Anterior Abdominal Wall

Question 1

Nine Abdominal Regions:

• H
• L
• I
• E
• U
• P
• -dividing right and left by ____ ____

Answer 1

Hypochondriac
Lateral
Inguinal
Epigastric
Umbilical
Pubic
--Midclavicular Planes

Question 2

Four Abdominal Regions:

• Quadrants
• -divided through center by ____

Answer 2

Median Plane

Question 3

Anterolateral Wall:

• S
• C
• S
• I
• E
• I
• I
• I
• T
• T
• E
• P

Answer 3

• Skin
• Superficial Fatty Layer of Subcutaneous Tissue (camper fascia)
• Deep Membranous Layer of Subcutaneous Tissue (Scarpa fascia)
• Investing (deep) fascia
• Exernal Oblique M
• Investing (deep) fascia
• Interal Oblique M
• Investing (deep) fascia
• Transversus Abdominis M
• Endo-Abdominal (transversalis) fascia
• Extraperitoneal fat
• Parietal Peritoneum

Question 4

-
-

Answer 4

• External Oblique m
• Internal Oblique m
• Transversus Abdominis m

Question 5

-

Answer 5

• Rectus Abdominis m

- Pyramidalis m

Question 6

Rectus Sheath:

• _______ (tendinous) sheath
• envelopes _____ _____ and ______ mm
• consists of anterior and posterior layer
• -structure of sheath is relative to the _____ ____ (midway btw umbilicus and public symphysis)

Answer 6

• aponeurotic
• rectus abdominus and pyramidalis
• arcuate line

Question 7

Superior to Arcuate Line:

Anterior Layer of the Rectus Sheath- formed by aponeuroses of _____ and 1/2 _____

Answer 7

aponeuroses of external oblique

1/2 internal oblique

Question 8

Superior to Arcuate Line:

Posterior Layer of the Rectus Sheath- formed by aponeuroses of 1/2 ____ and ____; along w/ ______ fascia

Answer 8

aponeuroses of 1/2 internal oblique and transversus abdominis
transversalis fascia

Question 9

Inferior of Arcuate Line:

Anterior Layer of the Rectus Sheath- formed by aponeuroses of ____, ____, ____

Answer 9

aponeuroses of external oblique, internal oblique, transversus abdominis

Question 10

Anterior Abdominal Wall Layer:

- ____ and ____ to ______ line

Answer 10

superior
inferior
arcuate

Question 11

Inferior of Arcuate Line:

Posterior Layer of the Rectus Sheath- formed by _____ _____

Answer 11

transversalis fascia

Question 12

Infraumbilical Peritoneal Folds:

-median umbilical fold= from ____ ____ to ____; covers ____ ____ _____

Answer 12

• urinary bladder to umbilicus

- median umbilical ligament

Question 13

Infraumbilical Peritoneal Folds:

-medial umbilical folds= covers ____ ____ ____; occuded portions of ______ aa

Answer 13

medial umbilical ligaments

umbilical aa

Question 14

Infraumbilical Peritoneal Folds:

-lateral umbilical folds= covers _____ _____ _____

Answer 14

inferior epigastric vessels

Question 15

Superficial Vessels:
Epigastric a/v
-branch of ______ a/v
-supplies abdomen _____ to _______

runs in superficial fat/fascia

Answer 15

femoral a/v

abdomen inferior to umbilicus

Question 16

Deep Circumflex Iliac Vessels:

• branch of ____ _____
• runs btw ____ and ____
• supplies ___ ____ abdominal mm

Answer 16

external iliac
internal oblique and transversus abdominis
inferior lateral abdominal mm

Question 17

Inferior Epigastric Vessels:

• branch of _____ ____
• enters ___ rectus sheath at ______ line
• supplies ____ ____ _____mm
• anastomoses w/ ____ _____

Answer 17

external iliac
posterior rectus sheath at arcuate line
lower rectus abdominus mm
superior epigasatric

Question 18

Superior Epigastric Vessels:

• branch of ___ ___ (mammary)
• enters ____ rectus sheath lateral to _______
• supplies ____ ____ ____ mm
• anastomoses w/ ______ _______

Answer 18

internal thoracic
posterior; lateral to sternum
upper rectus abdominus mm
inferior epigastric

Question 19

Superficial Vessels:
Circumflex Iliac a/v
-branch of _______ a/v
-supplies region of _______ ______

runs in superficial fat/fascia

Answer 19

femoral a/v

inguinal ligament

Question 20

NN of the Abdominal Wall:

• Ventral ______ of T7-L1 spinal nn
• T7, T8, and T9= supply region _____ umbilicus
• T10= supplies _____ region
• T11, T12, and L1= supply region ______ umbilicus

runs btw ____ and _____ mm

Answer 20

Venteral (anterior) rami
above
umbilical
below
internal oblique and transversus abdominus
-predisposes to developing direct inguinal hernias

Question 21

Inguinal Region:

• inferior lateral abdominal region
• ____ to thigh
• ____ to ilium
• ____ to pubic bone

area extends btw the ___ ___ ___ ___ and ____ ____

Answer 21

superior
medial
lateral

anterior superior iliac sping (ASIS) and pubic tubercle

inguinal ligament, inguinal canal, sup./deep rings of inguinal canal, walls of canal

Question 22

Inguinal Ligament:

• folded ____ border of the ____ ____ ____
• extends from _____ to ____ ____

Answer 22

inferior; external oblique aponeurosis

ASIS to pubic tubercle

Question 23

Inguinal Canal:

• obliquely set tunnel __ to __ cm long
• traverses ____ abdominal wall
• runs parallel and superior to _____ _____

Answer 23

3 to 5 cm
anterior abdominal wall
inguinal ligament

Question 24

Musculophrenic Vessels:

• branch of _____ _____ (mammary)
• runs along ______ _______
• supplies ____ abdominal mm and ______

Answer 24

internal thoracic
costal cartilages
upper abdominal mm and diaphram

Question 25

Male Inguinal Canal: -contains ____ cord and its contents (vas deferens, testicular nn/vv, cremasteric m/fascia) -_______ n. (____)

Answer 25

spermatic | ilioinguinal n of L1

Question 26

Inguinal Canal Rings: Superficial Ring- opening in ____ _____ _____ -obvious triangular opening lateral to ____ _____ canal extends btw sup and deep rings

Answer 26

external oblique aponeurosis | pubic tubercle

Question 27

Inguinal Canal Rings: Deep Ring- opening in _____ _____ -subtle piercing just lateral to ____ ____ vv canal extends btw sup and deep rings

Answer 27

transversalis fascia | inferior epigastric cc

Question 28

Female Inguinal Canal: - contains ____ ligament of _____ (corresponds to spermatic cord in males) - ______ n (L1)

Answer 28

round ligament of uterus | ilioinguinal n of L1

Question 29

``` Abdominal Hernia: -outpouching of ___ ___ w/in sec -hernial sac composed of 3 layers (p______, e______ ____, t____ ______) ~___% of hernias occur in inguinal region ```

Answer 29

abdominal viscera peritoneum, extraperitoneal fat, transversalis fascia 90%

Question 30

``` Inguinal Canal Walls: -Anterior Wall= ____ _____ _____ -Posterior Wall= _____ _____ and conjoint tendon (fusion of IO, TA aponeuroses medially) -Roof= ___ ___ and ___ ___ mm -Floor= _____ _____ ```

Answer 30

external oblique aponeurosis transversalis fascia internal oblique and transversus abdominus inguinal ligament

Question 31

Indirect Inguinal Hernia: - extends thru ______ inguinal canal - ______ to inferior epigastric vv - commonly enters ______ or _____ ____ - most common type of hernia (more in men than in women) - usually from persistent _____ _____ in males - -(connects peritoneum w/ descended testis) - referred to as canal of Nuck in females

Answer 31

entire lateral scrotum or labia majora processus vaginalis

Question 32

Direct Inguinal Hernia: - thru inguinal _____ (Hesselbach's) - emerges thru conjoing tendon by or at _______ ring - ____ to inferior epigastric vv - usually does not enter scrotum or labia majora - more common in men than women - usually associated w/ weakened abdominal wall

Answer 32

triangle superficial medial

Question 33

Femoral Hernia: - thru ____ ring and canal - ____ compartment of sheath - more common in females than males (ring is wider)

Answer 33

femoral | medial

Question 34

Umbilical Hernia: - thru _____ ring - most common in ______ - more common in females and obese individuals

Answer 34

umbilical | newborns

Question 35

Epigastric Hernia: - thru ____ ___ - most common in over ____ - usually associated w/ obesity

Answer 35

linea alba | 40