Abdominal Wall Flashcards
Anterolateral abdominal wall layers from superficial to deep
Skin Superficial campers fascia Deep scarpas fascia Investing fascia layers of EO EO muscle Investing fascia layers of IO IO muscle Investing Fascia layers of TA TA muscle Endoabdominal fascia Subcutaneous fat (if present) Parietal paratoneum
Functions of abdominal wall muscles combined
Respiration, dedication, micturation and parturition
“Valsalva maneuver”
Above arcuate line spread of muscle aponeruosis
EO and 1/2 IO aponeruosis in front of rectus abdominis
TA and 1/2 IO aponeruosis in front of rectus abdominis
Below Arcuate line spread of muscle aponeruosis
EO, IO and TA aponeruosis all anterior to rectus abdominis
posterior rectus abdominis is primary site of herniations
What fascial layer sits in front of potential space in the inguinal/abdonminal area?
Scarpas fascia
lower limbs do not pull here though
What abdominal muscle also forms inguinal regions?
IO
Subcostal nerve
Anterior/ventral rami of T12
Innervated skin from illiac crest to the umbillicus
Stimulates muscles of anterolateral abdominal wall
Thoracoabdominal nerves
anterior rami of T6-T11
Supplies muscles and skin above the umbilicus and below the costal margin.
Iliohypoogastric Nerve
anterior/ventral rami of L1
Stimulates skin over inguinal ligament and superolateral thigh
Innervated IO and TA muscles
Ilioinguinal nerve
Anterior/ventral rami of L1
Stimulates skin of the superomedial thigh, scrotum and labia major
Innervated IO and TA muscles
Genitofemoral nerve
Anterior/ventral rami of L1-L2
Stimulates skin of femoral triangle
Innervated cremaster, mons pubis and labia Majora Muscles
Venous drainage in abdominal wall
Superomedial = internal thoracic vein
Lateral = lateral thoracic vein
Inferiorally =. Superficial and inferior epigastric veins
Lymphatic drainage in abdominal wall
Above T10 (umbiliicus) = axillary nodes
Below T10 (umbillicus) = Inguinal nodes
Falciform ligament contains what?
Round ligament of liver and para-umbilical vein
Found between liver and superior wall
Umbilical folds from medial to lateral and their contents
Median umbilical fold: median umbilical ligament and Rachel’s (Allentois)
Medial umbilical fold: medial umbilical ligaments
Lateral umbilical fold: inferior epigastric vessels
Types of peritoneal fossea from medial to lateral
Peritoneal fossa= sites prone to herniation
Supravescial fossae: between median and medial umbilical folds
Medial inguinal fossa: between medial and lateral umbilical folds
most common site for direct herniations
Lateral inguinal fossa: lateral to the lateral umbilical folds
most common site for indirect herniations
Rectus sheath hematoma
Accumulation of blood in rectus sheath duration tearing of the epigastric artery or anticoagulation meds
Congenital umbilical hernia
Umbillicus fails to seal after ligation of umbilical cord
Acquired umbilical hernia
Extraperitoneal fat protrudes where aponeruosis fibers interlace and are weakened
Epigastric hernia
Herniations of usually fat along weakened portions of the linea alba
- very painful (nerve compression)
Spegelian hernia
Herniation of usually fat along semilunar lines
High risk incisions
Pararectus incisions: lateral border of rectus sheath (site of nerve supply for RA)
Inguinal incisions: may cut ilioinguinal nerve
Direct vs indirect herniations
Direct: acquired through intense pressure and weakness of aponeruosis stealths
Indirect: congenital through defects in birth
- 75% of hernias occur in inguinal region
- most common in males
