Anatomy of the Anterior Abdominal Wall and the Inguinal Canal Flashcards
What are the 9 regions of the abdomen?
Right hypochondrium
Right flank (lumbar)
Right inguinal (groin, iliac)
Epigastric
Umbilical
Hypogastric (pubic)
Left hypochondrium
Left flank (lumbar)
Left inguinal (groin, iliac)
What are the 4 quadrants of the abdomen?
Right upper quadrant
Right lower quadrant
Left upper quadrant
Left lower quadrant
What is the L1/2 plane?
Transpyloric plane
What is the L4/5 plane?
Intertubercular plane
What are the layers of the anterior abdominal wall?
Skin
Superficial fascia
Deep fascia
Muscles
Fascia transevarsalis
Extraperitoneal fat
Parietal peritoneum
What are the components of the superficial fascia?
Fatty layer: Camper’s fascia
Membranous layer: Scarpa fascia
What are the different muscles of the anterior abdominal wall?
External oblique
Internal oblique
Transversus
What are the layers of the skin of the anterior abdominal wall?
Epidermis
Dermis
Subcutaneous tissue
Muscle
What are the Langer’s skin lines?
They indicate the predominant direction of collagen fiber bundles in the dermis
What is the relation between lacerations/cuts and Langer’s skin lines?
Incision or laceration running parallel to the Langer’s lines have less tendency to gape than those crossing them
Which muscle is associated with the fatty layer of the superficial fascia?
Darto’s muscle
Which fascia is associated with the Scarpa’s fascia?
Colles’ fascia
What is the deep fascia of the anterior abdominal wall?
A thin layer of connective tissue covering the muscles
What is the deep fascia in the limbs like?
It forms a complete investment to the muscles and is fused with the periosteum over the subcutaneous surfaces of the bones
What are the components of the external oblique?
Superficial inguinal ring
External spermatic fascia
Inguinal ligament
What is the point of origin of the external oblique muscle?
Lower eight ribs
What are the different insertion points of the external oblique muscles?
Xiphoid process
Linea alba
Pubic symphysis, crest, and tubercule
The anterior half of the ileac crest, including ASIS
What is ASIS?
Anterior superior iliac spine, bony projection of the iliac bone
What are the components of the internal oblique?
Cremaster muscle
Conjoint tendon
What are the points of origin of the internal oblique muscle?
Thoracolumbar fascia
Iliac crest
Lateral 2/3 of the inguinal ligament
What are the insertion points of the internal muscle?
Xiphoid process
Linea alba
Pubic crest (via conjoint tendon)
Lower three ribs and costal cartilages
What are the origin points of the transversus?
Thoracolumbar fascia
Iliac crest
Lower six costal cartilages
Lateral 1/3 of the inguinal ligament
What are the insertion points of the transversus muscle?
Xiphoid process
Linea alba
Pubic crest (via conjoint tendon)
What connects the internal oblique and the transversus?
Conjoint tendon
What are the origin points of the rectus abdominis?
Symphysis pubis
Pubic crest
What are the insertion points of rectus abdominis?
Xiphoid process
5th, 6th and 7th costal cartilages
Is the rectus sheath above or below the connective muscle?
Above the costal margin
What are the components of the rectus sheath?
Aponeurosis of the external oblique
Thoracic wall
What are the structures between the costal margin and the level of ASIS?
Externa oblique aponeuphrosis + anterior 1/2 internal oblique aponeuphrosis
Posterior 1/2 aponeuphrosis + transversus abdominis aponeuphrosis
What is the fascia transervalis?
The thin layer that lines the transversus abdominis is continuous, with a similar layer lining the diaphragm and the iliacus muscle
What is the fascia transversalis continuous with?
Deep inguinal ring
Internal spermatic fascia
Femoral sheath
What is the extraperitoneal fat?
A thin layer of connective tissue that contains a variable amount of fat and lies between the fascia transversalis and the parietal peritoneum
What are the walls of the abdomen lined with?
Parietal peritoneum
What are the abdominal incisions? (10)
- Upper midline
- Right paramedian
- Transverse
- Nephrectomy
- Subcostal
- Gridiron
- Left iliac
- Lower midline
- Suprapubic
- Laparoscopic ports
What are the main arteries of the abdominal wall?
Internal thoracic artery
External iliac artery
Thoracic artery
Abdominal aorta
What are the associated branches of the internal thoracic artery?
Superior epigastric artery
What are the associated branches of the external iliac aretry?
Inferior epigatsric artrey
Deep circumflex iliac artery
What are the associated branches of the thoracic aorta?
Lower two posterior intercostal arteries
What are the associated branches of the abdominal aorta?
Four lumbar arteries
Where does the superior epigastric vein drain?
Internal thoracic vein
Where do the inferior epigastric and deep circumflex iliac veins drain?
External iliac vein
Which veins drain into the azygous veins?
Lower two posterior intercostal veins
Which veins drain into the inferior vena cava?
The four lumbar veins
What is the network of veins around the umbilicous?
Great saphenous vein
Superficial epigatsric vein
Lateral thoracic vein
Paraumbilical veins
Where do the great saphenous and superficial epigastric veins drain?
Femoral vein
Where does the lateral thoracic vein drain?
Axillary vein
Where do the paraumbilical veins drain?
Portal vein
What are the superficial lymph vessels of the anterior abdominal wall?
Anterior and Posterior
What are the divisions of the anterior superficial lymph vessels?
Above and below the umbilicus
Where do the lymph nodes above the umbilicus drain?
Anterior axillary nodes
What are the divisions of the posterior superficial lymph vessels?
Above and below the iliac crests
WHere do the posterior superficial lymph vessels above the iliac crest drain?
Posterior axillary nodes
Where do the lymph vessels below the umbilicus and the iliac crests drain?
Superficial inguinal nodes
What are the deep lymph vessels?
Internal thoracic nodes
External iliac nodes
Posterior mediastinal nodes
Para-aortic (lumbar) nodes
What are the nerves of the of the anterior abdominal wall?
First lumbar nerve
Lower six thoracic nerves
What are the nerves associated with the first lumbar nerve?
Ilioinguinal nerve
Iliohypogastric nerve
What do the ilioinguinal nerve and the iliohypogastric nerve supply?
Skin above inguinal ligament & symphysis pubis
What are the lower 6 thoracic nerves?
Thoracoabdominal nerves (T7 - 11)
Subcostal nerve
Which area does the subcostal nerve supply?
Pyramidalis
Which areas do the thoracoabdominal nerves supply?
External oblique
Internal oblique
Transversus abdominis
Rectus abdominis
What does bony part of the posteror abdominal wall form?
Lumbar vertebrae
Twelfth pair of ribs
Ilium
What are the layers of posterior abdominal wall?
Bony part
Muscles
Part of the diaphgram
What are the muscles of the posterior abdominal wall?
Psoas major
Quadratus lumborum
Transversus abdominis
Iliacus
What muscles make up the Iliopsoas?
Psoas major
Iliacus