Anterior Abdominal Wall Flashcards
where is the transpyloric plane found?
at the level of L1
what is found at the level of the transpyloric plane?
gall bladder fundus, pylorus, pancreatic neck, SMA origin, hepatic portal vein
where is the subcostal plane found?
it passes the inferior border of the 10th costal cartilage
what is found at the level of the subcostal plane?
transverse colon
where is the transtubercle plane found?
between the iliac tubercles
what is found at the level of the transtubercle plane?
iliocecal junction
where is the interspinous plane found?
between ASIS
what is found at the level of the interspinous plane?
appendix and sigmoid colon
how high can the abdominopelvic cavity extend?
as high as the 4th intercostal space
what separates the abdomen from the pevis?
the imaginary border of the pelvic inlet
what is the abdominopelvic cavity lined by?
peritoneum
What is found directly under the integument of the abdomen?
camper’s fascia
what is found under camper’s fascia?
scarpa’s fascia
What makes up scarpa’s fascia?
connective tissue
what is scarpa’s fascia continuous with?
Colle’s fascia of perineum
what is the first layer of abdominal muscles?
external obliques
how do the external obliques run?
in a downward medial direction
what are the external obliques innervated by?
the ventral rami of T7-12 of the intercostal nerves
What is the second layer of abdominal muscles?
internal oblique muscle
how do the internal oblique muscles run?
upward and medially
some fibers of the internal oblique muscles follow the spermatic cord to make what?
the cremasteric muscle
what are the internal obliques innervated by?
by T7-12 and L1
What is the third layer of abdominal muscles?
transverse abdominis muscle
what is the transverse abdominis muscle innervated by?
T7-L1
what is the rectus abdominis muscle innervated by?
T7-T12
when talking about the rectus sheath, how does the external oblique aponeurosis run?
it is always anterior to the rectus abdominis
when talking about the rectus sheath, how does the internal oblique aponeurosis run?
it splits in the upper 3/4s but it is all anterior in the lower 1/4th
when talking about the rectus sheath, how does the transversus abdominis aponeurosis run?
it is posterior to the rectus abdominis except in the lower 1/4th
what is the area of sharp transition where all the EO, IO, and TA aponeuroses become anterior to the rectus abdominis muscle?
the arcuate line
below the arcuate line, what is the rectus abdominis muscle in contact with?
the transversalis fascia
the iliohypogastric nerve is a branch off of what?
the ventral rami of L1
what is the role of the iliohypogastric nerve?
motor supply to the IO and the TA; sensory supply to the upper inguinal and hypogastric region
the ilioinguinal nerve is a branch off of what?
the ventral rami of L1
what is the role of the ilioinguinal nerve?
motor supply to the lower IO and TA muscle; sensory to the lower inguinal, anterior scrotum/labia, medial thigh
what artery runs along the inguinal ligament?
the superficial circumflex iliac artery
what artery runs deep along the inguinal ligament?
the deep circumflex iliac artery
what artery runs posterior to the rectus abdominis muscle?
inferior epigastric artery
what does the inferior epigastric artery anastomose with?
the superior epigastric artery
the superior epigastric artery is a terminal branch of what artery?
the internal thoracic artery
superficial vessels superior to the umbilicus drain into what?
axillary nodes
superficial vessels below the umbilicus drain into what?
superficial inguinal nodes
how is the inguinal ligament made?
it is basically the rolled-under inferior border of the external oblique muscle aponeurosis
what is the inguinal ligament attached to?
to the ASIS and pubic tubercle
what is the conjoint tendon?
it is the combined aponeurosis of the inferior/medial margins of internal oblique and transversus abdominal muscle inserting onto the pubis
what is the superficial inguinal ring?
the external opening within the aponeurosis for the spermatic cord or round ligament
what is the ligament between the pubic rami and inguinal ligament; it anchors the inguinal ligament to the pubis
lacunar ligament
what is the continuation of fibers from lacunar ligament running along the pectin pubis?
the pectineal ligament
what nerve traverses the inguinal canal and exits the superficial ring lateral to the spermatic cord?
the ilioinguinal nerve
what is the role of the genital branch of the genitofemoral nerve?
motor function to the cremasteric muscle and sensory function to a small part of the medial thigh and scrotal/labial fascia
what are the false ribs?
ribs 8, 9, and 10
what is scarpa’s fascia fused with?
the fascia lata of the lower limb
What surrounds the superficial inguinal ring?
crural fibers- medial crus, lateral crus, and intercrural fibers
Where do the gonads form originally?
near the T10 axial level
what are the gonads connected to?
to the future scrotal swellings by the gubernaculum
what is the outpocketing of the peritoneal cavity called?
processus vaginalis
what represents the remains of the processus vaginalis around the testes?
the tunica vaginalis
as the spermatic cord develops, what are the layers of the abdominal wall that are carried with it?
transversalis fascia, internal oblique, and external oblique
when does the communication between the peritoneum and the scrotum close?
within the first year postnatally
what is the medical term for an undescended testis?
cryptorchid testis
what is a person with a cryptorchid testis at risk for?
developing testicular cancer
What does the transversalis fascia make in the spermatic cord?
the internal spermatic fascia
what does the internal oblique make in the spermatic cord?
the cremasteric muscle
what does the external oblique make in the spermatic cord?
external spermatic fascia
What are the contents found within the spermatic cord?
vas deferens, testicular artery, testicular vein, gonadal nerves, and gonadal lymphatics
what is a persistent processus vaginalis?
it is a patent connection between the tunica vaginalis and abdomen
what is a hydrocele?
it is when peritoneal fluid accumulates within the tunica vaginalis
how is a hydrocele detected?
transillumination
what is a hematocele?
an accumulation of blood in the tunica vaginalis; opaque to light
where does the gubernaculum attach to during ovarian descent?
to the developing uterus
what does the gubernaculum form in females?
ovarian ligament and round ligament of the uterus
what is the route of the round ligament of the uterus?
it enters the deep ring and exits the superficial inguinal ring attaching to the labial swellings
what are the contents of the female inguinal canal?
round ligament of the uterus, ilioinguinal nerve, and the genitofemoral nerve of the genital branch
where is the lymphatic drainage from the scrotum?
it drains into the superficial inginal nodes and will eventually travel into the iliac and lumbar lymph nodes
where is the lymphatic drainage for the testes?
into the lumbar and pre-aortic lymph nodes
What causes the lateral umbilical fold?
inferior epigastric artery
what causes the medial umbilical fold?
the obliterated umbilical arteries
what causes the median umbilical fold?
the obliterated urachus
what makes up the inguinal (hasselbach’s) triangle?
the inguinal ligament, the lateral border of rectus abdominis, and the lateral umbilical fold
what is a direct hernia?
it is medial to the inferior epigastric artery; the peritoneum/transversalis fascia is alongside the spermatic cord
what is an indirect hernia?
it enters the deep ring; the peritoneum is within the spermatic cord
what is a femoral hernia?
it is below the inguinal ligament
