Anterior Abdominal Wall

Question 1

What are the 4 boundaries of the anterior abdominal wall?

Answer 1

1) Superior – right and left costal margins, xiphisternal joint
2) Inferior – a line on either side connecting the ASIS to the pubic symphysis
3) Lateral – vertical lines ascending from the ASIS on each side
4) Posterior – lumbar paravertebral musculature

Question 2

Location of subcostal plane

Answer 2

line through the most inferior points of the costal cartilage, 10th costal
cartilage. The line passes through the body of L3 vertebra

Question 3

Location of transtubercular plane

Answer 3

line passes through the iliac tubercles at the level of the L5 vertebra

Question 4

Location of sagittal plane

Answer 4

mid-clavicular lines, extends inferior from the mid-clavicle to the mid-inguinal point.

Question 5

Upper region consists of?

Answer 5

(1) Right hypochondriac
(2) Epigastric
(3) Left hypochondriac

Question 6

Middle region consists of?

Answer 6

(1) Right lumbar
(2) Umbilical
(3) Left lumbar

Question 7

Lower region consists of?

Answer 7

(1) Right inguinal
(2) Hypogastric
(3) Left inguinal

Question 8

Organs within the RUQ

Answer 8

Liver 
Gallbladder 
Right suprarenal gland 
Right kidney 
Ascending colon: superior part

Question 9

Organs within the LUQ

Answer 9

Spleen
Stomach
Pancreas – body and tail
Left kidney
Transverse colon (left half),
Descending colon (superior part)

Question 10

Organs within the RLQ

Answer 10

Cecum
Vermiform Appendix 
Right ovary
Right ureter
Most of the ileum

Question 11

Organs within the LLQ

Answer 11

Sigmoid colon
Descending colon: inferior part
Left ovary
Left ureter
Left spermatic cord

Question 12

OINA of Ext. Abdominal Oblique

Answer 12

0 – external surface of the 5th to 12th ribs
I – linea alba, pubic crest, iliac crest, pubic symphysis
N – Inferior 5 thoracic nerves and subcostal nerve(T12) and iliohypogastric
A – flex and rotate trunk, laterally rotate the trunk, compress abdominal contents

Question 13

OINA of Int. Abdominal Oblique

Answer 13

O – Thoracolumbar fascia, anterior iliac crest, lateral half of inguinal ligament
I – linea alba, pubic crest, ribs 10-12 inferior surface
N – lower 5 thoracic nerves, subcostal, iliohypogastric
A – flex and rotate the trunk, laterally rotate the trunk, compress abdominal contents

Question 14

OINA of Transverse Abdominis

Answer 14

0 – thoracolumbar fascia, iliac crest, lateral one third of the inguinal ligament, internal surface of costal cartilage’s 7 to 12
I – linea alba, pubic crest, pubic symphysis
N – lower 5 thoracic nerves, subcostal, iliohypogastric
A – compress and support abdominal viscera

Question 15

OINA of Rectus Abdominis

Answer 15

0 – pubic symphysis, pubic crest
I – xiphoid process, 5th and 7th costal cartilage’s
N – lower 5 thoracic nerves, subcostal, iliohypogastric
A – flexes trunk and tenses anterior abdominal wall

Question 16

Rectus Sheath-Structure

Answer 16

It is a dense fibrous sheath enclosing the rectus abdominis muscle.
It is formed by the fusion of the aponeuroses of the abdominal muscles.

Question 17

Rectus Sheath above the level of the Umbilicus - Anteriorly

Answer 17

Anteriorly – external abdominal oblique aponeurosis and ½ of the Internal abdominal oblique aponeurosis

Question 18

Rectus Sheath above the level of the Umbilicus - Posteriorly

Answer 18

Posteriorly - ½ of the Internal abdominal oblique aponeurosis and the aponeurosis of the Transversus abdominis

Question 19

The anterior and posterior walls meet and fuse in the anterior median line called the _____.

Answer 19

Linea Alba

Question 20

Rectus Sheath below the level of the Umbilicus - Anteriorly

Answer 20

Anteriorly – The aponeurosis from all three muscles now pass anteriorly over the rectus abdominis with no fascia from the muscle passing posteriorly

Question 21

Rectus Sheath below the level of the Umbilicus - Posteriorly

Answer 21

Posteriorly – a thin fascial film remains posteriorly that protects the rectus abdominis from rubbing against the abdominal contents.

Question 22

The point of transition were all three aponeurosis pass anteriorly is marked by the ______.

Answer 22

Arcuate Line

Question 23

Innervation of Ant. Abd. Wall

Answer 23

It is supplied by the ventral primary rami of thoracic spinal nerves of T6 – T11, ventral primary ramus of T12 or subcostal nerve and the iliohypogastric and ilioinguinal nerves from the ventral primary ramus of L 1

Question 24

Arterial Supply of Ant. Abd. Wall

Answer 24

1. Superior epigastric - branch of the internal thoracic artery
2. Inferior epigastric - a branch of the external iliac
   - They both enter the rectus sheath posterior to the rectus abdominis and anastomoses with the rectus muscle
3. The posterior intercostal arteries that accompany the intercostal nerves also contribute to the arterial supply of the anterior abdominal wall
4. Additional supply comes from the direct branches of the abdominal aorta and lumbar arteries

Question 25

Contents of Inguinal Canal

Answer 25

Spermatic cord in males
Round ligament of the uterus in females
Inguinal nerve
Blood and lymphatic vessel

Question 26

Chain of food:

Answer 26

Esophagus
Stomach
Duodenum
Small intestine - Jejunum & Ileum
(Spleen, pancreas, liver, gallbladder)
Large intestine - cecum
Large intestine - colon
Large intestine - Rectum and anal canal
(kidneys)