Abdominal Wall and Inguinal Regions

Question 1

What causes accumulation of fluid deep to scarpa’s membrane?

Answer 1

extravasation of urine (especially in males)

urine will flow down into the scrotum

Question 2

The upper extent of the dome of the diaphragm is where?

Answer 2

The 4th intercostal space

That means that all of the liver, spleen, and pancreas are deep to and, hence, protected by ribs as is nearly all of the stomach.

Question 3

Rectus Abdominus origin

Answer 3

pubic crest

Question 4

Rectus Abdominus insertion

Answer 4

xiphoid process and costal margin

Question 5

External abdominal oblique origin

Answer 5

lower 8 ribs

Question 6

External abdominal oblique insertion

Answer 6

rectus sheath (linea alba)

Question 7

Internal abdominal oblique origin

Answer 7

lateral 2/3 of inguinal ligament, iliac crest and thoracolumbar fascia

Question 8

Internal abdominal oblique insertion

Answer 8

rectus sheath (linea alba)

Question 9

Transverse abdominis origin

Answer 9

lower ribs, lateral 1/3 of inguinal ligament, iliac crest, and thoracolumbar fascia

Question 10

Transverse abdominis insertion

Answer 10

rectus sheath (linea alba)

Question 11

Innervation of all abdominal muscles

Answer 11

lower 6 intercostal, subcostal, iliohypogastric, and ilioinguinal NN.

Question 12

does the rectus abdominus run deep or superficial to the rectus sheath?

Answer 12

deep

Question 13

how do the fibers of the internal abdominal oblique run in relation to the fibers of the external abdominal oblique

Answer 13

perpendicular (external= hands in pockets)

Question 14

Where is the semilunar line?

Answer 14

in the vertical junction between the abdominal muscles and the rectus sheath

aka the lateral margin of the rectus abdominis muscle

Question 15

The lines that horizontally separate the rectus abdominis are called what?

Answer 15

tendinous intersections (aka the fibers of rectus abdominis are not continuous)

Question 16

Where does the superior epigastric artery run?

Answer 16

just anterior to the posterior wall of the rectus sheath.

Question 17

What forms the superior epigastric artery?

Answer 17

junction of two branches of internal thoracic

Question 18

What forms the inferior epigastric artery?

Answer 18

from branch of external iliac artery

Question 19

The junction of the superior and inferior epigastric arteries (thus connecting the internal thoracic arteries to the external iliac artery) provides what advantage?

Answer 19

collateral circulation in the case of occlusion (or stenoses) of the aorta

Question 20

Which process is active: inspiration or exspiration?

Answer 20

inspiration. Abdominal muscles contract to force the diaphragm to move inferiorly to expand the chest cavity

Question 21

Below the arcuate line, what are the structures posterior to the rectus abdominis?

Answer 21

just the transversals fascia (investing fascia of the abdomen), some fat, and the perineum

Question 22

The transpyloric plane lies at the level of the disk between which vertebrae?

Answer 22

L1-L2

Question 23

The transumbilical plane lies at the level of the disk between which vertebrae?

Answer 23

L3-L4

Question 24

What is the inguinal ligament?

Answer 24

It is the developed inferior margin of the external abdominal oblique muscles and runs from the ASIS to the pubic tubercle(?)

Question 25

What goes through the inguinal canal?

Answer 25

males- spermatic cord

females- ligamentum teres (round ligament)

These are both structures involved in the descent of the gonads. They originate from within the pelvis and begin deep to the transversalis fascia.

Question 26

What forms the sides of the superficial ring?

Answer 26

branching of the external abdominal oblique into the lateral and medial crura

Question 27

Where does the lateral crura go?

Answer 27

inferiorly to form part of the inguinal ligament

Question 28

Where does the medial crura go?

Answer 28

to the linea abla

Question 29

What forms the roof of the superficial ring?

Answer 29

intercrural fibers (the spermatic cord emerges from the superficial ring inferiorly)

Question 30

Why do women have a much lower frequency of inguinal hernias than males?

Answer 30

the inguinal canals are much smaller and stronger due to the testis passing in men

Question 31

Is an indirect hernia medial or lateral to the inferior epigastric artery?

Answer 31

lateral (a direct hernia is medial to it)

Question 32

Notes on nerve course around the side of the body to the abdominal muscles

Answer 32

Posterior they begin just superficial to the transversus muscles, around the midaxillary line they pierce the internal oblique abdominals and then travel to the ventral side of the body in between internal and external abdominal oblique muscles

Question 33

What is the deep inguinal ring?

Answer 33

the reflection of the transversalis fascia onto the spermatic cord/round ligament

Question 34

What structures contribute to the posterior wall of the inguinal canal?

Answer 34

the conjoint tendon (also called the falx inquinalis), the transversalis fascia, and the inferior epigastric vessels

Question 35

Where is the weak area of the inguinal canal?

Answer 35

aka Hesselbach’s triangle

MEDIAL to the inferior epigastric vessels

this is where direct hernias occur because the posterior wall is just transversalis fascia

Question 36

Do direct hernias occur medial or lateral to the inferior epigastric vessels?

Answer 36

medial

Question 37

What is the tunica albuginea?

Answer 37

thick CT layer on the testis

Question 38

What becomes the testicular vein?

Answer 38

pampininform veins that surround the vas deferens

Question 39

What is the tunica vaginalis?

Answer 39

the serous covering of the testis. It is a pouch of serous membrane, derived from the processus vaginalis of the peritoneum, which in the fetus preceded the descent of the testis from the abdomen into the scrotum.

Question 40

What innervates the cremaster muscles?

Answer 40

the genitofemoral nerve