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Reproduction > Anatomy of Surgical Incisions > Flashcards

Anatomy of Surgical Incisions Flashcards

1
Q

What are some common O & G incisions?

A

Lower segment C-section = suprapubic incision
Laparotomy = vertical midline incision
Laparoscopy = subumbilical incision
Abdominal hysterectomy = vertical midline incision

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2
Q

Where do the external obliques attach?

A

Attach between lower ribs and iliac crest, pubic tubercle and linea alba

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3
Q

What direction do the fibres of the external obliques go in?

A

Fibres run in same direction as external intercostals

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4
Q

Where do the internal obliques attach?

A

Attach between the lower ribs, thoracolumbar fascia, iliac crest and linea alba

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5
Q

What direction do the fibres of the internal obliques go in?

A

Fibres run in same direction as internal intercostals

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6
Q

What are the attachments of the transversus abdominis?

A

Attach between lower ribs, thoracolumbar fascia, iliac crest and linea alba

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7
Q

What is the purpose of the tendinous intersections of the rectus abdominus?

A

Divide each rectus abdominis into 3 or 4 smaller muscles

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8
Q

What forms the linea alba?

A

Interweaving of muscle aponeuroses = runs from xiphoid process to pubic symphysis

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9
Q

Where is the rectus sheath located?

A

Immediately deep to superficial fascia

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10
Q

What is the rectus sheath?

A

Combined aponeuroses of anterolateral abdominal wall muscles

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11
Q

What does the rectus sheath surround?

A

Rectus abdominis muscles

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12
Q

How is the rectus sheath incised during a suprapubic incision?

A

Incised anyeriorly

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13
Q

Where does the nerve supply of the anterolateral abdominal wall enter from?

A

Enters from the lateral direction

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14
Q

What is the nerve supply to the anterolateral abdominal wall?

A

7th-11th intercostal = become thoracoabdominal nerves

Subcostal (T12), iliohypogastric (L1), ilioinguinal (L1)

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15
Q

What is the blood supply to the anterior abdominal wall?

A

Superior epigastric arteries and inferior epigastric arteries

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16
Q

What are some features of the superior epigastric arteries?

A

Continuation of the internal thoracic arteries

Emerge at superior aspect of abdominal wall

17
Q

What are some features of the inferior epigastric arteries?

A

Branch of the external iliac artery

Emerge at inferior aspect of the abdominal wall

18
Q

What is the blood supply of the lateral abdominal wall?

A

Intercostal and subcostal arteries = continuations of posterior intercostal arteries, emerge at lateral aspect

19
Q

What are the principles when incising muscle?

A

Minimise traumatic injury to muscle fibres = incise in same direction as muscle fibre
Avoid damaging nerves and interrupting blood supply

20
Q

How is a lower segment C-section carried out?

A

Rectus muscle not cut = separated from each other in lateral direction

21
Q

What are the layers encountered when opening during a lower segment C-section?

A

Skin and fascia, anterior rectus sheath, rectus abdominis, fascia and peritoneum, (retract bladder), uterine wall, amniotic sack

22
Q

What are the layers that have to be stitched closed after a lower segment C-section?

A

Uterine wall with visceral peritoneum, rectus sheath, skin

23
Q

What are the layers encountered when opening during a laparotomy?

A

Skin and fascia, linea alba, peritoneum

24
Q

What are the layers that have to be stitched closed after a laparotomy?

A

Peritoneum and linea alba, fascia skin

25
Q

What kind of incision is used for a laparotomy?

A

Midline incision = relatively bloodless, increases chance of wound complications

26
Q

What kind of incision is used for a laparoscopy?

A

Subumbilical incision

27
Q

What must care be taken to avoid if a lateral port is needed during a laparoscopy?

A

Must avoid the inferior epigastric artery

28
Q

How can view of the organs during a laparoscopy be improved?

A

Position of uterus can be manipulated by grasping the cervix with forceps inserted through vagina

29
Q

Where does the inferior epigastric artery emerge?

A

Just medial to the deep inguinal ring = passes in superomedial direction posterior to rectus abdominis

30
Q

What occurs in an abdominal hysterectomy?

A

Removal of uterus via an incision in the abdominal wall

31
Q

What occurs in a vaginal hysterectomy?

A

Removal of uterus via vagina

32
Q

What structures must be differentiated from each other during a hysterectomy?

A

Ureter and uterine artery

33
Q

How can the ureter be distinguished from the uterine artery?

A

Ureter passes inferior to artery

Ureter will often vermiculate when touched

Reproduction (62 decks)

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