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PHA 500 > 6. Anterior Abdominal Wall > Flashcards

6. Anterior Abdominal Wall Flashcards

1
Q

Abdominal Wall (location)

A

Between xiphoid process/costal margin and pelvis

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2
Q

Pelvic Hip Bones

A

Fusion of:

  • ilium
  • pubis
  • ischium
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3
Q

Ilium (landmarks)

A

LOOK AT IMAGE

Iliac Crest

Anterior Superior Iliac Spine (ASIS)

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4
Q

Pubis (landmarks)

A

LOOK AT IMAGE

Pubic Symphysis

Pubic Tubercles

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5
Q

Umbilicus (location)

A

~L4 vertebral level

Former site of umbilical cord

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6
Q

Abdominal Planes

A

Median plane (vertical, xiphoid process to pubic symphysis)

Transumbilical plane (horizontal, level of umbilicus and iliac crests)

Transpyloric plane (level of L1)

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7
Q

Abdominal Quadrants

A

R and L upper

R and L lower

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8
Q

Abdominal Fascia (layers 1)

A

Superior to L4: undifferentiated fascia

Inferior to L4:

  • superficial fatty layer (camper fascia)
  • deep membranous layer (scarpa fascia)
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9
Q

Abdominal Fascia

A

Scarpa fascia attached at pubis

  • separates different regions of the body
  • hinders the spread of things
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10
Q

Abdominal Fascia (layers 2)

A

Deep (investing) fascia
-surrounds/invests muscles of abdominal wall

Transversalis fascia
-deep to musculature

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11
Q

Abdominal Muscles (function)

A

Maintain posture, move torso

Protect organs

Forced expiration

Increase intra-abdominal pressure (defecation, urination, childbirth)

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12
Q

Abdominal Muscles (obliques)

A

External: superficial, hand in pockets

Internal: hands in gloves

Transverus abdominis: deep, lateral to medial

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13
Q

Abdominal Muscles (rectus abdominis)

A

Located on either side of midline

Interrupted by tendinous intersections

Enclosed by rectus sheath

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14
Q

Aponeuroses

A

Flattened, sheetlike tendons

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15
Q

Rectus Sheath

A

Formed by aponeuroses of external obliques, internal obliques, transversus abdominis

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16
Q

Linea Alba

A

“white line”

Runs vertically in midline

Formed by fibers of rectus sheath fusing at midline

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17
Q

Arcuate Line

A

1/3 distance between umbilicus and pubis

Superior: aponeuroses of rectus sheath wrap around to enclose rectus abdominis

Inferior: aponeuroses pass anterior to rectus abdominis

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18
Q

Scrotum

A

Extension of anterior abdominal wall

Nothing restricts fluids from one area to another

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19
Q

Scrotum (layers)

A

Skin

Dartos fascia
-continuous w/ scarpa fascia (connection allows fluids/infections from abdominals to scrotum)

Dartos muscle

  • smooth muscle
  • wrinkles skin of scrotum in response to cold (reduces surface area)
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20
Q

Labia Majora

A

Homologous to scrotum

Extension of anterior abdominal wall

21
Q

Abdominal Wall (nerves)

A

Ventral rami of:

  • T7-T11 intercostal nerves
  • T12 subcostasl nerve
  • L1 (splits into iliohypogastric and ilioinguinal nerves)
22
Q

Abdominal Wall (innervation)

A

Segmental

Injury to single nerve only paralyzes segment - weakened - can lead to herniation

23
Q

Dermatomes of Abdominal Wall

A

Superior to umbilicus: T7-T9

At umbilicus: T10

Inferior to umbilicus: T11-L1

Inguinal fold: L1

24
Q

Arteries of the Abdominal Wall

A

LOOK AT IMAGE

LATERAL: posterior intercostal arteries (10th, 11th) and subcostal arteries

MIDLINE:

  • Superior epigastric arteries
  • Inferior epigastric arteries
  • Superficial epigastric arteries
25
Q

Superior Epigastric Arteries

A

Branches of internal thoracic arteries

Located within rectus sheath, deep to rectus abdominis

Anastomoses with inferior epigastric arteries

26
Q

Inferior Epigastric Arteries

A

Branches of external iliac arteries

Located within rectus sheath, deep to rectus abdominis

Anastomoses with superior epigastric arteries

27
Q

Superficial Epigastric Arteries

A

Branches of femoral arteries

Located in superficial fascia

28
Q

Veins of Abdominal Wall

A

Accompany arteries, share names

Anastomoses everywhere

29
Q

Venous Anastomoses (caval caval)

A

Superior and inferior epigastric veins

If there is block to IVC, blood in inferior is shunted to superior to get to SVC

30
Q

Venous Anastomoses (portal caval)

A

Paraumbilical veins (portal system) and superficial epigastric veins

Blood flow blockage in liver –> blood shunted to superficial

Caput medusae (dilation of veins of umbilicus, not inherently dangerous)

31
Q

Lymphatic Drainage

A

Axillary lymph nodes (drain superior to umbilicus)

Superficial inguinal nodes (drain inferior to umbilicus)

32
Q

Inguinal Region

A

aka Groin

Where lower limb meets abdomen

33
Q

Inguinal Ligament

A

Inferior part of external oblique aponeurosis

Spans from ASIS to pubic tubercle

34
Q

Inguinal Canal

A

Superior to inguinal ligament

Lateral to inferior epigastric vessels

Connects abdominal cavity to scrotum/labia majus

Deep (entrance) and superficial (exit) openings

35
Q

Inguinal Canal (weakness)

A

Potential site of weakness/herniation

Deep and SF rings to not overlap

Abdominal pressure keeps canal flat

36
Q

Ontogeny of Inguinal Canal (male)

A

Testes begin development in posterior abdominal wall

Testes move out and inferior from body through inguinal canal

37
Q

Gubernaculum (male)

A

Ligamentous cord

Connects testis to scrotum

Stays the same size as we grow - pulls testes through inguinal canal

38
Q

Spermatic Cord

A

As testes descend, drag associated vasculature, nerves, ductus deferens through canal = SPERMATIC CORD

39
Q

Spermatic Cord (fascia)

A

Transversalis fascia (internal spermatic fascia)

Transversus abdominis (not taken)

Internal oblique muscle and aponeurosis (cremaster muscle and fascia)

External oblique aponeurosis (external spermatic fascia)

40
Q

Cremaster Muscle

A

Raises the testes

41
Q

Ontogeny of the Inguinal Canal (female)

A

Ovaries develop in posterior abdominal wall and descend (slightly) - DO NOT EXIT ABDOMINAL CAVITY

42
Q

Gubernaculum Derivatives

A

Only in females

Ovarian ligament (between ovary and uterus)

Round ligament (between uterus and labium majus)

43
Q

Contents of Inguinal Canal

A

Male: spermatic cord

Female: round ligament

44
Q

Contents of Inguinal Canal (nerves)

A 
Ilioinguinal nerve (L1)
-sensory -inguinal region, scrotum, labia majora

Genital branch, genitofemoral nerve (L1, L2)

  • sensory: inguinal region, scrotum, labia majora
  • motor: cremaster muscle
45
Q

Inguinal Hernias

A

Protrusion of abdominal viscera through abdominal wall

More frequent in males

Indirect, Direct

46
Q

Indirect (Congenital) Inguinal Hernia

A

Most common

Mass enters deep inguinal ring

Lateral to epigastric vessels

Traverses inguinal canal - becomes enclosed in fascial coverings

Exits superficial inguinal ring

Can get into scrotum fairly easily

47
Q

Direct (Acquired) Inguinal Hernias

A

Punch through an area of weakness in abdominal wall (INGUINAL TRIANGLE)

Medial to inferior epigastric vessels

Rarely enters scrotum (if it does it lies lateral to spermatic cord)

48
Q

Inguinal Triangle

A

LOOK AT IMAGE

Bounded by:

  • rectus abdominis
  • inferior epigastric vessels
  • inguinal ligament

PHA 500 (11 decks)

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