Anterior Abdominal Wall Flashcards

1
Q

What is the superior and inferior boundary of the abdomen?

A

Superior - diaphragm/4th intercostal space

Inferior - pelvic girdle

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2
Q

What are the two horizontal planes and two vertical planes that divide the abdomen into 9 regions?

A

Horizontal - transpyloric and interspinous

Vertical - midclavicular lines

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3
Q

Where is the transpyloric plane located?

A

Tip of the 9th rib and projects back onto L1

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4
Q

What does the subcostal plane project back onto?

A

L3

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5
Q

Supracrystal plane projects posteriorly to where?

A

L4

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6
Q

Where does the transtubercular plane project posteriorly to?

A

L5

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7
Q

What are the layers of the abdominal wall?

A
Skin 
Camper’s fascia 
Scarpa’s fascia 
External oblique m
Internal oblique m
Transverus abdominus m 
Transversalis fascia 
Extraperitoneal fat 
Parietal peritoneum
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8
Q

As the scarpas fascia reaches the region of the scrotum, what does it become?

A

Dartos fascia

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9
Q

As the dartos fascia reaches the peritoneal region, what does it become?

A

Collies fascia

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10
Q

What is the first layer of muscle? Which direction do the fibers run?

A

External oblique m, inferomedially

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11
Q

What is the second layer of muscle? Which direction do the fibers run?

A

Internal oblique, superomedially

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12
Q

What is the third layer of muscles? Which direction do the fibers run?

A

Transversus abdominus, horizontally

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13
Q

What is the anterior most layer of muscles?

A

Rectus abdominus

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14
Q

What does the external oblique aponeurosis form?

A

Inguinal ligament and linea alba

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15
Q

What does the internal oblique aponeurosis become?

A

Linea alba

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16
Q

What does the pyramidalis do?

A

Pulls on the linea alba; absent in many people

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17
Q

What are the general functions of the abdominal muscles?

A

Inhalation, expiration, flexion, rotation, compression, sidebending, creating internal abdominal pressure

18
Q

What forms the posterior and anterior rectus sheath?

A

The three muscle layers

19
Q

What is the arcuate line?

A

The transition where the organization of the rectus sheath changes

20
Q

Below the arcuate line, how is the rectus sheath organized?

A

Anterior: external and internal oblique and transversus abdominus

Posterior: transversalis fascia

21
Q

Above the arcuate line, how is the rectus sheath organized?

A

Anterior: external and internal oblique

Posterior: internal oblique, transversus abdominus, transversalis fascia

22
Q

Where is the arcuate line located?

A

A third of the way between the umbilicus and pubic tubercle

23
Q

Where does the neurovasculature travel between?

A

The internal oblique and transversus abdominus

24
Q

What are the spinal nerve roots of the thoracoabdominal nerves?

25
What is the spinal level of subcostal nerve?
T12
26
What is the umbilicus innervated by?
T10
27
What are the major blood supplies of the anterior abdomen?
Internal thoracic a Musculophrenic a Superior epigastric a 10th posterior intercostal a 11th posterior intercostal a Subcostal a Inferior epigastric a
28
What does the superior epigastric a anastomose with?
Inferior epigastric a
29
What is the risk of the subcostal incision?
Nerve supply - There is a risk to cut the nerves between internal oblique and transversus abdominus Blood supply - superior epigastric could be cut
30
What is the risk to the suprapubic incision?
Muscle: not bad Nerve supply: watch for L1 Blood supply: inferior epigastric
31
What is the risk of the paramedian incision?
Muscle tension: pull of muscles in this area Nerve supply: thoraco-abdominal nerves T7-T11 Blood supply: posterior intercostal and subcostal aa.
32
What is the risk of the midline incision?
Nerve supply: none Muscles: pull of muscles Blood supply: not a lot of supply
33
Where would an infection travel through the lymph?
Above transumbilical plane - it would travel to the axillary lymph nodes Below it would travel to the superficial inguinal lymph nodes
34
What is the drainage of nodes in deep lymphatics?
External node to common iliac node to lumbar node
35
What is the drainage of the superficial lymphatics?
Axillary lymph node to parasternal lymph node to superficial inguinal nodes
36
What is the median umbilical fold a remnant of?
The uracus (used to be allantois)
37
What was the medial umbilical fold?
Obliterated umbilical arteries
38
What does the lateral umbilical fold do?
Goes over the inferior epigastric vessels
39
What is the significance of the medial inguinal fossa?
Its where you see direct inguinal hernias
40
What is the significance of the lateral inguinal fossa?
Indirect inguinal hernias