ANATOMY OF O&G SURGERY

Question 1

Give layers of abdominal wall from external to internal (anterior)

Answer 1

skin
superficial fascia
rectus sheath
rectus abdominus
rectus sheath

Question 2

Give layers of abdominal wall from external to internal (lateral)

Answer 2

skin
superficial fascia
external oblique
internal oblique transversus abdominus
transversalis fascia
extraperitoneal fat
parietal peritoneum

Question 3

Where do the external obliques attach?

Answer 3

Between the lower ribs and iliac crest, pubic tubercle and linea alba

Question 4

What direction do the external obliques run in?

Answer 4

same direction as external intercostals (hands in pockets)

Question 5

Where do the internal obliques attach?

Answer 5

Between the lower limbs, thoracolumbar fascia, iliac crest and linea alba

Question 6

What direction do the internal obliques run in?

Answer 6

same direction as internal intercostals

Question 7

Where does the transversus abdominus attach?

Answer 7

Between the lower ribs, thoracolumbar fascia, iliac crest and linea alba

Question 8

What direction does transversus abdominus run?

Answer 8

horizontally

Question 9

What is the linea alba?

Answer 9

midline blending of aponeurosis

Question 10

Where does the linea alba span?

Answer 10

from the xiphoid process to the pubic symphysis

Question 11

What do the tendinous intersections do to the rectus abdominus?

Answer 11

divide it into 3/4 smaller muscles to improve efficiency

Question 12

What is the rectus sheath?

Answer 12

a combined aponeurosis of anterolateral abdominal wall muscles

Question 13

Which layers does the iliolinguinal nerve run between?

Answer 13

internal oblique and transversus abdominus

Question 14

Which muscle’s aponeurosis forms the inguinal ligament?

Answer 14

external oblique

Question 15

Which nerves supply the anterolateral abdominal wall?

Answer 15

thoracoabdominal nerves (T12-L1)

Question 16

Name the nerves supplying the anterolateral abdominal wall

Answer 16

subcostal (T12)
Iliohypogastric (L1)
Ilioinguinal (L1)

Question 17

Path of thoracoabdominal wall nerves

Answer 17

7th-11th intercostal nerves become the thoracoabdominal nerves

enter laterally

Question 18

Which vessels supply the anterior abdominal wall?

Answer 18

superior and inferior epigastric

Question 19

Where do the anterior abdominal wall vessels lie?

Answer 19

posterior to rectus abdominus

Question 20

What is

a) the superior epigastric artery a continuation of?
b) the inferior epigastric artery a branch of?

Answer 20

a) internal thoracic

b) external iliac

Question 21

Which vessels supply the lateral abdominal wall?

Answer 21

the intercostal and subcostal arteries

Question 22

What are the intercostal and subcostal arteries a continuation of?

Answer 22

posterior intercostal arteries

Question 23

When incising a muscle which direction should you go?

Answer 23

same as muscle fibre

Question 24

What is LCSC?

Answer 24

Lower segment Caesarean section

Question 25

What happens to the rectus muscles in an LSCS incision?

Answer 25

they are not cut but separated from each other in a lateral direction

Question 26

Which layers are opened in a LSCS?

Answer 26

``` skin and fascia anterior rectus sheath rectus abdominus fascia and peritoneum bladder retracted uterine wall amniotic sac ```

Question 27

Which layers are stitched closed in a LSCS?

Answer 27

uterine wall with visceral peritoneum rectus sheath fascial layer if increased BMI skin

Question 28

What is the risk associated with a vertical midline incision in laparotomy?

Answer 28

it is relatively bloodless so wound healing may not be good and there is inc risk of complications eg, dehiscence, hernia

Question 29

What layers are opened and closed in laparotomy?

Answer 29

skin and fascia linea alba peritoneum

Question 30

What incisions are necessary in a laparoscopy?

Answer 30

a sub-umbilical incision +/- lateral ports

Question 31

In a laparoscopy, what can the lateral ports damage?

Answer 31

inferior epigastric artery

Question 32

Describe the path of the inferior epigastric artery

Answer 32

Emerges medial to the deep inguinal ring then passes in a superomedial direction

Question 33

Where is the deep inguinal ring?

Answer 33

half way between ASIS and pubic tubercle

Question 34

What are the two types of hysterectomy?

Answer 34

abdominal and vaginal

Question 35

Which of the ureter and uterine artery is inferior?

Answer 35

ureter | water under the bridge

Question 36

Layers cut during lower segment C section

Answer 36

``` Skin Superficial fascia Deep fascia Anterior rectus sheath Rectus abdominis muscle Transversalis fascia Extraperitoneal connective tissue Peritoneum Uterus ```