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MD3002 Anatomy > Abdominal wall 1: Anterolateral abdominal wall, inguinal region and hernias > Flashcards

Abdominal wall 1: Anterolateral abdominal wall, inguinal region and hernias Flashcards

1
Q

Where is the trans-umbilical plane?

A

L3/4 intervertebral disc

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2
Q

Where is the subcostal plane?

A
  • L3 vertebra

- Lowest point of the costal margins (10th costal cartilages)

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3
Q

Where is the transtubercular / intertubercular plane?

A
  • L5 vertebra

- Iliac tubercles

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4
Q

What are the layers of the abdominal wall?

A
  • Skin
  • Subcutaneous tissue
    Fatty layer = Camper’s fascia
    Deep membranous layer = Scarpa’s fascia
  • Abdominal muscles (3 layers) with their investing fascia
  • Transversalis fascia
  • Extraperitoneal fat
  • Parietal peritoneum
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5
Q

What is Camper’s layer

A

Subcutaneous fatty layer

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6
Q

What is Camper’s fascia continous with?

A

The subcutaneous tissue of the perineum (Cruveilhier’s fascia)

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7
Q

What is Scarpa’s fascia continous with?

A

Colle’s (Perineal) fascia

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8
Q

What are the common functions of abdominal wall muscles?

A
  • Support abdominal contents
  • Raise intra-abdominal pressure
  • Withstand pressure from descent of the diaphragm
  • Respiration
  • Support vertical column
  • Flex, laterally fles and rotate trunk
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9
Q

What are the abdominal wall muscles supplied by?

A
  • Thoraco-abdominal (7th - 11th intercostal nerves)
  • Subcostal nerve
  • L1
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10
Q

What muscle is responsible for the “six pack”

A

Rectus abdominus

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11
Q

Where is the origin of the Rectus Abdominis?

A
  • Pubic crest,

- Pubic symphysis

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12
Q

Where is the insertion of the rectus abdominis?

A
  • 5th to 7th costal cartilages

- Xiphoid process

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13
Q

What is the main function of the rectus abdominis?

A

Stabilises the pelvis during gait

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14
Q

What is the rectus abdominis enclosed in?

A

The rectus sheath formed by aponeuroses of the flat muscles of the abdominal wall

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15
Q

How many tendinous intersections are there for the rectus abdominis?

A

3

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16
Q

What is the most powerful flexor of the thigh?

A

iliopsoas

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17
Q

What is the linea alba?

A

Single midline fibrous line in the anterior abdominal wall formed by the median fusion of the layers of the rectus sheath medial to the bilateral rectus abdominis muscles. It attaches to the xiphoid process of the sternum and the pubic symphysis.

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18
Q

What are the three muscles that for the rectus sheath?

A
  • External oblique (+aponeurosis)
  • Internal obliquus (+ aponeurosis)
  • Transversus abdominis (+ aponeurosis)
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19
Q

What causes the linea alba to heal slowly?

A

Poor blood supply

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20
Q

What is deep to the transversalis abdominis?

A
  • Transversalis fascia

- Deep to this is the parietal peritoneum

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21
Q

What is the arcuate line?

A
  • A horizontal line that demarcates the lower limit of the posterior layer of the rectus sheath.
  • Where inferior epigastric vessels perforate the rectus abdominis.
  • Inferior border of aponeurosis of transversus abdominis behind rectus abdominis
  • Located a third of the way between the umbilicus and pubic symphysis
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22
Q

What is the linea semilunaris?

A

It is a curved tendinous intersection found on either side of the rectus abdominis muscle

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23
Q

What is different about the internal obiliquus and transversus abdominis below the arcuate line?

A
  • The posterior layer also moves anteriorly over the rectus abdominis
24
Q

What is the lateral border of the rectus muscle?

A

The semilunar line

25
Q

What is the origin of the external oblique muscle?

A

Lower 8 ribs

26
Q

What is the insertion of the external oblique muscle?

A
  • Iliac crest
  • ASIS
  • Linea alba
    Xiphoid process
    Pubic tubercle
27
Q

In what direction do the external oblique fibres run?

A

Infero-medially

28
Q

Where does the inguinal ligament run from?

A
  • ASIS to pubic tubercle
29
Q

What is the lower border of the external oblique muscle?

A

The inguinal ligament it is the lower border of the aponeurosis of the external oblique

30
Q

What is the lacunar ligament?

A
  • Forms medial border of femoral canal

- Some fibres from the medial end of the inguinal ligament turn posterolaterally and attach to pubic pecten

31
Q

What is the superficial inguinal ring?

A
  • A defect on the aponeurosis of the external oblique, just above the pubic tubercle
  • Superficial (medial) opening of the inguinal canal
  • Supported from behind by the conjoint tendon
  • Triangular opening
32
Q

Where is the thoraco lumbar fascia located?

A
  • Passes from the iliac crest to the lumbar vertebrae and ribs in 3 layers
  • Surround the back muscles
  • 3 layers fuse and provide the origin to the transversus abdominis and internal oblique muscles but not external oblique
33
Q

What is the origin of the internal oblique muscle?

A
  • Thoracolumbar fascia
  • Iliac crest (anterior 2/3)
  • Lateral 2/3 of inguinal ligament
34
Q

What is the insertion of the internal oblique muscle?

A
  • Inferior 3-4 ribs
  • Linea alba
    Xiphoid proces
    Pubic tubercle
35
Q

What is the nerve innervation of the internal oblique muscle ?

A

The iliohypogastric nerve (L1)

36
Q

Where do the fibres run in the internal oblique muscle?

A

Supero-medially and inferiorly to conjoint tendon

37
Q

What muscles make up the conjoint tendon?

A
  • Transversus muscle

- Internal oblique muscle

38
Q

Where does the conjoint tendon lie in relation to the superficial inguinal ring?

A

Posterior (supports it)

39
Q

What does the conjoint tendon attach to?

A

The pubic crest and pectineal line

40
Q

What is another name for the conjoint tendon?

A

The inguinal falx

41
Q

What is the inguinal ring?

A
  • Passage through the anterior abdominal wall
  • Connects the abdominal cavity to
    The scrotum or labia majora (females)
42
Q

What are the 2 openings of the inguinal canal?

A
  • Deep inguinal ring

- Superficial inguinal ring

43
Q

What are the contents of the inguinal canal?

A
  • Spermatic cord in males
  • Round ligament of uterus (ligamentum teres) in females
  • Genital branch of genitofemoral nerve (L1/2)
  • Ilioinguinal nerve (L1)
44
Q

What is the deep inguinal ring an opening of?

A

The transversalis fascia

45
Q

Where is the deep inguinal ring located?

A
  • Found in the lateral inguinal fossa
  • Lateral to the lateral umbilical fold (covering inferior epigastric vessels)
  • About 1 cm above the midway between the ASIS and pubic tubercle (mid point of the inguinal ligament)
46
Q

What is anterior to the inguinal canal?

A
  • External oblique

- Internal oblique laterally

47
Q

What is posterior to the inguinal canal?

A
  • Conjoint tendon medially

- Transversalis fascia laterally

48
Q

What is on the roof of the inguinal canal?

A
  • Arching inferior edges of internal oblique and transversus abdominis
49
Q

What is on the floor of the inguinal canal?

A
  • Inguinal ligament

- Lucunar ligament medially

50
Q

What is a hernia?

A
  • A condition in which part of an organ is displaced and protrudes through the wall of the cavity containing it
  • Occurs in weaker areas
51
Q

Where does an inguinal hernia usually appear?

A

Above and medial to the pubic tubercle

52
Q

Where does a femoral hernia usually appear?

A

Passes and appears below and lateral to the pubic tubercle

53
Q

Where is Hesselbach’s (inguinal) triangle located?

A
  • The area on the posterior wall of the inguinal canal
  • Medial to the inferior epigastric vessels
  • On the medial corner of Haselbach’s triangle is the inguinal flax / conjoint tendon
54
Q

What is a direct inguinal hernia usually caused by?

A

A weak conjoint tendon (usually in adult male)

55
Q

Where does a direct inguinal hernia take place and what does it consist of?

A
  • Fat or small bowel pushes the peritoneum and transversalis fascia
  • May pass through the superficial inguinal ring to enter the scrotum
  • Parallel to spermatic cord
  • Covered in peritoneum, transversalis fascia (and conjoint tendon)
56
Q

What is an indirect inguinal hernia?

A
  • Abdominal contents pass through deep inguinal ring
  • Persistent processus vaginalis
  • Contents are covered by all layers of the spermatic cord
  • Can be as a result of a congenital defect or increased abdomial pressure over a period of time

MD3002 Anatomy (14 decks)

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