Anterior Abdomen/Inguinal Anatomy

Question 1

5 muscles of anterior abdomen

Answer 1

ex oblique, in oblique, transversus abs, rectus abs, pyramidalis

last two in rectus sheath

Question 2

innervation of anterior ab muscles

Answer 2

thoracoabdominal nerves, ventral rami of T7-T12

Question 3

formation of inguinal ligament

Answer 3

inferior edge of aponeurosis of ex oblique, attaching to ASIS and medially to pubic tubercle

Question 4

fibers of ex oblique

Answer 4

run down and in, aponeurosis at mid clavicular

Question 5

fibers of internal oblique

Answer 5

out and up, aponeurotic at MCL

Question 6

attachment of three flat abs

Answer 6

linea alba in the center under xiphoid

Question 7

location/fn of quadratus lumborum muscle

Answer 7

behind psoas major, hikes the hip up

Question 8

main hip flexor

Answer 8

iliopsoas, where psoas major and iliacus muscle unite

Question 9

3 main diaphragmatic apertures and their locations

Answer 9

caval (IVC) opening- T8
esophageal hiatus- T10
aortic hiatus- T12

I 8 10 Eggs At 12

Question 10

list layers in order from skin to abdominal cavity

Answer 10

• skin
• superficial campers fascia
• deep membranous scarpas fascia
• ex oblique
• in oblique
• transversus ab
• transversus fascia
• peritoneum

Question 11

what makes up rectus sheath

Answer 11

interweaving aponeuroses of ex oblique, in oblique, transversus abs- surround recuts abs

Question 12

arcuate line

Answer 12

point of transition in rectus sheath, where all 3 aponeuroses course anterior to rectus abs instead of surrounding them, only transveralis fascia posterior

Question 13

3 types of folds on anterior ab wall

Answer 13

median umbilical fold- single midline fold from median umbilical ligament (urachus)

medial umbilical folds- obliterated fetal umbilical arteris

lateral umbilical folds- from inferior epigastric vessels

Question 14

ligamentum teres

Answer 14

remnant of umbilical vein, from umbilicus to liver, covered by falciform ligament

Question 15

falciform ligament

Answer 15

layer of peritoneum reflecting liver and anterior ab wall

Question 16

arterial supply to ab wall

Answer 16

superior and inferior epigastrics mainly, anastomose w/i rectus abs

also intercostals, musculophrenics, femoral and iliac arteries

Question 17

subcostal nerve is

Answer 17

T12 ventral ramus

Question 18

2 nerves from L1 ventral ramus

Answer 18

iliohypogastric, ilioinguinal

Question 19

main structures in inguinal canal

Answer 19

spermatic cord in males, round ligament of uterus in females, ilioinguinal nerve in both

Question 20

describe the boundaries of the inguinal canal

Answer 20

floor- inguinal ligament
roof- in obliqe, transversus ab
anterior wall- apo of ex oblique
posterior wall- transversalis fascia, w/ conjoint tendon medially

Question 21

conjoint tendon

Answer 21

fusion of aponeuroses from in oblique and transversus ab more medially inserting onto pubic crest

Question 22

what pulls testes down into scrotum

Answer 22

gubernaculum

Question 23

outpocketing of peritoneum into scrotum w/ testi and neurovasculature

Answer 23

processes vaginalis

Question 24

3 layers of spermatic cord and their origin

Answer 24

• external spermatic fascia from ex oblique
• middle cremasteric spermatic fascia from in oblique
• internal spermatic fascia from transversalis fascia
• not from transversus abs

Question 25

fate of processes vaginalis

Answer 25

mostly degenerates except around anterolateral testicle, this is the tunica vaginalis

Question 26

5 main contents of spermatic cord

Answer 26

1. testicular artery
2. ductus deferns- transmits sperm to pelvis
3. pampinoform plexus of veins- venous drainage and thermoregulation
4. genital branch of genitofemoral nerve- innervates cremaster muscle
5. lymphatics and autonomic nerves

Question 27

define hernia

Answer 27

protrusion of visceral structure into incorrect space

Question 28

indirect vs direct hernia

Answer 28

indirect (congenital)- follow path of spermatic cord through deep and superficial rings of inguinal canal, contents pushed into scrotum

direct: from ab or fascia weakness, viscera protrude from medial end of inguinal canal outside of spermatic cord

Question 29

boundaries of hesselbachs triangle

Answer 29

inferior: inguinal ligament
lateral: epigastric vessels
medial: rectus abs

Question 30

hernias in relation to epigastric vessels

Answer 30

direct hernias go thru triangle medial to epigastric

indirect thru deep ring, lateral to epigastric vessels (outside triangle)