Anterior Abdominal Wall

Question 1

External oblique (origin/insertion)

Answer 1

Origin = lower 8 ribs

Insertion = xiphoid process, linea alba, pubic tubercle, anterior 1/2 of iliac crest

Question 2

Internal oblique (origin/insertion)

Answer 2

Origin = lateral 1/3 of inguinal ligament, anterior 2/3 of iliac crest, lumbar fascia

Inserts = lower 3 ribs and costal cartilages, linea alba, pubic crest and pectineal line

Question 3

Transversus abdominus (origin/insertion)

Answer 3

Origin = lateral 1/3 of inguinal ligament, iliac crest, lumbar fascia and lower 6 costal cartilages

Inserts = lines alba, pubic crest and pectineal line

Question 4

Rectus abdominus (origin/insertion)

Answer 4

Origin = pubic crest and symphysis pubis

Inserts = 5th, 6th and 7th costal cartilages and xiphoid process

Question 5

Pyramidalis (origin/insertion)

Answer 5

Origin = pubic symphysis and pubic crest

Inserts = lines alba

Question 6

What does the rectus sheath contain?

Answer 6

Recurs abdominus and pyramidalis muscles

Superior and inferior epigastric vessels

Lower 5 intercostal and subcostal nerves

Question 7

What is the superficial inguinal ring?

Answer 7

An oval slit in the aponeurotic fibres of the external oblique muscle, just above pubic tubercle

Question 8

Where is the inguinal region?

Answer 8

Between lower part of abdomen and front of the thigh

Question 9

Where does the inguinal ligament extend from?

Answer 9

From the anterior superior iliac spine to the pubic tubercle.

Question 10

What are the layers of the anterior abdomen?

Answer 10

Skin
Superficial fascia (camper’s and scarpa’s)
Muscle layers (external oblique, internal oblique, transversus abdominus)
Fascia transversalis
Extraperitoneal fat
Parietal peritoneum

Question 11

Where is the inguinal canal?

Answer 11

Just above and parallel to the medial half of the inguinal ligament

Question 12

What is the deep inguinal ring?

Answer 12

An opening in the fascia transversalis above the middle of the inguinal ligament. Lies lateral to epigastric vessels.

Question 13

What travels through the inguinal canal?

Answer 13

In males, the spermatic cord. In females, the round ligament of the uterus. In both there’s also the ilioinguinal nerve.

Question 14

What is the anterior wall of the inguinal canal?

Answer 14

External oblique and lateral half of internal oblique

Question 15

What is the posterior wall of the inguinal canal?

Answer 15

Fascia transversalis, conjoint tendon, reflected ligament

Question 16

What makes up the floor of the inguinal canal?

Answer 16

Inguinal ligament supported by the lacunar ligament

Question 17

What makes up the roof of the inguinal canal?

Answer 17

Transversalis fascia, internal oblique and transversus abdominus

Question 18

What is the iliopubic tract?

Answer 18

Thickened inferior margin of fascia transversalis, a fibrous band that runs deep to the inguinal ligament.

Question 19

What does the iliopubic tract cover?

Answer 19

The myopectineal orifice

Question 20

What are the 5 folds of posterior fascia transversalis?

Answer 20

1 x median umbilical
2 x medial umbilical
2 x lateral umbilical

Question 21

What is an indirect inguinal hernia?

Answer 21

Most common inguinal hernia. Above and medial to pubic tubercle.

Question 22

What is a direct inguinal hernia?

Answer 22

Hernial sac that bulges through posterior wall of inguinal canal, medial to inferior epigastric vessels.

Question 23

What is a femoral hernia?

Answer 23

Hernial sac that descends through femoral canal within the femoral sheath. Lies at the femoral ring.

Question 24

Where is Hesselbach’s triangle?

Answer 24

Between rectus abdominus and iliopubic tract.