Abdominal wall and Hernias Flashcards
Regarding innervation of the abd wall, the skin, muscles and paritetial peritonium are supplied by which spinal nerves?
The skin, muscles and parietal peritoneum are supplied by T7 to T12 and L1 spinal nerves
Remember the visceral peritoneum does not have somatic sensory innervation, which is why pain localisation is more difficult
what is the source of these innervation from the spinal nerves?
The “source” is the anterior rami of these spinal nerves. The anterior rami pass around the body, giving off lateral cutaneous branches which end as anterior cutaneous branches
SEE diagram
what is the ext obliq innervted by?
anertior rami of lower six spinal nerves (T7 - T12) NOT L1
what is the intercostal nerve?
Intercostal nerves, each containing 1300 motor axons, are the anterior rami of the first eleven thoracic spinal nerves. They provide segmental cutaneous sensation and are the motor innervation of the intercostal, subcostal, serratus posterior superior and inferior, transversus thoracis, external and internal abdominal oblique, transversus abdominis, and rectus abdominis muscles.
what is the inter obli supplied by?
Anterior rami of lower size thoracic spinal nerves (T7 to T12) and L1
what is the transversus abd muscle supplied by?
Anterior rami of lower six thoracic spinal nerves (T7 to T12) and L1
what is the rectus abd supplied by?
Anterior rami of lower six thoracic spinal nerves (T7 to T12)
(NOT L1)
what is the pyramidalis supplied by?
anterior ramus of the T12
what is the arterial supple ad venous rainage of the abd wall?
Superior epigastric artery
Inferior epigastric artery –> which are originated from the internal thoracic artery.
these arteries enter the rectus shaeath and anastomses.
The lateral wall is supplied by the
- tenth and eleventh intercostal arteries
- Subcostal artery
- Deep circumflex iliac artery
VEINS HAVE SIMILAR NAMES AND FOLLOW THE ARTERIE
what is the function of the abdoment wall during inspiration and exp?
The abdominal wall relaxes during inspiration to accommodate the expansion of the thoracic cavity. The diaphragm contracts which pushes the abdominal viscera downwards.
During expiration the abdominal wall contracts to assist in elevating the diaphragm and reduce thoracic volume.
what other function of the abdomen?
The contracting abdomen can also increase intra-abdominal pressure
This is partly achieved by the closure of epiglottis in the larynx in the neck
Stops air from exiting the lungs
Net effect is dramatically increased intraabdominal pressure which assists in defecation, voiding of the bladder and in giving birth.
describe the basic structure of the inguinal canal
Cylindrical passage
Extends downwards and medially (oblique passageway)
Just above and parallel to the inguinal ligament
Begins at the deep inguinal ring
Continues for roughly 4cm
Ends at the superficial inguinal ring
what are the contents of the inguinl canal?
Contents of the inguinal canal include:
The ilio-inguinal nerve (does not run in spermatic cord!)
Spermatic cord in men - The testis and spermatic cord descend from the abdomen into the scrotum via the developing inguinal canal
Round ligament of the uterus in women - In females the round ligament descends through the developing inguinal canal
what is known as the mid-inguinal point and the midpoint of the inguinal ligamenet?
Mid-inguinal point–halfway between the pubic symphysis and the anterior superior iliac spine. The femoral pulse can be palpated here.
Midpoint of the inguinal ligament– halfway between the pubic tubercle and the anterior superior iliac spine (the two attachments of the inguinal ligament). The deep inguinal ring is located just above this point.
where is the deep inguinal ring?
deep ing ring is a hole in the transveraslis fasci and is 1.5cm above the midpoint // ASIS and pubic sym (Midpoint of the inguinal lig)
At the deep inguinal ring, part of the transversalis fascia can form part of the spermatic cord/round ligament of the uterus
