Abdominal Wall Flashcards

1
Q

what are the boundaries of the abdominal wall?

A

Superior- diaphragm
Inferior- pelvic inlet
Posterior- lumbar vertebrae and muscles
lateral and anterior- continuous soft tissues

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2
Q

what is the innervation of the posterior abdominal wall?

A

dorsal rami of spinal nerve

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3
Q

what is the innervation of the anterolateral abdominal wall?

A

ventral rami of spinal nerve
Lateral cutaneous branch- intercostal/subcostal n (T12)
Anterior cutaneous branch- intercostal/subcostal n (T12)
Muscular/ collateral branch

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4
Q

important dermatomes

A

T4: nipple line
T6: xiphoid process
T10: umbilicis
T12: iliac crest to ASIS and pubic symphysis
**innervation does not correlate with spinal nerve exit

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5
Q

what is the blood supply to the lateral abdominal wall?

A

posterior intercostal, subcostal, lumbar arteries

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6
Q

what is the blood supple to the anterior abdominal wall?

A

superior and inferior epigastric arteries, deep superficial circumflex of iliac artery

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7
Q

what happens if there is an abdominal aorta malfunction? Can the lower extremity still get blood supply?

A

yes, from the superior epigastric artery

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8
Q

what happens if there is an inferior vena cava malfunction? can the blood from the lower extremities still drain back to the heart?

A

yes, it can drain back to the superior vena cava

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9
Q

what are the 9 layers of the anterolateral abdominal wall?

A

1 skin
2 camper’s fatty layer
3 scarpa’s membranous layer
4 external oblique
5 internal oblique
6 transversus abdominis
7 transversalis fascia
8 extraperitoneal fascia
9 parietal peritoneum

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10
Q

what direction do the external oblique muscle fibers run?

A

hands in pocket

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11
Q

what is the innervation of the external oblique?

A

intercostal nerve (T7-T11) subcostal nerve (T12)

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12
Q

What are the motions of the external oblique?

A

pelvic stabilization, abdominal cavity compression, B FLX, I SB, Contralateral RT

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13
Q

What direction do the internal oblique muscle fibers run?

A

opposite to external oblique

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14
Q

what is the innervation to the internal oblique?

A

intercostal nerve (T7-T11) subcostal nerve (T12), iliohypogastric genital branch of genitofemoral nerve

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15
Q

what are the motions of the internal oblique?

A

core support, pelvic stabilization, B trunk FLX, I SB and RT

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16
Q

what abdominal muscle is the core muscle?

A

transversus abdominis

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17
Q

what direction do the transversus abdominis muscle fibers run?

A

horizontally

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18
Q

what is the innervation for the transversus abdominis?

A

intercostal nerve (T7-T11) subcostal nerve (T12)

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19
Q

what is the motions of the transversus abdominis muscle?

A

compression of abdomen, I RT, B spine stabilization

20
Q

where do the intercostal nerves run?

A

in between the transversus abdominis and internal oblique muscles

21
Q

what muscle makes up your 6 pack?

A

rectus abdominis

22
Q

what direction to the rectus abdominis muscle fibers fun?

A

vertically

23
Q

what is the innervation to the rectus abdominis?

A

intercostal nerve (T7-T11) and subcostal nerve (T12)

24
Q

what is the motion of the rectus abdominis?

A

compression and stabilization of the abdomen and trunk flexion

25
Q

structure of the rectus sheath above the arcuate line

A

superficial to rectus: aponeurosis of external oblique and half aponeurosis of internal oblique
deep to rectus: aponeurosis of half of internal oblique and aponeurosis of transversus abdominis

26
Q

structure of the rectus sheath below the arcuate line

A

superficial to rectus: aponeurosis of all 3 layers of abdominal muscles
deep to rectus: NONE, causes weakness of abdominal wall

27
Q

what are the umbilical folds of the posterior inferior abdominal wall?

A

Lateral: inferior epigastric vessels
medial: remnant of the umbilical artery
median: remnant of allantois

28
Q

what are the boundaries of the inguinal triangle?

A

lateral: medial to the lateral umbilical fold
inferior: inguinal ligament
medial: lateral rectus abdominis

29
Q

what causes portal hypertension?

A

liver pathology blocks to portal vein flow

30
Q

anastomosis of rectal vein and IVC

A

Internal hemorrhoids

31
Q

anastomosis of portal vein branches and esophageal veins

A

esophageal varices

32
Q

anastomosis of superficial epigastric veins and IVC

A

Caput medusa

33
Q

what forms the inguinal ligament?

A

the external oblique

34
Q

what forms the superficial/ external inguinal ring?

A

external oblique

35
Q

what forms the spermatic cord in males?

A

Internal oblique

36
Q

what forms the deep/ internal inguinal ring?

A

transversus abdominis

37
Q

what is the innervation of the inguinal ligament and canal?

A

motor- Genital branch of genitofemoral nerve
sensory- ilioinguinal nerve

38
Q

what is cryptorchidism?

A

testes not descending

39
Q

indirect inguinal hernia

A

happens at deep inguinal ring, abdominal contents enter the scrotum

40
Q

direct inguinal hernia

A

happens at superficial inguinal ring, weakness of abdominal wall at inguinal triangle, contents NEVER enter scrotum

41
Q

other hernias

A

umbilical, post surgical

42
Q

what is diastis recti

A

separation of linea alba

43
Q

what are the posterior abdominal wall muscles?

A

psoas major (and minor in SOME people) innervation: femoral nerve

44
Q

where does the ventral rami of T12/L1-L4 exit

A

between quadratus lumborum and psoas major

45
Q

what are the major surface landmarks and their deeper structures?

A

T8: IVC opening
T10: esophageal hiatus
T12: aortic hiatus
L1: Transpyloric plane, 1st part of duodenum, 8th intercostal space, superior mesenteric artery
L2: renal artery, L diaphragm crus attachment
L3: Subcostal plane- 12th rib, inferior mesenteric artery
L4: transumbilical plane, umbilicis, abdominal aorta divides into L/R common iliac artery
L5: Intertubecular plane, IVC formed by R/L common iliac vein