Abdominal Wall and Inguinal Regions Flashcards
What causes accumulation of fluid deep to scarpa’s membrane?
extravasation of urine (especially in males)urine will flow down into the scrotum
The upper extent of the dome of the diaphragm is where?
The 4th intercostal spaceThat means that all of the liver, spleen, and pancreas are deep to and, hence, protected by ribs as is nearly all of the stomach.
Rectus Abdominus origin
pubic crest
Rectus Abdominus insertion
xiphoid process and costal margin
External abdominal oblique origin
lower 8 ribs
External abdominal oblique insertion
rectus sheath (linea alba)
Internal abdominal oblique origin
lateral 2/3 of inguinal ligament, iliac crest and thoracolumbar fascia
Internal abdominal oblique insertion
rectus sheath (linea alba)
Transverse abdominis origin
lower ribs, lateral 1/3 of inguinal ligament, iliac crest, and thoracolumbar fascia
Transverse abdominis insertion
rectus sheath (linea alba)
Innervation of all abdominal muscles
lower 6 intercostal, subcostal, iliohypogastric, and ilioinguinal NN.
does the rectus abdominus run deep or superficial to the rectus sheath?
deep
how do the fibers of the internal abdominal oblique run in relation to the fibers of the external abdominal oblique
perpendicular (external= hands in pockets)
Where is the semilunar line?
in the vertical junction between the abdominal muscles and the rectus sheathaka the lateral margin of the rectus abdominis muscle
The lines that horizontally separate the rectus abdominis are called what?
tendinous intersections (aka the fibers of rectus abdominis are not continuous)
Where does the superior epigastric artery run?
just anterior to the posterior wall of the rectus sheath.
What forms the superior epigastric artery?
junction of two branches of internal thoracic
What forms the inferior epigastric artery?
from branch of external iliac artery
The junction of the superior and inferior epigastric arteries (thus connecting the internal thoracic arteries to the external iliac artery) provides what advantage?
collateral circulation in the case of occlusion (or stenoses) of the aorta
Which process is active: inspiration or exspiration?
inspiration. Abdominal muscles contract to force the diaphragm to move inferiorly to expand the chest cavity
Below the arcuate line, what are the structures posterior to the rectus abdominis?
just the transversals fascia (investing fascia of the abdomen), some fat, and the perineum
The transpyloric plane lies at the level of the disk between which vertebrae?
L1-L2
The transumbilical plane lies at the level of the disk between which vertebrae?
L3-L4
What is the inguinal ligament?
It is the developed inferior margin of the external abdominal oblique muscles and runs from the ASIS to the pubic tubercle(?)
What goes through the inguinal canal?
males- spermatic cordfemales- 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.
What forms the sides of the superficial ring?
branching of the external abdominal oblique into the lateral and medial crura
Where does the lateral crura go?
inferiorly to form part of the inguinal ligament
Where does the medial crura go?
to the linea abla
What forms the roof of the superficial ring?
intercrural fibers (the spermatic cord emerges from the superficial ring inferiorly)
Why do women have a much lower frequency of inguinal hernias than males?
the inguinal canals are much smaller and stronger due to the testis passing in men
Is an indirect hernia medial or lateral to the inferior epigastric artery?
lateral (a direct hernia is medial to it)
Notes on nerve course around the side of the body to the abdominal muscles
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
What is the deep inguinal ring?
the reflection of the transversalis fascia onto the spermatic cord/round ligament
What structures contribute to the posterior wall of the inguinal canal?
the conjoint tendon (also called the falx inquinalis), the transversalis fascia, and the inferior epigastric vessels
Where is the weak area of the inguinal canal?
aka Hesselbach’s triangleMEDIAL to the inferior epigastric vesselsthis is where direct hernias occur because the posterior wall is just transversalis fascia
Do direct hernias occur medial or lateral to the inferior epigastric vessels?
medial
What is the tunica albuginea?
thick CT layer on the testis
What becomes the testicular vein?
pampininform veins that surround the vas deferens
What is the tunica vaginalis?
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.
What innervates the cremaster muscles?
the genitofemoral nerve