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Block 1 > Abdominal Wall And Cavity > Flashcards

Abdominal Wall And Cavity Flashcards

0
Q

What does a median incision go through?

A

Linea alba

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1
Q

In a paramedial incision, which way would you displace the muscle and why?

A

Laterally, towards its nerve supply

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2
Q

Which incision would you use to access the gallbladder?

A

Subcostal

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3
Q

What would you use a pfannenstiel incision for?

A

C section

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4
Q

What happens to the rectus sheath at the arcuate line?

A

Above line, rectus abdominis covered anterior and posterior by aponeuroses of flat muscles of abdo wall
Below line, all 3 aponeuroses are anterior to muscle and so only fascia behind. This leaves region vulnerable to herniation

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5
Q

Which vessels are contained in rectus sheath?

A

Superior and inferior epigastric artery and veins

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6
Q

What are the 5 layers of the anterior abdominal wall?

A 
Skin
Superficial fascia
Muscles and aponeuroses
Transversalis fascia
Parietal peritoneum
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7
Q

Where does the inguinal ligament run?

A

From ASIS to pubic tubercle

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8
Q

Which muscle runs from rib 5-12 to anterior iliac crest, linea alba and pubic tubercle?

A

External oblique

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9
Q

What is an aponeurosis?

A

Broad flat sheet of tendon

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10
Q

What is the linea alba?

A

Midline fibrous aponeuroses

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11
Q

Why can you safely inject a needle or cannula into linea alba?

A

Avascular

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12
Q

Where does lymph of the anterior abdominal wall drain to?

A

Above umbilicus - axillary nodes

Below umbilicus - inguinal nodes

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13
Q

What is a hernia?

A

Protrusion of tissue or organ through its retaining tissue

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14
Q

Name 3 sites for an anterior abdominal wall hernia

A

Umbilical
Inguinal
Femoral

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15
Q

What is hesselbachs triangle?

A

Area of bulging of direct hernia. Medial to inferior epigastric artery. Bordered by rectus abdominis and inguinal ligament

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16
Q

Which type of anterior abdo wall hernia are women and men most likely to get?

A

Men - indirect inguinal

Women - femoral

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17
Q

What are the differences in contents of inguinal canal in males and females?

A

Males - spermatic cord and contents

Females - round ligament of uterus and lymphatics from uterus

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18
Q

What are the boundaries of the abdomen?

A

Diaphragm to pelvic girdle

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19
Q

What vertebral level is the Subcostal plane on?

A

L3

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20
Q

What vertebral level is the supracristal plane on?

A

L4

21
Q

What vertebral level is the transtubercular plane on?

A

L5

22
Q

What planes divide the abdomen into the 9 regions?

A

Mid clavicular lines
Subcostal plane
Transtubercular plane

23
Q

What does the external oblique aponeurosis lower free border form?

A

Inguinal ligament

24
Q

Where does the internal oblique run from and to?

A

From iliac crest and inguinal ligament

To linea alba, pubic bone and ribs 9-12

25
Q

What do the lower aponeurosis of the internal oblique form?

A

Part of the conjoint tendon

26
Q

Which arteries are united by the epigastric arteries?

A

Subclavian artery and external iliac artery

27
Q

What can the vascular supply of the abdominal wall provide a bypass for?

A

Descending aorta

28
Q

What nerve is at risk from a gridiron incision?

A

Ilioinguinal

29
Q

What serves as a reference point to differentiate between an inguinal and a femoral hernia?

A

Pubic tubercle
Above and medial - inguinal
Below and lateral - femoral

30
Q

What are the borders of the lumbar (petit) triangle?

A

External oblique
Latissimus dorsi
Iliac crest

31
Q

What is the deep inguinal ring?

A

Invagination of transversalis fascia

Lies between the midpoint of inguinal ligament and the midinguinal point (1cm above the inguinal ligament)

32
Q

What is the superficial inguinal ring?

A

Lies supero-lateral to the pubic tubercle

Point of emergence of spermatic cord (male) or round ligament and coverings (female)

33
Q

What forms the tunica vaginalis?

A

Testicle is retroperitoneal and descends through the anterior abdominal wall and pulls a fold of peritoneum with it that forms the tunica vaginalis

34
Q

What forms the posterior wall of the inguinal canal?

A

Transversalis fascia

35
Q

What level does the coeliac trunk, SMA and IMA branch from the aorta?

A

T12
L1
L3

36
Q

What pain modalities are viscera not sensitive to?

A

Cutting or thermal stimuli

37
Q

What are the 2 compartments of the greater sac?

A

Supracolic and infracolic

38
Q

Why does the lesser sac become sectioned off?

A

Pancreas, liver, duodenum and gallbladder become secondarily retroperitoneal

39
Q

How does the stomach rotate to reach its adult position?

A

Rotates to right about longitudinal axis & clockwise about sagittal axis

40
Q

What does the ventral mesentery become?

A

Lesser omentum

41
Q

What does the dorsal mesentery become?

A

Greater omentum

42
Q

Describe the surface anatomy of the liver

A

Right costal margin
Follows upper limit of diaphragm
5th rib at mid clavicular line
Associated with costodiaphragmatic recess

43
Q

What holds the liver in place?

A

Peritoneum

44
Q

Which part of the liver is in contact with the diaphragm?

A

Bare area

45
Q

What are the 4 lobes of the liver?

A

Left
Right
Caudate
Quadrate

46
Q

What is the porta hepatis?

A

Entry and exit point for portal vein, bile duct, hepatic artery and autonomics from liver

47
Q

What structures form a H shape on the posterior of the liver?

A 
Ligamentum venosum
Ligamentum teres
Porta hepatis
IVC
Gallbladder
48
Q

Which peritoneal recesses can accumulate fluid / be a focus for abscess formation?

A

Sub-phrenic space

Hepato-renal space - Morison’s pouch

49
Q

What are the functions of the peritoneum?

A

Facilitate movement between abdominal organs and between organs and the abdominal wall
Produce peritoneal fluid which contains leukocytes and antibodies

50
Q

What is the difference between intraperitoneal and retroperitoneal organs?

A

Intraperitoneal organs are almost completely covered by peritoneum and suspended by a mesentery whereas retroperitoneal organs are only partially covered by peritoneum

51
Q

What is the dermatome supply of the following regions – epigastric, umbilicus and suprapubic?

A

Epigastric: T7
Umbilicus: T10
Suprapubic: L1

Block 1 (17 decks)

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