Abdomen

Question 1

What are the structures of the superficial fascia below the umbilicus?

Answer 1

Camper fascia - superficial fatty layer of subcutaneous tissue
Scarpa fascia - deep membranous layer of subcutaneous tissue

Question 2

What is the order of deepness of the muscles of the anterolateral wall?

Answer 2

Transverse abdominis muscle - most deep
Internal oblique muscle
External oblique muscle - least deep

Question 3

Roles of the muscles of the anterolateral wall

Answer 3

All 3 muscles compress and support abdominal viscera
They are involved in any action that increases the intra-abdominal pressure
External and internal oblique muscles flex and rotate the trunk

Question 4

What are the directions of the external and internal oblique muscles?

Answer 4

External: downwards and forwards
Internal: downwards and backwards

Question 5

How is the external oblique muscle attached?

Answer 5

Originates from ribs 5-12 and inserts onto the iliac crest and pubic tubercle

Question 6

What are the actions of the external oblique muscles?

Answer 6

Contralateral rotation of the torso

Question 7

How is inguinal ligament formed?

Answer 7

Formed from the inferior free margin/border of the external oblique aponeurosis

Question 8

How is the inguinal ligament attached?

Answer 8

Attachment from the anterior superior iliac spine down to the pubic tubercle

Question 9

How is the internal oblique muscles attached?

Answer 9

Attachment originates from the inguinal ligament, iliac crest and lumbodorsal fascia and inserts onto ribs 10 and 12

Question 10

What are the actions of the internal oblique muscles?

Answer 10

Bilateral contraction compresses the abdomen, while unilateral contraction ipsilaterally rotates the torso

Question 11

How do the fibres of the transverse abdominis muscle pass?

Answer 11

Fibres of transverse abdominis muscle pass transversely

Question 12

What are the attachments of the transverse abdominis muscle?

Answer 12

Attachment originates from the inguinal ligament, costal cartilage 7-12, iliac crest and thoracolumbar fascia. It inserts onto the conjoint tendon, xiphoid process, linea alba and the pubic crest

Question 13

What are the actions of transverse abdominis muscles?

Answer 13

Compression of abdominal contents/abdominal viscera

Question 14

How is the inguinal canal formed?

Answer 14

Formed in relation to the descent of the testes during foetal development

Question 15

How does the inguinal canal lie?

Answer 15

The inguinal canal is 4cm long and lies parallel and superior to the medial half of the inguinal ligament

Question 16

What are the 2 openings of the inguinal canal?

Answer 16

Deep inguinal ring
Superficial inguinal ring

Question 17

What does the inguinal canal transmit in males and females?

Answer 17

Males: transmits spermatic cord
Females: transmits round ligament of the uterus

Question 18

What is the round ligament in a female?

Answer 18

It’s a remnant/remainder of the embryonic gubernaculum

Question 19

Where does the round ligament originate from and attach to?

Answer 19

Originates at the uterine horns and attaches to the labia majora, passing through the inguinal canal

Question 20

What is the deep inguinal ring?

Answer 20

It’s the entrance to the inguinal canal - it’s the beginning of the evagination of the transversalis fascia

Question 21

How does the deep inguinal ring lie?

Answer 21

It lies superior to the middle of the inguinal ligament and lateral to the inferior epigastric artery

Question 22

What is the superficial inguinal ring formed by?

Answer 22

Formed by the evagination of the external oblique aponeurosis

Question 23

What is the superficial inguinal ring?

Answer 23

It’s the exit point of the inguinal canal where the spermatic cord/round ligament of the uterus emerges from the canal

Question 24

How does the superficial inguinal ring lie?

Answer 24

It lies superolateral to the pubic tubercle

Question 25

Definition of inguinal hernia

Answer 25

a protrusion of the parietal peritoneum and viscera through a normal or abnormal opening

Question 26

What are the two types of inguinal hernia?

Answer 26

Indirect (more common) and direct

Question 27

Describe briefly the indirect inguinal hernia

Answer 27

Part of the gut passes through the inguinal canal, lateral to the inferior epigastric artery
Occurs due to the processus vaginalis not separating/cutting off

Question 28

What is a landmark to distinguish between a direct and indirect hernia?

Answer 28

Inferior epigastric artery

Question 29

Describe briefly the direct inguinal hernia

Answer 29

Part of the gut becomes placed medial to the inferior epigastric artery
More common in elderly patients, with a weakness of the abdominal wall

Question 30

What are the functions of heart valves?

Answer 30

To permit blood flow in one direction during circulation
Prevents backflow of blood

Question 31

Where is the tricuspid valve and how many cusps does it have?

Answer 31

Tricuspid valve is between right atrium and right ventricle
It’s connected to the ventricular papillary muscle via chordae tendinae
It has 3 cusps

Question 32

Where is the bicuspid/mitral valve and how many cusps does it have?

Answer 32

Bicuspid/mitral valve is between the left atrium and left ventricle
It has 2 cusps

Question 33

What are the 4 cardiac valves?

Answer 33

Pulmonary valve
Aorta valve
Bicuspid/mitral valve
Tricuspid valve

Question 34

Where is the pulmonary valve?

Answer 34

Between right ventricle and pulmonary trunk/pulmonary artery

Question 35

Where is the aorta valve?

Answer 35

Between left ventricle and aorta

Question 36

Which of the cardiac valves are semilunar valves?

Answer 36

Pulmonary valve and aorta valve

Question 37

Which of the cardiac valves are atrioventricular valves?

Answer 37

Tricuspid valve and bicuspid/mitral valve

Question 38

What does cardiomegaly mean?

Answer 38

When the heart has become enlarged and occupies more than half of the thoracic shadow

Question 39

What are the ventricles of the heart separated by?

Answer 39

Interventricular septum