Abdominal Powerpoints Flashcards
Hernia through weakness in abdominal wall; things in the abdominal wall push directly through it; result of weakness in the floor of the inguinal ring
Direct
What is more common: direct or indirect hernias? are the hernias more common in men or women?
Indirect; indirect more common in men, direct equally common in men and women
Slit-like opening in fascia transversals; Immediately superior to midpoint of inguinal ligament
Deep inguinal ring
What is contained in the inguinal canal?
Spermatic cord in men; round ligament of uterus in women
Where does the medial crus attach?
pubic bone and pubic crest medial to pubic tubercle
Where does the lateral crus attach?
pubic tubercle
What keeps the lateral and medial crus together and the superficial inguinal ring intact?
Intercrural fibers
What makes the superior wall (roof) of the inguinal canal?
Arching fibers of IAO and TA
What makes the inferior wall (floor) of the inguinal canal?
- Superior surface of inguinal ligament
2. Lacunar ligament
Medial part of inguinal ligament that is reflected back and attaches to pectineal line
Lacunar ligament
What makes the anterior wall of the inguinal canal?
- Part of aponeurosis of external oblique
2. Reinforced laterally by fibers of int. oblique and sometimes the transversus abdominis
What makes the posterior wall of the inguinal canal?
- Fascia trasversali
2. Medially by fibers of conjoint tendon, the common tendon of int. oblique and transversus abdominis muscles
What makes the posterior wall of the inguinal canal?
- Fascia trasversali
2. Medially by fibers of conjoint tendon, the common tendon of int. oblique and transversus abdominis muscles
Below the arcuate line, where are the aponeurosis of EAO, IAO, and trans. abdominis in relation to the rectus abdominis?
All are anterior, superficial to the rectus abdominis
What is the arcuate line?
Where the aponeurosis of the trans abd and IAO stop
Above the arcuate line, where are the aponeurosis of EAO, IAO, and trans. abdominis in relation to the rectus abdominis?
- EAO: anterior, superficial to rectus abd.
- IAO: split and both anterior, superficial and posterior, deep to rectus abd.
- TA: Posterior, deep to rectus abd.
What is the pundendal nerve important for?
control of bowl, bladder, and sexual function
What is the lowest cutaneous nerve in the abdomen?
Iliohypogastric nerve
What are the motor branches to the intercostal and abdominal muscles?
Branches of T1-L1 (Pudendal plexus)
What spinal levels are the cervical plexus?
C1-C4
What spinal levels are the brachial plexus?
C5-T1
What spinal levels are the lumbar plexus?
branch from T12, and L1-L4
What spinal levels are the sacral plexus?
L4-S3
What spinal levels are the pudendal plexus?
parts of S2 and S3, and all of S4
The [dorsal/ventral] primary ramus innervates the skin and muscles around the spine
Dorsal
The [dorsal/ventral] primary ramus innervates the skin and muscles for the rest of the body.
Ventral (lat/ant trunk, UEs and LEs)
As they exit the vertebral column, the dorsal and ventral roots join to form..
the spinal nerve (a mixed nerve)
The spinal nerve then divides into..
into a posterior (dorsal) primary ramus and an anterior (ventral) primary ramus
extension of pia mater
Film terminale
filum terminale fuses with dura mater and attaches to coccyx
Coccygeal ligament
Name the meninges layers from superficial to deep
- Dura mater
- Acrachnoid membrane
- Pia mater
meninges, tough outer layer; wraps around filum terminale
dura mater
meninges, shaped like a spider; fuses with dura mater at S2
Arachnoid membrane
attached to the nervous system itself (brain or spinal cord); innermost layer
Pia mater
gross anatomy in the spinal cord, thicker than surrounding regions; adding a lot of cells from lower (lumbar) and upper extremity
Cervical enlargement (C4-T1) Lumbar enlargement (T11-S1)
the tapered, lower end of thespinal cord
Conus medullaris (near L1 and L2)
Which part of the superficial fascia is the fatty, superficial layer?
Camper’s (only occurs in pubic region)
Which part of the superficial fascia is the deep fibrous layer?
Scarpa’s fascia
Name the m layers of the abdominal wall from superficial to deep
- External oblique muscle
- Internal oblique muscle
- Rectus abdominis
- Transverse abdominal muscle
- Pyramidalis muscle
What abdominal regions are above the subcostal plane? what level is the subcostal plane?
Right hypochondriac, epigastric, left hypochondriac;
L3
What abdominal regions are below the transtubercular plane? what level is the transtubercular plane?
Right ilioinguinal, hypogastric, left ilioinguinal;
L5
What abdominal regions are in between the subcostal and transtubercular plane?
Right lumbar, umbilical, and left lumbar
What plane of the abdominal region are lines dropped straight down through the middle of the clavicle?
Midclavicular planes
Identify the superior border of the anterior abdomen.
Diaphragm, 7 – 10 ribs, xiphoid process, intersternal notch, costal margins of the arch
Identify the inferior border of the anterior abdomen.
Abdomen and pelvic region, starts at iliac crest, ASIS, inguinal ligament,
pubic tubercle and crest.
hernia follows path from deep ring to canal to superficial ring; occurs through a weakness in the internal inguinal ring (deep inguinal ring); deep inguinal ring is a little bit open and the structures of deep abdominal cavity can potentially exit through the superficial inguinal ring; follows a passageway –not directly exiting through the wall
Indirect hernia