Abdominal

Question 1

What makes up the Anterolateral wall of Abdominal wall?

Answer 1

1. Skin
2. Superficial Fascia
3. Muscle: External & internal oblique, Transversus abdominis, rectus abdominis
4. Transversalis fascia
5. Parietal peritoneum

Question 2

What makes up Posterior wall of Abdominal wall?

Answer 2

1. Psoas & iliacus (run together from L1-L5 - lesser trochanter of femur) = Major Hip flexors ex. sit ups
2. Quadratus lumborum (Last rib & transverse processes of lumbar) permits lateral flexion vertebral column
3. Diaphragm

Question 3

What are the fascia of Abdomen?

Answer 3

1. S.C.S (skin, camper’s, Scarpa’s)
2. External oblique (Deep fascia)
3. Internal oblique (Deep fascia)
4. Transverse abdominal (Transversalis fascia)
5. Endoabdominal fat
6. Parietal peritoneum

Question 4

External oblique

Answer 4

• Origin: ribs 5-12
• Nerve supply: T7-T12 & subcostal nerve
• Action: Flex & Rotate trunk
• Inferior fibers for aponeurosis attached to ant. sup. iliac spine & pubic tubercle forming inguinal ligament

Question 5

Internal oblique

Answer 5

• Origin: Ant. 2/3 of iliac crest/lateral half of inguinal ligament
• Insertion: inferior border of 10-12th ribs
• Innervation: T7-T12 & L1
• Actions: Rotate trunk

Question 6

Transversus Abdominis

Answer 6

• Origin: internal surface of costal cart. 7-12 & lateral 1/3 of inguinal ligament
• Insertion: Linea alba & pubic crest
• Action: compress & support abdominal viscera

Question 7

Rectus Abdominus

Answer 7

• Attached @ pubic symphasis & @ xiphiod process.
• Innervation: Lower 6 thoracic nerves
• Action: flexes trunk
• enclosed in rectus sheath

Question 8

Rectus sheath

Answer 8

-Formed by aponeuroses of the 3 oblique muscles

Question 9

What is the structure of rectus sheath above & below arcuate line?

Answer 9

• Above: External oblique anterior, Internal oblique anterior/posterior, Transversus Abdominis posterior to rectus abdominus
• Below: External/internal oblique & transversus abdominis run anterior to rectus abdominus

Question 10

Deep inguinal ring

Answer 10

• Internal opening

- Opening through transversalis fascia

Question 11

Superficial inguinal ring

Answer 11

• External opening

- opening through external oblique

Question 12

Inguinal Canal

Answer 12

• oblique opening in the anterior abdominal wall.
• Males: permits passage of testes & spermatic cord from abdomen to scrotum
• Females: transmits round ligament of uterus

Question 13

Pathway of Inguinal canal

Answer 13

1. TF
2. Passes behind Trans. Abdominis/Internal oblique (conjoint tendon)
3. Comes back anteriorly to go through External oblique

Question 14

Inguinal Hernias

Answer 14

• Direct: Hernial sac bulges through posterior wall of canal, happens after trauma
• Indirect: Hernial sac enters deep inguinal ring, Bulge is in peritoneal sac, most common congenital, goes through BOTH deep/superficial/scrotum

Question 15

Femoral Hernia

Answer 15

• Located in Femoral ring: Anterior-inguinal ligament, Posterior-sup. pubic ramus/pectineus muscle, Medial-lacunar ligament, Lateral-Femoral vein
• Located @ the E in N.A.V.E.L

Question 16

Direct Hernia

Answer 16

• “Tears” through medial to epigastric vein/artery in the inguinal triangle
• Goes through the abdominal layers to exit out superficial ring
• Surrounded by one layer when it exits

Question 17

Indirect Hernia

Answer 17

• Enters through deep ring lateral to epigastric artery/vein
• “Travels” through inguinal canal to exit our superficial
• Surrounded by 3 layers of inguinal canal @ exit site

Question 18

Inguinal Triangle

Answer 18

• Medial: Rectus Abdominus (base)
• Lateral: Inf. epigastric artery/vein (base)
• Inferior: Inguinal ligament (apex)