Anterior Abdominal Wall Anatomy

Question 1

What line divides left from right quadrants?

Answer 1

Median plane

Question 2

What line divides the upper from lower quadrants?

Answer 2

Transumbilical Plane

Question 3

Xiphisternal Plane

Answer 3

Rib 7

T9

Question 4

Unnamed Plane

Answer 4

Rib 8

T11

Question 5

Transpyloric Plane

Answer 5

Rib 9

L1

Question 6

Subcostal Plane

Answer 6

Rib 10

L3

Question 7

Transtubercular Plane

Answer 7

L5

Widest part of the hips!

Question 8

Interspinous Plane

Answer 8

ASIS

S2

Question 9

Layers of Abdominal Wall

superficial –> Deep

Answer 9

Camper's Fascia (yellow, fatty layer)
Scarpa's Fascia (white, deep membranous layer)
External Oblique M.
Internal Oblique M.
Transversus Abdominis M.
Transversalis Fascia (Endoabdominal)
Extraperitoneal Fat
Parietal Peritoneum

Question 10

Direction of External Oblique Muscles?

Answer 10

Hands in pockets

Question 11

Direction of Internal Oblique Muscles

Answer 11

Perpendicular to external oblique muscles.

Up to heart

Question 12

Direction of Transversus Abdominis Muscles

Answer 12

Horizontal

Question 13

Direction of Transversus Abdominis Muscles

Answer 13

Horizontal

Question 14

Linea alba

Answer 14

central line where fascia of the rectus sheath connects

Xiphoid process to pubic symphysis

Question 15

What three layers make up the Rectus Sheath?

Answer 15

External Oblique
Internal Oblique
Transversus Abdominis

Medial fusion: Linea alba
Lateral fusion: Linea semilunaris

Question 16

Anterior structures above the Arcuate Line?

Answer 16

Anterior:
External Oblique
Internal Oblique

Question 17

Posterior structures above the Arcuate Line

Answer 17

Internal Oblique
Transversus Abdominis
Transversalis fascia

Question 18

Anterior structures below Arcuate line

Answer 18

External Oblique
Internal Oblique
Transversus Abdominis

Question 19

Posterior structures below Arcuate line

Answer 19

Transversalis fascia

Question 20

Neurovasculature of the abdominal wall is located between which two layers?

Answer 20

Internal Oblique

Transversus Abdominis

Question 21

Thoracoabdominal Nerves

Answer 21

T7-T11

Question 22

Subcostal Nerves

Answer 22

T12

Question 23

Iliohypogastric Nerve

Answer 23

L1

Question 24

Ilio-inguinal Nerve

Answer 24

L1

Question 25

What does the inferior epigastric artery branch off of?

Answer 25

External iliac A

Question 26

Where would you make a midline incision?

Answer 26

Xiphoid process to pubic symphysis

Question 27

Where would you make a subcostal incision?

Answer 27

Parallel to costal margin, 2.5 cm inferior

Question 28

Where would you make a suprapubic midline?

Answer 28

C-sections! Horizontal at the pubic hair line, with slight convexity

Question 29

Where would you make a paramedian incision?

Answer 29

From costal margin to iliac crest along the linea semilunaris

Question 30

What are the three Deep lymph nodes?

Answer 30

External iliac nodes Common iliac nodes Lumbar nodes

Question 31

What are the three Superficial lymph nodes?

Answer 31

Axillary lymph nodes Parasternal lymph nodes Superficial inguinal nodes

Question 32

Lymph above the transumbilical plane will travel to what lymph nodes?

Answer 32

Axillary lymph nodes

Question 33

Lymph below the transumbilical plane will travel to what LN?

Answer 33

Superficial inguinal lymph nodes

Question 34

Going medial to laterl, what is the order of folds on the internal surface of the anterior abdominal wall?

Answer 34

Median umbilical Fold Medial umbilical Fold Lateral umbilical Fold

Question 35

What is the medial umbilical fold a remnant of?

Answer 35

Umbilical arteries

Question 36

What is the median umbilical fold a remnant of?

Answer 36

Urachus (allantois)

Question 37

Where are the supravesical fossae located?

Answer 37

Between median and medial umbilical folds

Question 38

Where are the medial inguinal fossae located?

Answer 38

Between medial and lateral umbilical folds

Question 39

Where are the lateral inguinal fossae located?

Answer 39

Lateral to the lateral umbilical folds

Question 40

In which fossa would a direct inguinal hernia be located?

Answer 40

Medial inguinal fossa

Question 41

In which fossa would an indirect inguinal hernia be located?

Answer 41

Lateral inguinal fossa

Question 42

Three main features of Prune Belly Syndrome

Answer 42

1. Weak/ deficient Anterior abdominal wall muscles 2. Urinary Tract anomalies 3. Bilateral cryptorchidism