Anterior, Abdominal Wall Flashcards

1
Q

What are the 6 layers of the abdominal wall in order from outside to inside the abdomen?

A
  1. Skin
  2. Superficial Fascia
    - superficial fatty = Camper’s Fascia
    - deep MEMBRANOUS = Scarpa’s Fascia
  3. MUSCLES
    - External Oblique
    - Internal Oblique
    - Transversus Abdominus
    - -Rectus Abdominus, Pyramidalis, Cremaster
  4. Transversalis Fascia
  5. Extraperitoneum
  6. Peritoneum
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2
Q

What does Camper’s Fascia become in the scrotum? What is Scarpo’s Fascia continuous with?

A
  1. Campers –> Darto’s Muscle
    - (Super Fat Camper, Darts away*)
  2. Scarpo –> continuous with Colles’ Fascia –> of the perineum
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3
Q

What is the fatty layer of fascia in the abdomen? The membranous?

A

fatty = Camper’s Fascia

Membranous = Scarpo’s

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4
Q

Which layer of fascia disappears in the scrotum and why?

A

Camper’s Fascia (fatty)

Testes cannot function if the temperature is above 37 degrees (testes hang in a bag  scrotum) = NO FAT because of this

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5
Q

What two bony structures of the pelvis does the inguinal ligament attach to?

A

Inguinal Ligament stretches between
Anterior superior iliac Spine &
pubic tubercle

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6
Q

What muscle provides the LOW arching fibers for Cremaster?

What nerve innervates the Cremaster muscle? Where doe this muscle insert upon?

A
  1. INTERNAL oblique
  2. Genital Branch of Genitofemoral Nerve
  3. Pubic tubercle
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7
Q

What 2 muscles are the components of the Rectus Sheath? (not the aponeurosis itself)
What 2 vessels?

A

Rectus Abdominus & Pyramidalis

Superior & Inferior Epigastric Vessels

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8
Q

Describe the anterior/posterior layer of the rectus sheath ABOVE the arcuate line & BELOW

A

ABOVE

  • anterior = external oblique muscle & 1/2 internal oblique
  • posterior = transversalis abdominaux & 1/2 internal oblique

BELOW
- anterior = 1. external 2. internal oblique 3. transversals muscle

posterior = transversalis FASCIA lining the Rectus Abdomens Muscle

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9
Q

What 3 lines is the rectus abdominus related to?

A
  1. Linea Semilunaris
  2. Linea Alba
  3. Arcuate Line
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10
Q

The testes descend RETROPERITONEALLY. True or false?

A

TRUE

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11
Q

What is the name of the structure that:

  1. forms a path through the anterior abdominal wall for processus vaginalus
  2. ANCHORS the testis to the scrotum
  3. Guides the testis descent to the scrotum?
A

GUBERNACULUM TESTIS

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12
Q

What are the extensions of the following structures of the abdomen in the SCROTUM?

  1. Transversalis Fascia
  2. Internal Oblique
  3. External Oblique
A
  1. Internal Spermatic Fascia
  2. Cremaster Muscle (remember cremasteric reflex*)
  3. External Spermatic Fascia
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13
Q

What is the series membrane that covers the front & sides of the testis and was previously known as PROCESSES VAGINALIS

A

TUNICA VAGINALIS

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14
Q

What two muscles originate from the inguinal ligament?

A

Internal Oblique & Transverses Abdominus*

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15
Q

Where does the inferior epigastric artery gain access to the rectus sheath?

A

ARCUATE LINE

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16
Q

What are the two branches of internal thoracic artery?

A

Musculophrenic (lateral)

Superior EPigastric (medial)

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17
Q

The umbilicus is found at what dermatome? Which lumbar spine is it found at?

A

T10

but L4!!

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18
Q

What structure gives off the INFERIOR epigastric artery?

A

External Iliac Artery

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19
Q

What structures form the following boundaries of the inguinal canal?

  1. Anterior (2)
  2. Posterior (2)
  3. Roof (2)
  4. Floor (1)
A
  1. External Oblique & Internal
  2. Trasversalis FASCIA & Conjoint Tendon
  3. arch of Internal (LOW)
    arch of Transverses Abd. (HIGH)
  4. Inguinal Ligament
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20
Q

The transversals Fascia:

  1. Forms the ____ wall of the canal
  2. In the scrotum as_____
  3. Has the _____ inguinal ring.
A
  1. Posterior wall of canal (w/ Conjoint tendon)
  2. Internal Spermatic Fascia
  3. DEEP Inguinal Ring
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21
Q

The deep inguinal ring houses what 2 structures?

What muscles passes through the DEEP inguinal ring?

A
  1. Spermatic cord/round ligament
  2. Genital Branch of Genitofemoral
    * CREMASTERIC MUSCLE
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22
Q

What are the structures that make up the 3 boundaries of the Inguinal Triangle/ Hesselbach’s?

  • medial
  • lateral
  • inferior
A
  1. Medial: Linea Semilunaris of Rectus Abdominus
  2. Lateral:
    Lateral Umbilical Fold by INFERIOR EPIGASTRIC
  3. Inferior:

Inguinal Ligament (from anterior superior iliac spine to pubic symphysis)

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23
Q

What two muscles form the conjoint tendon?

A

Transversalis Abdominus

Internal Oblique

(both originate from Inguinal ligament*)

24
Q

What muscle is NOT represented in the scrotum & forms the ROOF of the inguinal canal?

A

TRANSVERSALIS ABDOMINUS

  • HIGH arching fibers (think: too high to reach)
25
Q

After the inguinal ligament, the Inferior Epigastric Artery becomes the _____

A

Femoral Artery

26
Q

What muscle forms the LOW arching fibers & contributes to the Conjoint tendon?

It is represented in the scrotum as _____.

A
  1. Internal Oblique

2. Cremasteric Muscle

27
Q

What two muscles form the roof of the inguinal canal?

A

Internal Oblique & Transverses Abdominus

28
Q

The EXTERNAL Oblique:

  1. Forms the ____ wall of the canal
  2. In the scrotum as_____
  3. Has the _____ inguinal ring.
A
  1. Anterior Wall
  2. External Spermatic Fascia
  3. SUPERFICIAL Inguinal Ligament
29
Q

What muscle forms the inguinal ligament?

A

External Oblique

  • anterior wall*
30
Q

A direct hernia travels through:

  1. Inguinal Triangle/Hesselbach’s
  2. Inguinal Canal
A

Inguinal Triangle

31
Q

What hernia is lateral to the inferior epigastric artery?

Medial?

A

Lateral = INDIRECT

Medial = DIRECT

32
Q

The inguinal ligament is the Roof of the inguinal canal. True or False

A

FALSE

  • it is the FLOOR
33
Q

What tendon supports the superficial inguinal ring posteriorly?

A

Conjoint Tendon

34
Q

What two structures does the SUPERFICIAL Inguinal Ring house?

A
  1. Spermatic Chord/Round Ligament (females)

2. Ilioinguinal Nerve

35
Q

What muscle forms the superficial Inguinal Ring?

A

External Oblique

36
Q

Between what two muscles does the Ilioinguinal Nerve travel through?

A

Transversalis Abdominus & Internal Oblique

  • pierces transversalis 1st
  • Internal Oblique 2nd
37
Q

What nerve is SUPERIOR to ilioinguinal nerve & is not found in the ilioinguinal canal?

A

ILIOHYPOGASTRIC NERVE

38
Q
Spermatic Cord Loves 3's
(somes)
1. 3 coverings
2. 3 arteries
3. V
4. Nerves

Name them

A
  1. External/Internal Spermatic Fascia & Cremasteric muscle in between
  2. Testicular A., Cremasteric., Artery of Vas
  3. Vas Deferens, VenouS Plexous, Vestige of Processus Vaginalis
  4. Genital branch of Genitofemoral N., Sympathetic plexus of Testicular A. & Artery of Vas
39
Q
  1. What is the course of the INDIRECT inguinal hernia?
  2. Does it go into the scrotum?*
  3. Is it medial or lateral to inferior epigastric artery?
  4. Is it More common or less common?
  5. Is it congenital?
A
  1. Deep Ring, Inguinal Canal, Superficial Ring
  2. YES
  3. LATERAL
  4. MORE COMMON
  5. CONGENITAL
40
Q
  1. What is the course of the DIRECT inguinal hernia?
  2. Does it go into the scrotum?*
  3. Is it medial or lateral to inferior epigastric artery?
  4. Is it More common or less common?
  5. Is it congenital?
A
  1. INGUINAL TRIANGLE
  2. NOT INTO SCROTUM
  3. MEDIAL
  4. Less common
  5. Not congenital, occurs w/ age & weakness of anterior abdominal wall
41
Q

What is a hernia?

A

intestines/abdominal contents protrude into the inguinal region/canal

42
Q

If the hernia is in the scrotum, is this a direct or indirect hernia?

A

INDIRECT

  • congenital
43
Q

What fold(s) is made from the Obliterated Urachus?

A

Median Umbilical Fold

44
Q

What fold(s) are made from the Obliterated Umbilical Artery?

A

MEDIAL Umbilical Fold (2)

45
Q

What fold(s) are made from the Inferior Epigastric Artery?

A

LATERAL Umbilical Fold

46
Q

What are the layers from outside to inside of the scrotum?

A
  1. Dartos
  2. External Spermatic Fascia
  3. Cremaster Muscle
  4. Internal Spermatic Muscle
  5. Tunica Vaginalis Parietal
  6. Tunica Vaginalis Visceral
47
Q

What is the only muscle not innervated by ventral Rami of T7-T12?

A

Pyramydalis

48
Q
In testing the child’s reflexes, which of the following nerves supplies the Cremaster muscle?
A) Subcostal nerve
B) Lateral femoral cutaneous nerve
C) Genitofemoral nerve
D) Iliohypogastric nerve
E) Femoral nerve
A

C) Genitofemoral Nerve

49
Q

He placed his fingers over the Hesselbach triangle & asked the man to hold his nose and blow. This direct inguinal hernia
A) Exits through the superficial inguinal ring
B) Is covered by spermatic fasciae
C) Lies medial to the inferior epigastric artery
D) Descends into the scrotum
E) Lies lateral to the inferior epigastric artery

A

c) Medial to the inferior epigastric artery

50
Q

Which of the following defines the point at which the posterior lamina of internal oblique & the aponeurosis of the Transversus abdominis become part of the anterior rectus sheath ?

 A) Arcuate line
 B) Tendinous intersection 
 C) Linea Alba
 D) Linea Semilunaris  
 E) Inguinal ligament
A

A) Arcuate Line

51
Q

The aponeuroses of all three flat muscles of the anterolateral abdominal wall interlace in which of the following ?

A) Inguinal ligament
B) Linea Alba
C) Linea Semilunaris 
D) Rectus abdominis
E) Transversalis fascia
A

B) Linea Alba

52
Q

What is the only muscle NOT in the Scrotum?

A

Transversus Abdominus

  • forms HIGH arching fibers
    & Roof of canal (w/ internal oblique)
53
Q

What two nerves are both a branch of L1?

A

Ilioinguinal & Iliohypogastric

54
Q

what is the Tunica Albiginea?

A

The fibrous layer over the testes

55
Q

Deep inguinal ring lies in the ______

Superficial lies in the _____

A
  1. Transversalis Fascia

2. External Oblique