Anatomy Lecture 1 -- Abdomen 1 Flashcards
List the 7 layers of the anterior abdominal wall
List and identify the 5 parts of the external oblique muscle
Describe the directionality of the external oblique muscle
Downwards medially
Define the free lower edge of the external oblique muscle
Inguinal ligament
List and identify the two parts of the internal oblique muscle
Describe the directionality of the internal oblique muscle
Downwards laterally
List and identify the parts of the transversus abdominis muscle
NOTE: hole in aponeurosis = arcuate line
List and identify the attachments of the rectus abdominis muscle
List and identify the 3 parts of the rectus abdominis muscle (disregarding the fleshy fibres)
Define the order of the layers in the rectus sheath above the costal margin
Define the order of the layers in the rectus sheath above the arcuate line
Define the order of the layers of the rectus sheath below the arcuate line
Define the arcuate line
Lower edge of the posterior sheath of the rectus abdominis so that the transversalis fascia is directly posterior to the rectus abdominis muscle below it
From where does the superior epigastric artery originate?
Internal thoracic artery
From where does the inferior epigastric artery originate?
External iliac artery
What does the external iliac artery divide into?
Deep circumflex iliac artery and the inferior epigastric artery
What is the relationship between the superior and inferior epigastric arteries?
They anastamose
From a posterior view, what contains the inferior epigastric vessels?
Lateral umbilical fold
From where does the superficial epigastric artery originate?
Femoral artery
Give important inferiorly located vessels that supply the anterior abdominal wall
- Deep circumflex iliac artery
- Superficial epigastric artery
- Inferior epigastric artery
Give 4 important deep veins of the anterior abdominal wall
- Superior epigastric vein
- Deep circumflex iliac vein
- Superficial circumflex iliac vein
- Inferior epigastric vein
Give 3 important superficial veins for the drainage of the anterior abdominal wall
- Axillary vein
- Thoraco-epigastric vein
- Superficial epigastric vein
Where does the superior epigastric vein drain to?
Internal thoracic vein
Where does the deep circumflex iliac vein drain to?
External iliac vein
Where does the superficial circumflex iliac vein drain to?
Femoral vein
Where does the inferior epigastric vein drain to?
External iliac vein
Where does the superficial epigastric vein drain to?
Femoral vein
2 lymph nodes that superficially drain the anterior abdominal wall
Axillary lymph nodes
Superficial inguinal lymph nodes
What innervates the anterior abdominal wall?
- Anterior and lateral cutaneous branches of the lowest five inercostal nerves (T7 - T11) and the subcostal nerves (T12)
- Iliohypogastric nerve
- Ilioinguinal nerve
Define “thoracoabdominal nerves”
The lowest five intercostal nerves, which supply portions of both the thoracic wall and abdominal wall
Thoracoabdominal nerve coinciding with the belly button
T10
Where do the iliohypogastric and ilioinguinal nerves originate from?
L1
Which parts of the anterior abdominal wall are supplied the motor iliohypogastric nerve?
Muscles of the abdominal wall
What does the sensory iliohypogastric nerve supply?
Suprapubic region
Lateral aspect of the buttocks
Which parts of the anterior abdominal wall are supplied by the motor inguinal nerve?
Muscles of the abdominal wall
What does the sensory ilioinguinal nerve supply?
- Upper medial part of the thigh
- Anterior part of scrotum
- Mons pubis and labium majus
Define the precise location of the iliohypogastric nerve
Pierces the aponeurosis of the external abdominal oblique muscle 3 - 5 cm above the superficial inguinal ring
Define the precise location of the ilioinguinal nerve
Emerges from the superficial inguinal ring and passes on the surface of the spermatic cord (or round ligament)
Define the inguinal canal
The space betwee nthe peritoneum and the external abdominal oblique muscle through which the testicle descended
List the 7 layers involved in the formation of the spermatic cord
Through which layer does the testes pass but it does not contribute to the formation of the spermatic cord?
Transversus abdominis muscle
Define the precise location of the deep inguinal ring
½ way between the
ASIS and pubic tubercle
What layer becomes the external spermatic fascia in the spermatic cord?
External oblique aponeurosis
What layer becomes the cremasteric fascia of the spermatic cord?
Internal oblique muscle fibers
What becomes the internal spermatic fascia of the spermatic cord?
Transversalis fascia
Define the spatial relationship of the spermatic cord and inguinal canal to the inferior epigastric vessels
Lateral to the inferior epigastric vessels
What is the conjoint tendon derived from?
The fusion of the aponeuroses of the transversus abdominis and internal oblique muscles
Role of the conjoint tendon
Insert into the pubic crest in continuity with the pectineal line and form the medial reinforcement to the posterior wall of the inguinal canal
Define the lacunar ligament
A posterior projection of the inguinal ligament formed by the inguinal ligament’s backward and lateralward reflection as it reaches the pubic tubercle and attaches to the pectineal line for about 1.25 cm
Define Cooper’s ligament
An extension of the lacunar ligament that runs on the pectineal line of the pubic bone
What does the inguinal canal contain in females?
Round ligament
2 types of inguinal hernias
More common type of inguinal hernia and the percent incidence
75% = indirect inguinal hernia
Differentiate between the age groups that more commonly experience direct vs. indirect inguinal hernias
Direct = men over 40
Indirect = male children
Location of herniation of direct vs. indirect inguinal hernias
DIrect = medial to inferior epigastric artery (inferior part of inguinal triangle; Hesselbach’s triangle)
Indirect = path taken by testis through inguinal canal; deep inguinal ring and superficial ring (outside Hesselbach’s triangle)
Most probably cause of direct inguinal hernia
Weakening of the conjoint tendon and/or weakening of the transversalis fascia
Most probable cause of indirect inguinal hernia
Patent processus vaginalis
How to alleviate temporarily a direct inguinal hernia
Lie down
Define the medial border of the inguinal/ Hesselbach’s Triangle
Lateral margin of the rectus abdominis muscle/sheath
Define the superolateral border of the inguinal triangle/ Hesselbach’s Triangle
Inferior epigastric vessels
Define the inferior border of the inguinal / hesselbach’s triangle
Inguinal ligament (Poupart’s ligament)
Define the processus vaginalis
An invagination of the peritoneum as it is carried with the testes as it descends to create the spermatic cord. Usually is obliterated (i.e. closed)
Define a femoral hernia
Hernia occuring just below the inguinal ligament, when abdominal contents pass through a naturally occurring wekaness called the femoral ring/canal
Which group of people are most commonly affected by femoral hernias and why
Women due to wider bone structure of the female pelvis
What vessel must one be careful of when operating on a femoral hernia
Aberrant obturator artery
