Anterior Abdominal Wall Flashcards
1
Q
What level is the xiphisternal joint?
A
T9
2
Q
What level is the xiphisternal process?
A
T10
3
Q
What is the lateral limit of rectus abdominis?
A
Linea semilunaris/ semilunar line
4
Q
Segment rectus abdominis and connect to anterior wall of aponeurotic coverings to prevent bowstringing
A
Tendinous intersections
5
Q
a midline tendinous line from xiphisternum to pubic symphysis where the aponeuroses of the abdominal muscles meet?
A
Linea alba “white line”
6
Q
All layers of the wall fuse at this level (L3-L4)
A
Umbilicus
7
Q
what are the vertical lines in abdomen?
A
Midline, midclavicular line
8
Q
What are the horizontal planes in abdomen?
A
Transpyloric Planes
Subcostal plane
Intercristal plane
Intertubercular plane
9
Q
Where does transpyloric plane passes?
A
tips of 9th costal cartilages on both sides
10
Q
Where does transpyloric plane lie?
A
L1 vertebra pylorus of the stomach duodenojejunal function neck of pancreas hila of kidneys
11
Q
Joins lowest point of costal margin on both sides that is the 10th costal cartilage
A
Subcostal Plane
12
Q
What level is the Subcostal Plane?
A
L3 vertebra
13
Q
Passes across highest points on iliac crests
A
Intercristal Plane
14
Q
At what level is the Intercristal Plane?
A
L4 vertebra
15
Q
What procedure is commonly done at the level of L4?
A
Lumbar spine tap
16
Q
Joins tubercles on iliac crests
A
Intertubercular Plane
17
Q
What level is the Intertubercular Plane?
A
L5 vertebra
18
Q
Divided topographically by two transverse and two longitudinal planes into nine regions
A
Abdomen
19
Q
Also divided by vertical and horizontal planes through the umbilicus into four quadrants
A
Abdomen
20
Q
What are the 9 regions of abdomen?
A
1: right hypochondriac/ hypochondrium
2: epigastrium
3: left hypochondriac/ hypochondrium
4: right lumbar/ flank
5: umbilical
6: left lumbar/ flank
7: right inguinal (iliac)/ groin
8: hypogastric (pubic)
9: left inguinal (iliac)/ groin
21
Q
What are the 4 regions of abdomen?
A
right and left upper quadrants and right and left lower quadrants
22
Q
What level is the umbilicus?
A
at the level of the intervertebral disk between L3-L4 vertebrae
23
Q
what innervates umbilicus?
A
10th thoracic nerve
24
Q
May occur due to failure of the midgut to return to the abdomen early in fetal life, and it occurs as a protrusion of intestines through a defect at the umbilicus.
A
Umbilical hernia
25
A persistence of the herniation of abdominal contents, which remain outside the abdominal cavity and are covered only by the amniotic membrane; thus, immediate surgical repair is required.
Omphalocele
26
A protrusion of the abdominal viscera through a defect in the abdominal wall without involving the umbilical card on the right side of the umbilicus.
Gastroschisis
27
What are the common actions of external oblique, internal oblique, transverse, and rectus abdominis muscles?
Flexes trunk
| Compresses abdomen
28
What is the exercise to reduce abdomen area?
sit-ups
29
What muscles are involved in forceful expiration?
Internal oblique muscle
| Transverse muscle
30
How many percent have an absent or unpaired pyramidalis muscle?
10-20% of cases
31
Continues over the inguinal ligament to merge with the superficial fascia of the thigh.
Superficial (Fatty) Layer of the Superficial Fascia (Camper Fascia)
32
Continues over the pubis and perineum as the superficial layer of the superficial perineal fascia
Superficial (Fatty) Layer of the Superficial Fascia (Camper Fascia)
33
Attached to the fascia lata just below the inguinal ligament.
Deep (Membranous) Layer of the Superficial Fascia (Scarpa Fascia)
34
Scarpa Fascia continues over the pubis and perineum as the membranous layer of the superficial perineal fascia.
Colles fascia
35
Scarpa Fascia continues over the penis as the superficial fascia of the penis and over the scrotum as the ____, which contains smooth muscle.
tunica dartos
36
Covers the muscles and continues over the spermatic cord at the superficial inguinal ring as the external spermatic fascia.
Deep Fascia
37
Continues over the penis as the deep fascia of the penis __ and over the pubis and perineum as the deep perineal fascia.
Buck fascia
38
Is a tendinous median raphe between the two rectus abdominis muscles, formed by the fusion of the aponeuroses of the external oblique, internal oblique, and transverse abdominal muscles.
Linea Alba
39
Linea Alba becomes the __ in pregnancy , probably due to hormone stimulation to produce more melanin.
linea nigra
40
Is a curved line along the lateral border of the rectus abdominis.
Linea Semilunaris
41
Is a crescent-shaped line marking the inferior limit of the posterior layer of the rectus sheath just below the level of the iliac crest.
Linea Semicircularis (Arcuate Line)
42
Represents the medial triangular expansion of the inguinal ligament to the pectineal line of the pubis.
Lacunar Ligament (Gimbernat Ligament)
43
Forms the medial border of the femoral ring and the floor of the inguinal canal.
Lacunar Ligament (Gimbernat Ligament)
44
May contain extravasated urine between this fascia and the deep fascia of the abdomen, resulting from rupture of the spongy urethra.
Deep (Membranous) Layer of the Superficial Fascia (Scarpa Fascia)
45
Extends from the xiphoid process to the pubic symphysis
Linea Alba
46
Is a strong fibrous band that extends laterally from the lacunar ligament along the pectineal line of the pubis.
Pectineal (Cooper) Ligament
47
Is the folded lower border of the aponeurosis of the external oblique muscle, extending between the anterior superior iliac spine and the pubic tubercle.
Inguinal Ligament (Poupart Ligament)
48
Forms the floor (inferior wall) of the inguinal canal.
Inguinal Ligament (Poupart Ligament)
49
Is a fascial partition that separates the muscular [(lateral) and vascular (medial) lacunae deep to the inguinal ligament.
Iliopectineal Arcus or Ligament
50
It transmits the iliopsoas muscle.
muscular lacuna
51
It transmits the femoral sheath and its contents, including the femoral vessels, a femoral branch of the genitofemoral nerve, and the femoral canal.
vascular lacuna
52
Is formed by fibers derived from the medial portion of the inguinal ligament and lacunar ligament and runs upward over the conjoint tendon to end at the linea alba.
Reflected Inguinal Ligament
53
Is formed by the aponeuroses of the internal oblique and transverse muscles of the abdomen and is inserted into the pubic tubercle and crest.
Falx Inguinalis (Conjoint Tendon)
54
Strengthens the posterior wall of the medial half of the inguinal canal.
Falx Inguinalis (Conjoint Tendon)
55
Is formed by fusion of the aponeuroses of the external oblique, internal oblique, and transverse muscles of the abdomen.
Rectus Sheath
56
What are the contents of Rectus Sheath?
```
rectus abdominis
pyramidal muscle
superior epigastric vessel
inferior epigastric vessel
lower 5 intercostal nerves
subcostal nerve
```
57
What forms the rectus sheath?
aponeuroses of:
external oblique
internal oblique
transverse muscles
58
In the Anterior Layer of the Rectus Sheath, what are above the arcuate line?
aponeuroses of the external and internal oblique muscles
59
In the Anterior Layer of the Rectus Sheath, what are below the arcuate line?
aponeuroses of the external oblique, internal oblique, and transverse muscles
60
In the Posterior Layer of the Rectus Sheath, what are above the arcuate line?
aponeuroses of the internal oblique and transverse muscles
61
In the Posterior Layer of the Rectus Sheath, what are below the arcuate line?
rectus abdominis is in contact with the transversalis fascia
62
It is a thin layer of fascia that lines the transversus abdominis muscle and is continuous with a similar layer lining the diaphragm and the iliacus muscle
Fascia Transversalis
63
It is a thin layer of connective tissue that contains fat and lies between the fascia transversalis and the parietal peritoneum
Extraperitoneal Fat (Tissue)
64
It is a serous membrane that lines the walls of the abdomen and is continuous below with the parietal peritoneum lining the pelvis
Parietal Peritoneum
65
Is bounded medially by the linea semilunaris (lateral edge of the rectus abdominis), laterally by the inferior epigastric vessels, and inferiorly by the inguinal ligament.
Inguinal (Hesselbach) Triangle
66
Inguinal (Hesselbach) Triangle is an area of potential weakness and hence is a common site of?
direct inguinal hernia
67
Is a triangular opening in the aponeurosis of the external oblique muscle that lies just lateral to the pubic tubercle
Superficial Inguinal Ring
68
Lies in the transversalis fascia, just lateral to the inferior epigastric vessels.
Inguinal Ring
69
Borders of Hesselbach Triangle
Medially: linea semilunaris
Laterally: inferior epigastric vessels
Inferiorly: inguinal ligament
70
Begins at the deep inguinal ring and terminates at the superficial ring.
Inguinal Canal
71
What does Inguinal Canal transmit?
spermatic cord or the round ligament of the uterus
| genital branch of the genitofemoral nerve
72
What clinical correlate passes through the Inguinal Canal?
indirect inguinal hernia
73
Where does ilioinguinal nerve run?
inguinal canal and the superficial inguinal ring
74
Where does ilioinguinal nerve don't pass?
deep inguinal ring
75
What are the contents of inguinal canal?
genital branch of the genitofemoral nerve
ilioinguinal nerve
spermatic cord or the round ligament of the uterus
76
What are the borders of the inguinal canal?
```
Anterior wall: aponeuroses of the external oblique and internal oblique muscles.
Posterior wall: aponeurosis of the transverse abdominal muscle and transversalis fascia.
Superior wall (roof): arching fibers of the internal oblique and transverse muscles.
Inferior wall (floor): inguinal and lacunar ligaments.
```
77
Arises when a portion of intestine protrudes through a weak spot in the inguinal canal or in the inguinal triangle.
Inguinal hernia
78
A hernia in which the contents of the hernial sac can be returned to their normal position.
Reducible hernia
79
An irreducible hernia in which the contents of the hernial sac are entrapped or stuck in the groin.
Incarcerated hernia
80
An irreducible hernia in which the intestine becomes tightly trapped or twisted; thus, the circulation is arrested, and gangrene (death of tissue) occurs unless relief is prompt.
Strangulated hernia
81
Passes through the deep inguinal ring, inguinal canal, and superficial inguinal ring and descends into the scrotum.
Indirect inguinal hernia
82
Where does Indirect inguinal hernia lie?
lateral to the inferior epigastric vessels
83
Which kind of hernia is congenital and which is acquired?
Congenital: Indirect inguinal hernia
Acquired: Direct inguinal hernia
84
Occurs in the inguinal triangle directly through the abdominal wall muscles (posterior wall of the inguinal canal), lateral to the edge of the conjoint tendon (falx inguinalis), and rarely descends into the scrotum.
Direct inguinal hernia
85
The hernia lies medial to the inferior epigastric vessels and protrudes forward (but rarely through) the superficial inguinal ring.
Direct inguinal hernia
86
What composes spermatic cord?
```
ductus deferens
testicular, cremasteric, and deferential arteries
pampiniform plexus of testicular veins
genital branch of the genitofemoral
cremasteric nerves
testicular sympathetic plexus
```
87
derived from the aponeurosis of the external oblique muscle.
External spermatic fascia
88
originating in the internal oblique muscle.
Cremasteric fascia
89
derived from the transversalis fascia.
Internal spermatic fascia
90
Is a peritoneal diverticulum in the fetus that evaginates into a developing scrotum and forms the visceral and parietal layers of the tunica vaginalis testis.
Processus Vaginalis Testis
91
Normally closes before birth or shortly thereafter and loses its connection with the peritoneal cavity.
Processus Vaginalis Testis
92
What may result if Processus Vaginalis Testis persists?
congenital indirect inguinal hernia
93
What may Processus Vaginalis Testis cause if it is occluded?
fluid accumulation (hydrocele processus vaginalis)
94
Is a double serous membrane, a peritoneal sac that covers the front and sides of the testis and epididymis.
Tunica Vaginalis
95
Tunica Vaginalis is derived from the abdominal peritoneum and forms the?
innermost layer of the scrotum
96
Is the fetal ligament that connects the bottom of the fetal testis to the developing scrotum.
Gubernaculum Testis
97
Appears to be important in testicular descent (pulls the testis down as it migrates)
Gubernaculum Testis
98
Is homologous to the ovarian ligament and the round ligament of the uterus.
Gubernaculum Testis
99
Consists of a thin pigmented skin and dartos fascia, a layer of smooth muscle fibers; when contracted, it wrinkles to regulate the temperature.
Scrotum
100
What innervates scrotum?
genital branch of the genitofemoral
anterior scrotal branch of the ilioinguinal
posterior scrotal branch of the perineal
perineal branch of the posterior femoral cutaneous nerves
101
Where does scrotum receive blood?
anterior scrotal branches of the external pudendal artery
| posterior scrotal branches of the internal pudendal artery
102
Where does scrotum drain lymph?
superficial inguinal nodes
103
Are surrounded by the tunica vaginalis in the scrotum and produce sperm in the seminiferous tubules and testosterone by interstitial (Leydig) cells.
Testes
104
What innervates the testes?
autonomic nerves
105
Where does testes drain lymph?
deep inguinal nodes
106
Where does testes receive blood?
testicular arteries arising from the aorta
107
Where does testes drain venous blood?
Right: IVC
Left: renal vein
108
Is a depression on the anterior abdominal wall between the median and medial umbilical folds of the peritoneum.
Supravesical Fossa
109
Is a depression on the anterior abdominal wall between the medial and lateral umbilical folds of the peritoneum. It lies lateral to the supravesical fossa.
Medial Inguinal Fossa
110
fossa where most direct inguinal hernias occur
Medial Inguinal Fossa
111
Is a depression on the anterior abdominal wall, lateral to the lateral umbilical fold of the peritoneum.
Lateral Inguinal Fossa
112
Is a fibrous cord, the remnant of the obliterated urachus,
Median Umbilical Ligament or Fold
113
Lies between the transversalis fascia and the peritoneum and extends from the apex of the bladder to the umbilicus.
Median Umbilical Ligament or Fold
114
Is a fibrous cord, the remnant of the obliterated umbilical artery, which forms a medial umbilical fold and extends from the side of the bladder to the umbilicus.
Medial Umbilical Ligament or Fold
115
Is a fold of the peritoneum that covers inferior epigastric vessels and extends from the medial side of the deep inguinal ring to the arcuate line.
Lateral Umbilical Fold
116
Is the lining fascia of the entire abdominopelvic cavity between the parietal peritoneum and the inner surface of the abdominal muscles.
Transversalis Fascia
117
Forms the deep inguinal ring and gives rise to the femoral sheath and the internal spermatic fascia.
Transversalis Fascia
118
Is directly in contact with the rectus abdominis below the arcuate line.
Transversalis Fascia
119
Continues with the diaphragmatic, psoas, iliac, pelvic, and quadratus lumborum fasciae.
Transversalis Fascia
120
Is the ventral ramus of the 12th thoracic nerve and innervates the muscles of the anterior abdominal wall.
Subcostal Nerve
121
Has a lateral cutaneous branch that innervates the skin of the side of the hip.
Subcostal Nerve
122
Arises from the first lumbar nerve and innervates the internal oblique ad transverse muscles of the abdomen.
Iliohypogastric Nerve
123
Divides into a lateral cutaneous branch to supply the skin of the lateral side of the buttocks and an anterior cutaneous branch to supply the skin above the pubis.
Iliohypogastric Nerve
124
Arises from the first lumbar nerve, pierces the internal oblique muscle near the deep inguinal ring, and accompanies the spermatic cord through the inguinal canal and then through the superficial inguinal ring.
Ilioinguinal Nerve
125
Innervates the internal oblique and transverse muscles
Ilioinguinal Nerve
126
Gives rise to a femoral branch, which innervates the upper and medial parts of the anterior thigh. and the anterior scrotal nerve, which innervates the skin of the root of the penis (or the skin of the mons pubis) and the anterior part of the scrotum for the labium majus)
Ilioinguinal Nerve
127
A drawing up of the testis by contraction of the cremaster muscle when the skin on the upper medial side of of the thigh is stroked
Cremasteric reflex
128
What is the efferent limb of cremasteric reflex arc?
genital branch of the genitofemoral nerve
129
What is the afferent limb of cremasteric reflex arc?
femoral branch of the genitofemoral nerve
| ilioinguinal nerve
130
Drain into the axillary lymph nodes.
Lymphatics in the Region above the Umbilicus
131
Drain into the superficial inguinal nodes.
Lymphatics in the Region below the Umbilicus
132
Receive lymph from the lower abdominal wall, buttocks, penis, scrotum, labium majus, and the lower parts of the vagina and anal canal. Their efferent vessels primarily enter the external iliac nodes and, ultimately, the lumbar (aortic) nodes.
Superficial Inguinal Lymph Nodes
133
Arises from the internal thoracic artery, enters the rectus sheath, and descends on the posterior surface of the rectus abdominis
Superior Epigastric Artery
134
Anastomoses with the inferior epigastric artery within the rectus abdominis.
Superior Epigastric Artery
135
Arises from the external iliac artery above the inguinal ligament, enters the rectus sheath, and ascends between the rectus abdominis and the posterior layer of the rectus sheath.
Inferior Epigastric Artery
136
Anastomoses with the superior epigastric artery, providing collateral circulation between the subclavian and external iliac arteries.
Inferior Epigastric Artery
137
Gives rise to the cremasteric artery, which accompanies the spermatic cord.
Inferior Epigastric Artery
138
Arises from the external iliac artery and runs laterally along the inguinal ligament and the iliac crest between the transverse and internal oblique muscles.
Deep Circumflex Iliac Artery
139
Forms an ascending branch that anastomoses with the musculophrenic artery.
Deep Circumflex Iliac Artery
140
Arise from the femoral artery and run superiorly toward the umbilicus over the inguinal ligament. Anastomose with branches of the inferior epigastric artery.
Superficial Epigastric Arteries
141
Arises from the femoral artery and runs laterally upward, parallel to the inguinal ligament. Anastomoses with the deep circumflex iliac and lateral femoral circumflex arteries.
Superficial Circumflex Iliac Artery
142
Arise from the femoral artery, pierce the cribriform fascia, and run medially to supply the skin above the pubis.
Superficial (External) Pudendal Arteries
143
* Are longitudinal venous connections between the lateral thoracic vein and the superficial epigastric vein.
* Provide a collateral route for venous return if a caval or portal obstruction occurs.
Thoracoepigastric Veins
