Abdominal Wall Flashcards

1
Q

Fascia

A

Above umbilicus single layer
Below superficial fatty (camper)
Deep membranous (scarpa)

3 layers investing fascia around muscles

Below muscles endoabdominal fascia

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2
Q

External oblique

A

T7-11 + SC nerves
Becomes inguinal ligament
From ext 5-12 rubs
To linea alba, pubic tubercle, and ant half iliac crest

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3
Q

Internal oblique

A

T6-12+L1
From thoracolumbar region, ant 2/3 iliac crest, CT deep to lat 1/3 inguinal lig
To 10-12th ribs, linea alba and pecton pubis via conjoint tendon

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4
Q

Transversus abdominus

A

T6-12+L1
Neurovascular plane lies superior to it
From int 7-12th ribs, thoracolumbar fascia, iliac crest + ct deep to lat 3rd inguinal lig (same as int oblique)
To linea alba, aponeurosis internal oblique, pubic crest, pecton pubis via conjoint tendon
becomes iliopubic tract

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5
Q

Rectus abdominus

A

T6-12 ant rami
From pubic symphysis and crest
To xiphoid process and 5-7th costal cartilages

Pyramidalis absent 20% people

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6
Q

Rectus sheath

A

Contains sup and inf epigastric arteries and veins, lymph vessels and distally nerves T7-12
Sup 2/3 post to obliques
Inf post to obliques and transverse

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7
Q

Thoracoabdominal nerves

A

T7-11
Continuation intercostals distal to costal margin
Between int oblique and transversus abdominus
Distal muscles and skin

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8
Q

Lateral cutaneous branches thoracic

A

T7-9 anterior rami
Skin R+L hypochindrium

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9
Q

Subcostal nerve

A

T12
Largest anterior ramus of t12
Between int oblique and transversus
Skin sup to iliac crest and inf to umbilicus

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10
Q

Iliohypogastric

A

L1
Sup terminal branch anterior ramus
Pierces transversus then between that and int oblique
Skin over iliac crest, upper inguinal and hypogastrium
Muscles int oblique and trans abdo

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11
Q

Ilioinguinal nerve

A

L1
Inferior terminal branch ant ramus
Normal route thn traverses inguinal canal NOT DEEP RING
Skin lower inguinal, mons pubis, ant scrotum, adjacent medial thigh
Muscle lower in oblique and transversus abdominus

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12
Q

Superficial veins ant abdo drainage

A

Sup medial internal thoracic
Sup lateral lat thoracic
Inf
Superficial epigastric to femoral
Inferior epigastric to external iliac

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13
Q

Superficial abdo arteries from internal thoracic

A

Musculophrenic - follows costal margin, supplies hypochondrium and ant lat diaphragm
Superior epigastric - in rectus sheath deep to rectus abdominus, supplies epigastric and supra umbilical plus rectus abdominus

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14
Q

Superficial abdo arteries from aorta

A

10+11 IC + subcostal
Supply lumbar and flank

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15
Q

Superficial abdo arteries from external iliac

A

Inferior epigastric - deep to rectus abdominus, supplies deep wall pubic and infra umbilical and rectus abdominus
Deep circumflex iliac - deep wal parallel to inguinal ligament, supplies deep wall inguinal + iliac fossa + iliacus muscle

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16
Q

Superficial abdo arteries from femoral

A

Superficial epigastric - in subcut tissue to umbilicus, supplies sup wall pubic and inf umbilical
Superficial circumflex iliac - subcut tissue along ing ligament, supplies superficial wall inguinal and adjacent ant thigh

17
Q

Lymph drainage ant wall

A

Superficial sup umbilicus to axillary
Inf to umbilicus superficial inguinal
Deep - follow vessels to iliac and lumbar

18
Q

Infra umbilical peritoneal folds

A

1x median, apex bladder to umbilicus, covers median umbilical lig
2x medial umbilicus, cover medial umb ligs (old umb arteries)
2x lateral, cover inferior epigastric vessels

19
Q

Infra umbilical fossae

A

med to lat
supravesicular - bladder
medial inguinal - direct hernia, hesselbachs triangle
lat inguinal - indirect (most common)

20
Q

Hesselbachs triangle

A

Base ing lig
lat inferior epigastric
Med rectus sheath (linea semilunaris)
DIRECT HERNIA

21
Q

Inguinal canal

A

formed by reocation testes, 4cm
parallel and SUP the inguinal lig
Contains: spermatic cord/ round ligament, , blood, lymph, ilioninguinal nerve L1, genital branch genitofemoral nerve L1+2

22
Q

Walls inguinal canal

A

MALT
2Muscles ROOF - tranversalis and in oblique
2Aponeurosis ANT - in and ext oblique
2Ligaments LOWER - inguinal and lacunar
2T POST - Transversalis fascia and conjoint Tendon

23
Q

Spermatic cord fascia

A

Internal spermatic - transversalis
Cremasteric - int oblique
External spermatic - ext oblique

24
Q

Spermatic cord contents

A

3 arteries - cremasteric, testicular and ductus deferens
Venous pampiform plexus
Ductus deferens
Symp nerves on arteries and ductus deferens
Genital branch genitofemoral (for cremasteric)
Lymph vessels (drain lumbar)

25
Q

Scrotal arteries

A

Post from int pudendal
Int scrotal from external pudendal
Cremaseric from inferior epigastric

26
Q

Lymph drainage scrotum and testes

A

Scrotum to superficial inguinal
Testes to lumbar and preaortic

27
Q

Testicular arteries and veins

A

Art - from aorta L2 - ant to ureters ->through ing canal
Veins - 8-12 veins, pampiform plexus -> testicular veins, R to aorta, left to renal vain

28
Q

Hernias

A

Direct medial to epigstric, 25%, weakness wall, preitoneum and transversalis fascia
Indirect due to processus vaginalis still present, can go to testes, through ing canal

29
Q

Processus vaginalis

A

Continuation of peritoneum
Absent in adults other than tunica vaginalis at end of testes

30
Q

Posterior abdominal wall fascia

A

Endoabdominal - continuous with transversalis
Psoas - from L ver and pelivis, sup med arcuate, lat quad lumborum and thoracolumbar, inf iliac
Thoracolumbar - 3 layers, post and middle deep back muscles, ant encloses quadratus laborum

31
Q

Psoas major

A

L1-3 ant rami
TP L, T12-L5 lat bodies to lesser trochanter
Flex trunk and thigh with iliacus
Vert column lat

32
Q

Iliacus

A

L2-4 innervation
From ant 2/3 iliac fossa to lesser trochanter and psoas tendon
Flex thigh and stabilise hip

33
Q

Quadratus lumborum

A

T12 -L4
12th rib and TPs l spine to int lip iliac crest and iliolumbar lig
Extention and lat flexion vertebral column, fixes 12th rib insp

34
Q

Subcostal nerve

A

Post to lat arcuate
Inf on quad lumborum
Supplies ext oblique and skin lat abdo wall

35
Q

Lumbar spinal nerves

A

Post rami back muscles and overlying skin
Ant rami rest
L1+2 lumbar splanchnic

36
Q

Lumbar plexus

A

Femoral l2-4
Obturator l2-4
Lumbrosacral l4-5

Ilioinguinal and hypogastric l1
Genitofemoral l1+2
Latcut thigh l2+3

37
Q

Femoral nerve

A

Lat border psoas major deep to ing lig to ant thigh
Hip flexors, extention knee, iliacus

38
Q

Obturator nerve

A

L2-4
Medial psoas major through obturator foramen
Adductor muscles