anterior abdominal exam 3 anatomy

Question 1

what are the landmarks of the ilium?

Answer 1

asis and iliac crests

Question 2

what vertebral level is iliac crest?

Answer 2

L4/L5
*transumbilical plan crosses iliac crest at L4

Question 3

name the dermatome and vertebral level of the umbilicus?

Answer 3

dermatome- T10
vertebral- L3/4

Question 4

abdominal fascia superficial to deep

Answer 4

-camper fascia- SF fatty layer
-scarpa fascia-deep membranous layer
-investing (deep) fascia
-transversalis fascia
-peritoneum *not fascia just fyi

Question 5

what fascia limits the spread of abdominal wall infection inferiorly into the thigh?

Answer 5

scarpa fascia

Question 6

functions of the abdominal muscles

Answer 6

-maintain posture, move torso
-protect abdominal organs
-active during forced expiration
-increase intra-abdominal pressure

Question 7

list the abdominal muscles

Answer 7

external oblique
internal oblique
transversus abdominis
rectus abdominis

Question 8

functions of external oblique

Answer 8

-pull chest inferior
-compress abdominal cavity
-ipsilateral side= bending
-contralateral side= rotation

Question 9

functions of internal oblique

Answer 9

-flexion of trunk
-compress abdominal cavity
-lateral trunk rotation
-lateral trunk flexion

Question 10

functions of transversus abdominis

Answer 10

-support abdominal wall
-compress abdominal cavity
-ipsilateral bending
-ipsilateral rotation

Question 11

what is the rectus sheath formed by?

Answer 11

aponeuroses of external and internal obliques and transversus abdominis

Question 12

linea alba

Answer 12

linear line formed by fibers of rectus sheath fusing at midline

Question 13

rectus sheath superior to acruate line

Answer 13

aponeurosis of internal oblique splits to enclose rectus abdominis

Question 14

rectus sheath inferior to acruate line

Answer 14

• 3 aponeurosis pass anteiror to rectus abdominis
• only transversalis fascia posterior to rectus abdominis

Question 15

do you think the anterior abdomen is more stable above or below the accruate line?

Answer 15

above

Question 16

what is the scrotum an extension of?

Answer 16

anterior abdominal wall

*initially develops in posterior abdominal wall tho

Question 17

skin, dartos fascia, and dartos muscle make up what structure?

Answer 17

scrotum

Question 18

what fascial layer is the dartos fascia continuous with?

Answer 18

scarpa layer of superficial fascia

Question 19

dartos muscle

function and what kind of muscle

Answer 19

• contracts in response to cold
• made of smooth muscle fibers

Question 20

what structure is homologous to the scrotum but for females? and what is it an extension of?

Answer 20

• labia majora
• extension of anterior abdominal wall

Question 21

nerves of the abdominal wall

know what vertebral level associated with each

Answer 21

VENTRAL RAMI
1. intercostal nerves (T7-T11)
2. subcostal nerves (T12)
3. iliohypograstric and ilioguinal nerves (L1)

intercostal between ribs, t12 floating rib

Question 22

what dermatomes make up abdominal wall?

Answer 22

T7-L1

Question 23

what artery does the inferior epigastric artery directly branch from?

Answer 23

external iliac artery

Question 24

what artery does the superficial epigastric artery branch from?

Answer 24

femoral artery

Question 25

what artery does the superior epigastric artery branch from?

Answer 25

internal thoracic artery

Question 26

what are the arteries of the abdominal wall?

Answer 26

1. posterior intercostal/subcostal 2. superior epigastric 3. inferior epigastric 4. superficial epigastric

Question 27

what fascial layer will the superficial veins and arteries travel in?

Answer 27

camper fascia | portal system runs through here as well

Question 28

caval-caval (venous anastomoses)

Answer 28

* superior epigastric veins= drain to SVC * inferior epigastric veins= drain to IVC

Question 29

portal-caval (venous anastomoses)

Answer 29

* paraumbilical veins= portal system to kidneys * superficial epigatric veins= to IVC

Question 30

what is caput medusae and what can cause it?

Answer 30

* it is distension of paraumbilical and superficial epigastric veins. * can be caused by cirrhosis of liver, tumor or stenosis blocking blood flow to liver

Question 31

SF lymphatic drainage of the liver

Answer 31

1. axillary nodes 2. superficial inguinal nodes | these drain to deeper veins to get back to R or L venous angle

Question 32

what landmarks are on either side of the inguinal ligament?

Answer 32

ASIS and pubic tubercle

Question 33

what part of the inguinal canal is an important landmark and where is it relative to the inferior epigastric vessels?

Answer 33

* deep inguinal ring * lateral to inferior epigastric vessels

Question 34

what can you check for by putting your finger in the superficial inguinal ring? | this is superolateral to pubic tubercle

Answer 34

you can check for hernia or testicular torsions

Question 35

ontogeny of inguinal canal-**male**

Answer 35

* gubernaculum= connects testis to scrotum * testes descend= through inguinal canal * testes drag vessels, nerves, and ductus deferens through inguinal canal to form **spermatic chord**

Question 36

layers of male inguinal canal superficial to deep

Answer 36

aponeurosis EO IO transversus abdominis **testes** transversalis fascia

Question 37

ontogeny of the inguinal canal- female

Answer 37

* ovaries develop in posterior abdominal wall and descend * gubernaculum deritvatives= ovarian ligament and round ligament of uterus

Question 38

sensory and motor innervation of the inguinal canal | for male and female

Answer 38

* ilioguinal nerve-L1 sensory= inguinal region, scrotum, labia majora * genitofemoral nerve (genital branch)- L1,L2 sensory=inguinal region, scrotum, labia majora motor=cremaster muscle

Question 39

what can cause the cremaster reflex to be absent?

Answer 39

* testicular torsion * upper and lower motor neuron disorders * spinal injury L1-L2 * can also be cut during hernia repair

Question 40

afferent and efferent limb of the cremaster reflex

Answer 40

afferent- femoral branch of genitofemoral nerve and ilioinguinal nerve efferent- genital branch of genitofemoral nerve

Question 41

indirect (congenital) inguinal hernias

Answer 41

* most common type * enters deep inguinal ring * lateral to inferior epigastric vessels * enclosed in fascial coverings * can end up in scrotum

Question 42

what are the layers of fascia that cover an indirect inguinal hernia

Answer 42

* external spermatic fascia * cremaster muscle/fascia * internal spermatic fascia

Question 43

direct (acquired) inguinal hernias

Answer 43

-inguinal triangle (area of weakness): rectus abdominis, inferior epigastric vessels, inguinal ligament -pushes into peritoneum and transversalis fascia -medial to inferior epigastric vessels -enters posterior wall, inguinal canal -rarely enters scrotum