Abdomen: Abdominal Wall Flashcards
1
Q
Abdominal cavity extends from
A
- Thoracic diaphragm superiorly
- To pelvic inlet inferiorly
2
Q
Abdominal cavity is continuous with
A
- Pelvic cavity (abdominopelvic cavity)
3
Q
Abdominal muscles/aponeuroses form a
A
- Non-rigid anterior and lateral wall
4
Q
Ribs overly some
A
- Abdominal viscera
- Rib fracture can damage abdominal viscera
5
Q
Structures that form the posterior abdominal wall
A
- Lumbar vertebrae
- IVD
- Pelvis
- Muscles
6
Q
Abdominal cavity contains organs of
A
- GI tract
- Urogenital tract
7
Q
9 abdominal regions formed by these 4 planes
A
- 2 midclavicular planes
- Subcostal plane
- Transtubercular (intertubercular) plane
8
Q
Subcostal plane located at level of
A
- L3 vertebral body
9
Q
Transtubercular (intertubercular) plane located at level of
A
- L5 vertebral body
10
Q
Abdominal quadrants formed by 2 planes
A
- Transumbilical plane
- Median plane
11
Q
Transumbilical plane located at level of
A
- L3/4 disc
12
Q
Transpyloric plane
A
- Midway between manubrium and pubic symphysis
- Transects pylorus
13
Q
Transpyloric plane located at level of
A
- L1 vertebral body
14
Q
Supracristal plane located at level of
A
- L4 vertebral body
15
Q
Layers of anterolateral abdominal wall (11)
A
- Skin
- Superficial fascia
- Deep fascia (investing)
- External oblique muscle
- Deep fascia (investing)
- Internal oblique muscle
- Deep Fascia (investing)
- Transversus abdominis
- Endoabdominal fascia
- Extraperitoneal tissue (fat)
- Parietal peritoneum
16
Q
Superficial fascia (subcutaneous fascia) has 2 layers
A
- Camper fascia (fatty layer)
- Scarpa fascia (fibrous layer)
17
Q
Endoabdominal fascia also called
A
- Transversalis fascia
18
Q
Abdominal muscles
A
- External oblique (EO)
- Internal oblique (IO)
- Transversus abdominis (TA)
- Rectus Abdominis (RA)
19
Q
External/Internal oblique muscle fibers run
A
- Perpendicular to each other
- Similar to plywood
- Fiber direction is important in muscle sparing incisions
20
Q
Aponeurosis
A
- Broad, flat sheet of fibrous connective tissue that functions like a tendon
21
Q
Anterior continuation of EO, IO, and TA aponeuroses forms
A
- Linea semilunaris
- Rectus sheath
- Midline raphe
- Intersection with contralateral aponeuroses
22
Q
Linea semilunaris is located
A
- Lateral to rectus abdominis
23
Q
Midline raphe (linea alba) extends
A
- Xiphoid to pubic symphisis
- Between rectus abdominis
24
Q
Midline raphe (linea alba) is a good incision point because
A
- It is avascular
25
Rectus abdominis inferior attachment
- Pubic symphysis/crest
26
Rectus abdominis superior attachments
- Xiphoid process
| - 5-7th ribs
27
Rectus abdominis muscle segments are
- Separated tendinous intersections
28
External oblique attachment points
- Ribs 5-12
| - Linea alba, pubic tubercle/crest, iliac crest, ASIS
29
Internal oblique attachment points
- Thoracolumbar fascia, iliac crest
| - Ribs 10-12, linea alba, pubic bone
30
Transversus abdominis attachment points
- Lower ribs, thoracolumbar fascia, iliac crest
| - Linea alba, pubic bone
31
Pyramidalis muscle
- Small, triangular muscle
| - Absent in ~20% of people
32
Rectus abdominis and external oblique do NOT attach to
- Thoracolumbar fascia
33
Rectus sheath
- Fibrous compartment
| - Formed by aponeuroses of EO, IO, TA
34
Arcuate line
- Demarcation of change in sheath structure
| - Located 1/3 distance between umbilicus to pubic symphysis
35
Anterior wall above arcuate line
- EO aponeurosis
| - Anterior lamina of IO aponeurosis
36
Posterior wall above arcuate line
- Posterior lamina of IO aponeurosis
| - TA aponeurosis
37
Anterior wall below arcuate line
- Aponeuroses of all muscles
38
Posterior wall below arcuate line
- None really
| - Only transversalis fascia and peritoneum
39
Posterior layer of rectus sheath is absent
- Above the costal margin
40
Rectus sheath contains
- Rectus abdominis
- Pyramidalis muscle
- Sup. and inf. epigastric vessels
41
Sensory innervation of abdominal wall involves
- Ventral rami T7-11
- Subcostal nerve (T12)
- Ventral rami of L1
42
Ventral rami T7-11
- Thoracoabdominal nerves
| - Lateral and anterior cutaneous branches
43
Ventral rami T10 supplies
- The umbilicus area
44
Ventral rami of L1 branches into
- Iliohypogastric nerve (ventral rami L1)
| - Ilioinguinal nerve (ventral rami L1)
45
Ilioinguinal nerve (ventral rami L1) supplies
- Inguinal region
| - Anterior scrotum/labia majora
46
Motor innervation to the abdominal muscles is
- The same as sensory
47
Blood supply of the abdominal wall
- Superior epigastric
- Inferior epigastric
- Superficial epigastric
- Superficial circumflex iliac
- 10th and 11th posterior intercostals
- Subcostal
- Lumbar arteries
48
Superior epigastric artery is a branch off
- Internal thoracic artery
49
Inferior epigastric is a branch off
- External iliac artery
50
Branches off femoral artery
- Superficial epigastric
| - Superficial circumflex iliac
51
Branches off the aorta
- 10th/11th posterior intercostals
| - Subcostal
52
Superior & inferior epigastric enter rectus sheath
| anastomose
- Around umbilicus
53
Superior & inferior epigastric enter rectus sheath provide the pathway of
- Collateral circulation in aortic stenosis/occlusion
54
Deep venous drainage of abdominal wall (mirrors arterial supply)
- Superior epigastric vein (internal thoracic vein)
| - Inferior epigastric vein (external iliac vein)
55
Superficial venous drainage
- Multiple superficial veins
| - Superficial epigastric (great saphenous vein)
56
Thoracoepigastric vein
- Communicates w/ axillary and saphenous veins
- Saphenous vein drains into the femoral vein
- Provides a collateral pathway when IVC or portal
57
Abdominal wall lymph drainage above umbilicus
- Anterior axillary nodes
58
Abdominal wall lymph drainage below umbilicus
- Superficial inguinal nodes
59
Anterolateral abdominal wall contains
- Peritoneal folds
- Fossae
- Falciform ligament
60
Peritoneal folds
- Median umbilical fold (ligament)
- Medial umbilical fold (ligament)
- Lateral umbilical fold
61
Median umbilical fold (ligament)
- Remnant of the urachus
62
Medial umbilical fold (ligament)
- Obliterated umbilical arteries
63
Lateral umbilical fold
- Inferior epigastric vessels
64
Fossae of the anterolateral abdominal wall are
- Depressions between umbilical folds
65
3 fossae of the anterolateral wall
- Supravescial
- Medial inguinal
- Lateral inguinal
66
Supravescial fossa
- Between median and medial fold
| - Related to the bladder
67
Medial inguinal fossa
- Between medial and lateral folds
- Inguinal triangle (Hesselbach triangle)
- Site of direct inguinal hernia
68
Lateral inguinal fossa
- Lateral to lateral folds
- Location of deep inguinal ring
- Site of indirect inguinal hernia
69
Falciform ligament
- Peritoneal reflection between liver and anterior/superior abdominal wall
70
Falciform ligament contains
- Round ligament of liver (ligamentum teres hepatis)
| - Paraumbilical veins
71
Round ligament of liver (ligamentum teres hepatis)
- Remnant of umbilical vein
