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Gross II Exam 3 > Anterior Abdominal Wall > Flashcards

Anterior Abdominal Wall Flashcards

1
Q

What is the nine region system of topographical division?

A
  • divided by two vertical and two horizontal planes

- divided into nine regions

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2
Q

What are the vertical planes in the nine region system called and where are they located?

A
  • midclavicular planes
  • extend inferiorly from the midpoints of the clavicles to the midpoints of lines joining the anterior superior iliac spine to the pubic symphysis
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3
Q

What are the horizontal planes in the nine region system called and where are they located?

A
  • subcostal plane: joins the lowest point of the costal margin on each side; lies at the inferior margin of rib 10 (L3 level)
  • transtubercular plane: joints the tubercles of the iliac crests (L5 level)
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4
Q

What are the nine regions?

A
  1. right hypochondrium
  2. epigastric
  3. left hypochondrium
  4. right flank (lateral)
  5. umbilical
  6. left flank (lateral)
  7. right groin (inguinal)
  8. pubic
  9. left groin (inguinal)
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5
Q

How are the organs related to these nine regions?

A
  • the liver lies mostly in the right hypochondrium and epigastric region
  • the spleen and fundus and body of the stomach are found in the left hypochondrium region
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6
Q

How is pain related to these nine regions?

A

pain is localized to the regions

- example: appendicitis is localized to the right groin area

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7
Q

What is the quadrant system of topographical division?

A
  • a simpler system that involves dividing the abdomen into four quadrants
  • median plane: vertical plane through midline
  • transumbilical plane: horizontal plane through the umbilicus
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8
Q

What are the four quadrants?

A
  1. right upper quadrant
  2. left upper quadrant
  3. right lower quadrant
  4. left lower quadrant
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9
Q

Why is the four quadrant system less precise?

A

the umbilicus is a variable landmark which lies between L2 and L5
- depends on age, weight, body position, etc.

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10
Q

What are the layers of the abdominal wall?

A
  1. skin
  2. superficial layer of superficial fascia (Camper’s fascia) - fatty layer
  3. deep layer of superficial fascia (Scarpa’s fascia) - thin and membranous layer
  4. deep (investing) fascia - ensheaths the muscles, thin/investing layer
  5. external oblique muscle
  6. internal oblique muscle
  7. transversus abdominis muscle
  8. transversalis fascia - thin and slippery
  9. extraperitoneal fascia - fatty
  10. parietal peritoneum - thin membrane
  11. peritoneal cavity - potential space
  12. visceral peritoneum
  13. abdominal organs
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11
Q

What are the two major layers of the fascia of the anterior abdominal wall?

A
  • superficial fascia

- deep (investing) fascia

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12
Q

What are the subdivisions of the superficial fascia?

A
  • superficial layer (Camper’s fascia)

- deep layer (Scarpa’s fascia)

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13
Q

What is Camper’s fascia?

A

a thin fatty layer of fascia which is continuous with the superficial fascia of the perineum and thigh

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14
Q

What is Scarpa’s fascia?

A

a membranous layer of fascia which is firmly fastened to the fascia lata of the thigh, just below the inguinal ligament

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15
Q

What does the deep (investing) fascia cover?

A

each of the anterior abdominal wall muscles on its anterior and posterior surface

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16
Q

What is extravasation of urine?

A
  • Between Scarpa’s fascia and the deep fascia of the abdomen, there is a potential space, where fluid can accumulate.
  • Rupture of the spongy urethra allows accumulation of urine within this space.
  • Urine can spread superiorly in the anterior abdominal wall within this space.
  • It cannot spread inferiorly into the thigh due to the firm attachment of Scarpa’s fascia to the fascia lata.
  • This problem is almost exclusive to males because the urethra is longer, more superficial, and more horizontally oriented than in females.
  • Cause: trauma
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17
Q

What is the linea alba?

A
  • a median tendinous raphe which extends from the xiphoid process to the pubic symphysis
  • anterior abdominal wall muscles insert into this raphe via their aponeuroses
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18
Q

What are the anterolateral muscles of the anterior abdominal wall?

A
  • external oblique
  • internal oblique
    transversus abdominus
19
Q

What is the origin, insertion, nerve supply, and function of the external oblique muscle?

A
  • O: lower 8 ribs
  • I: iliac crest, anterior superior iliac spine, pubic tubercle, and linea alba by aponeurosis
  • N: anterior primary rami of lower 6 thoracic nerves
  • F: compresses the abdomen, supports abdominal viscera, lateral flexor of trunk
20
Q

In which direction do the fibers of the external oblique muscle travel?

A

downward and forward

21
Q

What is the origin, insertion, nerve supply, and function of the internal oblique muscle?

A
  • O: lumbar fascia, iliac crest, lateral two-thirds of inguinal ligament
  • I: lower 3 ribs, linea alba by aponeurosis
  • N: anterior primary rami of lower 6 thoracic and first lumbar nerves
  • F: compresses the abdomen, supports abdominal viscera, lateral flexor of trunk
22
Q

In which direction do the fibers of the internal oblique muscle travel?

A

downward and backward

23
Q

What is the origin, insertion, nerve supply, and function of the transversus abdominis muscle?

A
  • O: lower 6 costal cartilages, lumbar fascia, iliac crest, lateral third of inguinal ligament
  • I: into linea alba by aponeurosis
  • N: anterior primary rami of lower 6 thoracic and first lumbar nerves
  • F: compresses the abdomen, supports abdominal viscera, acts as an internal back brace
24
Q

In which direction do the fibers of the transversus abdominis muscle travel?

A

horizontally

25
Q

What are the anterior muscles of the anterior abdominal wall?

A
  • rectus abdominis

- pyramidalis

26
Q

What is the origin, insertion, nerve supply, and function of the rectus abdominis muscle?

A
  • O: pubic crest and pubic symphysis
  • I: xiphoid process and the costal cartilages of ribs 5-7
  • N: anterior primary rami of the lower 6 thoracic nerves
  • F: compresses the abdomen, supports abdominal viscera, anterior flexor of trunk
27
Q

What unique features are associated with the rectus abdominis muscle?

A
  • the linea alba lies between the left and right rectus abdominis muscles
  • the linea semilunaris is a curved line along the lateral border of the rectus abdominis muscle
  • tendinous intersections: 3 bundles of connective tissue which run transversely across the rectus abdominis muscle and which fuse with the rectus sheath
28
Q

What is the origin, insertion, nerve supply, and function of the pyramidalis muscle?

A
  • O: body of pubis
  • I: linea alba
  • N: subcostal nerve
  • F: tenses linea alba
29
Q

What is unique about the pyrimidalis muscle?

A
  • small and often absent slip of muscle

- lies anterior to the rectus abdominis muscle within its sheath

30
Q

What is the chiropractic note associated with abdominal muscles?

A

low back pain is often related to weak abdominal muscles

31
Q

What visceral functions are the anterior abdominal muscles active in?

A
  • coughing
  • sneezing
  • vomiting
  • defecation
  • parturition
  • micturition (urinating)
32
Q

What is the rectus sheath formed by?

A

the aponeuroses of the external oblique, internal oblique, and transversus abdominis muscles

33
Q

What does the rectus sheath enclose?

A
  • rectus abdominis muscle
  • pyramidalis muscle
  • superior epigastric artery and vein
  • inferior epigastric artery and vein
  • anterior primary rami of lower 6 thoracic nerves
34
Q

What are the layers of the rectus sheath?

A
  • an anterior and posterior layer

- the composition of these layers changes when one passes above or below the arcuate line

35
Q

What is the arcuate line?

A

a crescent shaped line in the posterior layer of the rectus sheath located midway between the umbilicus and pubic crest

36
Q

Describe the layers of the rectus sheath above the arcuate line.

A
  • Anterior layer of rectus sheath: composed of the aponeuroses of the external and internal oblique muscles
  • Posterior layer of rectus sheath: composed of the aponeuroses of the internal oblique and transversus abdominis muscles
  • Above the arcuate line, the aponeurosis of the internal oblique muscle splits to enclose the rectus abdominis
37
Q

Describe the layers of the rectus sheath below the arcuate line.

A
  • Anterior layer of rectus sheath: composed of the aponeuroses of the external oblique, internal oblique, and transversus abdominis muscles
  • Posterior layer of rectus sheath: formed by the transversalis fascia
38
Q

What are the five folds on the posterior surface of the anterior abdominal wall?

A
  • 1 Median Umbilical Fold: extends from the apex of the bladder to the umblicus; it contains the urachus
  • 2 Medial Umbilical Folds: extend from the side of the bladder to the umbilicus; contain the obliterated umbilical artery
  • 2 Lateral Umbilical Folds: extend from the deep inguinal ring to the arcuate line; contain the inferior epigastric vessels
39
Q

What do the five folds on the posterior surface of the anterior abdominal wall form the boundaries between?

A
  • three paired fossae
  • Supravesical Fossa: between median and medial umbilical folds
  • Medial Inguinal Fossa: between medial and lateral umbilical folds
  • Lateral Inguinal Fossa: lateral to the lateral umbilical fold
40
Q

What does the word vesical refer to?

A

urinary bladder

41
Q

What is the ligamentum teres?

A
  • lies above the umbilicus and contains the obliterated umbilical vein
  • the free edge of the falciform ligament, which is attached to the liver
42
Q

What is the blood supply to the anterior abdominal wall?

A
  • superior epigastric artery (from the internal thoracic artery)
  • inferior epigastric artery (from the external iliac artery)
  • lumbar arteries (from the abdominal aorta)
  • deep circumflex iliac artery (from the external iliac artery)
43
Q

What is the innervation of the anterior abdominal wall?

A

lower 6 thoracic nerves (7th-12th)

  • motor to muscles
  • sensory to dermatomes
  • travel between internal oblique and transversus abdominis

Gross II Exam 3 (22 decks)

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