Anterior Abdominal Wall Flashcards
What are the planes that divide the abdominal wall into 9 regions?
mid-clavicular lines
10th rib
iliac spine
What are the 9 regions of the abdominal wall?
right hypochondriac, epigastric, left hypochondriac
right flank, umbilical, left flank
right inguinal, pubic, left inguinal
What structures lie within the right upper quadrant?
liver (right lobe), gallbladder, pylorus, duodenum, head of pancreas, right kidney and suprarenal gland, right (hepatic) colic flexure, ascending colon (superior part), transverse colon (right half)
What structures lie within the left upper quadrant?
liver (left lobe), spleen, stomach, jejunum, proximal ileum, body and tail of pancreas, left kidney and suprarenal gland, left colic (splenic) flexure, transverse colon (left half), descending colon (superior part)
What structures lie within the lower right quadrant?
cecum, appendix, most of the ileum, ascending colon (inferior part), right ovary and uterine tube, right ureter (abdominal part), right spermatic cord (abdominal part), uterus and bladder (right portions, if enlarged or full)
What structures lie within the left lower quadrant?
descending colon (inferior part), sigmoid colon, left ovary and uterine tube, ureter (left abdominal part), left spermatic cord (abdominal part), uterus and bladder (left portions, if enlarged or full)
What are the boundaries of the abdominal cavity?
superior = thoracic diaphragm
inferior = superior pelvic aperture (pelvic inlet)
-lined by peritoneum
-walls are mostly bone, muscle, and CT
At what vertebral level is the transpyloric plane?
- L1
- around the 8th rib
What structure(s) lie in the transpyloric plane?
-gallbladder fundus, pylorus, pancreatic neck, superior mesenteric A. origin, hepatic portal V., root of transverse mesocolon, hila of the kidneys
At what vertebral level is the subcostal plane?
- L3
- around the 10th costal cartilage
What structure(s) lie in the subcostal plane?
transverse colon
At what vertebral level is the transtubercular plane?
- L5
- b/w iliac tubercles
What structures lie in the transtubercular plane?
-ileocecal junction
At what vertebral level is the interspinous plane?
- S2
- b/w ASIS’s
What structures lie in the interspinous plane?
appendix
sigmoid colon
What are the layers of the anterior abdominal wall, superficial to deep?
skin, Camper’s fascia, Scarpa’s fascia, aponeurosis and muscles (external oblique, internal oblique, transversus abdominis), rectus abdominus within rectus sheath, transversalis fascia, peritoneum
What are the nerves of the anterior abdominal wall?
- thoracoabdominal nn. (T7-T11)
- subcostal N. (T12)
- iliohypogastric N. (L1)
- ilioinguinal N. (L1)
What are the characteristics of the thoracoabdominal nn. (T7-T11)?
- continuations of intercostal nn.
- both motor and sensory
- runs b/w IOand transversus abdominis
What are the characteristics of the subcostal N. (T12)?
- runs along inferior border of the 12th rib
- motor
- sensory superior to iliac crest
What are the characteristics of the iliohypogastric N. (L1)?
- runs b/w IO and transversus abdominis
- motor to IO and transversus abdominis
- sensory to upper inguinal and hypogastric areas
What are the characteristics of the ilioinguinal N. (L1)?
- motor to lower IO and transversus abdominis
- sensory to lower inguinal, anterior scrotum or labia, and proximal medial thigh
What are the arterial components of the anterior abdominal wall?
- lumbar aa. and continuations of intercostal aa.
- superficial epigastric A.
- superficial and deep circumflex iliac aa.
- inferior epigastric A.
- superior epigastric A.
What are types of common abdominal incisions?
- subcostal
- midline
- paramedian
- gridiron
- suprapubic
What are the characteristics of a subcostal incision?
- approx. 2.5 cm inferior to costal margin
- access to gallbladder, biliary tract, and spleen
