Abdominal Wall, Inguinal Region, Peritoneal Cavity- Clinical Correlations Flashcards
fascia and fascial spaces of the abdominal wall
the space between the membranous layer and deep fascia covering the rectus abdominis and external oblique muscles is a potential space for fluid accumulation
When closing surgical incisions, surgeons include the membranous layer when suturing because of its strength
spread of fluid is restricted inferiorly because the membranous layer of subcutaneious tissue fuses with the deep fascia on the thigh along a line inferior and parallel to the inguinal ligament
Abdominal surgical incisions
surgeons usually split muscle fibers instead of transecting them to prevent necrosis
Rectus abdomenis is an exception because its muscle fibers are short and its nerves entering the lateral part of the rectus sheath can be located and preserved
incisional hernia
protrusion of omentum or an organ through a surgical incision or scar
protuberance of the abdomen
six common causes of abdominal protrusion ar the 6F’s
Food, fluid, fat, feces, flatus or fetus
palpation of anterolateral abdominal wall
involuntary spasms of the anterolateral abdominal spasm during palpation make the abdominal wall tense (guarding) to protect the viscera from pressure which is painful in case of an abdominal infection
hydrocele of the testis
presence of EXCESS FLUID in persistent tunica vaginalis
hematocele of the testis
a collection of BLOOD in the cavity of the tunica vaginalis
vasectomy
a ligation and transection or removal of a segment of the DUCTUS DEFERENS on each side to sterilize a man
varicocele
the incompetent valves in the testicular vein may cause dilated and tortuous pampiniform plexus of veins resulting in a palpable enlargement that feels like a bag of worms
testicular cancer
cancer of the testis metastasizes initially to the lumbar lymph nodes
cancer of the scrotum metastasizes initially to superficial inguinal lymph nodes
due to testes relocating from dorsal abdominal wall whereas scrotum develops from an outpouching of the anterolateral abdominal wall during fetal development
cremasteric reflex
stroking the skin on the medial side of the superior part of the thigh that is supplied by ilioinguinal nerve with an applicator stick elevates the testis on that side due to contraction of the cremaster muscle
inguinal hernia
protrusion of the parietal peritoneum and viscera such as the small intestine through a normal or abnormal opening from the abdominal cavity
direct inguinal hernia
weakness of the anterior abdominal wall in inguinal triangle leads to protrusion of peritoneum plus transversalis fascia through the superficial inguinal ring medial to inferior epigastric vessels
herniated part traverses only medial third of the inguinal canal lateral to the cord
indirect inguinal hernia
parent processus vaginalis in a young person leads to protrusion of peritoneum of processus vaginalis plus all three facial coverings of the cord/round ligament through the deep inguinal ring lateral to the INFERIOR epigastric vessels
the herniated part traverses through the entire inguinal canal passing into the scrotum/labium majus
palpation of the superficial inguinal ring
palpable superolateral to the pubic tubercle by invaginating the skin of the upper scrotum with the index finger
detection of an impulse against the examining finger, when the person coughs, and a mass at the deep ring suggests an indirect hernia
cysts and hernias of canal of Nuck
persistent processus vaginalis in females forms a small peritoneal pouch in the inguinal canal called the canal of Nuck that may extend to the labium majus
in female infants, such remnants can enlarge and form cysts that may lead to an INDIRECT inguinal hernia
peritonitis
infection and inflammation of peritoneum due to bacterial contamination
causes severe abdominal pain, tenderness, guarding, nausea and or vomiting, fever, and constipation
ascites
excess fluid in the peritoneal cavity
occurs as a result of mechanical injury or pathological conditions such as portal hypertension and cancer cell metastasis
peritoneal adhesions
may be seen when peritoneum is damaged or as a complication of abdominal surgeries
inflamed peritoneal surfaces are sticky with fibrin that becomes fibrosed resulting in abnormal attachments between the visceral peritoneum of adjacent viscera or between the visceral peritoneum of a viscus and the parietal peritoneum of the adjacent abdominal wall resulting in adhesions
adhesiotomy
surgical separation of the adhesions
abdominal paracentesis
surgical puncture of the peritoneal cavity with a needle inserted through the anterolateral abdominal wall to aspirate the ascitic fluid in case of generalized peritonitis
functions of greater omentum
the structure is large and fat-laden
prevents the visceral peritoneum from adhering to the parietal peritoneum and is very mobile with the peristaltic movements of the viscera
