Anatomy 4: O&G Incisions Flashcards
Where do the External Obliques attach?
Between the lower ribs and iliac crest, pubic tubercle and linea alba
Where do the Internal Obliques attach?
Between the lower ribs, thoracolumbar fascia, iliac crest and linea alba
Where do the Transverse Abdominis attach?
Between the lower ribs, thoracolumbar fascia, iliac crest and linea alba
Where does the Linea Alba run from?
The xiphoid process to the pubic symphysis
Where is the rectus sheath?
Immediately deep to superficial fascia
Combined aponeuroses of anterolateral abdominal wall muscles
Surrounds rectus abdominis muscles
What is cut through in a supra-pubic incision from LSCS?
Anterior Rectus Sheath
What are the nerve supply to the anterolateral abdominal wall?
- Enters from lateral direction
- 7-11th intercostal nerves become the thoracoabdominal nerves
T12 nerve?
Subcostal
L1 nerves?
Iliohypogastric
Ilioinguinal
What is the blood supply to the anterior abdominal wall?
Superior epigastric arteries
Inferior epigastric arteries
What are the features of Superior Epigastric arteries?
- Continuation of internal thoracic
- Emerges at superior aspect of abdominal wall
- Lies posterior to rectus abdominis
What are the features of Inferior Epigastric arteries?
- Branch of external iliac artery
- Emerges at inferior aspect of abdominal wall
- Lies posterior to rectus abdominis
What is the blood supply to the lateral abdominal wall?
- Intercostal and subcostal arteries
- Continuations of posterior intercostal arteries
- Emerge at lateral aspect
Are the rectus muscles cut in a LSCS?
No
Separated from each other in a lateral direction
What are the layers incised through in a LSCS?
Skin and fascia Anterior Rectus Sheath Rectus abdominis Fascia and peritoneum Retract bladder Uterine wall Amniotic sac
What are the layers stitched closed in a LSCS?
Uterine wall
Rectus Sheath
Fascia
Skin
What are the layers opened in a laparotomy?
Skin and fascia
Linea Alba
Peritoneum
What are the layers to stitch closed in a Laparotomy?
Peritoneum and linea alba
Fascia
Skin
A midline incision is “relatively bloodless”, why is this significant?
- Can mean that the healing is notes good
- Increases the chance of wound complications e.g. incisional hernia
Where are the incisions made in a Laparoscopy?
- A sub-umbilical incision may be all that is required
- 2 lateral ports
What must be avoided if inserting a lateral port in for a laparoscopy?
Care must be taken to avoid the inferior epigastric artery
What os the Inferior Epigastric artery a branch of?
The external iliac artery
Where does the Inferior Epigastric Artery emerge?
Just medial to the deep inguinal ring
Then passes in a superomedial direction posterior to the rectus abdominis
When can the uterine fundus be palpated?
Only when it arises out of the pelvis at 12weeks gestation
