Abdomen: Abdominal Wall Flashcards
What type of hernia is associated with the semilunar line
spigelian hernia
What hernia is associated with the linea alba
umbilical hernia
What type of hernia is associated with the inguinal ligament
inguinal hernia
Where is the semilunar line
between abdominal oblique muscles and rectus abdominus muscles
What are the attachments of the inguinal ligament
ASIS and pubic tubercle
What are the functions of the abdominal wall
support for abdominal organs
movement of trunk
assist respiration
compress abdominal contents
What are the 6 F’s associated with a distended abdomen
fat fluid feces fetus flatus food
How will abdominal pressure change during inspiration and expiration
increase in inspiration, decrease in expiration
What are the two layers of superficial fascia within the abdomen
Campers and Scarpas
What type of fascia is campers fascia
thin, losse fatty layer
What type of fascia is Scarpas fascia
thick, dense layer
What layer will adipose be removed during liposunction
Camper’s fascia
What layer would sutures be placed in on the abdominal wall
Scarpa–thicker to maintain sutures
What spaces are continuous with Scarpa’s fascia
penis and scrotum (dartos)
perineum (colles)
What is Colle’s fascia
superficial perineal fascia
Can fluid from scarpas spread to the thigh
no, not continuous with fascia lata of thigh
How might urine extravasate in a “jumping over the fence” injury
pubic symphysis and fence will smash urethra, tearing it. Blood and urine enter into space of the perineum under colle’s fascia, dartos fascia, shaft of penis under dartos up to abdominal wall
What are the muscles of the abdomen innervated by
T7-T11
What direction are the fibers of the external abdominal oblique
hands in pocket
What direction are the fibers of the internal abdominal oblique
fans out more inferiorly
What direction are the fibers of the trasversus abdominus
completely horizontal
What will compose the anterior and posterior rectus sheath when above the arcuate line
Anterior: aponeurosis of EAO and part of IAO
Posterior: aponeurosis of IAO and TA
What composes the anterior and posterior rectus sheath when below the arcuate line
ANterior: no posterior rectus sheath. All three aponeuroses infront
What nerves come off T1-T11
Thoracoabdominals
Subcostal
Ilioinguinal, Iliohypogastric
What are the spinal cord levels for thoracoabdominals
T7-T11
What are the spinal cord levels for Subcostal
T12
What are the spinal cord levels for Ilioinguinal and iliohypogastric
L1
What is the main anastomosis within the abdominal wall
superior epigastric and inferior epigastric
What veins are responsible for draining the lateral aspect of the abdominal wall
lateral thoracic
superficial epigastric
How might the veins of the abdominal wall be used to compensate for a blockage in the IVC
superficial epigastric and lateral thoracic to drain
What is caput medusae
varicose enlargement of periumbilical veins of the abdominal wall due to portal hypertension
What is the median umbilical ligament a remnant of
urachus
What is the medial umbilical ligament a remnant of
umbilical arteries
What is the lateral umbilical ligament
inferior epigastric vessels on the backside of the abdominal wall
Where does superficial lymph drainage of the abdominal wall occur
above umbilicus to axillary
below umbilicus to superficial inguinal
What are the borders of Hesselbach’s triangle
rectus abdominus medially
inferior epigastric vessels laterally
inguinal ligament
What type of hernia will occur through hesselbach’s triangle
direct inguinal hernia
What is contained within the inguinal canal in males
ilioinguinal nerve
spermatic cord
genitofemoral nerve
What is contained within the inguinal canal in females
round ligament of uterus
ilioinguinal nerve
What composes the anterior portion of the inguinal canal
external oblique aponeurosis
What composes the psoterior portion of the inguinal canal
transversalis fascia and conjoint tendon
What composes the roof of the inguinal canal
attaching fibers or TA and IAO
What composes the floor of the inguinal canal
inguinal ligament, iliopubic tract
Where is the inguinal canal weak
lateral to conjoint tendon; posterior wall
What is the deep inguinal ring
opening in transversalis fascia at the start of inguinal canal
What is the superficial inguinal ring
opening in external oblique
What is the superficial inguinal ring bordered by
medial and lateral crus, intercrural fibers, reflected inguinal ligament
What muscle will contribute muscle to the spermatic cord
internal oblique
What muscle does internal oblique give rise to
cremaster muscle
What layers of the abdomen will contribute to the layers surrounding the spermatic cord
external oblique
internal oblique
transversalis fascia
subcutaneous tissue
What does the external oblique contribute to the spermatic cord
external spermatic fascia
What does the internal oblique muscle contribute to the spermatic cord
cremaster muscle
What does the transversalis fascia contibute to the spermatic cord
internal spermatic fascia
What does subcutaneous tissue contribute to the spermatic cord
dartos muscle and fascia
What abdominal muscle does not contribute to the spermatic cord
transversus abdominis
What are the major contents of the spermatic cord
testicular artery testicular vein (pampiniform plexus) vas deferens processus vaginalis cremateric artery lymphatics ilioinguinal and genitofemoral nerve
What is the function of the cremaster muscle
elevates testicles for temperature control; also involved in cremaster reflex
What is the cremaster reflex
gentle scraping of thigh will cause testes to pull upwards to abdomen
What spinal level is being tested by cremaster reflex
L1-L2
What nerve provides sensory info from cremaster
ilioinguinal
What nerve innervates cremaster muscle
genital branch of genitofemoral nerve
What is the function of the pampiniform plexus within the spermatic cord
cool blood in the arteries
What is the processus vaginalis
evagination of the peritoneum at the inguinal canal when testes descend to scrotum and will be obliterated
What does the processus vaginalis become
tunica vaginalis
What is the gubernaculum
a cord of tissue that guides the testes down through the inguinal canal and into the scrotum
What may occur if the processus vaginalis remains open
indirect hernias
How will lymph from the testes and scrotum drain
testes: lumbar nodes
skin of scrotum: superficial inguinal
What is cryptochidism
testes fail to descend
What is hydrocele
accumulation between visceral and paietal layers of tunica vaginalis
Where does a hydrocele occur in females
canal of nuck
What is testicular torsion
twisting of spermatic cord results in loss of blood flow and nerve function to the testicle
What is a predisposition to testicular torsion
tunica vaginalis is attached higher than usual allowing more mobility in the testicle
How will testicular torsion present
rapid onset of severe pain
dimpling
What causes dimpling in testicular torsion
gubernaculum pulling on scrotum
What are the characteristics of direct inguinal hernia
occur in older men due to weak abdominal muscles
occurs medial to the inferior epigastric vessels through the Hesselbach triangle
rarely reaches scrotum
What are the characteristics of indirect inguinal hernia
occur in younger individuals more than adults and in males more than females
travel through inguinal canal to scrotum
occur lateral to the inferior epigastric vessels
What rings will be affected by direct and indirect hernias
direct: may affect superficial
Indirect: deep and superficial
In which inguinal fossa will direct and indirect hernias occur
direct: medial
indirect: lateral
What layers will be seen on an indirect inguinal hernia
same layers as the spermatic cord plus periotneum and transversalis fascia
What layers will be seen on a direct inguinal hernia
only peritoneum and transversalis fascia
Where do femoral hernias occur
in femoral canal
How do inguinal hernias position differ from femoral hernias
femoral: inferolateral to pubic tubercle
inguinal: superomedial to pubic tubercle
