Ant. Abdominal Wall Flashcards
What is the pelvic inlet formed from?
Pectin pubis
Arcuate line
Sacral promontory
Where is the subcostal plane located?
10th costal cartilage
sup. Border of L3
Where is the transtubercular plane located?
Tubercles of iliac crests
L5
Where is the transumbilical plane located?
Alternate name?
L3-4
Supracristal plane
Where is the transpyloric plane located?
T12 - L1
Half-way between the jugular notch and the pubic symphysis
What are the anterior muscles of the abdomen?
Rectus abdominus and pyramidal is
What are the Anterolateral muscles of the abdominal wall?
Ext. oblique
Int. oblique
Transversus abdominus
What are the posterior muscles of the abdomen?
Iliacus
Psoas major and minor
Quadratus lumborum
Where is McBurney’s point located?
1/3 distance from lateral end of a line between umbilicus and ASIS
What forms the inguinal ligament?
Alternate name for inguinal ligament?
External abdominal oblique m.
Poupart’s ligament
How do the fibers run of the ext. abdom. Oblique?
What does the aponeurosis form?
Inferomedially
Linea alba
Where does the inguinal ligament attach?
ASIS and pubic tubercle
What makes up the superficial inguinal ring?
Medial crus
Lateral crus
Intercrural fibers
What is the lacunar ligament?
What can it cause?
Extension of the inguinal ligament
Femoral hernia by cutting the femoral canal
What is the pectineal ligament?
Lateral-posterior extension of the lacunar ligament
Can constrict a femoral hernia
How do the fibers run of the internal abdominal oblique muscle run?
What does it help to form?
Superomedially
Conjoint tendon (falx inguinalis)
What forms the Cremaster muscles?
What does this muscle surround?
Internal ab. Oblique m.
Spermatic cord
How do the fibers of the transversus abdominis m. Run?
What does it form medially?
Horizontally
Conjoint tendon w/internal oblique
What kind of muscle is the rectus abdominis?
Describe its tendons?
What muscle may be located here in the rectus sheath?
Strap muscles
Tendinous intersections perpendicular to fibers
Pyramidalis
What does the pyramidalis muscle do?
Where does it attach?
Tenses linea Alba
Pubic crest
Where do nerves and vessels run in the abdomen?
Between internal oblique and transversus abdominis
What are the functions of the anterior abdominal wall?
Flex the trunk anteriorly
Laterally flex the trunk
Rotate the trunk
What are 3 accessory actions of the anterior abdominal wall muscles?
Assist in respiration
Important in Valsalva maneuver
Act during coughing, sneezing, urination, defecation, vomiting, parturition
What is the fatty superficial layer called?
Camper’s
What is the membranous superficial layer called?
Scarpa’s
Where do superficial blood vessels run in the abdomen layers?
Camper’s (fatty layer)
What layer fuses with the fascia lats and is continuous over the penis and scrotum?
Scarpa’s (membranous)
What layer holds sutures in place?
Deep fascia of the abdominal wall
Where can fluid leak into a potential space in the abdomen?
Bw the membranous layer and deep fascia of the external abdominal oblique m.
What muscles does the rectus sheath enclose?
Pyramidalis and rectus abdominis
Where is the arcuate line located?
1/2 way between umbilicus and pubic symphysis
Above the arcuate line, what is the division like of the layers?
Ant: skin, Camper’s, Scarpa’s, ext. oblique m., 1 layer of int. oblique m., rectus abdominis m.
Post: 1 layer of int. oblique m., transversus abdominis m., transversalis fascia, extraperitoneal tissue, parietal peritoneum
What is the arrangement of layers below the arcuate line?
Ant: all the muscles including rectus abdominis
Post: transversalis fascia, extraperitoneal tissue, parietal peritoneum
Where do the deep arteries of the abdominal wall arise from Superiorly?
Inferiorly?
Subclavian artery via the internal thoracic a.
External iliac artery
Where do the superficial arteries arise from superiorly?
Inferiorly?
Perforating branches
Branches from femoral artery
What are the deep arteries of the anterior abdominal wall?
Musculophrenic Superior epigastric Inferior epigastric Deep circumflex iliac Intercostal, subcostal, and lumbar
What are the superficial arteries of the ant. Abdominal wall?
Superficial circumflex iliac
Superficial epigastric
External pudendal (superficial and deep branches)
Where do anterior abdominal wall deep veins drain to?
Subclavian v.
External iliac v.
Lumbar and intercostal v.
Where do superficial abdominal wall veins drain?
W/in Camper’s
Thoracoepigastric via lateral thoracic and superficial epigastric
What sensory dermatome is at T7?
T10?
L1?
Xiphoid tip
Umbilical region
Inguinal fold
What dermatomes does the intercostal n. Innervate?
Subcostal n.?
Lumbar n?
T7-11
T12
L1-4
What nerves supply the anterior abdominal wall muscles?
Ventral rami
Intercostal n.
What is the origin of the iliohypogastric n?
Ilioinguinal n.?
GenFem?
L1 and T12
L1
L1 and L2
What nerve supplies the groin, thigh and scrotum/labrum?
Ilioinguinal
What nerve supplies the cremaster muscle?
Genital branch of GenFem n.
What nerve supplies the suprapubic region?
What branches does it have?
Iliohypogastric
Lateral and anterior cutaneous
What does the femoral branch of the GenFem n. Supply?
Cutaneous area of the femoral triangle
Where does superficial lymphatic drainage drain superiorly?
Inferiorly?
from umbilical region ant. Axillary and sternal nodes
Umbilical region to superficial inguinal nodes
Ant. Abdominal wall lymphatic deep drainage?
Post. Intercostal and lumbar vessels to deep abdominal nodes
From testes to deep abdominal nodes
What are umbilical hernias?
Who is more susceptible?
Incomplete healing of a scar, weakened abdominal muscles
Infants and women
What is an epigastric hernia, what does it involve?
Who is more susceptible?
Hernia of Linea Alba, does not involve umbilicus
More common in men
Floor of inguinal canal?
Inguinal ligament and lacunar ligament
Roof of inguinal canal?
Internal abdominal oblique
Anterior wall of inguinal canal?
External abdominal oblique
Posterior wall of inguinal canal?
Transversalis fascia and conjoint tendon
What makes up the conjoint tendon?
Transversus abdominis and internal oblique
What makes up the spermatic cord?
Ductus deferens, testicular artery and vein
What is the entrance of the spermatic cord into the inguinal canal?
Deep inguinal ring
Where do the tests develop from?
How?
Urogenital ridge of mesoderm
Retroperitoneally
What guides the migration of the testes?
How is it attached?
Gubernaculum
Attached inferiorly to the labial-scrotal fold
What does the processus vaginalis do and what does it become?
Pushes into labial scrotal swelling
Becomes tunica vaginalis
What is cryptorchidism?
Undescended testes
What is hematocele?
Blood in the tunica vaginalis
What fascial layers do the testes acquire?
Internal spermatic fascia
Cremaster fascia and muscle
External spermatic fascia
Tunica vaginalis
CITE
What draws the testes in closer to the body to make it warm?
Cremaster muscle
Dartos muscle
In the descent of the ovaries, what does the upper gubernaculum become?
Lower?
Ovarian ligament
Round ligament of uterus
What is the exit point of the spermatic cord through external oblique muscle?
Superficial inguinal ring
What are the testis and epididymis partially covered by?
Tunica vaginalis
Where do femoral hernias exit the abdomen?
More common in who?
Through the femoral canal, inferior to the inguinal ligament
Women
Where is the bulge located in a direct inguinal hernia?
What causes it?
Most common in who?
Neck of hernial sac is Medial to inferior epigastric artery
Weak conjoint tendon
Older men, usually bilateral
Where is the neck of the hernial sac located in an indirect inguinal hernia?
What causes what?
More common in who?
Lateral to inferior epigastric artery
Incomplete closure of the processus vaginalis
Young boys (hernia descends all the way into scrotum)
Where is the supracristal plane located?
Iliac crests
Spinous process of L4
Where is the spleen located?
LUQ
Where is the tail of the pancreas located?
LUQ
Where is the vermiform appendix located?
RLQ
Where is the duodenum located?
RUQ
Where is the sigmoid colon located?
LLQ
Where is the gallbladder located?
RUQ
What does the deep circumflex iliac artery arise from?
External iliac artery
Where do the superficial arteries arise from?
Femoral artery
What drains to the subclavian vein?
Superior epigastric
Musculophrenic
What drains to the external iliac vein?
Inferior epigastric
Deep circumflex iliac
What drains to the azygos system?
Post. Intercostal veins 10 and 11
Subcostal v.
What drains to the IVC?
Lumbar veins
What is a spigelian hernia?
Hernia at the semilunar line of the anterior rectus sheath
Where can incisional hernias occur?
Surgical or laparotomy sites
Alternate name for the pelvic inlet?
What does it separate?
Above the line indicates what?
Linea terminales
True from false pelvis
False pelvis or abdomen
