Anatomy - Surgical Incisions

Question 1

where do the external oblique muscles attach?

Answer 1

ribs 5-12
iliac crest
pubic tubercle
linea alba

Question 2

what direction do the fibres of the external oblique run in?

Answer 2

anteroniferior

Question 3

what is the most superficial muscle of the lateral abdominal wall?

Answer 3

external oblique

Question 4

what does the inferior edge of the external oblique form?

Answer 4

the inguinal ligament

Question 5

where do the internal obliques attach?

Answer 5

lower ribs
thoracolumbar fascia
iliac crest
linea alba

Question 6

what direction do the fibres of the internal oblique run in?

Answer 6

anterosuperior

Question 7

where does the transversus abdominis attach?

Answer 7

costal cartilage ribs 7-12
thoracolumbar fascia
iliac crest
linea alba

Question 8

what direction do the fibres of the transversus abdominis run in?

Answer 8

anterior

Question 9

how is the rectus abdominis divided up?

Answer 9

tendininous intersections divide each muscle into three or four smaller muscles

to improve efficiency

Question 10

what forms the linea alba?

Answer 10

interweaving of the abdominal muscle aponeuroses

Question 11

where does the linea alba run?

Answer 11

from the xiphoid process to the pubic symphysis

Question 12

where do the rectus abdominis muscles attach?

Answer 12

5-7th costal cartilages
pubic symphysis
pubic crest

Question 13

what is the pubic crest and where is it found?

Answer 13

a bit of bone on the pubic bone

lies medially to the pubic tubercle

Question 14

where is the rectus sheath located?

Answer 14

immediately deep to the superficial fascia

Question 15

what is the rectus sheath?

Answer 15

the combined aponeuroses of the anterolateral abdominal wall muscles

Question 16

what is contained in the rectus sheath?

Answer 16

rectus abdominis muscles 
pyramidalis 
nerves 
vessels 
lymphatics

Question 17

what are the two parts of the rectus sheath?

Answer 17

anterior

posterior

Question 18

what is the anterior rectus sheath made of?

Answer 18

superiorly = external oblique

inferiorly = external oblique, internal oblique, transversus abdominus

Question 19

what is the posterior rectus sheath made of?

Answer 19

superiorly = transversus abdominis, internal oblique

posteriorly = vanishes

Question 20

what is the point where the change in the composition of the rectus sheath called?

Answer 20

the arcuate line

Question 21

where is the arcuate line located?

Answer 21

a third of the way between the umbilicus and the pubic crest

Question 22

what are these structures behind the muscles of the abdominal wall, from superficial to deep?

Answer 22

transversalis fascia
extra-peritoneal fat
parietal peritoneum
abdominal organs

Question 23

what does the nerve supply to the anterolateral wall consist of?

Answer 23

thoracoabdominal nerves
subcostal nerves
iliohypogastric nerve
ilioinguinal nerve

Question 24

what forms the thoracoabdominal nerves?

Answer 24

7-11th intercostal nerves

Question 25

what forms the subcostal nerve?

Answer 25

T12

Question 26

what forms the iliohypogastric nerve?

Answer 26

L1

Question 27

what forms the ilioinguinal nerve?

Answer 27

L1

Question 28

what arteries provide blood supply to the anterior abdominal wall?

Answer 28

superior epigastric | inferior epigastric

Question 29

what forms the superior epigastric arteries?

Answer 29

continuations of the internal thoracic arteries

Question 30

where do the superior epigastric arteries arise?

Answer 30

superior aspect of the abdominal wall

Question 31

what forms the inferior epigastric arteries?

Answer 31

branches of the external iliac

Question 32

where do the inferior epigastric arteries arise?

Answer 32

just medial to the deep inguinal ring on the inferior aspect of the abdominal wall

Question 33

what arteries make up the blood supply to the lateral abdominal wall?

Answer 33

intercostal and subcostal arteries

Question 34

where do the intercostal and subcostal arteries arise from?

Answer 34

continuations of the posterior intercostal arteries

Question 35

when can the uterus first be palpated?

Answer 35

12 weeks gestation

Question 36

where can the uterus be palpated at 20 weeks?

Answer 36

at the umbilicus

Question 37

how much does the uterus grow from week 20?

Answer 37

around 1cm a week

Question 38

where can the uterus be palpated at 36 weeks?

Answer 38

near the xiphoid process

Question 39

how does SFH correlate with gestation?

Answer 39

SFH in cm = weeks of gestation +/- 3cm

Question 40

what is SFH?

Answer 40

the distance between the pubic symphysis and the funds of the uterus

Question 41

what is an LSCS?

Answer 41

lower segment Caesarean section

Question 42

what layers are incised through during an LSCS?

Answer 42

``` skin + fascia anterior rectus sheath rectus abdominis fascia + peritoneum retract bladder uterine wall amniotic sac ```

Question 43

which layers are stitched closed in an LSCS?

Answer 43

uterine wall with visceral peritoneum rectus sheath skin

Question 44

what layers are incised during a laparotomy?

Answer 44

skin + fascia linea alba peritoneum

Question 45

what layers are stitched closed in a laparotomy?

Answer 45

all

Question 46

where is the incision made in a laparotomy?

Answer 46

in the midline

Question 47

what incisions may be made for laparoscopy?

Answer 47

sub umbilical may also need lateral ports

Question 48

what do you need to avoid if creating a lateral port for laparoscopy?

Answer 48

the inferior epigastric artery

Question 49

what are the two types of hysterectomy?

Answer 49

abdominal | vaginal

Question 50

what is an abdominal hysterectomy?

Answer 50

removal of the uterus via an incision in the abdominal wall

Question 51

what is a vaginal hysterectomy?

Answer 51

removal of the uterus via the vagina