Abdominal Wall Flashcards
1
Q
Which part of the abdominal wall is more mobile?
A
Anterolateral
Posterior is more stable
2
Q
What 3 structures make up the superior margin of the abdominal wall?
A
Xyphoid
Costal margin
Ribs 11 and 12
3
Q
What makes up the posterior margin of the Ab wall?
A
Lumbar vertebrae
4
Q
What makes up the inferior margin of the Ab wall?
A
Superior part of the bony pelvis
5
Q
What makes up the anterior margin of the Ab wall?
A
Epidermis
6
Q
What is the linea terminalis?
A
Imaginary line dividing abdominal and pelvic cavities
7
Q
What 3 structures make up the linea terminalis?
A
Pubic crest
Pectineal line on pubis
Arcuate line on ilium
8
Q
What 3 bones make up the pelvis?
A
Ilium
Ischium
Pubis
9
Q
What 6 structures comprise the pelvic inlet?
A
Sacral promontory (most superior) Ala (wings) of sacrum Arcuate line (most lateral) Pectineal line Pubic crest Pubic symphysis (most inferior)
10
Q
The umbilicus is located at which vertebral level?
A
L3-L4
11
Q
Which dermatome corresponds to the umbilicus?
A
T10
12
Q
What is the medial plane?
A
Separates quadrants into right and left
13
Q
What is the transumbilical plane?
A
Separates quadrants into upper and lower
14
Q
What region does epigastric refer to?
A
Anything above the umbilicus
15
Q
What region does suprapubic refer to?
A
Anything between pubic bone and umbilicus
16
Q
What region does periumbilical refer to?
A
Anything around the umbilicus
17
Q
Where is McBurney’s Point?
A
2/3 from umbilicus to ASIS
18
Q
What 2 structures can be palpated at McBurney’s Point?
A
Cecum
Appendix
19
Q
What forms the medial border of the rectus sheath?
A
Linea alba
20
Q
What forms the lateral border of the rectus sheath?
A
Semilunar line
21
Q
What forms the horizontal indentations in a six pack?
A
Tendinuous intersections
22
Q
What forms the middle longitudinal line in a six pack?
A
Linea alba
23
Q
What forms the side longitudinal lines in a six pack?
A
Semilunar lines
24
Q
What form the penis lines in a six pack?
A
Inguinal ligaments
25
What forms the boundary between the Ab wall and thigh?
Inguinal ligaments
26
True or false. The abdominal fascia is consistent throughout the entire Ab wall.
False. It is different between the upper and lower abdomen
27
What are the layers of the fascia in the upper ab wall?
Skin
Superficial fascia
Deep fascia
Muscle
28
What are the layers of the fascia in the lower abdomen?
```
Skin
Camper's fascia
Scarpa's fascia
Deep fascia
Muscle
```
29
What is the superficial fascia divided into in the lower abdomen?
Camper's fascia- fatty
| Scarpa's fascia- membranous
30
Both the fatty and membranous layers of the superficial fascia of the lower abdomen extend inferiorly into which 2 regions?
Pubic
| Perineal
31
The pubic and perineal regions contain which layers of the superficial fascia of the lower abdomen?
BOTH fatty and membranous
32
True or False. Both fatty and membranous superficial fascia layers in the lower abdomen descend inferiorly into the thighs.
False. Fatty layer DOES descend into thighs but membranous layer STOPS and fuses with fascia lata of thigh.
33
What comprises the fascia lata?
Membranous Scarpa's fascia of the lower abdomen
34
If blood or fluid accumulates below Scarpa's fascia, would you expect it to accumulate in the pelvic, perineal or thigh regions?
Pelvic and perineal only
| Scarpa's fascia stops and becomes fascia lata in the thigh
35
What are the 4 major ab muscles?
External oblique
Internal oblique
Transversus abdominis
Rectus abdominis
36
Which ab muscles are considered flank muscles?
Ext. Ob
Int. Ob
Trans abdominis
37
Which ab muscle is most medial?
Rectus ab
38
Which ab muscles form aponeuroses?
Ext ob
Int ob
Trans ab
39
What is the rectus ab sheathed by?
Aponeuroses of Ext, Int and Trans
40
The external oblique is a continuation of which muscle?
External intercostal
41
What are the orientation of the fibers of ext ob?
Hands in pockets ////////
42
Where does the ext ob start forming aponeurosis?
Semilunar line
43
What is the most lateral and medial border of the ext ob aponeurosis?
Lateral- semilunar line
| Medial- linea alba
44
What comprises the inguinal ligament? What 2 structures does it attach to?
Inferior edge of the rectus sheath which folds in on itself and attaches to ASIS and pubic tubercle
45
What is the orientation of int ob fibers?
90* to ext ob fibers \\\\\\\
46
Where does the int ob originate from?
Lateral 2/3 of inguinal ligament
47
What is the orientation of trans ab fibers?
Horizontal =
48
Where does the trans ab originate?
Lateral 1/3 of inguinal ligament
49
There is a larger gap between the inguinal ligament and which muscle?
Trans ab
50
What is the orientation of the rectus ab fibers?
Vertical |||||
51
What surrounds the rectus ab?
Rectus sheath
52
How does the rectus sheath connect to the rectus ab?
Tendinuous intersections
53
What comprises the rectus sheath?
Aponeuroses of ext ob, int ob, trans ab
54
True or False. The rectus sheath is NOT continuous.
True! It is separated into upper and lower parts by the arcuate line
55
What is the arcuate line?
Separation of the rectus sheath into upper and lower halves
56
What comprises the rectus sheath anterior to the rectus ab and superior to arcuate line?
External oblique
| 1/2 internal oblique
57
What comprises the rectus sheath posterior to the rectus ab and superior to arcuate line?
1/2 internal oblique
| Trans ab
58
What comprises the rectus sheath anterior to the rectus ab and inferior to arcuate line?
All 3 aponeuroses: ext ob, int ob, trans ab
59
What comprises the rectus sheath posterior to the rectus ab and inferior to arcuate line?
NO aponeuroses
| Just transversalis fascia
60
What are the 3 layers of fascia BELOW the rectus ab inferior to the arcuate line?
Transversalis fascia
Extraperitoneal fascia
Parietal peritoneum
61
What 2 regions does the extraperitoneal fascia divide into?
Preperitoneal- anterior
| Retroperitoneal- posterior
62
What 4 nerves innervate the ab wall?
Lower intercostals
Subcostal
Iliohypogastric
Ilioinguinal
63
All 4 ab wall nerves are:
Ventral rami
64
Lower intercostal nerves originate where?
T7-T11
65
Subcostal nerve originates where?
T12
66
Iliohypogastric nerve originates where?
L1
67
Ilioinguinal nerve originates where?
L1
68
True or false. The iliohypogastric and ilioinguinal nerves originate from the same location and are branches of the same nerve.
True! Both originate at L1 and are branches of the same ventral ramus
69
What dermatome marks the region inferior to xyphoid and above umbilicus?
T7
70
What dermatome marks the umbilicus region?
T10
71
What dermatome marks the suprapubic region?
T12
72
What dermatome marks the upper medial thigh and genitalia region?
L1
73
What are the 2 important artery pathways that supply the ab wall?
Descending aorta
| Epigastric
74
What 4 arteries branch from abdominal descending aorta?
Posterior intercostal
Subcostal
2 common iliacs
75
Posterior intercostal arteries travel where?
Between ribs
76
Subcostal arteries travel where?
Below the 12th rib
77
What arteries travel between int ob and trans ab?
Posterior intercostal
| Subcostal
78
What arteries supply the flank muscles? (E, I, T)
Posterior intercostal
| Subcostal
79
True or False. The posterior intercostal and subcostal arteries travel together to supply the same muscles.
False. They travel separately (between ribs or below 12th rib) but within the same region (between int ob and trans ab).
80
There are how many branches of the common iliac?
2
81
Common iliac branches into which arteries?
External iliac
| Internal iliac
82
The femoral artery comes from which artery?
External iliac
83
The femoral artery supplies the?
Thigh
84
The internal iliac arteries supply the?
Pelvis
85
The internal thoracic artery splits into which 2 arteries?
Musculophrenic
| Superior epigastric
86
True or false. The superior epigastric artery enters the rectus sheath.
True! It enters rectus sheath superiorly on the ab wall
87
What arteries supply the rectus ab muscles?
Superior epigastric
| Inferior epigastric
88
What arteries supply the int ob?
Subcostal and posterior intercostal
89
What arteries supply the ext ob?
Subcostal and posterior intercostal
90
What arteries supply the trans ab?
Subcostal and posterior intercostal
91
Where does the inferior epigastric artery enter the rectus sheath?
Enters inferiorly on ab wall
92
Where does the inferior epigastric artery branch from?
External iliac artery
93
What are the 2 sets of veins draining the ab wall?
Superficial
| Deep
94
The superficial veins are also known as the?
Thoracoepigastric veins
95
What do the thoracoepigastric veins drain?
Superficial fascia
96
Where do the thoracoepigastric veins drain superiorly?
Axilla veins
97
Where do the thoracoepigastric veins drain inferiorly?
Groin veins
98
Where do the thoracoepigastric veins drain medially?
Umbilicus veins
99
What are the deep veins also called?
Same names as the arteries
100
What do the deep veins drain?
Muscle
| Deep tissue
101
Where do the deep veins drain superiorly?
Subclavian vein
102
Where do the deep veins drain inferiorly?
External iliac veins
| Femoral veins
103
Where do deep veins drain posteriorly?
IVC
| Azygos vein
104
What are the 2 divisions of the lymphatic vessels?
Superficial
| Deep
105
Where do the superficial lymphatic vessels travel?
With veins superiorly and inferiorly
106
Where do the superficial lymph vessels drain superiorly?
Axilla nodes
107
Where do the superficial lymph vessels drain inferiorly?
Groin nodes
108
Where do deep lymph nodes drain?
To nodes along major vessels --> cisterna chyli --> thoracic duct
109
What carries oxygenated blood to fetus?
Umbilical vein
110
What is the falciform ligament?
Fold of parietal peritoneum over the umbilical vein
111
What carries deoxygenated blood from fetus?
Umbilical arteries
112
Where do umbilical arteries branch from?
Internal iliac arteries
113
What does the umbilical vein form when it closes?
Ligamentum teres hepatis
114
What is the ligamentum teres hepatis made of?
Fibrous remnant of umbilical vein
| Fold of peritoneum
115
What do the umbilical arteries form after they close?
Medial umbilical folds
116
What does the allantois form?
Urachus
117
Where does the urachus run?
Bladder to umbilicus
118
What does the urachus form?
Median umbilical fold
119
Where do medial umbilical folds come from?
Umbilical arteries
120
Where does median umbilical fold come from?
Urachus
121
What two folds are found in the peritoneum?
Medial umbilical folds
| Lateral umbilical folds
122
Where do lateral umbilical folds come from?
Inferior epigastric vessels
123
Where do inferior epigastric vessels travel between?
Transversalis fascia and peritoneum
124
Where do the inferior epigastric vessels pierce through rectus sheath at?
Inferiorly at deep surface of rectus abdominis
125
What 2 parts is the abdominal wall divided into?
Anterolateral
| Posterior
126
A pain within the skin of the abdominal wall is sensed by which nerves?
Intercostals
Subcostal
Iliohypgastric
127
After a car accident, a patient presents with abdominal pain and internal bleeding within the peritoneal cavity. Which nerves could be sensing this pain?
Nerves sensing parietal peritoneum:
Intercostals
Subcostal
Iliohypogastric
128
Which nerves provide motor function to the anterior abdominal wall?
Intercostals
Subcostal
Iliohypogastric
Ilioinguinal
129
A gash to the medial thigh causes pain that would be sensed by which nerve?
Ilioinguinal
130
A swift kick to the scrotum would cause pain that might travel via which two nerves?
Ilioinguinal
| Genitofemoral
131
If the temperature drops outside and a man gets cold, his testes will rise upward toward his body to conserve heat. This action is controlled by which nerve?
Genitofemoral
132
What are the two sympathetic nerves that sense abdominal pain in organs?
Thoracic splanchnics- greater, lesser, least
| Lumbar splanchnics
133
Which sympathetic nerves provide motor innervation to organs and blood vessels in the foregut and midgut?
Thoracic splanchnics- greater, lesser, least
134
Which sympathetic nerves provide motor innervation to the organs and abdominal blood vessels in the hindgut?
Lumbar splanchnics
135
What two parasympathetic nerves carry sensory information from abdominal viscera?
Vagus
| Pelvic splanchnics
136
Which nerve carries parasympathetic innervation to foregut and midgut organs?
Vagus
137
Which nerve carries parasympathetic innervation to the hindgut and pelvic organs?
Pelvic splanchnics
138
Where does the rectus abdominis originate?
Pubic symphysis and crest
139
Where does the rectus abdominis insert?
Costal margin and ribs
| Xyphoid process
140
What innervates the rectus abdominis?
Intercostals
Subcostal
Ilioinguinal
Iliohypogastric
141
What two functions does the rectus abdominis have?
Flexes trunk
| Supports abdominal contents
142
Where does the external oblique originate?
Lower Ribs
143
Where does the external oblique insert?
Iliac crest
Linea alba
Pubic tubercle
144
What innervates the external oblique?
Intercostals
Subcostal
Ilioinguinal
Iliohypogastric
145
What 3 functions does the external oblique have?
Flexes trunk
Rotates trunk to the opposite side
Compresses abdominal contents
146
What muscles would help rotate the trunk to the right?
Left external oblique
| Right internal oblique
147
What muscles would help the trunk rotate to the left?
Right external oblique
| Left internal oblique
148
Where does the internal oblique originate?
Thoracolumbar fascia
Iliac crest
Inguinal ligament
149
Where does the internal oblique insert?
Lower ribs
Linea alba
Pubic crest
150
What innervates the internal oblique?
Intercostals
Subcostal
Ilioinguinal
Iliohypogastric
151
What 3 actions does the internal oblique have?
Flexes trunk
Rotates trunk to same side
Compresses abdominal contents
152
Where does the transversus abdominis originate?
Thoracolumbar fascia
Iliac crest
Inguinal ligament
153
Where does the transversus abdominis insert?
Linea alba
| Pubic crest
154
What innervates the transversus abdominis?
Intercostals
Subcostal
Ilioinguinal
Iliohypogastric
155
What does the transversus abdominis do?
Compresses abdominal contents
156
Where does the cremaster muscle originate?
Internal oblique
157
Where does the cremaster muscle insert?
Surrounds testes
158
What innervates the cremaster muscle?
Genitofemoral nerve
159
What does the cremaster muscle do?
Raises testes
