abdominal wall and Inguinal region

Question 0

nine regions of abdominal cavity

Answer 0

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

Question 1

abdominal cavity is

Answer 1

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

Question 2

planes that divide to 9 regions

Answer 2

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

Question 3

midinguinal point

Answer 3

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

Question 4

planes that define 4 quadrants

Answer 4

transumbilical: through umbilicus and L3/L4 IV disc

median plane: longitudinally through body

Question 5

median umbilical fold

Answer 5

extending from apex of urinary bladder to umbilicus

covers median umbilical ligament

Question 6

median umbilical ligament

Answer 6

remnant of urachus that joined apex of fetal bladder to umbilicus

Question 7

two medial umbilical folds

Answer 7

lateral to median umblical fold

cover medial umbilical ligaments

Question 8

medial umbilical ligaments

Answer 8

formed by occluded parts of umbilical arteries

Question 9

two lateral umbilical folds

Answer 9

lateral to medial umbilical folds

cover inferior epigastric vessels

Question 10

peritoneal fossae

Answer 10

depressions lateral to umbilical folds

location of hernias, determines classification

Question 11

supravesical fossa

Answer 11

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

Question 12

medial inguinal fossae

Answer 12

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

Question 13

lateral inguinal fossae

Answer 13

lateral to lateral umbilical folds

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

Question 14

incisional hernia

Answer 14

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

Question 15

causes of protuberance of abdomen

Answer 15

food, fluid, fat, feces, flatus and fetus

Question 16

musculophrenic artery

Answer 16

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

Question 17

superior epigastric artery

Answer 17

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

Question 18

inferior epigastric artery

Answer 18

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

Question 19

drainage of abdominal lymphatic vessels

Answer 19

superior to umbilicus: drain to axillary lymph nodes

inferior: drain to superficial inguinal lymph nodes

Question 20

inguinal region

Answer 20

extends between anterior superior iliac spine and pubic tubercle

Question 21

inguinal hernia commonality

Answer 21

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

Question 22

inguinal ligament

Answer 22

most inferior part of external oblique aponeurosis

Question 23

iliopubic tract

Answer 23

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

Question 24

lacunar ligament

Answer 24

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

Question 25

reflected inguinal ligament

Answer 25

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

Question 26

inguinal canal

Answer 26

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

Question 27

main structures of inguinal canal

Answer 27

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

Question 28

openings of inguinal canal

Answer 28

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

Question 29

boundaries of inguinal canal

Answer 29

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

Question 30

fascial coverings of spermatic cord

Answer 30

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

Question 31

passof spermatic cord

Answer 31

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

Question 32

cremaster muscle

Answer 32

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

Question 33

dartos muscle

Answer 33

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

Question 34

innervation of cremaster

Answer 34

genitalbranch of genitofemoral nerve L1, L2 | derivative of lumbar plexus

Question 35

innervation of dartos

Answer 35

autonoic

Question 36

constituents of spermatic cord

Answer 36

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

Question 37

ductus deferens

Answer 37

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

Question 38

testicular artery

Answer 38

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

Question 39

artery of ductus deferens

Answer 39

arises from inferior vesical artery

Question 40

cremasteric artery

Answer 40

arises from inferior epigastric artery

Question 41

pampiniform venous plexus

Answer 41

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

Question 42

vestige of processus vaginalis

Answer 42

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