Anatomy - Surgical Incisions Flashcards
where do the external oblique muscles attach?
ribs 5-12
iliac crest
pubic tubercle
linea alba
what direction do the fibres of the external oblique run in?
anteroniferior
what is the most superficial muscle of the lateral abdominal wall?
external oblique
what does the inferior edge of the external oblique form?
the inguinal ligament
where do the internal obliques attach?
lower ribs
thoracolumbar fascia
iliac crest
linea alba
what direction do the fibres of the internal oblique run in?
anterosuperior
where does the transversus abdominis attach?
costal cartilage ribs 7-12
thoracolumbar fascia
iliac crest
linea alba
what direction do the fibres of the transversus abdominis run in?
anterior
how is the rectus abdominis divided up?
tendininous intersections divide each muscle into three or four smaller muscles
to improve efficiency
what forms the linea alba?
interweaving of the abdominal muscle aponeuroses
where does the linea alba run?
from the xiphoid process to the pubic symphysis
where do the rectus abdominis muscles attach?
5-7th costal cartilages
pubic symphysis
pubic crest
what is the pubic crest and where is it found?
a bit of bone on the pubic bone
lies medially to the pubic tubercle
where is the rectus sheath located?
immediately deep to the superficial fascia
what is the rectus sheath?
the combined aponeuroses of the anterolateral abdominal wall muscles
what is contained in the rectus sheath?
rectus abdominis muscles pyramidalis nerves vessels lymphatics
what are the two parts of the rectus sheath?
anterior
posterior
what is the anterior rectus sheath made of?
superiorly = external oblique
inferiorly = external oblique, internal oblique, transversus abdominus
what is the posterior rectus sheath made of?
superiorly = transversus abdominis, internal oblique
posteriorly = vanishes
what is the point where the change in the composition of the rectus sheath called?
the arcuate line
where is the arcuate line located?
a third of the way between the umbilicus and the pubic crest
what are these structures behind the muscles of the abdominal wall, from superficial to deep?
transversalis fascia
extra-peritoneal fat
parietal peritoneum
abdominal organs
what does the nerve supply to the anterolateral wall consist of?
thoracoabdominal nerves
subcostal nerves
iliohypogastric nerve
ilioinguinal nerve
what forms the thoracoabdominal nerves?
7-11th intercostal nerves
what forms the subcostal nerve?
T12
what forms the iliohypogastric nerve?
L1
what forms the ilioinguinal nerve?
L1
what arteries provide blood supply to the anterior abdominal wall?
superior epigastric
inferior epigastric
what forms the superior epigastric arteries?
continuations of the internal thoracic arteries
where do the superior epigastric arteries arise?
superior aspect of the abdominal wall
what forms the inferior epigastric arteries?
branches of the external iliac
where do the inferior epigastric arteries arise?
just medial to the deep inguinal ring on the inferior aspect of the abdominal wall
what arteries make up the blood supply to the lateral abdominal wall?
intercostal and subcostal arteries
where do the intercostal and subcostal arteries arise from?
continuations of the posterior intercostal arteries
when can the uterus first be palpated?
12 weeks gestation
where can the uterus be palpated at 20 weeks?
at the umbilicus
how much does the uterus grow from week 20?
around 1cm a week
where can the uterus be palpated at 36 weeks?
near the xiphoid process
how does SFH correlate with gestation?
SFH in cm = weeks of gestation +/- 3cm
what is SFH?
the distance between the pubic symphysis and the funds of the uterus
what is an LSCS?
lower segment Caesarean section
what layers are incised through during an LSCS?
skin + fascia anterior rectus sheath rectus abdominis fascia + peritoneum retract bladder uterine wall amniotic sac
which layers are stitched closed in an LSCS?
uterine wall with visceral peritoneum
rectus sheath
skin
what layers are incised during a laparotomy?
skin + fascia
linea alba
peritoneum
what layers are stitched closed in a laparotomy?
all
where is the incision made in a laparotomy?
in the midline
what incisions may be made for laparoscopy?
sub umbilical
may also need lateral ports
what do you need to avoid if creating a lateral port for laparoscopy?
the inferior epigastric artery
what are the two types of hysterectomy?
abdominal
vaginal
what is an abdominal hysterectomy?
removal of the uterus via an incision in the abdominal wall
what is a vaginal hysterectomy?
removal of the uterus via the vagina
