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Functional Anatomy and Embryology > Abdominal Wall > Flashcards

Abdominal Wall Flashcards

Define boundaries of abdomen and pelvis, and bony and cartilaginous landmarks visible or palpable on abdominal examination. Demonstrate descriptive regions of abdomen (four regions, nine quadrants and bloodless plane) and common incision sites. Demonstrate surface projections of abdominal organs. Describe anatomy, innervation, blood supply, lymphatic drainage and functions of the muscles of anterior abdominal wall.

1
Q

Where is the abdomen?

A

In the region:
Below the thorax
Above the ‘true’ pelvis

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2
Q

The abdominal Cavity is bounded by:

A

Roof: Diaphragm
Walls: anterior and posterior muscles
Floor: Pelvic inlet/ pelvic floor

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3
Q

What is the structure of the diaphragm?

A

Bi-domed meaning it arches upwards into the thoracic cavity

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4
Q

What is the significance of the bi-domed structure of the diaphragm?

A

Means that part of the abdominal content lies behind the ribcage meaning it is protected
(chest wound may cause protrusion of abdominal content)

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5
Q

What is the inlet of the ‘true’ pelvis bounded by?

A

Upper border of the sacrum posteriorly and the iliopectineal line of the hip bone

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6
Q

What is the relation between the iliopectineal line of the hip bone and the pubic symphysis?

A

It leads forwards towards the upper border of the pubic symphysis

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7
Q

What is the iliopectineal line comprise of?

A

The arcute line on the ilium and the pectineal line of the pubis

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8
Q

What is the ilipectineal line also known as?

A

Pelvic brim

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9
Q

What is the lower limit of the pelvis bounded by?

A

The pelvic diaphragm

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10
Q

What is the pelvic diaphragm?

A

Transverse sheet of muscle

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11
Q

The abdomino-pelvic cavity is enclosed by muscle in which directions?

A

Anteriorly, posteriorly and laterally

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12
Q

Why are the lateral muscles of the abdomino-pelvic cavity referred to as anterior muscles?

A

They have flat tendons which run anteriorly

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13
Q

What does the pelvic diaphragm divide?

A

The pelvis from the perineum

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14
Q

What does the diaphragm divide?

A

The thorax and the abdominal organs

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15
Q

What is the posterior bony margin of the abdomen?

A

The lumbar vertebrae which sit on top of the sacrum

L1-L5

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16
Q

Why is the iliac known as the false pelvis?

A

It lies laterally to the lumbar vertebrae hence it is in the abdomen

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17
Q

What is the ASIS?

A

Anterior Superior Iliac Spine

Palpable

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18
Q

What is the front part of the hip bones known as?

A

The pubis

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19
Q

Which ligament forms the most anterior identifiable boundary of the anterior abdominal wall?

A

The inguinal ligament

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20
Q

What is the costal margin?

A

Cartilage along the edge of the eighth through tenth ribs in the middle of the chest. Where ribs 7-10 join

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21
Q

Which bony ribs form attachments to some abdominal wall muscles?

A

Tip of 11th rib
12th rib
Costal margin

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22
Q

What are the boundaries of the abdominal wall muscles?

A

Costal margin above

Inguinal ligament below

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23
Q

What in an identifiable boundary at the top of the abdomen?

A

Xiphisternum

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24
Q

Where does the inguinal ligament run from?

A

ASIS and the pubic tubercle

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25
Q

What is the inguinal ligament?

A

Infolding of the lower border of an aponeurotic tendon of the external oblique abdominis muscle of the anterior abdominal wall

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26
Q

How many hip bones are there?

A

2

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27
Q

How do the two hip bones attach to the sacrum?

A

By sacroiliac joints

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28
Q

Where do the two hip bones meet in the front?

A

Pubic symphysis

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29
Q

Why is the diaphragm slightly higher on the right hand side than the left hand side?

A

The presence of the liver

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30
Q

Which intercostal space does the right side of the diaphragm reach?

A

4th intercostal space

right nipple in males

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31
Q

Which intercostal space does the left side of the diaphragm reach?

A

5th intercostal space

below nipple in males

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32
Q

Where does the costal margin lead up to?

A

The bottom end of the breastbone

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33
Q

What is the name of the ridge where the anterior abdominal wall muscles meet in the midline?

A

Linea Alba

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34
Q

Why is the linea alba white?

A

It is relatively avascular

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35
Q

What is useful about the avascular nature of the linea alba?

A

good place to make emergency abdominal incisions

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36
Q

What happens to the linea alba when females become pregnant.

A

The placenta produces melanocyte-stimulating hormone which pigments the linea alba to become the linea nigra

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37
Q

What is found at the lateral borders of rectus abdominis muscle?

A

Linea semilunaris

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38
Q

What causes the linea semilunaris to form?

A

The fusion of aponeuroses of the anterior abdominal wall muscles either side of the rectus sheath

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39
Q

What planes separate the abdomen into 4 quadrants?

A

Paraumbilical plane

Median plane

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40
Q

What planes separate the abdomen into 9 regions?

A

Midclavicular Lines
Transpyloric plane/ subcostal plane
Trans-tubercular plane

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41
Q

What is the subcostal plane?

A

The lowest point on the costal margin

42
Q

Why is the trans-pyloric plan used?

A

The pylorus of the stomach is relatively fixed.

Splits the abdomen into equal parts

43
Q

How is the trans-pyloric plane located?

A

(lies midway between the supersternal notch and the pubic symphysis)
Lies a hand’s breadth below the sternum

44
Q

Where is the trans-tubercular plane?

A

Runs between the 2 tubercles that lie on the iliac crest

45
Q

What are the 9 sections of the abdomen?

A 
Right hypochondrium
Epigastric
Left hypochondrium
Right lumber/lateral
Umbilical
Left lumber/lateral
Right inguinal/iliac
Suprapubic
Left inguinal/iliac
46
Q

Where do the muscle bellies of the anterior abdominal wall muscles lie?

A

Laterally

47
Q

Where do the aponeurotic tendons of the anterior abdominal wall muscles run?

A

To the midline- anteriorly

48
Q

What are the anterior abdominal wall muscles?

A

External Oblique Abdominis
Internal Oblique Abdominis
Transversus Abdominis

49
Q

Where do the anterior abdominal wall muscles fuse?

A

Lateral to the rectus abdominis to form the linea semilunaris

50
Q

Where do the aponeurotic tendons meet?

A

Front of the abdomen to form the linea alba

51
Q

Where does the endoabdominal fasica lie?

A

Inside the abdominal cavity

52
Q

What lies inside the endoabdominal fascia?

A

Peritoneum which is a serous membrane and secretes fluid that goes into the space between the peritoneal membranes

53
Q

Where does the parietal peritoneum lie?

A

abdominal and pelvic cavities

54
Q

What is visceral peritoneum?

A

double fold of peritoneum that wraps around viscera

55
Q

What is the mesentery?

A

Connecting stalk of peritoneum that attaches organs to the body wall

56
Q

What are the layers of the abdomen?

A

Skin
Superficial Fascia
Deep Fascia

57
Q

What are the two layers of superficial fascia in the abdomen?

A

Camper’s fascia

Scarpa’s fascia

58
Q

What is contained within the superficial fascia?

A

Cutaneous blood vessels and cutaneous nerves

59
Q

What are intraperitoneal organs?

A

Organs that are surrounded by peritoneum

60
Q

Why are intraperitoneal organs mobile?

A

They have a mesentery which gives them flexibility

61
Q

What are retroperitoneal organs?

A

Organs that are behind the peritoneal cavity- relatively immobile

62
Q

What is the Camper’s Fascia?

A

Fatty layer of connective tissue- thick, semi-fluid and variable

63
Q

How far down does Camper’s fascia travel?

A

To the inguinal ligament- after that is the superficial fascia of the thigh

64
Q

What is the composition of Scarpa’s fascia?

A

Membranous not fatty

65
Q

Where is Scarpa’s fascia particularly located?

A

Lower abdomen particularly on the anterior abdominal wall and is continuous into the perineum where the genitalia lie

66
Q

What is the function of Scarpa’s fascia?

A

Keeps fluids away from the genital region

67
Q

What is the feature of Scarpa’s fascia?

A

Semipermeable membrane which is resistant to fluid

68
Q

What is sometimes incised to gain access to retroperitoneal organs?

A

Lumber fascia

69
Q

Where does the rectus abdominis run?

A

Straight down from chest to pubis

70
Q

What does the rectus abdominis do?

A

Draws the trunk downwards- helps flex the muscles

71
Q

Where does the external oblique run?

A

From the chest wall and runs downwards, forwards and medially to the midline

72
Q

How is the inguinal ligament formed?

A

By the external abdominal oblique aponeurosis that is flipped over

73
Q

What does the external oblique do?

A

Draws the chest/trunk down to the opposite side

74
Q

Where is the internal oblique?

A

Inside the external oblique

75
Q

In what direction do the fibres of the internal oblique run?

A

Downwards and laterally

As you go down the muscle fibres become more horizontal

76
Q

Where does the internal oblique attach?

A

Iliac crest and lateral third of the inguinal ligament

77
Q

What does the internal oblique muscle do?

A

Ipsilateral movement- left internal oblique brings abdomen to the left along with right external oblique

78
Q

What does the transversus abdominis do?

A

Compress the abdomen

79
Q

Where does the transversus abdominis run?

A

From the lateral third of the inguinal ligament, iliac crest posteriorly and attaches to the ribs and the lumber fascia
Horizontally

80
Q

What forms the conjoint tendon?

A

The lower part of the common aponeurosis of the internal abdominal oblique and the transverse abdominal

81
Q

What forms the anterior layer of the rectus sheath?

A

External Oblique

82
Q

What happens to the internal oblique in the rectus sheath?

A

It splits into 2, one half goes behind the rectus and the other goes in front

83
Q

What happens at the Arcuate line (Douglas’ line)?

A

All the aponeurotic tendons come anteriorly which leaves behind the transversalias fascia which creates a ridge at the back of the rectus abdominis

84
Q

What is the purpose of the Arcuate line?

A

Allows the inferior epigastric artery to gain access to the back of rectus abdominis

85
Q

What is the nerve supply of the abdomen?

A

Supplied segmentally from cutaneous branches of T7 through to L1

86
Q

What supplies the umbilicus?

A

T10

87
Q

What is a dermatome?

A

An area of the skin supplied by nerves from a single spinal root

88
Q

What supplies the rectus abdominis?

A

T7-T12

89
Q

What supplies the internal oblique and Transversus Abdominis?

A

T7-L1

90
Q

What supplies the external oblique?

A

T7-T12

91
Q

What is the first branch of L1?

A

Ilioinguinal nerve

92
Q

What does the ilioinguinal nerve do?

A

Supplies the conjoined tendon

93
Q

Where does the iliohypogastric nerve arise from?

A

L1

94
Q

What does the iliohypogastric nerve do?

A

Cutaneous supply

95
Q

Where do the superficial veins of the abdomen lie?

A

Camper’s fascia

96
Q

Where do the veins of the abdomen originate from?

A

The umbilicus- paraumbilical

97
Q

Where do the veins of the abdomen drain?

A

Upwards- thoraco-epigastric/ thoraco-abdominal veins

Downwards- Superficial epigastric

98
Q

Where do the Thoraco-epigastric veins connect?

A

Around the breast- lateral thoracic veins

99
Q

Where do the superficial epigastric veins drain?

A

Into the femoral vein along with the superficial circumflex iliac veins

100
Q

where do the lymphatics above the umbilicus drain?

A

Axillary nodes

101
Q

where do the lymphatics below the umbilicus drain?

A

Superficial inguinal nodes

Functional Anatomy and Embryology (2 decks)

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