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Gross > abdominal wall and Inguinal region > Flashcards

abdominal wall and Inguinal region Flashcards

0
Q

nine regions of abdominal cavity

A 
right hypochondriac, epigastric, left hypochondriac
right lateral (lumbar), umbilical, left lateral (lumbar)
right inguinal (groin), pubic (hypogastric), left inguinal
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1
Q

abdominal cavity is

A

enclosed anterolaterally by dynamic musculo-aponeurotic abdominal walls
separated superiorly from thoracic cavity and posteriorly from the posterior thoracic vertebrae by the diaphragm
under cover of the thoracic cage superiorly extending to the 4th intercostal space
continuous with pelvic cavity

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2
Q

planes that divide to 9 regions

A

horizontal: subcostal plane (through inferior border of 10th cosal cartilage on each side) and transtubercular plane (passing through the iliac tubercles and the body of L5)
vertical: 2 midclavicular planes: passing from midpoint of clavicles to midinguinal points

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3
Q

midinguinal point

A

midpoint of lines joining anterior superior iliac spines and superior edge of pubic symphysis

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4
Q

planes that define 4 quadrants

A

transumbilical: through umbilicus and L3/L4 IV disc

median plane: longitudinally through body

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5
Q

median umbilical fold

A

extending from apex of urinary bladder to umbilicus

covers median umbilical ligament

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6
Q

median umbilical ligament

A

remnant of urachus that joined apex of fetal bladder to umbilicus

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7
Q

two medial umbilical folds

A

lateral to median umblical fold

cover medial umbilical ligaments

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8
Q

medial umbilical ligaments

A

formed by occluded parts of umbilical arteries

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9
Q

two lateral umbilical folds

A

lateral to medial umbilical folds

cover inferior epigastric vessels

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10
Q

peritoneal fossae

A

depressions lateral to umbilical folds

location of hernias, determines classification

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11
Q

supravesical fossa

A

between median and medial umbilical folds
formed as peritoneum reflects from anterior abdominal wall onto the bladder
level rises and falls with filling and emptying of bladder

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12
Q

medial inguinal fossae

A

between the medial and lateral umbilical folds, areas also commonly called inguinal triangles (Hesselbach triangles)
potential sites for direct inguinal hernias

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13
Q

lateral inguinal fossae

A

lateral to lateral umbilical folds

include deep inguinal rings and are potential sites for most common type of inguinal hernia: indirect inguinal hernia

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14
Q

incisional hernia

A

protrusion of omentum (fold of peritoneum) or an organ through a surgical incision or scar

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15
Q

causes of protuberance of abdomen

A

food, fluid, fat, feces, flatus and fetus

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16
Q

musculophrenic artery

A

originates off internal thoracic artery
descends along costal margin
distributed along abdominal wall of hypochondriac region, anterolateral, diaphragm

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17
Q

superior epigastric artery

A

originates off of internal thoracic artery
descends in rectus sheath deep to rectus abdominis
distributed along superior rectus abdominis and superior part of anterolateral abdominal wall

18
Q

inferior epigastric artery

A

originates off external iliac artery
runs superiorly and enters rectus sheath
runs deep to rectus abdominis
distributed along inferior rectus abdominis and medial part of anterolateral abdominal wall

19
Q

drainage of abdominal lymphatic vessels

A

superior to umbilicus: drain to axillary lymph nodes

inferior: drain to superficial inguinal lymph nodes

20
Q

inguinal region

A

extends between anterior superior iliac spine and pubic tubercle

21
Q

inguinal hernia commonality

A

86% in males because of passage of spermatic cord through inguinal canal

22
Q

inguinal ligament

A

most inferior part of external oblique aponeurosis

23
Q

iliopubic tract

A

thickened inferior margin of transversalis fascia
runs parallel and deep (posterior) to inguinal ligament
reinforces posteror wall and floor of inguinal canal as it bridges structures (Hip flexors and neurovascular supply of LL) traversing the retro-inguinal space

24
Q

lacunar ligament

A

fibers from inguinal ligament that attach to superior ramus of pubis, lateral to pubic tubercle
fibers continue to run along pectin pubis as pectineal ligament of Cooper

25
Q

reflected inguinal ligament

A

fibers of inguinal ligament arch superiorly to blend with contralateral external oblique aponeurosis

26
Q

inguinal canal

A

formed in relation to relocation of gonad during fetal development
about 4 cm long in adults
inferomedially directed oblique passage between superficial and deep inguinal rings
lies parallel and just superior to medial half of inguinal ligament

27
Q

main structures of inguinal canal

A

spermatic cord: conveying ductus deferens in males and vestigial round ligament of uterus in females
also contains blood and lymphatic vessels and ilio-inguinal nerve

28
Q

openings of inguinal canal

A

deep (internal) ring: internal entrance to canal, evagination of transversalis fascia superior to middle of inguinal ligament and lateral to inferior epigastric vessels
superficial (extenal) inguinal ring: exit: slit like opening in aponeurosis of external oblique, superolateral to pubic tubercle. lateral and medial crura are lateral and medial margins. intercrural fibers form superolateral margin of ring

29
Q

boundaries of inguinal canal

A

anterior wall: external oblique aponeurosis. lateral part reinforced by internal oblique
posterior wall: transversalis fascia: medial part reinforced by merging of pubic attachments of internal oblique and transversus abdominis aponeuroses into common tendon: inguinal falx (conjoint tendon)
roof: laterally by transversalis fascia, centrally by musculo-aponeurotic arches of internal oblique and transversus abdominis muscles and medially by medial crus and intercrural fibers
floor: laterally by iliopubic tract, centrally by superior surface of inguinal ligament and medially by lacunar ligament

30
Q

fascial coverings of spermatic cord

A

internal spermatic fascia: derived from transversalis fascia at deep inguinal ring
cremasteric fascia: derived from fascia of both superficial and deep surfaces of internal oblique muscle
external spermatic fascia: derived from external oblique aponeurosis and its investing fascia

31
Q

passof spermatic cord

A

begins at deep inguinal ring lateral to inferior epigastric vessels, passes through the nguinal canal, exits at the superficial inguinal ring and ends in the scrotum at the tests

32
Q

cremaster muscle

A

loops in cremasteric fascia
extends as a continuation of internal oblique muscle
contraction draws testis superiorly in scrotum,when it is cold

33
Q

dartos muscle

A

smooth muscle of fat free subcutaneous tissue of scrotum (dartos fascia) which inserts into the skin
darts assists in testicular elevation as it produces contraction of skin of scrotum

34
Q

innervation of cremaster

A

genitalbranch of genitofemoral nerve L1, L2

derivative of lumbar plexus

35
Q

innervation of dartos

A

autonoic

36
Q

constituents of spermatic cord

A

ductus deferens, testicular artery, artery of ductus deferens, cremasteric artery, pampiniform venous plexus, sympathetic nerve fibers, genital branch of genitofemoral nerve, lymphatic vessels, vestige f processus vaginalis

37
Q

ductus deferens

A

aka vas deferens
muscular tube that conveys sperms from epididymis to ejaculatory duct
courses through substance of prostate to open into prostatic part of urethra

38
Q

testicular artery

A

arises from aorta (vertebral level L2) and supplies testis and epididymis

39
Q

artery of ductus deferens

A

arises from inferior vesical artery

40
Q

cremasteric artery

A

arises from inferior epigastric artery

41
Q

pampiniform venous plexus

A

network formed by up to 12 veins that converge superiorly as the right or left testicular veins

42
Q

vestige of processus vaginalis

A

may be seen as a fibrous thread in anterior part of spermatic cord extending between abdominal peritoneum and tunica vaginalis but also may not be detectable

Gross (31 decks)

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