Abdominal Wall/Inguinal Flashcards

1
Q

What are the superior/inferior bordered of the abdominal diaphragm?

A

Superior: Thoracic diaphragm

Infineon: Pelvic Rim (Linea Terminalis)

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2
Q

How far superiorly does the abdomen lie?

A

5th intercostal space

  • in supine position
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3
Q

What are the contents of the abdomen?

A
  • Peritoneal cavity
  • GI organs: Inferior esophagus, Stomach, duodenum, intestines, appendix…
  • Liver and Biliary system
  • Pancreas
  • Suprarenal glands
  • Kidneys and superior parts of ureter
  • Vessels
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4
Q

What are the layers around the abdomen from superficial to deep?

A

Skin —> Fatty superficial fascia (Camper’s) —> Membranous superficial fascia (Scarpa’s) —> Deep fascia —> External obliques —> Internal obliques —> Transverse abdominal muscle —> Endoabdominal fascia

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5
Q

What are the limits of the anterior abdominal wall?

A

Superiorly: Right/left Costal margins

Inferiorly: A Line connecting each ASIS to pubis

Laterally: Vertical line through ASIS

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6
Q

What is the Linea Semilunaris?

A
  • Curved Line/groove
  • EXTENDS FROM 9th CC TO PUBIS AND IS LOCATED 5-8 CM f/ MEDIAN PLANE
  • Represents Lateral border of rectus abdomin
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7
Q

Where is the Pubic crest and Tubercle located? What attaches on it?

A

Bony landmark 2.5 cm laterally of pubic symphysis

Inguinal ligament

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8
Q

Where can the Iliac crest be palpated?

A

6 cm posterior or ASIS

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9
Q

Where is the subcostal plane?

A

Joins the inferior margin of 10th costal cartilages through L2/L3

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10
Q

Where is the transtubercular plane?

A

Through the Iliac Tubercles passing through L5

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11
Q

Where is the Transpyloric Plane?

A
  • Midway between Xiphisternal joint and umbilicus

- INFERIOR BORDER OF L1

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12
Q

Where is the Transumbilical Plane?

A

Though umbilicus and at Levels L3-L4

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13
Q

Which Vertebra are associated with which abdominal plane?

A

SCP: L2-3

TTP: L5

TPP: L1

TUP: L3-4

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14
Q

What are the different Abdominal regions?

A
  • Right/Left Upper Quadrant (RUQ/LUQ)
  • Epigastric (EQ)
  • RIGHT/Left Lumbar (RLQ/LLQ)
  • Hypogastric (HQ)
  • Right/left Ingunal Quadrant (RIQ/LIQ)
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15
Q

What are contents of RUQ?

A
  • Liver: Right lobe
  • Gallbladder
  • Pyloris of Stomach
  • Duodenum 1-3
  • Head of Pancreas
  • Right suprarenal gland/Kidney
  • Right Kidney
  • Right Colic flexure
  • superior Ascending/Right Transverse Colon
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16
Q

What are contents of LUQ?

A
  • Liver: Left Lobe
  • Spleen
  • Stomach
  • Jejunum and Proximal Ileum
  • Pancreas: Body and Tail
  • Left Kidney/Suprarenal gland
  • LEft Colic flexure Colon
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17
Q

What are contents of Right Lower Quadrant?

A
  • Cecum
  • Vermiform Appendix
  • Inferior Ascending Colon
  • Right ovary/Uterine Tube or Spermatic cord
  • Right Ureter
  • Full bladder
  • Enlarged Uterus
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18
Q

What are contents of LLQ?

A
  • Sigmoid Colon
  • Inferior Descending Colon
  • Left ovary/UterineTube or Left spermatic cord
  • Left Ureter
  • Full Bladder
  • Enlarged Uterus
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19
Q

Scarpa’s Fascia is continuous inferiorly with the ________ and the _____.

A

Fascia Lata of the Thigh

Colle’s Fascia of perineum

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20
Q

The Aponeurosis of the External Obliques fold back on itself and form the _________.

A

Inguinal ligament (Poupart’s Ligament)

21
Q

What forms from the medial part of the inguinal ligament?

A

Medial Inguinal Ligament reflects back horizontally forming the Lacunar ligament (Gumbernats) and then continues as the Pectineal ligament (Coopers).

22
Q

What is formed just superiorly to the medial part of the inguinal ligament?

A
  • Triangular opening —> Superficial (External) Inguinal Ring
23
Q

Where doe the Cruces of the superficial inguinal ring insert?

A

Lateral Crus —> Pubic Tubercle

Medial Crus —> Pubic Symphysis

24
Q

What are the contents of the superficial inguinal ring?

A
  • Spermatic Cord
  • Round ligament in females
  • Ilioinguinal nerve (L1)
25
What does the Ilioinguinal nerve supply?
Skin over superomedial thigh, skin of lower inguinal region, Mons pubis, anterior scrotum or labia majorum
26
What are the structures of the EOM Aponeurosis?
- Inguinal Ligament (Poupart) - Lacunar (Gubernat) - Pectineal (Cooper) - Superficial Inguinal Ring - External Spermatic Fascia
27
How does the spermatic cord run in males?
- Passes through Internal obliques fibers from which the cremasteric muscle is formed
28
Which structure runs through the cremasteric muscle fibers?
Spermmatic cord
29
Which structure is partly formed by the IOM?
Inguinal Canal
30
What is the Conjoint Tendon (Falx Inguinalis)?
Insertion of IOM/trans versus abdominis into pubic symphysis
31
How does the wall of the abdomen change above/below the arcuate line?
Above arcuate line (Upper 2/3): - EO, IO, and TA surround RA - Bundles are surrounded by Anterior and posterior rectus sheath Below Arcuate Line (Lower 1/3): - All lie superficial to RA - NO Posterior Rectus Sheath
32
What structure is derived from the Fascia Transversalis?
Internal Spermatic Fascia of the spermatic cord
33
What do the Iliohypogastric nerve and Ilioinguinal nerve supply?
IlioHypogastric (L1): Skin over upper inguinal region and iliac crest Ilioinguinal (L1): Skin over medial thigh and lower inguinal regions, mons pubis, Anterior croute or labia majorum
34
Where does the superior epigastric artery enter the rectus sheath?
Inferior to 7th costal cartilage
35
What are the umbilical folds?
MEdian: Urachus Medial: Obliterated umbilical artery Lateral: Patent Inferior epigastric artery
36
What is the Large Median Fold? What is its free edge, and what is it the remnant of
Falciform ligament; Ligamentum teres; Umbilical vein
37
What is Hesselbachs triangle?
Medial Inguinal Fossa
38
What forms the floor for he inguinal canal?
Inguinal ligament
39
Where is the Deep inguinal ring?
Slit like opening in the fascia transversalis
40
Where is the Superficial inguinal Ring?
Triangular opening in EOM aponeurosis
41
How do Indirect Inguinal hernias leave the abdominal cavity?
Leave Laterally to inferior epigastric vessels, transverse the deep inguinal ring, canal, and superficial inguinal ring
42
How do Direct inguinal hernias run?
- Protrude anteriorly though posterior wall of inguinal canal and leave abdominal cavity MEDIAL to Inferior epigastric vessels - PAss through Hesselbachs triangle
43
Where is Hesselbachs triangle located, and what bounds it?
- Located posterior to superficial inguinal ring. - Bounded: Inferior: Inguinal ligament Lateral: Inferior epigastric vessels Medial: LAteral border of RA
44
Differentiate Indirect and Direct Hernias and how they run with the spermatic cord.
Indirect: Enter deep inguinal ring and run within spermatic cord Direct: Enter inguinal canal and run parallel to spermatic cord
45
What are the contents of the Spermatic cord?
- Vas Deferens | - Testicular artery and vein (Pampiniform plexus)
46
Differentiate right/left testicular drainage.
Right Teste: Single vein which drains directly to IVS at L1 Left Teste: Single veins which drain to left renal vein at L1
47
Which nerve runs within the inguinal canal but NOT the spermatic cord?
Ilioinguinal nerve
48
Where does the cremaster muscle terminate?
The Testes
49
Differentiate Afferent and Efferent arms of the Cremasteric reflex.
Afferent:Ilioinguinal nerve (L1) which supplies skin on anteromedial skin of thigh Efferent: Gential branch of genitofemoral Nerve (L1-L2) —> Cremaster muscle