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GI Midterm > Abdominal Wall > Flashcards

Abdominal Wall Flashcards

1
Q

What are the contents of the inguinal canal?

A

Spermatic cord (in males) or the round ligament of the uterus (in females) as well as blood vessels, lymphatic vessels, and the ilioinguinal nerve (which enters the canal from the side, rather than passing through the deep ring).

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2
Q

Where and what creates the deep (internal) inguinal ring?

A

The transversalis fascia pouches out, creating an opening through which structures can leave the abdominal cavity

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3
Q

Where and what creates the superficial (external) inguinal ring?

A

Formed by the splitting of the diagonal fibers of the external abdominal oblique aponeurosis. Since the fibers split, anatomists get to give them different names. A lateral crus and a medial crus are formed. the lateral crus attaches to the pubic tubercle, while the medial crus attaches to the pubic crest.

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4
Q

What makes up the following of the inguinal canal:

  1. roof.
  2. floor
  3. anterior wall
  4. posterior wall
A
  1. fibers of internal abdominal oblique and transversus abdominis muscles
  2. inguinal ligament throughout, with lacunar ligament added medially
  3. external abdominal oblique aponeurosis throughout, with internal abdominal oblique aponeurosis added laterally
  4. mostly transversalis fascia, with conjoint tendon (falx inguinalis) which is the joining of internal abdominal oblique and transversus abdominis paoneuroses, medialy
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5
Q

What characteristics describes indirect inguinal hernia?

A
  1. congenital
  2. lateral to inferior epigastric vessels
  3. enter canal via deep inguinal ring
  4. often enters scrotum
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6
Q

What characteristics describes direct inguinal hernia?

A
  1. Acquired (not congenital)
  2. medial to inferior epigastric vessles,
  3. literally pierce the canal
  4. seldom enter scrotum
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7
Q

For the following layers of the anterolateral abdominal wall, match what it becomes in the spermatic cord/testes covering.
1. Skin
2. Superficial fascia
3. External abdominal oblique aponeurosis
4. Internal abdominal oblique msucle
5. Fascia from internal abdominal oblique muscle
6 Transversalis fascia
7. peritoneum

A
  1. Scrotum
  2. scrotum/dartos fascia and muscle
  3. external spermatic fascia
  4. cremaster muscle
  5. Cremasteric fascia
  6. internal spermatic fascia
  7. processus vaginalis (obliterated)/ tunica vaginalis
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8
Q

Complete the passage below.:
Testes begin as 1 structures in the 2(3 words). They are attached to the anterolateral abdominal wall by 3. As 3 pulls the testes into the pelvis and developing inguinal canal, it is preceded by the 4 (two words), derived from the peritoneum which lies anterior to the testes. The 4 pushes the muscle and fascia layers, which will eventually make up the canal and spermatic cord, into the scrotum. After the testes are in position in the scrotum, the gubernaculum persists as the 5 (two words), while part of the processus vaginalis remains as a bursa-like sac called 6 (three words).

A
  1. retroperitoneal
  2. posterior abdominal wall
  3. gubernaculum
  4. processus vaginalis
  5. scrotal ligament
  6. tunica vaginalis testis
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9
Q

In female, what does the gubernaculum attach to?

A

ovaries and the anterolateral abdominal wall.

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10
Q

In female, during development, the gubernaculum attaches to what other structure besides the ovaries?

A

uterus

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11
Q

In the male the gubernaculum pulls the testes into the scrotum. In the female what prevents the ovaries from being pulled down?

A

The gubernaculum’s attachment to the uterus.

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12
Q

In the female, what does the gubernaculum give rise to?

A

Ovarian ligament and round ligament of the uterus.

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13
Q

What structures are the ovarian ligament connected to?

A

Ovary and uterus

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14
Q

what structures are round ligaments connected to?

A

uterus and labium majus.

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15
Q

The lateral umbilical fold contains what structure?

A

inferior epigastric vessels

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16
Q

The medial umbilical cord contain what structure and what is it a fetal remnant of?

A

contains medial umbilical ligament and it’s a fetal remnant of fetal umbilical artery

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17
Q

The median umbilical fold contains what structure and what is it a fetal remnant of?

A

Contains median umbilical ligament and it’s a remnent of the urachus.

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18
Q

what does the small genital branch of the genitofemoral nerve innervate/

A

Innervates cremaster muscle. It also anastomoses with the anterior scrotal/labial nerve (from ilioinguinal nerve) to supply the skin of the area.

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19
Q

What are the relationships of he medial inguinal fossa and lateral inguinal fossa to the weak fascia and the deep inguinal ring?

A

direct inguinal hernias start in the inguinal triangle, which is at the base of the medial inguinal fossa, between the medial and lateral umbilical folds. This triangle, since it is covered by weak fascia, allows direct hernias to pierce the anterior abdominal wall. Indirect inguinal hernias start at the base of the lateral inguinal fossa, lateral to the lateral umbilical fold. The deep inguinal ring, which transmits indirect hernias, is just lateral to the inferior epigastric vessels at the base of this fold.

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20
Q

What is the inguinal triangle?

A

Weak area defined by the lateral border of rectus abdomnis muscle, the inferior epigastric artery, and the inguinal ligament

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21
Q

What anterior abdominal wall structure are you not likely to find in the layers of he scrotum/testes

A

Transversus abdominus.

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22
Q

What separates the true pelvis from the false pelvis?

A

a line called the linea terminalis.

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23
Q

What forms the pelvic inlet?

A

Pectun pubis, arcuate line and sacral promontory

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24
Q

What is linea semilunaris?

A

lateral border of the rectus abdominis muscle

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25
Q

Where is the subcostal horizontal plane?

A

10th costal cartilages, superior border of LV3.

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26
Q

Where is the transtubercular plane?

A

tubercles of the iliac crests, body of LV5

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27
Q

Where is the transumbilical plane?

A

LV3-4.

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28
Q

Where is the transpyloric plane?

A
  • T12-LV1.
  • Halfway between jugular notch and the pubic symphysis.
  • Goes through the pyloric part of the stomach which is fixed
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29
Q

Where is the supracristal plane?

A

Similar to transumbilical plane.

-crosses the superior edges of the iliac crest

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30
Q

What are you likely to find in the right upper quadrant?

A
  • gallbladder
  • duodenum
  • right pleura
  • liver (right lobe)
  • right kidney
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31
Q

What are you likely to find in the left upper quadrant?

A
  • spleen
  • stomach
  • left pleura
  • tail of the pancreas
  • left kidney
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32
Q

What are you likely to find in the right lower quadrant?

A
  • right ureter
  • cecum
  • ilial diverticulum
  • vermiform appendix
33
Q

What are you likely to find in the left lower quadrant?

A
  • left ureter

- descending and sigmoid colon

34
Q

What are the nine REGIONS of the abdomen?

A
  1. right hypochondriac
  2. left hypochondriac
  3. epigastric
  4. right lumbar
  5. left lumbar
  6. umbilical
  7. right inguinal
  8. left inguinal
  9. pubic (hypogastric)
35
Q

What two muscles are found on the anterior abdominal wall?

A

rectus abdominis and pyramidalis.

36
Q

What gives the six pack appearance?

A

tendinous intersections of the rectus abdominis

37
Q

what is the function of pyramidalis?

A

tenses the linea alba

38
Q

Where is McBurney’s point and why is it clinically significant?

A

It’s located 1/3 of distance from lateral end of line between umbilicus and ASIS. This is where anterior abdominal wall incisions are made.

39
Q

What are the functions of anterior abdominal wall muscles?

A
  1. assist in respiration
  2. important for valsalva maneuver
  3. also act during coughing, sneezing, urination, defecation, vomitting and parturition
40
Q

What are the three anterolateral muscles of the abdominal wall.

A
  1. external abdominal oblique
  2. Internal abdominal oblique
  3. transversus abdominis
41
Q

In what directions do the fibers of the external oblique run?

A

inferomedially.

42
Q

What is the lacunar ligament?

A

An extension of the inguinal ligament, triangular in shape with apex at the pubic tubercle. The base is concave, lateral and sharp

43
Q

Clinically why is the lacunar ligament noteworthy?

A

It’s sharp edge can cut into the femoral canal which enlarges with a femoral hernia.

44
Q

what is the pectineal ligament?

A

it’s the lateral-posterior extension of the lacunar ligament that runs along the pectineal line.
it can also form a sharp border that can constrict femoral hernia.

45
Q

in what direction do internal abdominal oblique muscle fibers run?

A

superomedially, usually perpendicular to external obliques.

46
Q

What makes the falx inguinalis?

A

Aka conjoint tendon is made up of internal abdominal oblique aponeurosis and the aponeurosis of transversus abdominis.

47
Q

In the abdominal wall, between what layers do deep nerves and vessels run?

A

between internal oblique and transversus abdominis.

48
Q

What is the fatty layer (camper’s) fascia continuous with?

A

superficial fatty layers in the thorax, thigh, and perineum.

49
Q

Where do superficial blood vessels run?

A

Runs in the superficial fatty layer (Camper’s fascia)

50
Q

What is the membranous layer (Scarpa’s fascia) continuous with?

A

Continuous with fascia lata in the thigh and with the deep perineal fascia and continuous over the penis and scrotum.

51
Q

The deep fascia (investing fascia of the muscles) are clinically important because there is a potential space between 1 where fluid can leak into.

A

Potential space between the membranous layer of superficial fascia and deep fascia of the external abdominal oblique muscles.

52
Q

What is the rectus sheath formed by?

A

Formed by the fusion of the abdominal muscles and their associated fascias.

53
Q

What structures does the rectus sheath enclose?

A

rectus abdominis and pyramidalis mm.

54
Q

the layers of fascia and aponeuroses of the muscles forming the rectus sheath are arranged differently in the upper abdominal wall than they are in the lower wall. Where is the dividing line where this distinction takes place?

A

the arcuate line located 1/2 way between umbilicus and the pubic symphysis.

55
Q

Name the layers in order above the arcuate line.

A
  1. Skin
  2. camper’s fascia
  3. scarpas fascia
  4. aponeurosis of external oblique (2 layers)
  5. 1 layer of internal oblique aponeurosis
  6. rectus abdominis muscle
  7. 1 layer of internal oblique
  8. aponeurosis of transversus abominis (2 layers)
  9. transversus fascia
  10. extrapeirotneal tissue
  11. parietal peritoneum.
56
Q

Name the layers in order from anterior to posterior below the arcuate line.

A
  1. Skin
  2. Camper’s fasica
  3. Scarpas fascia
  4. aponeurosis of external oblique (2 layers)
  5. Aponeurosis of internal oblique (2 layers)
  6. Aponeurosis of transversus abdominis (2 layers)
  7. rectus abdominis
  8. transversalis fascia
  9. extraperitoneal tissue
  10. parietal peritoneum.
57
Q

What are the three origins of arteries in the deep system of anterior abdominal wall?

A
  1. subclavian artery via the internal thoracic
  2. branches in the mid-abdomen from the abdominal aorta
  3. inferiorly from the external iliac artery
58
Q

What are two arteries that comes off of the internal thoracic that supplies the deep abdominal wall?

A

Via the internal thoracic: 1. musculophrenic aa. 2. superior epigastric

59
Q

What are some branches of the abdominal aorta that supplies the deep anterior abdominal wall?

A

Subcostal aa.
lumbar aa.
intercostal aa.

60
Q

What are two arterties that originate in the external iliac artery and supplies the deep anterior abdominal wall?

A

inferior epigastric a. and deep circumflex iliac a.

61
Q

What are the origins of the superficial system of arteries that supplies the superficial abdominal wall?

A
  1. superiorly from perforating branches

2. inferiorly from the femoral artery

62
Q

What are some branches of the femoral artery that which supplies the superficial abdominal wall?

A
  1. superficial epigastric artery
  2. external pudendal artery (deep and superficial)
  3. superficial circumflex iliac artery
63
Q

In the deep abdominal wall, where are the main venous drainage?

A

Subclavian vv.
External iliac vv.
lumbar and intercostal vv

64
Q

In the superficial abdominal wall, where are the main venous drainage?

A

Thoracoepigastric vv.
superficial epigastric vv
lateral thoracic vv.

65
Q

Which sensory dermatomes innervate the following regions: a. xiphoid region

b. umbilical region
c. inguinal fold region

A

a. T7
b. T10
c. L1

66
Q

What three main nerves innervate the abdominal area?

A

iliohypogastric (L1)
ilioinguinal (L1)
Genitofemoral (L1 and L2)

67
Q

which nerve exits posterior abdominal wall between quadratus lumborum and psoas and enter the anterolateral abdominal wall between muscles and then enters the inguinal canal and emerges through the superficial inguinal ring.

A

ilioinguinal n.

68
Q

Which nerves supplies the groin, thigh, scrotum/labium majus?

A

ilioinguinal n.

69
Q

which nerve enters the inguinal canal through the deep ring and emerges out through the superficial ring and rungs along the spermatic cord/round ligament and innervates the cremaster msucles and is cutaneous to the labium major?

A

Genital branch of the geniforemoral n.

70
Q

what is contained inside of spermatic cords?

A
  1. Arteries (testucuar, deferential, cremasteric)
  2. Nerves (genital branch of genitofemoral, testicular)
  3. Vas deferens
  4. pampiniform plexus
  5. lymphatic vassels
  6. tunica vaginalis
71
Q

In male, what is contained under the inguinal canal?

A
  1. ductus deferens, ilioinguinal n., genital branch of genitofemoral n., testicular artery and pampinoform plexus of veins all surrounding the fascial layer
72
Q

what are the layers of the covering of the spermatic cord?

A
  1. external spermatic fascia
  2. cremasteric fascia and muscle with genital branch of genitofemoral n.
  3. internal spermatic fascia.
73
Q

what structures are surrounded by the internal spermatic fascia?

A
  1. ductus deferns
  2. artery of the ductus deferns
  3. testicular artery (with autonomic n.)
  4. pampiniform plexus of veins
  5. lymphatics (drains to lumbar nodes)
74
Q

T or F. The tesis and epididymis are completely covered by tunica vaginalis.

A

F. they’re partially covered by tunica vaginalis.

75
Q

what is the appendix of the testis?

A

a development remnant of the paramesonephric duct

76
Q

what part of the epididymis connects to the ductus deferens?

A

the Tail of epididymis is continuous with the ductus deferens

77
Q

what is the sinus epididymis?

A

a space of visceral layer of tunica vaginalis

78
Q

what is chyptorchidism?

A

undescended testes

GI Midterm (11 decks)

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