Anterior Abdominal Wall Flashcards

1
Q

What are the layers of the anterior abdominal wall?

A

Skin, fatty layer of superficial fascia (Camper’s fascia), membranous layer of superficial fascia (Scarpa’s fascia), external oblique, internal oblique, transversus abdominus, fascia transversalis, extra peritoneal fat, parietal peritoneum

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2
Q

What direction are the fibres of external oblique?

A

Anteroinferior (hands in front pockets)

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3
Q

What is the upper origins of the external oblique muscle?

A

Overlaps the costal margin and extends onto the front of the lower 8 ribs - lies edge to edge with pec major and serratus anterior

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4
Q

What is the lower insertion of the external oblique muscle?

A

Anterior half of the iliac crest, ASIS, pubic tubercle and pubic crest

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5
Q

What are the 3 free edges of the external oblique muscle?

A

superior aponeurotic edge (where pec major starts), free posterior muscle edge, free inferior edge (inguinal ligament)

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6
Q

What direction are the fibres of internal oblique?

A

Posteroinferior (hands in back pockets)

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7
Q

What is the upper origin of the internal oblique muscle?

A

The costal margin

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8
Q

What is the lower insertion of the internal oblique muscle?

A

Anterior 2/3rds of the iliac crest and the lateral 2/3rds of the inguinal ligament and the pubic crest (insert as the conjoined tendon)

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9
Q

What is the posterior origin of the internal oblique muscle?

A

Thoracolumbar fascia

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10
Q

What direction are the fibres of transverses abdominus?

A

Horizontal

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11
Q

What is the upper origin of the transversus abdominus?

A

The diaphragm - it is in one continuous muscle plane

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12
Q

What is the lower insertion of the transversus abdominus muscle?

A

Anterior 2/3rds of the iliac crest and the lateral 1/2 of the inguinal ligament and the pubic crest (insert as the conjoined tendon)

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13
Q

What is the posterior origin of the transversus abdominus?

A

thoracolumbar fascia

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14
Q

What direction are the fibres of rectus abdominus?

A

Vertical

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15
Q

What is the upper origin of rectus abdominus?

A

Costal cartilage 5,6 and 7

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16
Q

What is the lower insertion of rectus abdominus?

A

Body and crest of the pubis

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17
Q

What is the lateral border of rectus abdominus?

A

Linea semilunaris

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18
Q

What is the medial border of rectus abdominus?

A

Linea alba

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19
Q

Where are the tendinous intersections of rectus abdominus?

A

The umbilicus, the xiphy sternum and half way in between

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20
Q

What is the surface marking for the gall bladder?

A

Where linea semilunaris intersects with the costal margin

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21
Q

What is the rectus sheath?

A

An aponeurotic envelope that contains rectus abdominus - formed by the aponeusosi of the 3 muscles of the anterior abdominal wall

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22
Q

What makes up the anterior part of the rectus sheath above the arcuate line?

A

aponeurosis of external oblique and half of internal oblique

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23
Q

What makes up the posterior part of the rectus sheath above the arcuate line?

A

half of the aponeurosis of internal oblique and the aponeurosis of transversus abdominus

24
Q

What makes up the anterior part of the rectus sheath below the arcuate line?

A

The aponeurosis of external oblique, internal oblique and transversus abdominus

25
Q

What makes up the posterior part of the rectus sheath below the arcuate line?

A

There is no posterior part of the rectus sheath below the arcuate line

26
Q

Where is the neurovascular plane of the anterior abdominal wall?

A

Between internal oblique and transversus abdominus

27
Q

Which spinal segment is the dermatome for the umbilicus?

A

T10

28
Q

Which spinal segment is the dermatome for the groin?

A

L1

29
Q

What is the blood supply of the anterior abdominal wall?

A

superior epigastric (branch of internal thoracic) and inferior epigastric (branch of external iliac)

30
Q

What is the venous drainage of the anterior abdominal wall?

A

Dual drainage - portal and systemic - site of portosystemic overlap

31
Q

What is the inguinal region?

A

The transition zone between the lower abdomen and upper thigh

32
Q

What is the inguinal ligament?

A

The inferior edge of the external oblique muscle

33
Q

What is the lacunar ligament?

A

The aponeurosis of the external oblique that is reflected against the pectineal line of the pubis

34
Q

What is the pectineal ligament?

A

The extension of the lacunar ligament

35
Q

Where do the testes develop?

A

In the posterior abdominal wall in the extra peritoneal fat

36
Q

How do the testes get to the scrotum?

A

Via the inguinal canal

37
Q

Where are the testes at in the 12th week of development?

A

The pelvis

38
Q

Where are the testes at in the 28th week of development?

A

The deep ring

39
Q

How long does it take for the testes to traverse the inguinal canal?

A

3 days

40
Q

How long is the inguinal canal?

A

4cm

41
Q

What is the opening of the inguinal canal?

A

The deep inguinal ring - a deficiency in the fascia transversalis half way between the ASIS and pubic tubercle a fingers breadth above the inguinal ligament

42
Q

What is the exit of the inguinal canal?

A

The external inguinal ring - a triangular opening in external oblique between the pubic tubercle and pubic crest

43
Q

What is the roof of the inguinal canal?

A

Arching fibres of internal oblique and transversus abdominus

44
Q

What is the floor of the inguinal canal?

A

The inguinal ligament

45
Q

What is the anterior wall of the inguinal canal?

A

external oblique aponeurosis and the internal oblique muscle (laterally)

46
Q

What is the posterior wall of the inguinal canal?

A

transversalis fascia and the conjoint tendon (medially)

47
Q

What is the spermatic cord?

A

The vas deferens and neurovascular structures surrounded by 3 layers of covering

48
Q

What is the 1st layer of covering of the spermatic cord?

A

Internal spermatic fascia - from the fascia transversalis

49
Q

What is the 2nd layer of covering of the spermatic cord?

A

Cremasteric fascia and cremaster muscle - from internal oblique

50
Q

What is the 3rd layer of covering of the spermatic cord?

A

External spermatic fascia - from external oblique

51
Q

What are the common sites of abdominal wall hernias?

A

umbilicus, linea alba, linea semilunaris, incisional, inguinal

52
Q

What is an indirect inguinal hernia?

A

Where the abdominal contents traverse the inguinal canal and go into the scrotum

53
Q

Why does an indirect inguinal hernia occur?

A

Incomplete closure of the processes vaginalis

54
Q

What is a direct inguinal hernia?

A

A protrusion directly forwards into the inguinal canal through a weakness in its posterior wall - abdominal contents don’t go into the scrotum

55
Q

Why are you predisposed to an indirect inguinal hernia post appendectomy?

A

Because L1 fibres are cut