Abdominal Wall

Question 1

Superior: diaphragm
Posterior: lumbar vertebrae and muscles
Lateral and anterior: abdominal muscles
Inferior: pelvic inlet - form sacral promontory to pubic symphysis along the pectineal line

Answer 1

Structures Between Thorax and Pelvis

Question 2

What is the vertebral level of the renal artery, L diaphragm crus attachment (renal artery can be higher)

Answer 2

L2

Question 3

Which plane is located on the L3 vertebral level?

Answer 3

a) . subcostal plane - 12th rib, inferior mesenteric arteries
b) . transpyloric plane- 1st part of the duodenum, 8thh intercostal space, superior mesenteric artery
c) . supracristal plane- umbilicus, abdominal aorta divides into R/L common illiac arteries
d) . intertubercular plane- IVC formed by R/L common veins

Question 4

Name the 4 quadrants of the abdominal wall?

Answer 4

R Upper quadrant: liver duodenum
L Upper quadrant: stomach
R Lower quadrant: cecum and ascending colon **Mcburney’s point- appendix referral pain
L Lower quadrant: descending and sigmoid colon

Question 5

What region is medial to the R and L lumbar/flank region?

Answer 5

a) .umbilic
b) .epigastric
c) .hypogastric/pubic

Question 6

What is the nerve innervation of the posterior abdominal wall?

Answer 6

dorsal rami of spinal nerves

Question 7

What is the nerve innervation of the lateral abdominal wall?

Answer 7

intercostal nerve- lateral cutaneous branch T6/T7 lateral cutaneous branch impingement by serratus anterior 2/2 shoulder problems.

Question 8

What is the nerve innervation of the anterior wall of the abdomen?

Answer 8

intercostal nerve- anterior cutaneous branch

Question 9

If a patient was injured and served T9 spinal nerves what vertebral level would lose sensation or have numbness and tingling?

Answer 9

a) . L3
b) . L2
c) . L1

Question 10

T9 spinal root is at what vertebral level?

Answer 10

L3

Question 11

What is the blood supply for the lateral wall of the abdomen?

Answer 11

posterior intercostal vessels

Question 12

Superior and inferior epigastric vessels deep and superficial circumflex iliac artery is blood supply for the ________ abdominal wall

Clincial importance:
portal hypertension: caput-medusae

Answer 12

Anterior

Question 13

Skin 
Fatty Layer (Camper's)
Membranous layer (Scarpa's) 
External Oblique 
Internal Oblique 
Transversus abdomonis 
Transversalais fascia
Extraperitoneal fascia 
Parietal peritoneum

Answer 13

The 9 layers of the anterolateral abdominal wall

Question 14

Clinical importance: testis descending, and herniation will ______ through the anterolateral abdominal layers of structures

Answer 14

push

Question 15

External surface of 5th-12th ribs
Attaches to the iliac crest, linea alba, pubic tubercle, folds to form inguinal ligament
Function: compression of the abdominal cavity, stabilization of the pelvis ipsilateral SB, contralateral RT (L/R), trunk FLX (B)
Innervation: Intercostal nerves (T7-T12 )

Answer 15

a) .Internal oblique
b) .Transverse abdominis
c) .External oblique
d) .Rectus abdominis

Question 16

The inferior border of 10th-12th ribs, thoracolumbar fascia
Attaches to the linea alba, anterior 2/3 iliac crest
Function: Core to support abdominal contents, and stabilize pelvis; ipsilateral SB and RT (L/R), trunk FLX elevates testes

Intercostal nerves T7-T12 and 2 branches of L1

  iliohypogastric: internal oblique 
   ilioinguinal: cremaster part 

like the pair of external and internal intercostal

Answer 16

a) .Internal oblique
b) .Transverse abdominis
c) .External oblique
d) .Rectus abdominis

Question 17

Core muscles

intercostal nerves running between transverses abdominis and internal oblique

Answer 17

a) .Internal oblique
b) .Transverse abdominis
c) .External oblique
d) .Rectus abdominis

Question 18

6 pack muscles

Distal attachment narrows down and forms a weak point on the anterior abdominal wall

Answer 18

a) .Internal oblique
b) .Transverse abdominis
c) .External oblique
d) .Rectus abdominis

Question 19

A fusion of the aponeurosis creates the ______ and happens at the_______

Answer 19

rectus sheath and linea alba

internal/external oblique + transverse abdominis

Question 20

All 3 abdominal muscles of aponeurosis are superficial to the rectus abdominis. Does this occur below or above the arcuate line?

Answer 20

Below

Question 21

trans
subs
super
intratarbercula

Question 22

The supracristal plane lies at the ________

Answer 22

iliac crest, umbilicus, abdominal aorta divides into R/L common iliac arteries

L4 vertebral level

Question 23

The midline of the aponeurosis fiber exchange

Answer 23

Linea alba

Question 24

Intermuscular exchange from superficial to deep

Answer 24

Between opposite external and internal oblique

Question 25

landmark of development, completed in 3rd week of gestation nutrients and oxygen exchange with mother's blood

Answer 25

Placenta

Question 26

Within the foramen ovale _______ may not fully close

Answer 26

fossa ovalis

Question 27

What happens when there is an issue with the epigastric veins to IVC or SVC if IVC has problems too?

Answer 27

a) . portal hypertension; caput-medusae b) . esophageal varices c) . internal hemorrhoids

Question 28

External oblique aponeurosis: as a scaffold, distal part forms a superficial inguinal ring Internal oblique muscle slip: cover inner structures cremaster muscles Transverse abdominis: deep inguinal rings (spermatic/duct vessels in males, ligament teres in females)

Answer 28

Layers of of inguinal canal

Question 29

Most common abdominal hernia (3/4) Abdominal contents enter the scrotum in males and the groin in females occurs at deep inguinal ring

Answer 29

Indirect inguinal hernia

Question 30

weakness of the abdominal wall at Hesselbach's (inguinal) triangle Abdominal contents never enter the scrotum can sometimes be predisposed

Answer 30

direct inguinal hernia

Question 31

Internal organs push outward when intra-abdominal pressure increases but return after **worsens with increasing intra-abdominal pressure**

Answer 31

Diastasis recti

Question 32

Anterior layer: internal oblique Middle layer: quadrates lumborum Posterior layer: erector spinae/extrinsic back muscles

Question 32

Anterior layer: internal oblique Middle layer: quadrates lumborum Posterior layer: erector spinae/extrinsic back muscles

Answer 32

Thoracolumbar fascia

Question 33

What are the posterior core muscles?

Answer 33

``` Multifdi psaos major (possible) ```

Question 34

Too much: hyperlordosis results in over stretch of the _______________, resulting in weakness

Answer 34

transverse abdominis

Question 35

What is McBureny's point and what quadrant is it in?

Answer 35

appendix pain; R lower quadrant