Anterior Abdominal Wall Flashcards
External Oblique
Attaches to linea alba, pubic tubercle, anterior half of iliac crest
Function: laterally flex and rotate trunk
Internal Oblique
Attaches to inferior border of last 3 or 4 ribs, ilnea alba, pectineal line via conjoint tendon
Function: laterally flex and rotate trunk
Transverse Abdominis
Attaches to aponeurosis of posterior and anterior rectus sheath, conjoint tendon to pubic crest and pectineal line
Function: supports viscera
Rectus Abdominis
Attaches to cartilages of ribs 5-7, xiphoid process
Function: flex trunk
What is inside the rectus sheath?
Rectus abdominis, superior epigastric vessels (internal thoracic), inferior epigastric vessels (external iliac), lymphatic vessels, nerves (ventral rami T7-T12)
What are the boundaries of the rectus sheath?
Anterior: aponeurosis of internal and external obliques
Midline: linea alba
Posterior: aponeuroses of internal oblique and transversus abdominus —> ends at arcuate line
Which umbilical ligament is the only one to function post-partum?
The 2 lateral ligaments contain the internal epigastric vessels, and thus function after the fetus state.
Are the retroperitoneal organs within the peritoneal cavity? Where are they, specifically?
No, these organs lie outside the PC in the lesser sac or omental bursa, in a cavity behind the stomach.
How do the greater and lesser sacs communicate?
They communicate via the Omental foramen = epiploic foramen = foramen of Winslow.
What is the hepatoduodenal ligament?
It is a ligament between the liver and duodenum using the lesser omentum.
Which ligament connects the less curvature of the stomach to the liver?
Gastrohepatic ligament.
Why is the inguinal region clinically significant?
Because this is the site of hernias.
What can palpation of the spermatic cord at the inguinal rings tell us?
This indicates hernia in this area, if one can feel bulging when palpating the spermatic cord and the patient coughs.
What can weakening of the conjoint tendon do?
This can cause a direct inguinal hernia.
What does the spermatic cord contain?
Inside there are 8 things:
1) Ductus (vas) deferens
2) Artery of vas deferens
3) Testicular artery
4) Pampiniform plexus
5) Cremasteric arter
6) Sympathetic nerve fibers
7) Lymphatic vessels
8) Genital branch of the genitofemeral nerve
What does the spermatic cord do? And where is it located?
It suspends the testis in the scrotum and it is found in the inguinal canal.
What is the thermoregulatory mechanism at work in the scrotum?
There are 3 main parts:
1) The dartos muscle contracts and wrinkles the skin so as not to lose heat. It also relaxes so heat can dissipate.
2) The testicular artery and pampiniform plexus work together. The blood from the outside the body is cooler and the blood from the testicular artery is warmer. The veins pull heat from the artery so the blood entering the scrotum is cooled.
3) The cremaster reflex involves a muscle derived from the internal oblique that contracts when it is cold, drawing the testes closer to the body. It also relaxes, descending the testes farther from the body, allowing heat to dissipate.
What is the difference between a direct inguinal hernia and an indirection inguinal hernia?
A direct inguinal hernia has a protrusion that bypasses the deep inguinal ring and penetrates the posterior wall of the inguinal canal, medial to IEV. The indirect version traverses the deep inguinal ring lateral to the IEV, runs through the canal, and exits through the superficial ring into the scrotum; mostly congenital.
