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MRCS Part A (KF edition) > Anterior Abdominal Wall anatomy > Flashcards

Anterior Abdominal Wall anatomy Flashcards

1
Q

What is the umbilical dermatome root?

A

T10

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2
Q

What is the inter tubercular plane and where is it located?

A

Found at L5

Line that crosses horizontally separating the umbilical quadrant from hypogastric quadrant

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3
Q

What is the interspinous plane?

A

Horizontal line between the ASIS

Found at S1

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4
Q

What is the Supracristal plane and what is its clinical significance?

A

The highest point of Iliac crest, found at L4

This is the level of Lumber punctures

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5
Q

At what spinal level is the transpyloric plane found?

A

L1

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6
Q

What is the name of the plane at the level of L3?

A

Subcostal plane

Lower border of the 12th rib separating the epigastric region from umbilical region

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7
Q

If entering the abdomen laterally, what structures will you encounter, from superficial to deep?

A

Skin - Campers fascia (superficial fatty layer) - Scarps fascia (deep fibrous layer)

  • External Oblique - Internal Oblique - Transversus abdominus muscle
  • Fascia transversals - Peritoneum
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8
Q

What is the significance of the arcuate line in relation to the posterior wall?

A

Above the arcuate line, the posterior wall of the rectus sheath can be found

Below the arcuate line, there is no posterior wall, only the Anterior rectus sheath

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9
Q

What are the origins and attachments of the external oblique and what is it innervated by?

A

Originates from lower 8 ribs and inserts into the Xiphoid process + Linea alba + pubic symphysis

Innervated by intercostal nerve 7-11 and subcostal nerve

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10
Q

In which incision must the Rectus abdominis be divided?

A

Kocher incision

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11
Q

What is the innervation of the Transversus abdominis muscle?

A

Intercostal nerves 7-11, Subcostal nerve and Iliohypogastric nerve

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12
Q

Which vessel is liable to damage at the medial extension of the Grid Iron incision?

A

Inferior epigastric artery within the rectus sheath

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13
Q

Why are haematomas of the rectus abdominis usually localised?

A

Due to Tendinous intersections of the sheath

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14
Q

The internal and external rings of the inguinal canal are opening in which structures?

A

Internal ring: opening in the transversals fascia (inch above the midpoint of the inguinal ligament)

External ring: opening of the external oblique aponeurosis

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15
Q

What are the boundaries of the inguinal canal?

A

Anteriorly: Ext oblique / trasnversus abdominis

Posteriorly: Fascia trasversali

Roof: Arching fibres of Int oblique / transverses abdominis

Floor: Inguinal ligament

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16
Q

What are the attachments of the inguinal ligament?

A

ASIS to Pubic tubercle

17
Q

Where is the mid inguinal point?

A

Midway between AIS and pubic symphysis (surface anatomy of femoral artery)

18
Q

Where is the mid point of the inguinal ligament?

A

Midway between ASIS and pubic tubercle and is the location of the deep ring

19
Q

What causes a paralytic hernia?

A

Damage to the ilioinguinal nerve (which supplies conjoint tendon that reinforces posterior wall)

Damage can occur during open appendicectomy

20
Q

Which structure prevents descent of direct hernia into scrotum?

A

Conjoint tendon

21
Q

What are the boundaries of the Hesselbach triangle?

A

Medial: Rectus abdominis

Lateral: Inferior epigastric vessels

Inferior: Inguinal ligament

22
Q

Which part of the inguinal canal lies in the Hesselbach’s triangle?

A

Superficial (external) ring of the inguinal canal

23
Q

What is a direct hernia and how does it present anatomically?

A

Caused by a defect in the posterior wall and will protrude medially to the inferior epigastric vessels through Hesselbach’s triangle

Never descends into the scrotum

24
Q

What is the origin and insertion of the lacunar ligament?

A

Starts at the medial end of the inguinal ligament and inserts into Pecten pubis on superior ramus of pubic bone

25
Q

What is the innervation of the cremasteric muscle?

A

Genital branch of genitofemoral nerve

26
Q

What is the dermatome of the diploid region?

A

T7

27
Q

Where is the L1 dermatome?

A

Inguinal fold region

28
Q

What are the 12 structures found in the transpyloric plane?

A
  • Termination of spinal cord
  • Renal hilum (left)
  • SMA
  • 9th rib
  • Portal vein
  • Neck of pancreas
  • Pylorus of stomach
  • 2nd part of duodenum
  • Sphincter of Oddi
  • Duodenojejunal flexure
  • Fungus of gallbladder- L1 vertebral body
29
Q

In which fold is the urachus found and what may occur if the urachus remains patent?

A

Median umbilical fold

If urachus is patent, urine will come out of the umbilicus

30
Q

What is the name of the visceral layer covering the testis?

A

Tunica vaginalis

31
Q

Is the ilioinguinal nerve part of the spermatic cord?

A

No

content of the inguinal canal, not spermatic cord

32
Q

What are the contents of the spermatic cord?

(3 arts, 3 nerves, 3 structures)

A

Arteries:
- Testicular artery
- Cremasteric artery
- Artery of the vas

Nerves:
- Genital branch of the genitofemoral nerve
- Sympathetic ns around testicular artery
- Sympathetic ns around artery to vas

Structures:
- Pampiniform plexus
- Vas deferans
- Obliterated processus vaginalis

33
Q

What are the coverings of the spermatic cord (from deep to superficial)?

A

Internal spermatic fascia (continuation of transversals fascia) –> Cremasteric fascia –> External spermatic fascia

34
Q

How many medial and lateral umbilical folds are there?

A

2 medial and 2 lateral

35
Q

What are the borders of Hesselbach’s triangle and what is the significance of this in relation to differentiation of hernias?

A

Medial: Rectus abdominis
Lateral: Inferior epigastric vessels
Inferior: Inguinal ligament

Hernias within Hesselbach’s triangle are direct. Outside of this triangle, they are in indirect

MRCS Part A (KF edition) (18 decks)

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