Anterior Abdominal Wall

Question 1

9 regions of abdomen

Answer 1

1) right hypochondrium
2) epigastric region
3) left hypochondrium
4) Right flank
5) umbilical region
6) left flank
7) right groin
8) pubic region
9) left groin

Question 2

layers of anterolateral abdominal wall

Answer 2

Skin.
Superficial fascia (Camper’s/fatty/Scarpa’s/membranous).
Deep fascia (connective tissue sheaths, transversalis fascia).
Extraperitoneal fat.
Parietal peritoneum.

Question 3

flat muscles of anterolateral abdominal wall

Answer 3

external oblique
internal oblique
transversus abdominus

Question 4

2 vertical muscles of anterolateral abdominal wall

Answer 4

rectus abdominis

pyramidalis

Question 5

innervation of external oblique

Answer 5

intercostal nerves T7-T11,

subcostal nerve T12

Question 6

origin/insertion of external oblique

Answer 6

O: 5th -12th ribs
I: linea alba, pubic tubercle, anterior iliac crest

Question 7

innervation of internal oblique

Answer 7

intercostal nerves T7-12, 
iliohypogastric n.
ilioinguinal n (L1)

Question 8

origin/insertion of internal oblique

Answer 8

O: thoracolumbar fascia, iliac crest, ASIS, iliopsoas fascia

I: 10th-12th ribs, linea alba

Question 9

innervation of transversus abdominis

Answer 9

intercostal nerves T7-12, 
iliohypogastric n.
ilioinguinal n (L1)

Question 10

transversus abdominis origin/insertion

Answer 10

O: 7th-12th costal cartilages, thoracolumbar fascia, iliac crest, ASIS, iliopsoas fascia

I: linea alba, pubic crest

Question 11

rectus abdominis O,I,N

Answer 11

O: pubis
I: 5th-7th intercostal cartilages, xiphoid process
N: intercostal nn (T5-12)

Question 12

pyramidalis OIN

Answer 12

O: pubis
I: linea alba
N: subcostal T12

Question 13

semilunar line

Answer 13

Lateral sides of rectus abdominis

Question 14

arcuate line

Answer 14

lower line of the “six pack”

shift from 1.5 anterior/posterior to all 3 anterior (layers of the rectus sheath)

Question 15

nerves of anterolateral abdominal wall

Answer 15

above umbilicus: T7-T9

umbilicus = T10

below umbilicus: T11-L1

Question 16

arteries of anterolateral abdominal wall

Answer 16

superior epigastric (from internal thoracic) anastamoses with inferior epigastric (external iliac)

deep

Question 17

veins of anterolateral abdominal wall

Answer 17

1) superior epigastric v
2) inferior epigastric v
3) paraumbilical vv in round ligament of liver

Question 18

infraumbilical peritoneal folds

Answer 18

Median fold (1) [urachus]
Medial umbilical folds (2) [umbilical arteries]
Lateral umbilical folds (2) [inferior epigastric vessels]

Question 19

counterpart from fetal circulation: ligamentum teres of liver

Answer 19

paraumbilical veins

Question 20

counterpart from fetal circulation: medial umbilical ligament

Answer 20

umbilical arteries

Question 21

counterpart from fetal circulation: median fold

Answer 21

urachus

Question 22

inguinal ligament

Answer 22

Inferior border of external oblique aponeurosis (folded over).
From ASIS to pubic tubercle.

Question 23

inguinal canal

Answer 23

Transmits spermatic cord (male) or round ligament (female)

Made of deep inguinal ring and superificial inguinal ring

Question 24

superficial inguinal ring

Answer 24

medial crus + lateral crus + intercrural fibers

Question 25

relocation of testes

Answer 25

Start in extraperitoneal CT. | Gubernaculum pulls testes inferior, pulling surrounding tissue with it.

Question 26

scrotum equivalent of abdominal superficial fascia (fatty and membranous)

Answer 26

dartos muscle and fascia

Question 27

scrotum equivalent of abdominal external oblique

Answer 27

external spermatic fascia

Question 28

scrotum equivalent of abdominal internal oblique

Answer 28

cremaster muscle

Question 29

scrotum equivalent of abdominal fascia transversalis

Answer 29

internal spermatic fascia

Question 30

scrotum equivalent of abdominal extraperitoneal fatty tissue

Answer 30

areolar tissue with localizwed collections of fat

Question 31

scrotum equivalent of abdominal peritoneum

Answer 31

tunica vaginalis

Question 32

iliohypogastric nerve

Answer 32

L1 | Skin above inguinal ligament.

Question 33

ilioinguinal nerve

Answer 33

L1 Skin of anterior scrotum and adjacent thigh. Runs parallel and inferior to iliohypogastric n. Emerges from superficial inguinal ring.

Question 34

genitofemoral nerve

Answer 34

L1, L2 Skin below inguinal ligament. Motor to cremaster.

Question 35

spermatic cord contents

Answer 35

``` Ductus deferens. Artery of ductus deferens. Testicular artery. Pampiniform vein plexus. Cremaster muscle. Nerve fibers. ```

Question 36

round ligament contents

Answer 36

Artery/vein of round ligament. Nerve fibers. CT cord.

Question 37

common places for hernias

Answer 37

Of linea alba. Umbilical. Incisional. At semilunaris (Spigelian)

Question 38

inguinal hernia

Answer 38

``` Indirect hernia (also: congenital, acquired) Inside spermatic cord ```

Question 39

indirect hernia

Answer 39

Loop of bowel inside the spermatic cord. Travels through canal, taking an indirect route. LATERAL to inferior epigastric artery.

Question 40

direct hernia

Answer 40

Does NOT go through canal. Loop of bowel parallels spermatic cord. MEDIAL to inferior epigastric artery

Question 41

strangulated hernia

Answer 41

blood supply is lost | Necrosis occurs

Question 42

diastasis recti linea alba

Answer 42

large herniation between muscles of rectus abdominus

Question 43

direct inguinal hernia

Answer 43

MEDIAL to deep epigastric vessels. ABOVE inguinal ligament. In HASSELBACK's TRIANGLE.

Question 44

femoral hernia

Answer 44

Neck of hernia is below inguinal ligament. | Passes thru femoral ring into femoral canal

Question 45

lumbar hernia

Answer 45

Occurs thru lumbar triangle. (superior to middle iliac crest, covered only by transversus abdominis muscle and internal oblique., AKA Petit's triangle)

Question 46

spigelian hernia

Answer 46

Lateral ventral hernia thru semilunar line