Anterior abdominal wall Flashcards
What separates the abdominal cavity from the pelvic cavity?
The pelvic inlet
T/F the abdominal and pelvic cavities are continuous with each other?
Truth
What are the layers of the lateral portion of the abdominal wall from outside to inside?
Skin, superficial fascia- fatty layer, superficial fascia- membranous layer, muscular layer, transversalis fascia, extraperitoneal fascia, parietal peritoneum
What muscles are contained in the muscle layer of the anterolateral wall
external oblique, internal oblique, transversus abdominus muscles
What are the layers of the muscles of the anterolateral wall from outside to inside?
External oblique (which continues as an aponeurosis) Underneath that is the internal oblique muscle rectus abdominis muscles are deep and on either side of the midline
What is the medial border of the rectus abdominis muscles?
The linea alba
What is the rectus sheath made of?
An aponeurotic sheath
What does the rectus sheath do?
It envelops the rectus abdominus and pyramidalis (pyramidalis might not be seen)
The rectus sheath’s structure/shape is dependent on what other structure?
The arcuate line
How is the rectus sheath formed superior to the arcuate line?
Anterior layer is formed by the aponeurosis of external oblique and 1/2 of the internal oblique.
The posterior layer is formed by the aponeurosis of 1/2 the external oblique and transversus abdominis and transversalis fascia
How is the rectus sheath formed inferior to the arcuate line?
Anterior layer is formed by aponeuroses of EO, IO, TA
Posterior layer formed by transversalis fascia
Where is the median umbilical fold and what does it cover?
It is from the urinary bladder to the umbilicus
It covers the median umbilical ligament
The medial umbilical folds cover what and what?
Cover the medial umbilical ligaments and occluded portions of the umbilical artery
What do the lateral umbilical folds cover?
The inferior epigastric vessels
You should probably go draw the path of the circumflex iliac and epigastric arteries and their veins.
yep
Where do the circumflex iliac and epigastric vessels travel?
In the superficial fat and fascia
The deep circumflex iliac artery is a branch of what? What does it supply?
It is a branch of the external iliac artery
It supplies the inferior lateral abdominal muscles
The inferior epigastric artery is a branch of what? What does it supply? What does it anastomose with?
It is a branch of the external iliac artery
It supplies the lower rectus abdominus muscle
It anastomoses with the superior epigastric
The superior epigastric artery is a branch of what? It supplies what? What does it anastomose with?
A branch of the internal thoracic (mammary) artery
Supplies the upper rectus abdominus
Anastomoses with inferior epigastric
The musculophrenic vessels are branches of what?
What do they supply?
Branches of internal thoracic (mammary)
Supplies upper abdominal muscles and diaphragm
T/F, spinal nerves supply the abdominal wall?
Truth
What level of spinal nerves are involved in the abdominal wall?
Ventral rami of T7-L1
Which spinal nerves supply the region above the umbilicus?
T7-T9
Spinal nerve T10 supplies what?
the umbilical region
Which spinal nerves supply the region below the umbilicus?
T11-L1
Injury to what spinal nerves predisposes you to developing direct inguinal hernias?
T11-L1
As the internal thoracic artery descends, it becomes what?
The superior epigastric artery medially and the musculophrenic artery laterally
What is the dividing line that distinguishes the femoral artery from the iliac artery?
The inguinal ligament
Where is the inguinal region?
Inferior and lateral to the abdominal region
Superior to the thigh
Medial to ilium
Lateral to pubic bone
The inguinal ligament is the folded inferior border of the aponeurosis of which muscle?
The external oblique
The inguinal ligament extends from where to where?
From the anterior superior iliac spine (ASIS) to the pubic tubercle
T/F the inguinal canal runs parallel and inferior to the inguinal ligament?
False, parallel and superior to the inguinal ligament
What important structure present only in males is found in the inguinal canal?
The spermatic cord and its contents (vas deferens, testicular nerves and vessels, cremasteric muscle and fascia) Ilioinguinal nerve (L1)
The female inguinal canal contains what?
The round ligament of uterus (in males it would be the spermatic cord) Ilioinguinal nerve (L1)
The inguinal canal extends between two openings. What are they?
Superficial and deep inguinal canal rings
Where is the superficial inguinal canal ring found?
it’s an obvious triangular opening in the external oblique aponeurosis lateral to the pubic tubercle
Where is the deep inguinal canal ring found?
It is a subtle piercing in the transversalis fascia just lateral to the inferior epigastric vessels
Where are the deep and superficial inguinal canal rings in relation to each other?
The superficial inguinal canal ring is more superficial, more inferior, and more medial than the deep inguinal canal ring
For the inguinal canal, what is the anterior wall?
The external oblique aponeurosis
For the inguinal canal, what is the posterior wall?
the transversalis fascia and conjoint tendon (which is the fusion of the internal oblique and transversus abdominus aponeurosis medially)
For the inguinal canal, what is the roof?
Internal oblique and transversus abdominus muscles
For the inguinal canal, what is the floor?
The inguinal ligament
Describe an abdominal hernia.
An outpouching of abdominal viscera within a sac
A hernial sac is composed of 3 layers- what are they?
Just remember, you’ve got a PET hernia-
Peritoneum
Extraperitoneal fat
Transversalis fascia
Where do most hernias occur?
In the inguinal region ~ 90%
What is an indirect inguinal hernia?
It is one that extends through the entire inguinal canal that often enters the scrotum or labia majora (more common in men)
What is Hesselbach’s triangle (inguinal triangle)?
The triangle is made between the inferior epigastric artery, the rectus abdominus muscle and the inguinal ligament
Where does a direct inguinal hernia emerge?
It emerges through the conjoint tendon by or at the superficial ring (usually doesn’t enter the scrotum or labia major and is more common in men)
Which type of hernia is most common in women?
The femoral hernia
