Ach: Anterior Abdominal Wall and Inguinal Region Flashcards
What are the major regions of the anterior abdominal wall?
Upper- hypochondriac
Middle- lateral
Lower- inguinal
Epigastric
umbilical
hypogastric
What are the two layers of the superficial fascia?
- Outer fatty layer (campers)- continuous with the superficial fascia of the thorax
- Deep fibrous or membranous layer (scarpas)
Which layer of superficial fascia is important in closing abdominal incisions?
Outer fatty layer (camper’s fascia)
Which is confined to the lower abdominal wall and attaches to the deep fascia of the thigh just below the inguinal ligament?
Deep, fibrous layer
What is the Dartos layer?
Camper’s + Scarpa’s minus the fat plus smooth muscle
What is Colles fascia?
Fascia in the perineum that attaches to the urogenital diaphragm (part of the deep fibrous layer/Scarpa’s)
What is the linea alba?
Where the aponeurosis that covers the three pairs of flat muscles extends to anterior midline and intersect
What are the muscle layers arranged from superficial to deep of the anterior abdominal wall?
- External oblique
- internal oblique
- Transverus abdominus
What do the EO and IO do?
Compress viscera and flex and rotate the trunk
What is the conjoint tendon?
FIBROUS ARCH formed by the fusion of the aponeuroses of IO and TA muscles as they insert on the pectineal ligament.
What is the rectus abdominis?
Pair of strap muscles extending from the xiphoid process and adjacent costal cartilages (ribs 5-7) to the pubic crest.
What encloses the rectus abdominus?
Rectus sheath
Composed of anterior and posterior laminae of the aponeurotic portions of the oblique muscles.
The anterior layer of the rectus sheath provides points of attachment, tendinous intersections, to the anterior layer of the rectus muscles.
What is hte arcuate line?
Crescentic lower border of the posterior layer of the rectus sheath.
Above the arcuate line, the anterior layer is formed by the
aponeurosis of the external and internal obliques; below the arcuate line, by all three aponeurosis.
What is the transversalis fascia?
Lines the entire abdominopelvic cavity and is
separated from the peritoneum by a layer of fat-filled extraperitoneal connective tissue.
What is the median umbilical fold?
covering the median umbilical ligament;
remnant of the urachus, an embryonic connection between the bladder and the umbilicus
What is the medial umbilical fold?
covering the medial umbilical ligaments, which are the obliterated umbilical arteries
What is the lateral umbilical fold?
covering the inferior epigastric vessels.
What are the nerves of the anterior abdominal wall?
- Intercostal nerves (ventral rami of T7-T11)
- Subcostal nerve (T12 ventral ramus under rib 12)
- Ilioinguinal and iliohypogastric nerves (branches of L1)
What do the nerves of the anterior abdominal wall?
MOTOR to the muscles of the anterior abdominal wall (somatic efferent)
CUTANEOUS (somatic afferent) fibers from the anterolateral abdominal wall traveling in anterior and lateral cutaneous branches of these nerves
What does T10 supply?
the skin surrounding the umbilicus.
What are the arteries of the anterior abdominal wall?
- Superior epigastric artery
2. Inferior epigastric artery
The superior epigastric artery is a terminal branch of what artery?
Internal thoracic artery
Where is the superior epigastric artery located?
Descends behind rectus abdominis within the rectus sheath.
Anastomoses with inferior epigastric artery within rectus abdominis.
The inferior epigastric artery is a branch of what artery?
The external iliac artery just ABOVE the inguinal ligament
Where is the inferior epigastric artery located?
Ascends behind the rectus muscle w/in the rectus sheath
What intercostal and lumbar arteries supply the abdominal wall?
Lower two intercostal arteries
Four lumbar arteries
*Veins correspond to the arteries
What is an umbilical hernia?
Common in NEWBORNS because the anterior abdominal wall is relatively weak in the umbilical ring
Usually small, result from increased intra-abdominal pressure in the presence of incomplete closure of the anterior abdominal wall after ligation of the umbilical cord after birth
What is an acquired umbilical hernia?
occurs mostly in women and obese people, or as a result of trauma or surgical incisions; fat or peritoneum protrudes into the hernial sac
What is an epigastric hernia?
Located in the epigastric region through the linea alba
Where is a spigelian hernia located? What is a risk factor for it?
Located along the semilunar lines or arcuate line
Obesity is risk factor