Anterior Abdominal Wall

Question 1

Surface landmarks

Answer 1

Linea alba
Linea semilunaris
Tendinous intersections
Inguinal ligament

Question 2

Right upper quadrant

Answer 2

Right love
Gallbladder
Upper colon

Question 3

Left upper quadrant

Answer 3

Spleen
Stomach
Pancreas
Left kidney

Question 4

Right lower quadrant

Answer 4

Appendix
Right uterine tube

Question 5

Left lower quadrant

Answer 5

Sigmoid and descending colon
Left uterine tube

Question 6

Planes

Answer 6

Transumblical L3/L4
Subcostal
Transtubercular L5
Transpyloric L1
Supracristal L4
Interspinous S1

Question 7

Subdivision of abdomen

Answer 7

(9)
Right and left hypochondriac
Right and left lumbar
Right and left iliac
Epigastrium
Umbilical
Hypogastrium

Question 8

Layers of anterior abdominal wall

Answer 8

Skin
Superficial fascia
Muscles/aponeurosis/investing fascia
Transversalis fascia
Extraperitoneal fascia fascia
Parietal peritoneum

Question 9

Langer’s Lines

Answer 9

Tension lines are important for incisions and decreasing scarring

Question 10

Gridiron incision

Answer 10

Split muscles without cutting them
Ex. McBurney incision at McBurney point

Question 11

McBurney point

Answer 11

Maximum tenderness site in appendicitis
1/3 from ASIS to umbilicus (2/3 from umbilicus to ASIS)
Iliohypogastric n

Question 12

Superficial fascia

Answer 12

Above umbilicus - Camper’s fascia
Below umbilicus - Camper’s and Scarpa’s fascia

Question 13

Abdominal muscles

Answer 13

Support and protect, posture, stabilization
EO, IO, TA, RA, P

Question 14

External oblique

Answer 14

Hands in pocket
Aponeurosis forms anterior wall of rectus sheath, inguinal ligament

Question 15

Internal oblique

Answer 15

Hands to chest
Perpendicular to EO

Question 16

Transversus abdominis

Answer 16

Run horizontally

Question 17

Rectus abdominus

Answer 17

Enclosed within rectus sheath, run vertically

Question 18

Pyramidalis

Answer 18

Triangular muscles anterior to inferior part of rectus sheath

Question 19

Linea alba

Answer 19

Seperates two sides of RAs

Question 20

Linea semilunaris

Answer 20

Lateral border of RA

Question 21

Rectus sheath

Answer 21

Encloses RA
Above umbilicus/arcuate line - EO & ant IO anterior, post IO & TA posterior
Below umbilicus/arcuate line everything goes anterior except transversals fascia

Question 22

Rectus sheath contents

Answer 22

Contains rectus abdominis, pyramidalis, superior and inferior epigastric, lower five intercostal nerves, subcostal nerves

Question 23

Tendinous intersections

Answer 23

Make abs

Question 24

Arcuate line

Answer 24

Posterior layer of rectus sheath has arcuate line between umbilicus and pubic symphysis

Question 25

Internal surface of anterior abdominal wall

Answer 25

Median umbilical fold Medial umbilical fold Lateral umbilical fold

Question 26

Median umbilical fold

Answer 26

Apex of bladder, remnant of urachus (hindgut communication)

Question 27

Medial umbilical fold

Answer 27

Occluded umbilical arteries

Question 28

Lateral umbilical fold

Answer 28

Cover inferior epigastric vessels

Question 29

Hesselbach's triangle

Answer 29

Landmark for hernia Borders = lateral border of rectus abdominis, lateral umbilical fold, inguinal ligament

Question 30

Dermatomes

Answer 30

T7-T9 superior to umbilicus T10 around umbilicus T11-T12, L1 inferior to umbilicus

Question 31

Nerves of abdominal wall

Answer 31

Iliohypogastric and ilioinguinal nerves from lumbar plexus

Question 32

TAP block

Answer 32

Block T7-T11

Question 33

ASIS block

Answer 33

Block iliohypogastric and ilioinguinal

Question 34

Arteries of abdominal wall

Answer 34

Internal thoracic which gives of superior epigastric and musculophrenic External iliac which gives off inferior epigastric and deep circumflex iliac Femoral which gives off superficial epigastric, circumflex iliac and external pudendal Aortic which gives off lower 6 post intercostal, lumbar

Question 35

Veins of abdominal wall

Answer 35

Drain from umbilicus to axillary above, femoral below umbilicus

Question 36

Lymphatic drainage of abdominal wall

Answer 36

Above - axillary, below - superficial inguinal

Question 37

ASIS

Answer 37

Anterior Superior Iliac Spine bony prominence on pelvis, front of iliac