abdominal wall, inguinal region

Question 1

the importance of abdominal wall

Answer 1

• protection and stabilization of abdominal contents
  -surgical access to abdominal contents
• trunk rotation and flexion (anterior and lateral)
• maintain and control intra abdominal pressure for parturition and defecation
• respiration: opposes diaphragm

Question 2

muscles that makes up the posterior abdominal wall

Answer 2

quadrates lumborum muscle
psoas major muscle
iliacus muscle

Question 3

boundaries of the anterolateral abdominal wall

Answer 3

from: costal cartilage or ribs 7-10 and xyphoid process
to: inguinal ligament, anterior superior iliac spine, and pubic tubercle

Question 4

abdominal wall divisions

Answer 4

• 4 quadrants and 9 regions
• internal anatomy of the quadrants is important to know for physical examinations
• RUQ - LUQ - RLQ - LLQ

Question 5

foregut pain

Answer 5

epigastric

Question 6

midgut pain

Answer 6

umbilical

Question 7

hindgut pain

Answer 7

hypogastric

Question 8

layers of anterior abdominal wall

Answer 8

• skin
• subcutaneous fascia layers
• three overlapping muscular sheets with aponeurotic tendinous fascia
  -transversalis fascia
• peritoneum

Question 9

1st layer of the anterior abdominal wall

Answer 9

skin

Question 10

2nd layer of the abdominal wall (2 of them)

Answer 10

campers fascia (fatty)
scrapas fascia (membraneous)

Question 11

third layer of abdominal wall

Answer 11

external oblique muscle

Question 12

4th layer of abdominal wall

Answer 12

internal oblique muscle

Question 13

5th layer of abdominal wall

Answer 13

transverse abdominal muscle

Question 14

the layer below the transverse abdominal muscle is

Answer 14

transversalis fascia

Question 15

layer below transversalis fascia

Answer 15

endoabdominal (extraperiotneal) fat

Question 16

layer below endoabdominal fat

Answer 16

parietal peritoneum

Question 17

campers fascia

Answer 17

adipose (fatty) layer coursing with cutaneous nerves and blood vessels

Question 18

scrapas fascia

Answer 18

membranous fascial layer deep to the camper’s fascia (inferior to umbilicus)
- fuses with fascia lata of the thigh

Question 19

clinical importance of “potential space”

Answer 19

• between: membranous scarpa’s fascia and aponeurosis of eternal oblique
• fluid can accumulate in the potential space (a ruptured urethra)
• no barriers to prevent superior spreading of the fluid
• deep fascia of the thigh prevents inferior spreading

Question 20

muscles of the abdominal wall

Answer 20

rectus abdominis
external oblique
internal oblique
transversus abdominis

Question 21

actions of the abdominal muscles

Answer 21

flex the trunk
rotate the trunk
compress the abdominal viscera

Question 22

the primary muscle that compresses abdominal viscera and the deepest

Answer 22

transversus abdominis

Question 23

external oblique origin and insertion

Answer 23

O: external surfaces of ribs 5-12
I: linea alba, pubic tubercle and anterior half of iliac crest
(CONTRIBUTES TO THE INGUINAL LIGAMENT)

Question 24

internal oblique origin and insertion

Answer 24

O: thoracolumbar fascia, anterior two thirds of iliac crest, and lateral half o inguinal ligament
I: inferior borders of ribs 10-12, lines alba

Question 25

rectus abdominis origin and insertion

Answer 25

O: pubic symphysis (medial) and pubic crest (lateral) I: typhoid process and costal cartilage form ribs 5-7

Question 26

transversus abdominis origin and insertion

Answer 26

O: internal surfaces of costal cartilage of ribs 7-12, thoracolumbar fascia, iliac crest, and iliopsoas fascia I: Linea alba with aponeurosis of internal oblique and pubic crest

Question 27

contribution of abdominal muscles to the rectus sheath

Answer 27

Above arcuate line EO IO TA TF Below arcuate line EO IO TA

Question 28

arterial supply of the abdominal wall

Answer 28

internal thoracic artery aorta external iliac artery

Question 29

what supplies the superior and epigastric arteries and musculophrenic arteries

Answer 29

internal thoracic artery

Question 30

what supplies the lower posterior intercostals/subcostal and lumbar arteries

Answer 30

aorta

Question 31

what supplies the inferior epigastric arteries

Answer 31

external iliac artery

Question 32

innervation of the abdominal wall

Answer 32

intercostal nerves: lateral cutaneous branch anterior cutaneous branch thorax-abdominal nerves subcostal nerve iliohypogastric nerve ilioinguinal nerve genitofemoral nerve

Question 33

intercostal nerve of abdominal wall is

Answer 33

ventral rami wrapping around body wall between the inner most and internal intercostals (neuromuscular plane)

Question 34

anterior cutaneous nerve entrapment

Answer 34

cause of chronic abdominal wall pain

Question 35

Carnett's sign

Answer 35

- positive: abdominal wall/somatic pain - negative: abdominal viscera/visceral pain

Question 36

if increase pain during flexed abdomen which are you most likely going to have? negative or positive carnett's sign?

Answer 36

positive carnett's sign

Question 37

thorax-abdominal nerves of abdominal wall

Answer 37

from intercostals - innervation of abdominal muscles and cutaneous innervation of body wall (T7-T11)

Question 38

nerves in neurovascular layer between internal oblique and transversus abdominus

Answer 38

thorax-abdominal nerves subcostal nerve iliohypogastric nerve ilioinguinal nerve

Question 39

lateral and anterior cutaneous branch of subcostal nerve

Answer 39

T12

Question 40

lateral and anterior cutaneous branches of iliohypogastric nerve

Answer 40

L1

Question 41

anterior scrotal branch of ilioinguinal nerve

Answer 41

L1

Question 42

Genital and femoral branches of genitor femoral nerve

Answer 42

L1-L2 (sensory inguinal region)

Question 43

inguinal canal

Answer 43

- deep inguinal ring - entrance - transversals fascia forms innermost layer of coverings - superficial inguinal ring - exit

Question 44

what comes out of the inguinal anal?

Answer 44

spermatic cord with cremaster muscle

Question 45

what covers the inguinal canal?

Answer 45

transversalis fascia

Question 46

what makes up the superficial inguinal ring

Answer 46

lateral crus intercrural fibers medial crus

Question 47

the layers around the inguinal canal

Answer 47

- external abdominal oblique aponeurosis - internal oblique muscle - transversals fascia - parietal peritoneum - inguinal ligament

Question 48

supravescial fossa

Answer 48

between the median and medial umbilical folds (site of supravescial hernias (rare)

Question 49

median inguinal fossa

Answer 49

between the medial and lateral umbilical folds (site of direct inguinal hernias)

Question 50

lateral inguinal fossa

Answer 50

lateral to the lateral umbilical folds (site of indirect inguinal hernias)