Anterior Abdominal Wall Flashcards
The abdomen is divided topographically into how many regions?
9
What are the vertical planes of the abdomen that extend inferiorly from the midpoints of the clavicles to the midpoints of lines joining the ASIS to the pubic symphysis?
Midclavicular Planes
What is the horizontal plane of the abdomen that joins the lowest point of the costal margin on each side?
Subcostal Plane
Where does the subcostal plane lie?
L.V. 3 level
What is the horizontal plane of the abdomen that joins the tubercles of the iliac crests?
Transtubercular Plane
Where does the transtubercular plane lie?
L.V. 5 level
What are the nine regions of the abdomen?
Right hypochondrium, epigastric, left hypochondrium, right flank, umbilical, left flank, right groin, pubic, left groin
Which regions of the abdomen are covered by costal cartilages?
Right hypochondrium, epigastric, left hypochondrium
In which region of the abdomen does the liver lie?
Mostly in the right hypochondrium and epigastric regions
In which region of the abdomen do the spleen and the body and fundus of the stomach lie?
Left hypochondrium
What two planes divide the abdomen into four quadrants?
Median plane and transumbilical plane
Which plane dividing the abdomen into quadrants is vertical through the midline?
Median plane
Which plane dividing the abdomen into quadrants is horizontal through the umbilicus?
Transumbilical plane
In which quadrant of the abdomen is pain from appendicitis felt?
Right lower quadrant
In which quadrant of the abdomen is pain from a gallbladder attack felt?
Right upper quadrant
Between which vertebrae does the umbilicus typically lie as a variable landmark?
L.V. 2 and L.V. 5
What are the 13 layers of the anterior abdominal wall in order?
Skin, superficial layer of superficial fascia (camper’s fascia), deep layer of superficial fascia (scarpa’s fascia), deep (investing) fascia, external oblique muscle, internal oblique muscle, transversus abdominis muscle, transversalis fascia, extraperitoneal fascia, parietal peritoneum, peritoneal cavity, visceral peritoneum, abdominal organs
What is the epinym for the superficial layer of the superficial fascia?
Camper’s fascia
What is the epinym for the deep layer of the superficial fascia?
Scarpa’s fascia
What type of layer is the superficial layer of the superficial fascia?
Thin fatty layer
What type of layer is the deep layer of the superficial fascia?
Membranous
Where is the superficial layer of the superficial fascia located?
Continuous with the superficial fascia of the perineum and thigh
Where is the deep layer of the superficial fascia located?
Firmly fastened to the fascia lata of the thigh just below the inguinal ligament
Which layer of the superficial fascia does not continue?
Deep layer
What is the cause of extravasation of urine?
Trauma
Which gender is more like to have extravasation of the urine?
Males
Why are males more likely to have extravasation of the urine?
The urethra is longer, more superficial, and more horizontally orientated than females
Where is the potential space where fluid can accumulate in extravasation of urine?
Between the Scarpa’s fascia and the deep fascia of the abdomen
Why can’t the urine spread inferiorly with extravasation of urine?
Due to the firm attachment of Scarpa’s fascia to the fascia lata
Where can urine spread to during extravasation of the urine?
Superiorly in the anterior abdominal wall within the potential space
What do anterior abdominal wall muscle insert into via their aponeuroses?
Linea alba
What is the largest and longest raphe in the body?
Linea alba
The linea alba extends from which two structures?
Xiphoid process to the pubic symphysis
What is the origin of the external oblique muscle?
Lower 8 ribs
What is the insertion of the external oblique muscle?
Iliac crest, ASIS, pubic tubercle, and linea alba by aponeurosis
What is the nerve supply to the external oblique muscle?
Anterior primary rami of lower 6 thoracic nerves
What is the function of the external oblique muscle?
Compresses the abdomen, supports abdominal viscera, lateral flexor of trunk
How do the fibers of the external oblique muscle run?
Downward and forward
The external oblique muscle is a continuation of which other muscle?
External intercostal muscle
What is the origin of the internal oblique muscle?
Lumbar fascia, iliac crest, lateral two-thirds of inguinal ligament
What is the insertion of the internal oblique muscle?
Lower 3 ribs, linea alba by aponeurosis
What is the nerve supply to the internal oblique muscle?
Anterior primary rami of lower 6 thoracic and first lumbar nerves
What is the function of the internal oblique muscle?
Compresses the abdomen, supports abdominal viscera, lateral flexor of trunk
How do the fibers of the internal oblique muscle run?
Downward and backward
The internal oblique muscle is a continuation of which other muscle?
Internal intercostal muscle
What are the three anterolateral abdominal muscles?
External oblique, internal oblique, and transversus abdominis muscles
What is the origin of the transversus abdominis muscle?
Lower 6 costal cartilages, lumbar fascia, iliac crest, lateral third of inguinal ligament
What is the insertion of the transversus abdominis muscle?
Into linea alba by aponeurosis
What is the nerve supply to the transversus abdominis muscle?
Anterior primary rami of lower 6 thoracic and first lumbar nerves
What is the function of the transversus abdominis muscle?
Compresses the abdomen, supports abdominal viscera
Which abdominal muscle acts as an internal back brace to stabilize the spine?
Transversus abdominis muscle
How do the fibers of the transversus abdominis run?
Horizontally across the abdomen
The transversus abdominis muscle is a continuation of what other muscle?
Transversus thoracis
What are the anterior abdominal muscles?
Rectus abdominis and pyramidalis muscles
What is the origin of the rectus abdominis muscle?
Pubic crest and pubis symphysis
What is the insertion of the rectus abdominis muscle?
Xiphoid process and the costal cartilages of ribs 5-7
What is the nerve supply of the rectus abdominis muscle?
Anterior primary rami of the lower 6 thoracic nerves
What is the function of the rectus abdominis muscle?
Compresses the abdomen, supports the abdominal viscera, anterior flexor of the trunk
The linea alba lies between which two muscles?
Left and right rectus abdominis muscles
What is the linea semilunaris?
Curved line along the lateral border of the rectus abdominis muscle seen in physically fit people
What are tendinous intersections?
3 bundles of connective tissue that run transversely across the rectus abdominis muscle and fuse with the rectus sheath (see in physically fit people)
Which anterior muscle is often absent and lies anterior to the rectus abdominis within its sheath?
Pyramidalis muscle
What is the origin of the pyramidalis muscle?
Body of pubis
What is the insertion of the pyramidalis muscle?
Linea alba
What is the nerve supply of the pyramidalis muscle?
Subcostal nerve
What is the function of the pyramidalis muscle?
Tenses the linea alba
What is the connection between low back pain and anterior abdominal muscles?
Low back pain is often related to WEAK anterior abdominal muscles
Which two anterior abdominal wall muscle actions are involved with forced expiration?
Coughing and sneezing
What are the six major actions of the anterior abdominal wall muscles?
Coughing, sneezing, vomiting, defecation, micturition, parturition
What forms the rectus sheath?
Aponeuroses of the external oblique, internal oblique, and transversus abdominis muscles
What five things does the rectus sheath enclose?
Rectus abdominis muscle, pyramidalis muscle (when present), superior epigastric artery and vein, inferior epigastric artery and vein, anterior primary rami of lower 6 thoracic nerves
What is the arcuate line of the rectus sheath?
A crescent shaped lines in the posterior layer located midway between the umbilicus and pubic crest
The aponeuroses of which muscles make up the anterior layer of the rectus sheath above the arcuate line?
External and internal oblique muscles
The aponeuroses of which muscles make up the posterior layer of the rectus sheath above the arcuate line?
Internal oblique and transversus abdominis muscles
The aponeurosis of which muscle splits above the arcuate line to enclose the rectus abdominis?
Internal oblique muscle
The aponeuroses of which muscles make up the anterior layer of the rectus sheath below the arcuate line?
External oblique, internal oblique, and transversus abdominis muscles
What makes up the posterior layer of the rectus sheath below the arcuate line?
Transversalis fascia
What forms the five folds present on the posterior surface of the anterior abdominal wall?
Parietal peritoneum overlying a structure
Which fold on the posterior surface of the anterior abdominal wall contains the urachus?
Median Umbilical Fold
Which fold on the posterior surface of the anterior abdominal wall contains the obliterated umbilical artery?
Medial Umbilical Fold
Which fold on the posterior surface of the anterior abdominal wall contains the inferior epigastric vessels?
Lateral Umbilical Fold
The median umbilical fold extends from what two locations?
Apex of the bladder to the umbilicus
The medial umbilical fold extends from what two locations?
Side of the bladder to the umbilicus
The lateral umbilical fold extends from what two locations?
Deep inguinal ring to the arcuate line
What is the urachus?
Remnant of the embryonic and fetal bladder
What is the name of the fossa that is between the median and medial umbilical folds?
Supravesical fossa
What is the name of the fossa that is between the medial and lateral umbilical folds?
Medial inguinal fossa
What is the name of the fossa that is lateral to the later umbilical fold?
Lateral inguinal fossa
What does the ligamentum teres contain?
The obliterated umbilical vein
What is the ligamentum teres?
The free edge of the falciform ligament, which is attached to the liver
Where does the ligamentum teres lie?
Above the umbilicus
The superior epigastric artery arises from which artery?
Internal thoracic artery
The inferior epigastric artery arises from which artery?
External iliac artery
The lumbar arteries arise from which artery?
Abdominal aorta
The deep circumflex iliac artery arises from which artery?
External iliac artery
What are the four arteries that make up the blood supply to the anterior abdominal wall?
Superior and inferior epigastric arteries, lumbar arteries, and deep circumflex iliac artery
What is the innervation of the anterior abdominal wall?
Lower 6 thoracic nerves (T7-T12)
The lower 6 thoracic nerves run in between which two muscles?
Internal oblique and transversus abdominis muscles
