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anatomy exam 4 > anterior abdominal wall > Flashcards

anterior abdominal wall Flashcards

1
Q

what are the four quadrants of the abdominal wall defined by and called?

A
  • line thru umbilicus
  • upper left, lower left
  • upper right, lower right
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2
Q

what are the borders of the abdominal wall defined by and called?

A
  • line thru the midclaviculars (or nipples) plus line thru pelvic region and subcostal region
  • L/R- hypochondriac, lumbar, iliac
  • epigastric, umbilical, hypogastric
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3
Q

what is the vertebral level of the umbilicus? what innervates it?

A
  • L3-4

- innervation T10

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4
Q

what are the linea alba and the semilunaris

A
  • linea alba is the white line down the middle of the absdomen
  • semilunaris is the sagittal line down abdomen
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5
Q

what are the four pelvic landmarks?

A

-iliac crest, iliac tubercle, pubic tubercle, ASIS

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6
Q

what are the three bones of the pelvis?

A
  • ilium
  • ischium
  • pubis
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7
Q

what are the four functions of the abdominal wall?

A

1) to protect the abdominal contents
2) help control intra-abdominal pressure for defecation and parturition (giving birth)
3) aid in respiration
4) trunk rotation and extension

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8
Q

how many layers of muscle cover the anterior abdominal wall?

A

4

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9
Q

where can there be a potential space in the fascia? when does this present a problem? why?

A

-there can be a space created by trauma in the urethra between the scarpa’s fascia and the external oblique muscle
-problem with male patients if they pee and abdomen distends. it could be the urine getting caught in this space
=called urinary extravasation

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10
Q 
external oblique:
origin
insertion
action
innervation
A

fibers- hand in pockets
O: ribs 5-12
in: linea alba, pubic tubercle, ant. 1/2 of iliac crest
action: rotate/flex trunk, support/compress abdominal viscera
innervation: thoracoabdominal n. (ant. rami of t7-11) and SUBCOSTAL NERVE (because high up)

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11
Q 
internal oblique
origin
insertion
action
innervation
A

fibers: hands in gloves
o: thoracolumbar fascia, ant 2/3 of iliac crest, connective tissue deep to the inguinal ligament
insertion: linea alba, pubis (via conjoin tendon), ribs 10-12
action: rotate/flex trunk, support/compress abdominal viscera
innervation: thoracoabdominal n. (off ant. rami of T7-11), FIRST LUMBAR NERVE (because sits low)

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12
Q 
transversus abdominus
origin
insertion
action
innervation
A
  • important for back probs, wraps around back to front and looks like corset
  • O: internal surfaces of ribs 7-12 costal cartilages, thoracolumbar fascia, iliac crest and connective tissue deep to inguinal ligament
    in: linea alba- aponeurosis of internal oblique, pubic crest, pecten pubis (pectinate line)
    action: protect/compress abdominal viscera
    innerv: thoracoabdom nerves (t7-11), first lumbar nerve
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13
Q 
rectus abdominus
origin
insertion
action
innervation
A

six pack muscles

o: pubic symphysis and pubic crest
i: xiphoid process and costal cartilages 5-7
axn: flexes trunk (lumbar vertebrae) and compresses abdominal viscera- acts as antagonist to diaphragm, stabilizes and controls pelvic tilt (ANTILORDOSIS)
inner: thoracoabdominal nerves (ant. rami of inferior 6 thoracic nerves- 6-12)

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14
Q

what do tendons do above the arcuate line? Below?

A
  • ABOVE: tendons split and run anteriorly and posteriorly around the rectus abdominus
  • BELOW: tendon fuses and wraps only anteriorly around the rectus abdominus
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15
Q

arcuate line

A
  • line that is half way between umbilicus and the pubic crest
  • no rectus sheath under the arcuate line
  • inferior epigastric artery runs thru it
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16
Q

what are the layers of the ant. abdominal wall?

A
  • epidermis, dermis
  • camper’s fascia
  • scarpa’s fascia
  • external oblique
  • internal oblique
  • transversus abdominus
  • rectus abhominus
  • transversalis fascia
  • parietal peritoneum
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17
Q

why is the area below the arcuate line so much more prone to hernias than the area above?

A
  • Above the arcuate line, the internal oblique splits to contribute to the external oblique and the transversus abdominus
  • below, all three aponeuroses pass anteriorly to the rectus and posterior wall is composed only of transversalis fascia and parietal peritoneum. this makes this area weak and prone to hernias
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18
Q

transversalis fascia

A
  • fascia that lines the internal abdominal wall

- forms the deep inguinal ring

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19
Q 
parietal peritoneum
what is it?
what does it do?
where?
look for what here?
innerv?
A
  • serous peritoneum
  • secretes serous fluid for lubrication of abdominal organs
  • slightly fused with the transversalis fascia and contains fat stores
  • inferior epigastric a/v here (enastamose with superior epigastric)
  • inner: somatic body wall nerves
20
Q

falciform ligament

A
  • part of the internal reflection and is last remaining part of ventral mesentery (from embryo)
  • connects to liver
21
Q

round ligament aka ligamentum teres

A

-last remnant of the fetal umbilical vein (that delivered oxygen to baby)

22
Q

what are the three umbilical folds? what lies in each?

A
  • median
  • medial
  • lateral
23
Q

median umbilical fold

A

(most centered)- urachus (remnant of alantosis which drained fetal bladder) and paraumbilical veins (can become enlarged and patent when pt is in portal htn

24
Q

medial umbilical fold

A

there are two, remnants of umbilical arteries (delivered deoxygenated blood back to mom)

25
Q

lateral umbilical fold

A
  • two, inferior epigastric arteries and veins run thru
26
Q

Thoracoabdominal nerves

  • spinal level
  • origin of nerve
  • course
  • innervate what?
A
  • T7-11
  • Origin: continuation of the lower intercostal nerves
  • Course: run between second and third layers of abdominal muscles
    innervate: muscles of anterolateral wall and overlying skin
27
Q

subcostal nerve

  • spinal level
  • origin
  • course
  • innervate what?
A
  • spinal level: T12 (because it’s subcostal)
  • origin: anterior ramus of L1 spinal nerve
  • course: inferior border of 12th rib, then onto subumbilical abdominal wall
  • innervate what? muscles of anterolateral abdominal wall and overlying skin SUPERIOR to iliac crest and inferior to umbilicus
28
Q

Iliohypogastric nerve

  • spinal level
  • origin
  • course
  • innervate what?
A
  • spinal level- L1
  • origin: anterior ramus of T12 spinal nerve
  • course: pierces transversus abdominus muscle; branches pierce aponeurosis of external oblique
  • innervate what? skin OVER iliac crests, upper inguinal and hypogastric region, internal oblique and transversus abdominus (because it pierces thru)
29
Q

Ilioinguinal nerve

  • spinal level
  • origin
  • course
  • innervate what?
A
  • spinal level- L1
  • origin- L1
  • course- passes thru 2nd and 3rd layers of abdominal muscles to transverse inguinal canal
  • innervate what? mons pubis, skin of scrotum, labia majora, medial aspect of thigh, lower pt of internal oblique and transversus abdominus
30
Q

Musculophrenic artery
origin:
course:
what it oxygenates:

A

origin:internal thoracic artery
course: descends along costal margin
what it oxygenates: abdominal wall of hypochondriac region, anterolateral, diaphragm

31
Q

superior epigastric artery
origin:
course:
what it oxygenates:

A

origin: Internal thoracic artery
course: descends in rectus sheath deep to rectus abdominus
what it: oxygenates recus abdominus and SUPERIOR part of anterolateral wall

32
Q

Posterior intercostal artery
origin:
course:
what it oxygenates:

A

origin: aorta
course: continues along ribs to descend in abdominal wall between internal oblique and transversus abdominus
what it oxygenates: lateral region of the abdominal wall

33
Q

subcostal artery
origin:
course:
what it oxygenates:

A

origin: aorta
course: continue beyond ribs to descend in abdominal wall between internal oblique and transersus abdominus
what it oxygenates: lateral region of abdominal wall

34
Q

inferior epigastric artery
origin:
course:
what it oxygenates:

A

origin: external iliac artery
course: runs superiorly and enters rectus sheath and runs deep to rectus abdominus
what it oxygenates: rectus abdominus and MEDIAL PART OF THE ANTEROLATERAL ABDOMINAL WALL

35
Q

Deep circumflex iliac artery
origin:
course:
what it oxygenates:

A

origin: external iliac artery
course: runs parallel to inguinal ligament very DEEP
what it oxygenates: iliacus muscle and inferior portion of the anterolateral abdominal wall

36
Q

superficial circumflex artery
origin:
course:
what it oxygenates:

A

origin: femoral artery
course: runs in SUPERFICIAL fascia along inguinal ligament
what it oxygenates: superficial abdominal wall of inguinal region and adjacent anterior thigh

37
Q

superficial epigastric
origin:
course:
what it oxygenates:

A

origin: femoral artery
course: in superficial fascia towards umbilicus
what it oxygenates: subcutaneous tissue and skin over pubic and inferior umbilical region

38
Q

If an infection occurs in the lower part of the transumbilical plane what occurs? upper?

A
  • lower- there is increased congestion in superficial inguinal lymph nodes
  • upper- there is increased lymph nodes in axillary lymph nodes
39
Q

subcostal incision is usually done for?

A

gall bladder removal

40
Q

where is the median incision done?

A

linea alba

41
Q

where is the paramedian incision performed?

A

thru rectus sheath retracting muscle to one side

42
Q

where is the Gridiron incision performed? used for?

A
  • down and lateral (at Mcburney point)

- appendectomy

43
Q

transverse incision. for?

A

horizontal thru muscle layers

ovaries

44
Q

what procedure usually used for suprapubic incision?

A

hysterectomy

45
Q

consequences of corset wearing (6)

A
  • aggravate prolapsed uterus
  • decreased appetite/increased constipation
  • decreased lung capacity
  • tightlacing while pregnant is dangerous to fetal growth
  • weakened abdominal muscles cuz acts as transverus abdominus and spinal muscles
  • does not cause liver tumors but does change shape of liver

anatomy exam 4 (8 decks)

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