Anterior Abdominal Wall

Question 1

Abdominal Regions

Answer 1

Right and Left hypochondriac, Right and Left flank, Right and Left Inguinal, Epigastric, Umbilical, Pubic

Question 2

Abdominal Quadrants

Answer 2

Right upper quadrant, Left upper quadrant, Right lower quadrant, Left lower quadrant

Question 3

Contents of Right Upper Quadrant (RUQ)

Answer 3

Liver: right lobe, Gallbladder, Stomach:pylorus, Duodenum: parts 1-3, Pancreas: head, Right suprarenal gland, Right kidney, Right colic (hepatic) flexure, Ascending colon: superior part, Transverse colon: right half

Question 4

Contents of Left Upper Quadrant (LUQ)

Answer 4

Liver: left lobe, Spleen, Stomach, Jejunum and proximal ileum, Pancreas: body and tail, Left kidney, Left suprarenal gland, Left colic (splenic) flexure, Transverse colon: left half, Descending colon: superior part

Question 5

Contents of Right Lower Quadrant (RLQ)

Answer 5

Cecum, Appendix, Most of Ileum, Ascending colon: inferior part, Right ovary, Right uterine tube, Right ureter: abdominal part, Right spermatic cord: abdominal part, Uterus (if enlarged), Urinary bladder (if very full)

Question 6

Contents of Left Lower Quadrant (LLQ)

Answer 6

Sigmoid colon, Descending colon: inferior part, Left ovary, Left uterine tube, Left ureter: abdominal part, Left spermatic cord: abdominal part, Uterus (if enlarged), Urinary bladder (if very full)

Question 7

Level of Transpyloric Plane

Answer 7

L1 level, Level of gall bladder fundus, pylorus, pancreatic neck, SMA origin, hepatic portal vein, root of transverse mesocolon, hila of kidneys

Question 8

Level of Subcostal Plane

Answer 8

Passes inferior border 10th costal cartilage, Level of transverse colon

Question 9

Level of Transtubercle Plane

Answer 9

Between iliac tubercles, level of ileocecal junction

Question 10

Level of Interspinous plane

Answer 10

Between ASIS, Level of appendix, sigmoid colon

Question 11

External Oblique Muscle (Origin/Insertion,Action, Innervation, )

Answer 11

Origin: Outer surface lower 6 ribs
Insertion: Aponeurosis and linea alba, anterior iliac crest and pubic tubercle
Innervation: T7-12
Action: Compress abdomen and increase intra-abdominal pressure; move trunk and retain posture

Question 12

Internal Oblique Muscle (Origin/Insertion,Action, Innervation)

Answer 12

Origin: Iliac crest and some of thoracolumbar fascia
Insertion: lower 10-12 ribs, aponeurosis, linea alba, and pubic crest, lower part makes part of conjoint tendon (inguinal falx)
Innervation: T7-12 and L1
Action: Compresses and supports viscera, lateral flexes and rotates

Question 13

Transversus Abdominis Muscle (Origin/Insertion,Action, Innervation)

Answer 13

Origin: Lower 7-12 ribs, thoracolumbar fascia, iliac crest, some even off of upper inguinal ligament
Insertion: linea alba, pecten pubis, and pubic crest
Innervation: T7-L1
Action: Compresses and supports viscera

Question 14

Rectus Abdominis Muscle (Origin/Insertion, Action, Innervation)

Answer 14

Origin: pubic symphysis and pubic crest
Insertion: Xiphoid process and outer surface of 5-7 intercostal cartilages
Innervation: Ventral rami T7-12
Action: Flexes abdomen and compresses

Question 15

What is the arcuate line?

Answer 15

Sharp transition where all external oblique, internal oblique, transverse abdominis aponeuroses become anterior to rectus abdominis m.

Question 16

(T/F) External oblique is always anterior.

Answer 16

True.

EO is always anterior. IO splits in upper 3/4s but is all anterior in lower 1/4. TA is posterior except in lower 1/4.

Question 17

The thoracoabdominal n. (T7-11) is a continuation of what nerve?

Answer 17

Intercostal n. It is both motor and sensory.

Question 18

Subcostal n. (T12) rubs along what rib?

Answer 18

Inferior 12th rib. It is motor.

Question 19

Iliohypogastric n. (L1) innervation

Answer 19

motor to IO and TA; sensory to upper inguinal and hypogastric region

Question 20

Ilioinguinal n. (L1) innervation

Answer 20

motor to IO and TA; sensory to lower inguinal, anterior scrotum/labia, near medial thigh

Question 21

What is the median umbilical fold created by?

Answer 21

Obliterated urachus

Question 22

What is the medial umbilical fold created by?

Answer 22

Obliterated umbilical arteries

Question 23

What is the lateral umbilical fold created by?

Answer 23

Inferior epigastric artery

Question 24

Gutter on either side of upper bladder

Answer 24

Supravesicular fossa

Question 25

Gutter lateral to medial umbilical folds

Answer 25

Medial inguinal fossa

Question 26

Gutter lateral to lateral umbilical folds

Answer 26

Lateral inguinal fossa

Question 27

Superficial vessels superior to umbilicus drain where?

Answer 27

Axillary nodes with few going to parasternal

Question 28

Superficial vessels inferior to umbilicus drain where?

Answer 28

Superficial inguinal nodes

Question 29

This incision is 2.5 cm inferior from margin; provides access to gallbladder and biliary tract and spleen

Answer 29

Subcostal

Question 30

This incision can be made rapidly (few BVs or nerves)

Answer 30

Midline

Question 31

This incision opens anterior sheath, pushing rectus muscle aside laterally and enter peritoneum

Answer 31

Paramedian

Question 32

This incision is typical of an appendectomy; muscle splitting

Answer 32

McBurneys

Question 33

This incision is used most in gynecological/obstetrical surgeries

Answer 33

Suprapubic