Abdomen Flashcards
Liposuction
Remove subcutaneous fat with a percutaneously placed suction tube and high vacuum pressures
Tubes inserted subdermally through small skin incisions
Closing abdominal skin incisions inferior to the umbilicus
Include membranous layer of subcutaneous tissue when suture bc of strength
What is between the membranous layer of subcutaneous tissue and the deep fascia covering the rictus abdominis and external oblique muscles
Potential space where fluid may accumulate (urine from ruptured urethra)
Where can fluid spread from between the membranous layer of subcutaneous tissue and deep fascia covering rictus abdominis and external oblique
Can spread superiorly
Can’t spread inferiorly into thigh bc the deep membranous later of subcutaneous tissues fuse with the deep fascia of the thigh along a line approximately 5.5cm inferior and parallel to the inguinal ligament
Why is the endoabdominal fascia of importance in surgery
Provides a plane that can be opened , enabling the surgeon to approach structures on or in the anterior aspect of the posterior abdominal wall , such as kidneys or bodies of lumbar vertebrae without entering the membranous peritoneal space between the transversalis fascia and the parietal peritoneum is used for placement of prostheses when repairing inguinal hernias
Space of bogros and what is it used for
Between the transversalis fascia and the parietal peritoneum
Placing prostheses when repairing inguinal hernias
Why is. a prominent abdomen normal in infants and young children
Abdomen contains a lot of air and anterolateral abdominal cavities are enlarging an their abdominal muscles gaining strength
What are the six common causes of abdominal protrusion
6F
Food, Fluid, Fat, Feces, Flatus, Fetus
What is inversion of the umbilicus a sign of
Increased intra abdominal pressure usually ascites or large mass , organometallic
Most obesity fat is what
Subcutaneous
But can be extraperitoneal
What happens when anterior abdominal muscles are underdeveloped or atrophy from aging or insufficient exercise
Insufficient tonus to resist the increased weight of a protuberant abdomen on the anterior pelvis. The pelvis tilts anteriorly at the hip joints when standing producing excessive lordosis of the lumbar spine
Where do anterolateral abdominal wall hernias occur
Places where something (vessels, spermatic cord) pierce the abdominal wall creating a potential weakness
Where do most hernias occur
Inguinal, umbilical, epigastric
Umbilical hernia
Think neonates (esp low birth weight) bc the anterior abdominal wall is weak in the umbilical reign, which had failed to close normally, causing a protrusion of the umbilicus
Sooo what causes umbilical hernia in baby
Increased abdominal pressure in the presence of weakness and incomplete closure of the anterior abdominal wall after ligation of the umbilical cord at birth
Acquired umbilical hernia
Most commonly in women and obese people
Extraperitoneal fat and,or peritoneum protrude into the hernial sac
Lines along which the fibers of the abdominal aponeurosis interlace are also potential sites of herniation(can have gaps where these fiber exchanges occur)
What is a common site of gaps where fiber exchange occurs
Midline or in the transition from aponeurosis to rectus sheath
What causes these gaps that hernias can happen at
Congenital, obesity stress, aging, surgical or traumatic wounds
Epigastric hernia
Through linea alba at midline between diploid process and the umbilicus
Usually just lobules of fat
Are epigastric hernias painful
YES especially when a nerve is compressed
Spigelian hernias
Along semilunar lines
Who gets spigelian hernias
People over 40 that are obese
In spigelian hernia what is in the sac
The hernial sac is composed of peritoneum and covered with only skin and fatty subcutaneous tissue, but may occur deep to muscle
Why are warm hands important when palpating the abdominal wall
Cold hands cause guarding