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SHB Exam 2 > Ant Abd Wall > Flashcards

Ant Abd Wall Flashcards

1
Q

What are the names of the upper abdominal sections, lateral the midclavicular lines? B/w them? Middle? Lateral to middle? Lower middle? Lower lateral?

A
  • Hypochondriacs
  • Epigastric
  • Umbilical
  • Flanks
  • Hypogastric/suprapubic/pubic
  • Inguinal
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2
Q

Name the layers of the abdominal wall, superficial to deep?

A 
1 - Skin    
2 - Superficial Fascia (Camper’s, then Scarpa’s)  
3 - External Oblique 
4 - Internal Oblique 
5 - Transverse Abdominis
6 - Transversalis fascia   
7 - Extrapertioneal CT   
8 - Peritoneum
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3
Q

Above the umbilicus, what makes up the superficial fascia?

A

Fat

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4
Q

Below the umbilicus, what makes up the superficial fascia?

A

Superficial: Fascia of Camper’s (fatty)
Deep: Fascia of Scarpa’s (membranous)

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5
Q

During descent of the testes, what does Camper’s fascia become?

A

Dartos muscle

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6
Q

During descent of the testes, what does Scarpa’s fascia become?

A

Colle’s fascia

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7
Q

What are the 3 anterolateral mm. of the abd wall?

A

External oblique, internal oblique, and transversus abdominis mm.

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8
Q

What are the 3 mm. that are close to the midline of the abd wall?

A

Rectus abdominis, pyramidalis (not always present), and cremaster mm.

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9
Q

External oblique m: OIIA?

A

O: External surfaces of ribs 5–12
I: Linea alba, pubic tubercle, anterior half of iliac crest

I: Ventral rami of six inferior thoracic nerves
A: Compresses and supports abdominal viscera, flexes and rotates trunk

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10
Q

Internal oblique m: OIIA?

A

O: Thoracolumbar fascia, anterior 2/3 of iliac crest, lateral half of inguinal ligament
I: Inferior borders of ribs 10–12, linea alba, pubis via conjoint tendon

I: Ventral rami of six inferior thoracic and first lumbar nerves
A: Compresses and supports abdominal viscera, flexes and rotates trunk

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11
Q

Transversus abdominis m: OIIA?

A

O: 7–12, thoracolumbar fascia, iliac crest, lateral third of inguinal ligament
I: Linea alba with aponeurosis of internal oblique, pubic crest, and pecten pubis via conjoint tendon

I: Ventral rami of six inferior thoracic and first lumbar nerves
A: Compresses and supports abdominal viscera

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12
Q

Pyramidalis m (not too important): OIIA?

A

O: Body of pubis, anterior to rectus abdominis
I: Linea alba

I: Iliohypogastric nerve
A: Tenses linea alba

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13
Q

Rectus abdominis m: OIIA?

A

O: Pubic symphysis, pubic crest
I: Xiphoid process, costal cartilages 5–7

I: Ventral rami of six inferior thoracic nerves
A: Flexes trunk, compresses abdominal viscera

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14
Q

Where is the insertion of the cremaster m?
Nerve supply?
Action?

A
  • Pubic tubercle
  • Genital branch of genitofemoral n.
  • Suspends testes and is part of the cremasteric reflex
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15
Q

What is the rectus sheath and what comes together to form it?

A
  • An aponeurotic sheath

- Formed by aponeuroses of the internal/external obliques + transversus abdominus mm.

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16
Q

What is contained within the rectus sheath?

A
  • 2 mm: rectus abdominus and pyramidalis
  • 2 vessels: inferior and superior epigastric vessels
  • Lower 6 intercostal nn.
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17
Q

What forms the anterior rectus sheath layer above the arcuate line? Below?

A

Above: Aponeuroses of internal and external obliques mm (ant layer)

Below: Aponeuroses of internal and external obliques + transverse abdominis mm

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18
Q

What forms the posterior rectus sheath layer above the arcuate line? Below?

A

Above: Aponeuroses of internal oblique + transverse abdominis mm (post layer)

Below: Rectus abdominis is in contact w/transversalis fascia

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19
Q

What is the arcuate line?

What is an event takes place there?

A
  • Marks inferior limit of posterior rectus sheath

- It’s where the inferior epigastric vessels ascend to perforate the rectus abdominis m.

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20
Q

What is the linea alba?
What forms it?
Where does it span from?

A
  • A tendinous median raphe between the two rectus abdominis muscles
  • Formed by the fusion of the aponeuroses of the external oblique, internal oblique, and transverse abdominal muscles
  • Extends from the xiphoid process to the pubic symphysis.
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21
Q

What is the linea semilunaris?

A

A curved line along the lateral border of the rectus abdominis

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22
Q

By what week of pregnancy have the testes descended retroperitoneally, from superior lumbar region to post abd wall to deep inguinal rings?

A

26 weeks

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23
Q

What changes are going on in the fetus as the testes descend, dragging vessels and nerves from the post abd wall?

A

Fetal pelvis enlarges, body/trunk elongates

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24
Q

What is the gubernaculum testes?

A

A mesenchymal band that extends from the caudal part of testis along the course of its descent (in the inguinal canal) to blend with the scrotal fascia

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25
Q

What is the umbilical dermatome?

A

T10

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26
Q

What branches of what artery supply the ant abd wall’s upper half?

A

Internal thoracic a, branches into musculophrenic and superior epigastric aa.

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27
Q

What branch of what artery supply the ant abd wall’s lower half?

A

External iliac a branches into inferior epigastric a.

28
Q

What is the processus vaginalis?

A

A diverticulum or outpouching of the peritoneum which develops ventral to the gubernaculum

29
Q

What does the gubernaculum testes do for the processus vaginalis during descent of the testes?
What does it do for the testis?

A

The gubernaculum forms a path through the anterior abdominal wall for the processus vaginalis to follow during formation of the inguinal canal.
- It anchors the testis to the scrotum and guides its descent into the scrotum.

30
Q

What is trailing the testis during descent?

A

Ductus deferens

31
Q

What does the transversalis fascia become in the scrotum?

A

Internal spermatic fascia

32
Q

What does the internal oblique m become in the scrotum?

A

Cremasteric m.

33
Q

What does the external oblique aponeurosis become in the scrotum?

A

External spermatic fascia

34
Q

What does the testis project into, w/in the scrotum?

A

Processus vaginalis

35
Q

During the perinatal period, part of the processsus vaginalis obliterates to form the _______________, covering the front and sides of the testes.

A

Tunica vaginalis (serous membrane)

36
Q

What is the inguinal canal?

What direction is it angled?

A
  • An oblique passage in the lower part of the anterior abdominal wall just above the medial ½ of the inguinal ligament (larger in males)
  • Directed downwards, forwards, and medially
37
Q

Where does the inguinal canal start and end?

A

Begins at deep inguinal ring, ends at superficial inguinal ring (pw of testes descent)

38
Q

What are the boundaries of the inguinal canal?

A

Ant wall: External oblique aponeuroses, lateral 1/3 internal oblique fibers

Post wall: Transversalis fascia, medial 1/3 of conjoint tendon

Roof: Arched fibers of internal oblique (low arched) & transversus abdominis (high arched).

Floor: Inguinal ligament

39
Q

What layer contains the deep inguinal ring?

A

Transversalis fascia (becomes internal spermatic fascia)

40
Q

What passes through the deep inguinal ring?

A
  • Spermatic cord (males) or round ligament (females)

- Genital branch of genitofemoral n.

41
Q

What are the boundaries of the inguinal triangle (Hesselbach’s triangle).

A

Medial: linea semilunaris (lateral edge of rectus abdominus)
Lateral: lateral umbilical fold (inf epigastric vessels)
Inferior: inguinal ligament

42
Q

What injury commonly occurs at the inguinal triangle?

A
  • Direct inguinal hernia
43
Q

What forms the conjoint tendon?

What does it support?

A

The high arching fibers of the transversus abdominis m. + internal oblique m.

-Works as a support to the superficial inguinal ring (at posterior end of ring)

44
Q

What does the transversus abdominis m become in the scrotum?

A

Trick: it’s not represented

45
Q

What is the lacuna ligament?

A

A triangular posterior extension from the medial end of inguinal ligament

46
Q

What is the superficial inguinal ring?

A
  • A triangular opening, lies in the external oblique aponeurosis superolateral to the pubic crest.
  • Its base is the pubic crest.
  • Its sides are medial & lateral crura.
47
Q

What passes through the superficial inguinal ring?

A
  • Spermatic cord (males) or round ligament of uterus (females)
  • Ilioinguinal nerve
48
Q

What does the ilioinguinal n. do prior to entering superficial inguinal ring?

A
  • First pierces Transversus abdominis m. to run between it & internal oblique (neurovascular plane)
  • Then pierces the lower part of internal oblique
  • Then enters the canal to exit through the superficial inguinal ring (*Iliohypogastric n. is not in canal!)
49
Q

What is the spermatic cord?

A

A group of structures which meet at the deep inguinal ring & traverse the inguinal canal down to the posterior border of testis at the scrotum
- Loves 3’s!

50
Q

What are the 3 coverings of the spermatic cord?

A

Creme sandwich (b/w fascia bread)

1) External spermatic fascia (from external oblique m.)
2) Cremaster muscle and fascia (from internal oblique m.)
3) Internal spermatic fascia (from transversalis fascia)

51
Q

What are the 3 arteries of the spermatic cord?

A
  • Testicular a.
  • Cremasteric a.
  • Artery of Vas
52
Q

What are the 3 V’s of the spermatic cord?

A
  • Vas deferens (ductus deferens)
  • Pampiniform Venous plexus
  • Vestige of processus Vaginalis
53
Q

What are the 3 nerves of the spermatic cord?

A
  • Genital branch of genitofemoral n.
  • Sympathetic plexus around the testicular a.
  • Sympathetic plexus around the artery of Vas
54
Q

What is an inguinal hernia?

A

It is the protrusion of abdominal contents (usually intestine) within a sac of peritoneum into the inguinal region (canal)

55
Q

What’s going on during an indirect inguinal hernia?
Does it reach the scrotum?
On what side of the inf epigastric a. is it?
Is it congenital or acquired?

A
  • Passes through the deep ring, inguinal canal & superficial ring.
  • Descends into the scrotum.
  • Lies lateral to the inferior epigastric artery.
  • It is congenital, associated with the persistence of processus vaginalis.
56
Q

What’s going on during a direct inguinal hernia?
Does it reach the scrotum?
On what side of the inf epigastric a. is it?
Is it congenital or acquired?

A
  • Occurs through a weakened area of the abdominal wall muscles as the hernia pushes its way directly through the posterior wall of the inguinal canal (i.e. through the inguinal triangle).
  • It is unusual for the direct hernia to reach the scrotum.
  • Lies medial to the inferior epigastric artery.
  • It is acquired hernia.
57
Q

What type of inguinal hernia is more common?

A

Indirect (2 out of 3)

58
Q

What layer contains the 5 umbilical folds (ligaments)?

A

Parietal peritoneum (suprapubically), via structures running in the extraperitoneal tissue

59
Q

What are the medial umbilical folds?

A
  • Raised by medial umbilical ligaments (obliterated umbilical artery)
60
Q

What are the lateral umbilical ligaments?

A
  • Raised by the inferior epigastric arteries in their way to rectus sheath.
61
Q

What/where is the median umbilical fold?

A
  • Raised by median umbilical ligament (fibrosed Urachus)

- Extends from apex of the urinary bladder towards the umbilicus.

62
Q

What lines span horizontally across the rectus abdominis m?

A

Tendoneous lines

63
Q

What is a remnant of the gubernaculum testis?

A

Scrotal ligament

64
Q

What was processus vaginalis a layer of?

A

Peritoneum (parietal, I believe)

65
Q

What vertebral level would you typically find the belly button?

A

L4

SHB Exam 2 (17 decks)

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