Ant abd wall and inguinal canal Flashcards
What are the layers of the anterior abdominal wall?
Skin
Superficial fascia
Muscles and aponeuroses
Deep fascia
Extraperitoneal fat
Parietal peritoneum
What are the two layers of superficial fascia in the ant abd wall?
Camper’s fascia
Scarpa’s fascia
What is the innervation of the external oblique?
Anterior rami of T7-T11 - thoracoabdominal splanchnic N
Subcostal N (T12)
What is the innervation of the internal oblique?
Anterior rami of T7-T11 - thoracoabdominal splanchnic N
Subcostal N (T12)
L1 splanchnic N
What is the innervation of the transversus abdominis?
Anterior rami of T7-T11 - thoracoabdominal splanchnic N
Subcostal N (T12)
L1 splanchnic N
What is the innervation of the rectus abdominis?
Anterior rami of T7-T11 - thoracoabdominal splanchnic N
Subcostal N (T12)
What continues as Colles’ fascia and forms the dartos muscle?
Scarpa’s fascia
What forms the inguinal ligament, superficial inguinal ring, and external spermatic fascia?
External oblique and its aponeurosis
What forms the cremaster fascia and muscle?
Internal oblique and aponeurosis
What forms the deep inguinal ring and internal spermatic fascia?
Transversalis fascia
What forms the conjoint tendon?
Internal oblique and transversus abdominis
What forms the processus vaginalis?
Parietal peritoneum
What forms the anterior layer of the rectus sheath above the arcuate line?
External oblique aponeurosis
Anterior lamina of internal oblique
What forms the posterior layer of the rectus sheath above the arcuate line?
Posterior lamina of internal oblique
Transversalis abdominus
What forms the anterior layer of the rectus sheath below the arcuate line?
Aponeuroses of the internal and external oblique, and the transversalis abdominis
What forms the posterior layer of the rectus sheath below the arcuate line?
Transversalis fascia
What are the contents of the rectus sheath?
Rectus abdominis
Pyramidalis
Superior and inferior epigastric arteries, veins, and lymphatics
T7-T12 splanchnic N
What are the commonly used abdominal incisions?
Median
Paramedian
Transverse
Suprapubic
Subcostal
Gridiron (Mcburney’s point)
What are the six common causes of abdomoinal distention?
Food
Fluid
Fat
Feces
Flatus
Fetus
What are some of the principle arteries of the anterolateral abdominal wall?
Internal thoracic to musculophrenic and superior epigastric
Aorta to 10th and 11th posterior intercostal and subcostal
External iliac to inferior epigastric and deep circumflex iliac
Femoral to superficial circumflex iliac and superficial epigastric
What is the afferent limb of the cremaster reflex?
Ilioinguinal N
What is the efferent limb of the cremaster reflex?
Genital branch of genitofemoral N
What nerve root is involved in the cremaster reflex
L1
What is anastomosed by the thoraco-epigastric vein?
Superficial epigastric V and lateral thoracic V
What is the importance of the thoraco-epigastric vein?
Collateral pathway of drainage to superior vena cava when inferior vena cava is bloacked
Where do superficial lymphatics from the ant abd wall above the umbilicus drain to?
Axillary lymph nodes
Where do superficial lymphatics from the ant abd wall below the umbilicus drain to?
Superficial inguinal lymph nodes
Where to deep lymphatic from the ant abd wall drain to?
External and internal iliac lymph nodes
Lumbar lymph nodes
What is the remnant of the urachus?
Median umbilical fold
What are the remnants of the occluded umbilical arteries?
2 medial umbilical folds
What covers the inferior epigastric vessels?
Two lateral umbilical folds
What is the Hesselbach triangle?
Medial inguinal fossae between the medial and lateral umbilical folds
What is the location of the inguinal canal?
Parallel and above medial 1/2 of inguinal ligament
What are the contents of the inguinal canal?
Spermatic cord in males
Round ligament of uterus in females
Blood and lymphatic vessels
Ilioinguinal N
When do the testes move through the inguinal ring?
Weeks 9-28
What is the course of an indirect inguinal hernia?
Through inguinal canal, can pass all the way through, with the processus vaginalis
Exits through the superficial ring entering scrotum
What is the course of a direct inguinal hernia?
Only medial third of inguinal canal, external to processus vaginalis
Exits via superficial ring lateral to cord, not entering scrotum
Where can you palpate the superficial inguinal ring?
Superolateral to pubic tubercle
Where can you palpate the deep inguinal ring?
Superior to inguinal ligament, 2-4 cm superolateral to pubic tubercle
What are the coverings of the spermatic cord?
Internal spermatic fascia
Cremasteric fascia
External spermatic fascia
What makes up the spermatic cord?
Vas deferens
Testicular A
Artery of ductus deferens
Cremasteric A
Pampiniform venous plexus
Sympathetic nerve fibers
Genital branch of genitofemoral N
Lymphatic vessels
Vestige of processus vaginalis
What are the two layers of the scrotum?
Skin
Dartos fascia
What are the arteries of the scrotum?
Posterior scrotal branches of perineal A
Anterior scrotal branches of external pudendal A
Cremasteric branch of inferior epigastric A
What are the nerves of the scrotum?
Genital branch of genitofemoral N
Anterior scrotal branch of ilioinguinal N
Posterior scrotal branch of perineal N
Perineal branches of posterior cutaneous nerve of thigh
Where does lymph from the scrotum drain?
Superficial inguinal lymph nodes
What are signs of a testis hydrocele?
Scrotum enlarges and does not reduce in size when lying down
Scrotum transmits light
Where is the fluid located in a testis hydrocele?
In persistent processus vaginalis
What is a hematocele?
Collection of blood in tunica vaginalis
What are signs of varicocele?
Does not transmit light
Enlarged scrotum that reduces in size when lying down
