ABDOMINAL WALL Flashcards
What are the boundaries of the femoral triangle?
- lateral = medial border of sartorius
- medial = medial border of adductor longus
- base = inguinal ligament
- floor = iliacus, psoas major, pectineus, adductor longus (lateral to medial)
- roof = fascia lata
What are the contents of the femoral triangle?
Lateral to medial = NAVEL
Nerves
- femoral, gentifemoral, pectineus, lateral femoral cutaneous
Artery
- femoral
- 3 superficial branches (sup epigastric, sup circumflex iliac, sup external pudendal)
- 3 deep branches (profunda, deep external pudendal, muscular)
Vein
- femoral
- long saphenous pierces cribiform fascia at fossa ovalis
- same tribuatries as femoral artery (sup branches)
Empty
- femoral canal
- contains deep inguinal nodes
Lymphatics
- superficial
- deep lymphatics (i.e. deep to fascia lata)
- Cloquet’s node
What are the boundaries of the femoral canal?
medial = lacunar ligament
superior = inguinal
inferior = pectineus
lateral = femoral vein
What are the contents of the femoral canal?
- lymphatics (deep)
- Cloquet’s lymph node
What forms the femoral sheath?
Anterior
- transversalis fascia
Posterior
- psoas fascia
What structures are contained within the femoral sheath?
- femoral artery
- femoral vein
- femoral branch of genitofemoral pierces it
- femoral canal
what are the boundaries of the inguinal canal?
Boundaries
roof
- Internal oblique
- Transversus abdominis
floor
- Inguinal ligament
Anterior
- External oblique
- Internal oblique (laterally)
Posterior
- Transversalis fascia
- Conjoint tendon
what are the contents of the inguinal canal?
3 layers
- external spermatic fascia
- Cremaster
- Internal spermatic fasica
3 arteries
- Testicular = From aorta L1
- Artery of vas = from Superior / inferio vesical
- Cremasteric artery from Inferior epigastric
3 nerves
- ilioinguinal L1
- genitofemoral L1/2
- Sympathetics
3 others
- Vas
- Lymphatics
- Processus vaginalis
Also pampinifrom plexus
What are each layers of spermatic fascia derived from?
- external spermatic fascia = external oblique aponeurosis
- cremasteric fascia = internal oblique
- internal spermatic fascia = transversalis
What is the iliopubic tract?
- thickening of the fascia transversalis
- extending from the iliopectineal arch to the pubic ramus.
- It curves around the medial surface of the femoral sheath to attach to the pectin eal ligament.
What is the transplyoric plane?
- located halfway between the jugular notch and the pubic symphysis
- is named as it passes through the pylorus of the stomach.
What structures pass through at the transplyoric plane?
- L1 vertebrae (and pylorus of the stomach)
- first part of duodenum
- DJ flexure
- fundus of gallbladder
- neck of pancreas
- origin of SMA and PV
- hilum of kidneys
- L1 vertebrae
- tips of 9th costal cartilage
Where does the transtubercular plane run?
- L5
- The transtubercular plane is a plane uniting the two tubercles of the iliac crests.
what important structures lie on the transtubercular plane?
- It marks the start of the inferior vena cava at the confluence of the common iliac veins
- a surface marking for which is 2.5 cm to the right of midline.
Where does the accessory obturator artery come from and how frequently does it occur?
- Comes from inferior epigastric (external iliac) and occurs between 30-50%
- Inferior epigastric artery gives a pubic branch, which sometimes takes place of obturator artery (replaced obturator artery)
- In other cases the pubic branch of inferior epigastric artery joins the obturator artery, and is then called as the accessory obturator artery.
- Accessory obturator artery sometimes lies over the lacunar ligament (medial boundary of femoral ring)
What is Spigel’s fascia?
The fascia of the transverse abdominal muscle limited by the linea semilunaris laterally and the lateral edge of the rectus muscle medially.
Mostly, these hernias lie in the “spigelian hernia belt,” a transverse 6-cm-wide zone above the interspinal plane (i.e. transverse plane at ASIS levels)
