Abdominal wall chp 30

Question 1

Abdomen

Answer 1

portion of trunk btw thorax and pelvis
abdominal cavity - outer wall / inner wall
anterolateral and posterior abd wall

Question 2

Transpyloric plane

Answer 2

horizontal plane halfway btw jugular notch of sternum and pubic symphysis - level of LV1

Question 3

Transtubercular plane

Answer 3

horizontal plane thru tubercles of iliac crests - level of LV5

Question 4

Right and left Mid-clavicular (lateral) planes

Answer 4

midpoint of clavicle

Question 5

9 regions formed:

Answer 5

Umbilical,
Epigastric area of epigastric fossa (inf to infrasternal angle
Pubic (hypogastric) area above pubic symphysis
Right/left hypochondriac areas r/t costal cartilages
Right/left lateral (lumbar) area
Right/left inguinal area

Question 6

Quadrants

Answer 6

Uses umbilicus for horizontal/vertical planes:

4 regions: upper right/left and lower right/left

Question 7

What is the anterolateral abd wall composed of:

Answer 7

Skin - avg thickness, have striae gravidarum (red) and linea albicante (thin/white)
sub-q tissue - 2 layers: superficial fatty (Camper’s fascia) and deep membranous (Scarpa’s fascia)
muscles - see below
peritoneum - inner wall lined w parietal

Question 8

External oblique

Answer 8

O: lower 8 ribs (id w serratus ant + lat dorsi)
I: iliac crest, rectus sheath via aponeurosis (forms inguinal ligament)
N: Thoracoabdominal nerves, subcostal nerve
Fibers course medially and inferiorly

Question 9

Internal oblique

Answer 9

O: iliac crest
I: Costal margin (sup), rectus sheath via apn (ant)
pubic crest (inf)
N: same
Fibers course ant and sup in upper half and transversely/inf in lower half (think of fan)

Question 10

Transversus abdominis

Answer 10

O: iliac crest, fascia of back, lower 6 cc
I: Rectus sheath via apn
N: same
Fiber direction is transverse

Question 11

Rectus abdominis

Answer 11

O: Xiphoid process, cc 5-7
I: Pubic crest and symphysis
N: same
Fiber direction is vertical

Question 12

Rectus sheath

Answer 12

Fibrous structure formed by apn of External and Internal oblique and transverse abdominis

Question 13

3 lines formed by rectus sheath:

Answer 13

Linea alba - median furrow from xiphoid process to pubis, tough tendinous raphe of apn
Linea semilunaris - curved line, lateral border, where apn of internal oblique splits forming layers of rectus sheath
Arcuate line - horizontal landmark change in rectus sheath

Question 14

Chief arteries of abd wall:

Answer 14

2 branches of internal thoracic artery or internal mammary artery (sup): superior epigastric and musculophrenic
2 branches of external iliac artery (inf): inf epigastric and deep circumflex iliac

Question 15

Explain the formation of the 2 longitudinal channels

Answer 15

Anstms of Sup and Inf epigastric = anstms of Subclavian via IMA and External iliac arteries

Anstms of Musculophrenic and deep circumflex iliac = anstms of subclavian artery and external iliac artery
Important if aorta occludes

Question 16

Nerves of anterolateral abd wall

Answer 16

Muscles all segmentally innervated by thoracoabdominal nerves and subcostal nerve
Give off ant and lateral cutaneous branches to skin of abd

Question 17

Posterior abd wall muscles:

Answer 17

Quadratus lumborum
Psoas major
abd aorta lies retroperitoneally on post abd wall