Ant abd wall and inguinal canal

Question 1

What are the layers of the anterior abdominal wall?

Answer 1

Skin
Superficial fascia
Muscles and aponeuroses
Deep fascia
Extraperitoneal fat
Parietal peritoneum

Question 2

What are the two layers of superficial fascia in the ant abd wall?

Answer 2

Camper’s fascia
Scarpa’s fascia

Question 3

What is the innervation of the external oblique?

Answer 3

Anterior rami of T7-T11 - thoracoabdominal splanchnic N
Subcostal N (T12)

Question 4

What is the innervation of the internal oblique?

Answer 4

Anterior rami of T7-T11 - thoracoabdominal splanchnic N
Subcostal N (T12)
L1 splanchnic N

Question 5

What is the innervation of the transversus abdominis?

Answer 5

Anterior rami of T7-T11 - thoracoabdominal splanchnic N
Subcostal N (T12)
L1 splanchnic N

Question 6

What is the innervation of the rectus abdominis?

Answer 6

Anterior rami of T7-T11 - thoracoabdominal splanchnic N
Subcostal N (T12)

Question 7

What continues as Colles’ fascia and forms the dartos muscle?

Answer 7

Scarpa’s fascia

Question 8

What forms the inguinal ligament, superficial inguinal ring, and external spermatic fascia?

Answer 8

External oblique and its aponeurosis

Question 9

What forms the cremaster fascia and muscle?

Answer 9

Internal oblique and aponeurosis

Question 10

What forms the deep inguinal ring and internal spermatic fascia?

Answer 10

Transversalis fascia

Question 11

What forms the conjoint tendon?

Answer 11

Internal oblique and transversus abdominis

Question 12

What forms the processus vaginalis?

Answer 12

Parietal peritoneum

Question 13

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

Answer 13

External oblique aponeurosis
Anterior lamina of internal oblique

Question 14

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

Answer 14

Posterior lamina of internal oblique
Transversalis abdominus

Question 15

What forms the anterior layer of the rectus sheath below the arcuate line?

Answer 15

Aponeuroses of the internal and external oblique, and the transversalis abdominis

Question 16

What forms the posterior layer of the rectus sheath below the arcuate line?

Answer 16

Transversalis fascia

Question 17

What are the contents of the rectus sheath?

Answer 17

Rectus abdominis
Pyramidalis
Superior and inferior epigastric arteries, veins, and lymphatics
T7-T12 splanchnic N

Question 18

What are the commonly used abdominal incisions?

Answer 18

Median
Paramedian
Transverse
Suprapubic
Subcostal
Gridiron (Mcburney’s point)

Question 19

What are the six common causes of abdomoinal distention?

Answer 19

Food
Fluid
Fat
Feces
Flatus
Fetus

Question 20

What are some of the principle arteries of the anterolateral abdominal wall?

Answer 20

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

Question 21

What is the afferent limb of the cremaster reflex?

Answer 21

Ilioinguinal N

Question 22

What is the efferent limb of the cremaster reflex?

Answer 22

Genital branch of genitofemoral N

Question 23

What nerve root is involved in the cremaster reflex

Answer 23

L1

Question 24

What is anastomosed by the thoraco-epigastric vein?

Answer 24

Superficial epigastric V and lateral thoracic V

Question 25

What is the importance of the thoraco-epigastric vein?

Answer 25

Collateral pathway of drainage to superior vena cava when inferior vena cava is bloacked

Question 26

Where do superficial lymphatics from the ant abd wall above the umbilicus drain to?

Answer 26

Axillary lymph nodes

Question 27

Where do superficial lymphatics from the ant abd wall below the umbilicus drain to?

Answer 27

Superficial inguinal lymph nodes

Question 28

Where to deep lymphatic from the ant abd wall drain to?

Answer 28

External and internal iliac lymph nodes Lumbar lymph nodes

Question 29

What is the remnant of the urachus?

Answer 29

Median umbilical fold

Question 30

What are the remnants of the occluded umbilical arteries?

Answer 30

2 medial umbilical folds

Question 31

What covers the inferior epigastric vessels?

Answer 31

Two lateral umbilical folds

Question 32

What is the Hesselbach triangle?

Answer 32

Medial inguinal fossae between the medial and lateral umbilical folds

Question 33

What is the location of the inguinal canal?

Answer 33

Parallel and above medial 1/2 of inguinal ligament

Question 34

What are the contents of the inguinal canal?

Answer 34

Spermatic cord in males Round ligament of uterus in females Blood and lymphatic vessels Ilioinguinal N

Question 35

When do the testes move through the inguinal ring?

Answer 35

Weeks 9-28

Question 36

What is the course of an indirect inguinal hernia?

Answer 36

Through inguinal canal, can pass all the way through, with the processus vaginalis Exits through the superficial ring entering scrotum

Question 37

What is the course of a direct inguinal hernia?

Answer 37

Only medial third of inguinal canal, external to processus vaginalis Exits via superficial ring lateral to cord, not entering scrotum

Question 38

Where can you palpate the superficial inguinal ring?

Answer 38

Superolateral to pubic tubercle

Question 39

Where can you palpate the deep inguinal ring?

Answer 39

Superior to inguinal ligament, 2-4 cm superolateral to pubic tubercle

Question 40

What are the coverings of the spermatic cord?

Answer 40

Internal spermatic fascia Cremasteric fascia External spermatic fascia

Question 41

What makes up the spermatic cord?

Answer 41

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

Question 42

What are the two layers of the scrotum?

Answer 42

Skin Dartos fascia

Question 43

What are the arteries of the scrotum?

Answer 43

Posterior scrotal branches of perineal A Anterior scrotal branches of external pudendal A Cremasteric branch of inferior epigastric A

Question 44

What are the nerves of the scrotum?

Answer 44

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

Question 45

Where does lymph from the scrotum drain?

Answer 45

Superficial inguinal lymph nodes

Question 46

What are signs of a testis hydrocele?

Answer 46

Scrotum enlarges and does not reduce in size when lying down Scrotum transmits light

Question 47

Where is the fluid located in a testis hydrocele?

Answer 47

In persistent processus vaginalis

Question 48

What is a hematocele?

Answer 48

Collection of blood in tunica vaginalis

Question 49

What are signs of varicocele?

Answer 49

Does not transmit light Enlarged scrotum that reduces in size when lying down