
Q

What does the Inguinal canal lie in between?

A

Muscles of anterolateral abdominal wall

18
Q

What passes through the Inguinal Canal? (2 things)

A
  1. Ilioinguinal nerve
  2. Men: Spermatic Cord

Women: Round ligament of uterus

19
Q

What’s the difference between Direct and Indirect Inguinal Hernias?

A

Direct: Protrudes into ingunal canal through weakened area in Tranversalis Fascia within Inguinal (Hesselbach’s) triangle

Indirect: Protrudes into inguinal canal through Deep Inguinal Ring

20
Q

What are the borders of the Inguinal (Hesselbach’s) triangle? (3 things)

A
  1. Medial: Rectus Abdominis
  2. Lateral: Inferior Gastric Artery
  3. Inferior: Inguinal Ligament
21
Q

What is the main cause of Indirect Inguinal hernias

A

Failure of embryonic closure of deep inguinal ring after testicles have passed through it

22
Q

Where do Epigastric Hernias occur? (2 points)

A

In the epigastric region

In midline between Xiphoid process (just under sternum) & umbilicus (through linea alba)

23
Q

Where do Umbilical Hernias occur?

A

Through umbilical ring (belly button innit)

24
Q

What causes Umbilical Hernias?

A

Raised Intra-abdominal pressure

25
Q

What are Femoral Hernias?

A

Protrusions of abdominal viscera (organs) into femoral canal

26
Q

Where do Femoral Hernias occur?

A

Through femoral ring

27
Q

What do Femoral Hernias appear as?

A

Tender mass in femoral triangle

28
Q

What are 2 complications of Hernias?

A
  1. Strangulation
    * Constriction of blood vessels → prevent blood flowing to tissue
  2. Incarceration
    * Hernias can’t be reduced / pushed back into place
29
Q

What is constipation?

A

Pooing less than 3 times a week

30
Q

What are some causes of constipation? (6 things)

A
  1. Metabolic imbalance
  2. Immobility
  3. Meds (opioid analgesics / tricyclines)
  4. Diet
  5. Dehydration
  6. Diseases (diabetes / colorectal stricture)

Malfunction In Making Doo Doo Doo

31
Q

What metabolic imbalances can cause constipation? (4 things)

A
  1. Hypercalcaemia
  2. Hypokalaemia
  3. Hypothyroidism
  4. Lead poisoning
32
Q

What are the causes for constpiation in a Neonate? (6 things)

A
  1. Milk bolus obstruction
  2. Intestinal Atresia
  3. Meconium ileus (causes intestinal obstruction)
  4. Intestinal Stenosis
  5. Hirschprung’s
  6. Hypothyroidism

Malfunction In Making IHH

IHH is da sound babies make when pooing

33
Q

What are the causes for constpiation in infancy / older kids?

A
  1. Hypothyroidism
  2. Ecorpresis (vol / invol pooing yourself)
  3. Anal fissure (tear)
  4. Polyuria
  5. Severe vomiting

HEAPS

34
Q

How is constipation managed? (2 things)

A
  1. Treat underlying cause
  2. Symptomatic relief (Hey FML)
  • Hydration
  • Fibre rich diet
  • Mobilise patient
  • Laxatives

GASTRO (10 decks)

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