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Y3 Reproductive > Anatomy Lecture 5 Abdominal Incisions > Flashcards

Anatomy Lecture 5 Abdominal Incisions Flashcards

1
Q

Name 3 different common surgical incisions on the abdomen

A

Laparotomy
Laparoscopy
Suprapubic ‘bikini line’ incision

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2
Q

What common operations are performed using a suprapubic ‘bikini line’ incision?

A

Lower segment caesarean section

Abdominal hysterectomy

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3
Q

Name the layers cut through in a lower segment caesarean section

A

ddd

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4
Q

What abdominal wall muscle attaches “between lower ribs and iliac crest, pubic tubercle and linea alba”?

A

External obliques

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5
Q

What abdominal wall muscles attaches “between lower ribs, thoracolumbar fascia, iliac crest and linea alba”?

A

Internal obliques and transversus abdominis

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6
Q

What direction to the fibres of the external obliques run?

A

Hands in pockets - same as external intercostals

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7
Q

What direction to the fibres of the internal obliques run?

A

Hands on chest - same as internal intercostals

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8
Q

What direction to the fibres of the transversus abdominis run?

A

Transverse direction

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9
Q

What is the linea alba?

A

Midline blending of aponeuroses

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10
Q

What is the superior attachments of the rectus abdominis?

A

Xiphoid process and costal cartilages

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11
Q

What is the inferior attachments of the rectus abdominis?

A

Pubic bones - symphysis

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12
Q

What is the name of the part of the rectus abdominis that divides each rectus abdominis into 3 or 4 smaller muscles?

A

Tendinous intersections

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13
Q

What is the function of the tendinous intersections of the rectus abdominis?

A

Improved mechanical efficiency

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14
Q

What does the linea alba run between?

A

Xiphoid process to the pubic symphysis

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15
Q

The __________ is immediately deep to superficial fascia

A

rectus sheath

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16
Q

What is the rectus sheath formed of?

A

combined aponeuroses of anterolateral abdominal wall muscles

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17
Q

The rectus sheath surrounds the ______

A

rectus abdominis

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18
Q

Following abdominal incisions, the rectus sheath should always be stitched closed. T or F

A

True

to increase the strength of the wound and reduce the risk of wound complications e.g. incisional hernia

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19
Q

Name the 2 parts of the rectus sheath?

A

Anterior and posterior

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20
Q

At the level of a suprapubic incision, what parts of the rectus sheath are cut?

A

Only anterior part

21
Q

At the level of a suprapubic incision, where is the anterior part of the rectus sheath in relation to the rectus abdominis?

A

Anterior

here formed of external oblique, internal oblique and transversus abdominis aponeurosis

22
Q

What layer of the abdominal wall is between the transversus abdominis and extra-peritoneal fat?
(deep to extra-peritoneal fat is parietal peritoneum)

A

Transversalis fascia

23
Q

The nerve supply to the anterolateral abdominal wall enters from a ______ direction

A

Lateral

24
Q

Nerve supply to the anterolateral abdominal wall: the __th to __th intercostal nerves become the ______ nerves

A

7th-11th

thoracoabdominal

25
Q

The nerves supplying the anterolateral abdominal wall travel between the ____ and ____ layers.

A

Internal oblique and transversus abdominis

26
Q

Name 3 named nerves, and their vertebral levels, that supply the anterolateral abdominal wall

A

Subcostal T12
Iliohypogastric L1
Ilioinguinal L1

27
Q

Name the 2 main arteries that supply the L and R anterior abdominal wall

A

Superior epigastric arteries

Inferior epigastric arteries

28
Q

What artery is the superior epigastric artery a continuation of?

A

Internal thoracic

29
Q

What artery is the inferior epigastric artery a branch of?

A

External iliac artery

30
Q

Where do the superior epigastric and inferior epigastric arteries lie in relation to the rectus abdominis?

A

Posterior

31
Q

What arteries supply the lateral abdominal wall?

A

Intercostal and subcostal arteries

32
Q

The intercostal and subcostal arteries are continuations of the ______ and emerge at the lateral aspect

A

posterior intercostal arteries

33
Q

When incising muscle, to minimise traumatic injury to muscle fibres, incise in the _____ direction as muscle fibre

A

same

34
Q

Name the layers cut through in a lower segment caesarean section

A 
Skin 
Superficial fascia
Anterior rectus sheath
RECTUS ABDOMINIS SEPARATED NOT CUT
Fascia
Parietal peritoneum 
Visceral peritoneum
Uterine wall
Amniotic sac
35
Q

What cautions are made to prevent injury to the bladder during a LSCS?

A

Retrate bladder

Catheter inserted pre-op

36
Q

What layers should be stitched closed in a lower segment caesarean section?

A

Uterine wall
Visceral peritoneum
Rectus sheath
Skin

37
Q

Name the layers cut through in a laparotomy

midline incision

A

Skin
Fascia
Linea alba
Peritoneum

38
Q

What layers should be stitched closed in a laparotomy?

A

Peritoneum
Linea alba
Skin

39
Q

A laparotomy is relatively bloodless. T or F

A

True

40
Q

What complications are at an increased risk in laparotomy compared to suprapubic incisions?

A

Increases wound complications e.g. dehiscence, incisional hernia

41
Q

Where are the sites of laparoscopy?

A

Subimbilical +- lateral port

42
Q

What structure should you be careful of when inserting a lateral port laparoscopy?

A

Inferior epigastric artery

43
Q

What is the route of the inferior epigastric artery after branching off the external iliac?

A

Just medial to the deep inguinal ring
Superomedial direction
Posterior to rectus abdominis
Anastomoses with superior epigastric

44
Q

What are the 2 approaches to hysterectomy

A

Abdominal and vaginal

45
Q

What structure must you be cautious of during a hysterectomy?

A

Differentiate the ureter from the uterine artery

46
Q

How do you differentiate the ureter from the uterine artery?

A

Ureter inferior to the artery (water under the bridge)

Ureter pulses when touches

47
Q

What is more medial to the bladder, the ureter or the uterine artery?

A

Ureter

48
Q

Where is the deep inguinal ring?

A

Halfway between ASIS and pubic tubercle

Y3 Reproductive (28 decks)

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