Abdominal wall chp 30 Flashcards
Abdomen
portion of trunk btw thorax and pelvis
abdominal cavity - outer wall / inner wall
anterolateral and posterior abd wall
Transpyloric plane
horizontal plane halfway btw jugular notch of sternum and pubic symphysis - level of LV1
Transtubercular plane
horizontal plane thru tubercles of iliac crests - level of LV5
Right and left Mid-clavicular (lateral) planes
midpoint of clavicle
9 regions formed:
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
Quadrants
Uses umbilicus for horizontal/vertical planes:
4 regions: upper right/left and lower right/left
What is the anterolateral abd wall composed of:
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
External oblique
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
Internal oblique
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)
Transversus abdominis
O: iliac crest, fascia of back, lower 6 cc
I: Rectus sheath via apn
N: same
Fiber direction is transverse
Rectus abdominis
O: Xiphoid process, cc 5-7
I: Pubic crest and symphysis
N: same
Fiber direction is vertical
Rectus sheath
Fibrous structure formed by apn of External and Internal oblique and transverse abdominis
3 lines formed by rectus sheath:
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
Chief arteries of abd wall:
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
Explain the formation of the 2 longitudinal channels
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
Nerves of anterolateral abd wall
Muscles all segmentally innervated by thoracoabdominal nerves and subcostal nerve
Give off ant and lateral cutaneous branches to skin of abd
Posterior abd wall muscles:
Quadratus lumborum
Psoas major
abd aorta lies retroperitoneally on post abd wall
