Ant. Abdominal Wall 2 Flashcards
The internal surface of the anterior abdominal wall is lined with _____ _____.
parietal peritoneum
There are ___ umbilical folds (ligaments covered by parietal peritoneum) that extend from the umbilicus along the inferior, internal abdominal surface.
5
This Umbilical FOLD extends from the apex of the bladder to the umbilicus and contains the median umbilical ligament.
Median
This Umbilical LIGAMENT is the remnant of the reduced ALLANTOIC STALK OR URACHUS.
Median
Which umbilical ligament connects the bladder to the umbilicus?
Median umbilical ligament
These umbilical folds are lateral to the median umbilical fold.
Right and left MEDIAL umbilical folds
Right and left MEDIAL umbilical folds contains which umbilical ligaments?
R/L medial umbilical ligaments
R/L medial umbilical ligaments is the remnant of the fetal umbilical arteries which carried which type of blood?
DEOXYGENATED BLOOD!
These umbilical folds are lateral to the medial umbilical folds.
R/L Lateral umbilical folds
R/L Lateral umbilical folds are peritoneal coverings of the _____ _____ arteries & veins.
inferior epigastric
_____ _____ _____: patent arteries that arise from the external iliac arteries.
Inferior epigastric arteries
Which ligaments forms the lateral border of the inguinal triangle (Hesselbach’s triangle)?
R/L lateral umbilical ligaments
This LIGAMENT has an embryological derivative of urachus (reduced allantoic stalk).
Median umbilical ligament
This LIGAMENT has an embryological derivatives of the occluded umbilical arteries.
R/L medial umbilical ligaments
This LIGAMENT has the patent inferior epigastric arteries and veins.
R/L lateral umbilical ligaments
What is the shallow fossae between the folds?
Peritoneal fossae
What are the 3 fossaes in Peritoneal fossae?
- Supravesical fossae
- Medial inguinal fossae
- Lateral inguinal fossae
Which one of the Peritoneal fossae is between the median and medial folds (site for rare external supravesicular hernias)?
Supravesical fossae
Which one of the Peritoneal fossae is between the medial and lateral folds (site for less common, direct inguinal hernias)?
Medial inguinal fossae
Which one of the Peritoneal fossae is lateral to the lateral umbilical folds, which includes the deep inguinal rings (site for MOST COMMON, INDIRECT INGUINAL HERNIAS IN MALE)?
Lateral inguinal fossae
_____ Canal–oblique, inferomedially directed
passage through the inferior abdominal wall.
Inguinal
Inguinal canal lies parallel to the inguinal ligament and contains the _____ _____(males) or the _____ _____ of the uterus (female).
spermatic cord; round ligament of the uterus
Borders of the Inguinal Canal:
-Formed by aponeuroses of external oblique and internal oblique.
Anterior & lateral borders
Borders of the Inguinal Canal:
-Formed by transversalis fascia & conjoint tendon (joining of the internal oblique and the transversus abdominis muscles. (medial support)
Posterior & medial borders
Borders of the Inguinal Canal:
-Formed by the arching muscle fibers of the internal oblique and transverse abdominal muscles.
Roof
Borders of the Inguinal Canal:
-Formed by the trough of the inguinal ligament
Floor
What is a slit-like opening between the fibers of the external oblique aponeurosis.
Superficial inguinal ring
Superficial inguinal ring is located _____ to the pubic tubercle.
superolateral
What are the contents in the Inguinal canal? (4)
- Spermatic cord
- Round ligament
- Genital branch of the gentofemoral nerve
- Ilioinguinal nerver
(Parts of the Superficial Inguinal Ring):
-The _____ crus attaches to the pubic tubercle and the _____ crus attaches to the pubic crest.
lateral crus; medial crus
(Parts of the Superficial Inguinal Ring):
-_____ _____ are fibers found between the crura which prevent the crura from spreading.
Intercrural fibers
(Parts of the Superficial Inguinal Ring):
_____ ligament – horizontally oriented ligament running along the pectineal line of the pecten pubis.
Pectinate
(Parts of the Superficial Inguinal Ring):
_____ ligament – fibers from the deep aspect of the inguinal ligament which also attaches to the pectineal line of the pecten pubis. It reinforces the medial floor of the inguinal canal.
Lacunar ligament
The _____ ligament forms the medial border of the femoral canal through which a femoral herniation passes (MOST COMMON IN FEMALE).
Lacunar
What is A DEFECT OF THE TRANSVERSALIS FASCIA, forming an opening and the internal lining of the inguinal canal.
Deep (Internal) Inguinal Ring
What allows the passage of the ductus deferens, round ligament of the uterus and gonadal vessels.
Deep (Internal) Inguinal Ring
What is located just superior to the middle of the inguinal ligament, and LATERAL TO THE INFERIOR EPIGASTRIC ARTERY.
Deep (Internal) Inguinal Ring
_____ Hernia is a protrusion of parietal peritoneum and viscera through the abdominal cavity LATERAL to the lateral umbilical fold. It enters the deep inguinal ring if congenital and exits the superficial ring if it is complete.
Indirect
_____ Hernia – protrusion MEDIAL to the inferior epigastric vessels that enters Hesselbach’s triangle ( triangle bounded by the inferior epigastric vessels, rectus abdominis and the inguinal ligament). Does not traverse the entire canal.
Direct
_____ Herniation: A protrusion of parietal peritoneum and/or abdominal viscera into the femoral canal.
Femoral herniation
- Femoral herniation is more prevalent in FEMALES and protrudes _____ to the inguinal ligament and _____ to the lacunar ligament.
- Strangulation of the herniation may occur.
inferior; lateral
Development of the Inguinal Canal in the male:
_____ _____- a peritoneal diverticulum (expansion) that carries the muscular and fascial layers with it as it forms the inguinal canal. It eventually enters the primordial scrotum. THIS IS A SPACE.
Processus Vaginalis
Development of the Inguinal Canal in the male:
_____- a fibrous cord that connects the UNDESCENDED TESTES with the anterior abdominal wall at the site of the future deep inguinal ring.
Gubernaculum
Which congenital anomalies occurs in 30% of premature male babies; condition whereby the ONE OR BOTH TESTES FAILS TO DESCEND AND MATURE. The testis may be in the abdominal cavity or anywhere along the route of descent. There is 20 – 44 % increase in risk of TESTICULAR CANCER.
Cryptorchidism (Undescended testicle)
Which congenital anomaly?
-After traversing the inguinal canal, the testes deviate from the route of DESCENT INTO ABNORMAL LOCATIONS. (E.g. proximal thigh, dorsal penis and opposite side.)
Ectopic Testes
Which congenital anomaly?
-excess fluid in a persistent processus vaginalis.
Hydrocele
What are the 4 Spermatic cord coverings?
- Internal spermatic fascia
- Cremasteric muscle
- External spermatic fascia
- Transversus abdominis muscle
Spermatic cord coverings:
Which structure is derived from transversalis
fascia?
Internal spermatic fascia
Spermatic cord coverings: Which structure is derived from the internal oblique aponeurosis? This is the EFFERENT arch of the CREMASTERIC REFLEX.
Cremasteric muscle
What is the innervation to cremasteric muscle?
Genital branch of the genitofemoral nerve
Spermatic cord coverings:
Which structure is derived from the external oblique aponeurosis?
External spermatic fascia
Spermatic cord coverings:
Which structure does NOT contribute to spermatic cord layers?
Transversus abdominis muscle!
“Point and Shoot”-
-Point is to _____ and
under _____ control.
-Shoot is to _____ and under _____ control.
- Urinate; Parasympathetics
- Ejaculate; Sympathetics
Development of the Inguinal Canal in the female:
-A similar process as in the male, diverticulum through the muscular and fascial layers along with the peritoneum that forms the inguinal canal.
Processus Vaginalis
Development of the Inguinal Canal in the female:
-A fibrous cord that connects the OVARIES AND UTERUS to the developing LABIUM MAJUS.
Gubernaculum
Development of the Inguinal Canal in the female:
-This is the ADULT remnant of the GUBERNACULUM that connects the OVARIES TO THE UTERUS.
Proper ovarian ligament
Development of the Inguinal Canal in the female:
-This is the ADULT remnant of the GUBERNACULUM that connects the UTERUS TO THE LABIUM MAJUS.
Round ligament
The inguinal canals and rings in the female are much _____ and _____ than in males.
smaller; narrower
Development of the Inguinal Canal in the female:
- The ovaries descend into the _____ _____ and stops.
- After this, the processus vaginalis obliterates forming the _____ vaginalis.
- true pelvis
- tunica vaginalis
Development of the Inguinal Canal in the female:
-If there is incomplete closure of the PROCESSUS VAGINALIS, a persistent canal may remain called the _____ __ _____. A herniation into the labia majora may occur.
Canal of Nuck
What are the 3 Round ligaments (Ligamentum teres)?
- Round ligament of the uterus (Ligamentum teres of uterus)
- Round ligament of femur (Ligamentum teres of femur)
- Round ligament of liver