Anatomy of O and G incisions Flashcards
What is a laparotomy
A vertical midline incision
What type of incision is used in a lower segment caesarean or abdominal hysterectomy
Suprapubic or Pfannenstiel incision
What is the linea alba
midline blending of aponeuroses
where do the external oblique muscles attach
Between the lower ribs and iliac crest, pubic tubercle and linea alba
What direction do the external oblique fibres run in
hand in pockets direction
Where does the internal obliques attach
Lower ribs, thoracolumnar fascia, iliac crest and linea alba
what direction dot he internal obliques run in
same direction as internal intercostals
where does transversus abdominus attach
between lower ribs, thoracolumar fascia, iliac crest and linea alba
what divides up each rectus abdominus
tendinous intersections
What is the rectus sheath
combined aponeuroses of anterolateral abdominal wall muscles
why is the rectus sheeth stitched up again after surgery
Increases the wound strength and reduces the risk of complications such as an incisional hernia
What is the nerve supply to the anterolateral abdominal wall
thoracoabdominal nerves
subcostal
iliohyogastric
ilioinguinal
Where do the thoracoabdominal nerves emerge from
the 7-11th intercostal nerves
what is the nerve root of the subcostal nerve
T12
What is the root of iliohypgastric
L1
What is the root of ilioinguinal
L1
Where do the named nerves travel in the abdomen
they travel in the plane between internal oblique and transversus abdominus
What is the blood supply to the anterior abdominal wall
Superior epigastric arteries and inferior epigastric arteries
Where does the superior epigastic artery continue form
the internal thoracic
Where does the inferior epigastric artery branch from
the external iliac
At what layer do both superior and inferior epigastric arteries lie in the abdomen
Posterior to rectus abdominis
what arteries supply the lateral abdominal wall
Intercostal and subcostal arteries (continuation of posterior intercostal arteries)
in what circumstance is the fasicila layer stitched closed
in increased BMI
Why are misline laparotomies more difficult to heal
relatively bloodless - increases chance of wound complications
In what areas are ports inserted for laparoscopy
subumbilical
lateral ports
what artery can be injured when inserting a lateral port
inferior epigastric
where is the deep inguinal ring situated
half way between the ASIS and the pubic tubercle
where does the inferior epigastric artery emerge in the abdomen
just medial to the deep inguinal ring
Which artery could be damaged easily in a hysterectomy
uterine artery - water under the bridge
