Anterior Abdominal Wall Flashcards
What is in the right upper quadrant of the anterior abdomen?
- liver & galbladder
- stomach
- duodenum
- pancreas
- right kidney & suprarenal gland
- right colic
- ascending + transverse colon
What is in the right lower quadrant of the anterior abdomen?
- cecum
- ileum
- vermiform appendix
- ascending colon
- right ovary, uterine tube, ureter, spermatic cord
- uterus bladder
What is in the left upper quadrant of the anterior abdomen?
- liver
- stomach
- jejunum + prox. ileum
- pancreas
- left kidney + suprarenal gland
- left colic
- descending + transverse colon
What is in the left lower quadrant of the anterior abdomen?
- sigmoid colon
- descending colon
- left ovary, ureter, spermatic cord
- uterus
- urinary bladder
What does the paraumbilical vein drain the abdomen into?
portal vein of liver
What is the cause and symptom of Caput Medusae?
- cause -> portal hypertension + blockage of IVC
- symptom -> swelling of paraumbilical veins
What are the layers of the anterior abdominal wall?
skin -> superficial fascia -> deep fascia-> flat muscles -> transversalis fascia -> fat -> peritoneum
What are the layers of the superificial fascia of the anterior abdomen?
- camper’s (fatty layer): superficial
- scarpa’s (membranous layer): deep
What are the flat muscles of the anterior abdomen?
- external & internal oblique
- transversus abdominis
What gives the 6 pack appearance?
tendinous intersections
What divides the anterior and posterior rectus sheath?
rectus abdominis
What are the insertions of the external oblique?
- linea alba
- pubic tubercle
- ant. iliac crest
What direction do the external oblique fibers run in?
infero-medially
What is the origin of the external oblique?
ribs 6-12
What does the external oblique contribute to?
inguinal lig. & spermatic fascia
What are the origins of the internal oblique?
- thoracoumbar fascia
- ant. iliac crest
- lat. linguinal lig
What are the insertions of the internal oblique?
- linea alba
- ribs 10-12
- pubis
What direction do the fibers of the internal oblique run in?
supero-medially
What contributes to the cremaster muscle?
internal oblique
What are the origins of the transversus abdominis?
- ribs 7-12
- thoracolumbar fascia
- iliac crest
- lat. 1/3 inguinal lig
What are the actions of the anterior abdominal wall muscles?
assist in vomiting, sneezing, & defecation
How is the rectus sheath formed?
by aponeuroses of ant. abdominal wall muscles
What is the main difference between above & below the arcuate line?
fibers
What is included in the anterior sheath ABOVE the arcuate line?
ext. & 1/2 int. oblique
What is included in the posterior sheath ABOVE the arcuate line?
- int. oblique
- transversus abdominis
- transversalis fascia
- peritoneum
What is included in the anetrior sheath BELOW the arcuate line?
- ext. & int. oblique
- transversus abdominis
What is included in the posterior sheath BELOW the arcuate line?
- transversalis fascia
- peritoneum
Where is the transversalis fascia located?
deep to flat muscles
What gives rise to the posterior rectus sheath?
transversalis fascia
What continues as the internal spermatic fascia?
transversalis fascia
Aneterior abdominal wall layers are dragged down with the testes when they descend into what?
scrotum
What are the trends with the ant. abdominal muscles in the spermatic cord?
- ext. oblique -> ext. spermatic fascia= outer spermatic cord
- int. oblique -> cremaster muscle= middle spermatic cord
- trans. fascia -> int. spermatic fascia= inner spermatic cord
What runs from the deep inguinal ring?
testis
What is contained in the spermatic cord?
vas deferens & testicular art. + vein
What do the superficial and deep inguinal ring come from?
- super -> ext. oblique aponeurosis
- deep -> trans. fascia
What are the borders of the inguinal canal?
- roof: int. oblqiue + trans. abdominis
- ant. wall: ext. + int. oblique apon.
- floor: inguinal + lacunar lig.
- post. wall: conjoint tendon + trans. fascia
What are the contents of the inguinal canal?
- ilioinguinal nerve
- genital branch off genitofemoral nerve
- spermatic cord (male) or round lig. of uterus (female)
What is the origin & insertion of the inguinal ligament?
- origin -> ASIS
- insertion -> pubic tubercle
What does the inguinal ligament contribute to?
lacunar lig.
What are the 5 peritoneal folds?
- median umbilical (1) -> over remnant of urachus
- medial umbilical (2) -> over fetak umbilical art.
- lat umbilical (2) -> over inf. epigastric vessels
What is the site of direct hernias?
inguinal triangle
What are the borders fo the inguinal triangle?
- lat= lat. umbilical
- medial= med. umbilical
- base= inguinal lig.
Where is a direct hernia?
through weak spot on post. wall of inguinal canal
Where is an indirect hernia?
through deep inguinal ring of inguinal canal
What are the characteristics of a direct hernia?
- LESS common
- LESS prone to strangulation
- covered by peritoneum
- originates from inguinal canal
What are the characteristics of an indirect hernia?
- MOST common
- MORE prone to strangulation
- covered by peritoneum + spermatic cord
- originates from lat. inf. epigastric vessels
Where would direct inguinal hernias typically occur?
med. to lat. umbilical lig.
