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Anatomy ICOM > Anterior Abdominal Wall > Flashcards

Anterior Abdominal Wall Flashcards

1
Q

Boundaries

A
  1. Superior: diaphragm
  2. Anterolaterally: musculoaponeurotic walls
  3. Posterior: vertebral column
  4. Inferior: pelvic girdle
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2
Q

Abdominal wall fxns

A
  1. Protect viscera
  2. Maintain posture
  3. Provide mobility
  4. Assist resp
    E. Pressure: dedication, micturation, and paruition
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3
Q

Umbilicus

A

L3-L4 disc level

1. T10 dermatome

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4
Q

Surface anatomy

A
  1. Umbilicus
  2. Linea alba: median fascial line
  3. Semilunar lines: from inferior costal margins to pubic tubercles
  4. Tendinous intersection: transverse lines between linea alba and semilunar lines
  5. Inguinal groove: inguinal ligament
    A. Marks division of anterolateral wall and thigh
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5
Q

Fascial and muscular layers

A
  1. Skin and fat
  2. Subcutaneous fascia
  3. Potential space between subQ fascia and superficial investion fascia
  4. Muscular layers
  5. Endoabdominal (tranversalis) fascia
  6. Extraperitoneal fat
  7. Parietal peritoneum
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6
Q

Superficial fatty layer (Camper’s fascia)

A
  1. Continuous w/ superficial fascia of lower limb and thoracic wall
    A. Cont. into labia
    B. NOT in scrotum
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7
Q

Deep membranous layer (Scarpa’s fascia)

A
  1. Cont. w/ darto’s and colle’s fascia in scrotum and perineum
    A. NOT thighs
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8
Q

External oblique

A
  1. Fxn: bilateral flexion and compress abdomen, unilat. Sidebend same side and rotate opp side
  2. Prox: ribs 5-12
  3. Distal: linea alba, iliac crest, pubis
  4. Innervation: thoracoabdominal n. (T7-T11) and subcostal n. (T12)
  5. Supply: musculophrenic, post intercostal, subcostal, sup an inf epigastric, superficial and deep circumflex iliac and post lumbar a.
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9
Q

Internal oblique

A
  1. Fxn: bilateral flexion and compress abdomen, unilat. Sidebend same side and rotate same side
  2. Prox: thoracolumbar fascia, iliac crest, ASIS, inguinal ligament
  3. Distal: ribs 10-12, linea alba, pectineal line
  4. Innervation: thoracoabdominal n. (T7-T11), iliohypogastric n. (L1), and ilioinguinal (L1), and subcostal n. (T12)
  5. Supply: musculophrenic, post intercostal, subcostal, sup an inf epigastric, superficial and deep circumflex iliac and post lumbar a.
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10
Q

Transversus abdominus

A
  1. Fxn: bilateral compress abdomen
  2. Prox: ribs 7-12, thoracolumbar fascia, iliac crest, ASIS, inguinal ligament
  3. Distal: linea alba, pectineal line
  4. Innervation: thoracoabdominal n. (T7-T11) and subcostal n. (T12)
  5. Supply: musculophrenic, post intercostal, subcostal, sup an inf epigastric, superficial and deep circumflex iliac and post lumbar a.
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11
Q

Rectus abdominus

A
  1. Fxn: flex trunk and compress abdomen
  2. Prox: pubic symphysis and crest
  3. Distal: costal cartilages rubes 5-7, xiphoid process
  4. Innervation: thoracoabdominal n (T6-T11) and subcostal (T12)
  5. Supply: post intercostal, subcostal, superior and inf epigastric a.
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12
Q

Pyramidalis

A
  1. Fxn: tenses linea alba
  2. Prox: pubis
  3. Distal: linea alba
  4. Innervation: subcostal (T12)
  5. Supply: inferior epigastric and circumflex iliac a.
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13
Q

Rectus sheath

A
  1. Aponeurotic fibers
    A. Arcuate line: marks transition from sup to inf sheath
    B. Sup to umbilicus: aponeurosis internal oblique splits
    1. Ant in front of rectus abdominis
    2. Post behind rectus abdominis
      C. Inf to umbilicus: aponeurosis from all 3 muscles fuse -> ant rectus abdominis
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14
Q

Falciform ligament

A

Sagittal peritoneal reflection between liver and sup wall

1. Encloses round ligament of liver an para-umbilical veins

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15
Q

Peritoneal folds

A 
1. Median umbilical: median umbilical ligament
  A. Urachus: remnant of allantois
2. Medial umbilical: lateral median
3. Lateral umbilical: lateral medial
  A. Inf. Epigastric vessels
  B. Prone to bleeding
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16
Q

Peritoneal fossae

A
  1. Prone to herniation
  2. Supravesical: between median and medial umbilical folds
  3. Medial inguinal: between medial and lateral umbilical folds
    A. “Hasselbach’s triangle”
    B. Direct inguinal hernias
  4. Lateral inguinal: lateral to lateral umbilical folds
    A. Indirect inguinal hernias
17
Q

Lumbar plexus

A
  1. Iliohypogastric
  2. Ilioinguinal
  3. Genitofemoral
18
Q

Iliohypogastric n.

A

Ant. Rami L1

1. Innervates: skin supermedial thigh and inguinal region, internal oblique and transversus abdominis

19
Q

Ilioinguinal n.

A

Ant. Rami L1
1. Innervates: skin supermedial thigh and scrotum/labia majora, internal oblique and transversus abdominis

  1. Passes thru sup inguinal ring
20
Q

Genitofemoral n.

A

L1 and L2, pierces psoas major ->divides

  1. Femoral branch: supply roof femoral triangle
  2. Genital: external oblique -> cremaster muscles and mons pubis and labia majora
21
Q

Incisional routes

A
  1. Longitudinal: exploratory surgery, access to organs
  2. Oblique: location and direction determined by muscle fiber orientation
    A. Gridion (muscle-splitting): appendectomy, on McBurney in external oblique orientation
    B. Subcostal: parallel subcostal margin
    1. Gallbladder an biliary ducts right side and spleen left
    2. Avoids 7th and 8th spinal n.
  3. Transverse:
    A. Suprapubic “bikini”: OB/GYN prodecures, linea alba and rectus abdominis retracted
  4. High risk (nerve damage): Pararectus and inguinal
  5. Incisional hernia
  6. Endoscopic surgery (min. Invasive)
22
Q

Abdominal hernias

A

Structures penetrate and pass thru abdominal wall in weaker areas (umbilical and epigastric)

  1. Congenital umbilical: weakness or incomplete closure due to inc. pressure
  2. Acquired umbilical: common in women and obese people
    A. Due to surgery sometimes
    B. Extrperitoneal fat protrudes area of weakness
  3. Epigastric: via linea alba
    A. Usually fat lobules
    B. Painful (nerve compression)
  4. Spegelian: via semilunar lines
    A. Common in obese
23
Q

Rectus sheath hematoma

A

Blood in rectus sheath

1. Tear in arterial supply of epigastric artery

24
Q

Ventral body wall defect

A

Lateral folds don’t progress ventrally or abnormal fusion at midline
1. Gastroschisis: ventral body wall doesn’t close -> intestines herniate

Anatomy ICOM (34 decks)

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