anterior abdominal exam 3 anatomy Flashcards
what are the landmarks of the ilium?
asis and iliac crests
what vertebral level is iliac crest?
L4/L5
*transumbilical plan crosses iliac crest at L4
name the dermatome and vertebral level of the umbilicus?
dermatome- T10
vertebral- L3/4
abdominal fascia superficial to deep
-camper fascia- SF fatty layer
-scarpa fascia-deep membranous layer
-investing (deep) fascia
-transversalis fascia
-peritoneum *not fascia just fyi
what fascia limits the spread of abdominal wall infection inferiorly into the thigh?
scarpa fascia
functions of the abdominal muscles
-maintain posture, move torso
-protect abdominal organs
-active during forced expiration
-increase intra-abdominal pressure
list the abdominal muscles
external oblique
internal oblique
transversus abdominis
rectus abdominis
functions of external oblique
-pull chest inferior
-compress abdominal cavity
-ipsilateral side= bending
-contralateral side= rotation
functions of internal oblique
-flexion of trunk
-compress abdominal cavity
-lateral trunk rotation
-lateral trunk flexion
functions of transversus abdominis
-support abdominal wall
-compress abdominal cavity
-ipsilateral bending
-ipsilateral rotation
what is the rectus sheath formed by?
aponeuroses of external and internal obliques and transversus abdominis
linea alba
linear line formed by fibers of rectus sheath fusing at midline
rectus sheath superior to acruate line
aponeurosis of internal oblique splits to enclose rectus abdominis
rectus sheath inferior to acruate line
- 3 aponeurosis pass anteiror to rectus abdominis
- only transversalis fascia posterior to rectus abdominis
do you think the anterior abdomen is more stable above or below the accruate line?
above
what is the scrotum an extension of?
anterior abdominal wall
*initially develops in posterior abdominal wall tho
skin, dartos fascia, and dartos muscle make up what structure?
scrotum
what fascial layer is the dartos fascia continuous with?
scarpa layer of superficial fascia
dartos muscle
function and what kind of muscle
- contracts in response to cold
- made of smooth muscle fibers
what structure is homologous to the scrotum but for females? and what is it an extension of?
- labia majora
- extension of anterior abdominal wall
nerves of the abdominal wall
know what vertebral level associated with each
VENTRAL RAMI
1. intercostal nerves (T7-T11)
2. subcostal nerves (T12)
3. iliohypograstric and ilioguinal nerves (L1)
intercostal between ribs, t12 floating rib
what dermatomes make up abdominal wall?
T7-L1
what artery does the inferior epigastric artery directly branch from?
external iliac artery
what artery does the superficial epigastric artery branch from?
femoral artery
what artery does the superior epigastric artery branch from?
internal thoracic artery
what are the arteries of the abdominal wall?
- posterior intercostal/subcostal
- superior epigastric
- inferior epigastric
- superficial epigastric
what fascial layer will the superficial veins and arteries travel in?
camper fascia
portal system runs through here as well
caval-caval (venous anastomoses)
- superior epigastric veins= drain to SVC
- inferior epigastric veins= drain to IVC
portal-caval (venous anastomoses)
- paraumbilical veins= portal system to kidneys
- superficial epigatric veins= to IVC
what is caput medusae and what can cause it?
- it is distension of paraumbilical and superficial epigastric veins.
- can be caused by cirrhosis of liver, tumor or stenosis blocking blood flow to liver
SF lymphatic drainage of the liver
- axillary nodes
- superficial inguinal nodes
these drain to deeper veins to get back to R or L venous angle
what landmarks are on either side of the inguinal ligament?
ASIS and pubic tubercle
what part of the inguinal canal is an important landmark and where is it relative to the inferior epigastric vessels?
- deep inguinal ring
- lateral to inferior epigastric vessels
what can you check for by putting your finger in the superficial inguinal ring?
this is superolateral to pubic tubercle
you can check for hernia or testicular torsions
ontogeny of inguinal canal-male
- gubernaculum= connects testis to scrotum
- testes descend= through inguinal canal
- testes drag vessels, nerves, and ductus deferens through inguinal canal to form spermatic chord
layers of male inguinal canal superficial to deep
aponeurosis
EO
IO
transversus abdominis
testes
transversalis fascia
ontogeny of the inguinal canal- female
- ovaries develop in posterior abdominal wall and descend
- gubernaculum deritvatives= ovarian ligament and round ligament of uterus
sensory and motor innervation of the inguinal canal
for male and female
- ilioguinal nerve-L1
sensory= inguinal region, scrotum, labia majora - genitofemoral nerve (genital branch)- L1,L2
sensory=inguinal region, scrotum, labia majora
motor=cremaster muscle
what can cause the cremaster reflex to be absent?
- testicular torsion
- upper and lower motor neuron disorders
- spinal injury L1-L2
- can also be cut during hernia repair
afferent and efferent limb of the cremaster reflex
afferent- femoral branch of genitofemoral nerve and ilioinguinal nerve
efferent- genital branch of genitofemoral nerve
indirect (congenital) inguinal hernias
- most common type
- enters deep inguinal ring
- lateral to inferior epigastric vessels
- enclosed in fascial coverings
- can end up in scrotum
what are the layers of fascia that cover an indirect inguinal hernia
- external spermatic fascia
- cremaster muscle/fascia
- internal spermatic fascia
direct (acquired) inguinal hernias
-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
