Anterior abdominal wall and Inguinal anatomy Flashcards
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List all the muscles found in the lateral abdominal wall in order and state the direction that the fibers run in
- External oblique -
Fibers run anterior - inferior
- Internal oblique
Fibers run- Anterior superior
- Transverse abdominis
Fibers run- transverse direction
List all the muscles found in the anterior abdominal wall in order
External oblique, internal oblique, transversus abdominis, rectus abdominis
What is the significance of the arcuate line in the naterior abdominal wall?
Rectus abdominis muscle is enclosed by an aponeurotic sheath, which is derived from the aponeuroses of external oblique, internal oblique and transversus abdominis
Above the arcuate line the rectus abdominis is enclosed in the internal oblique aponeurosis
Below the acruate rectus abnominis is behind the fascia of the transversis abdominis - enclosed by the transversalis fascia
What are the attachments of the rectus abdominis
Xiphoid process and costal cartilages to the pubic symphysis
What is the rectus sheath composed of?
aponeurosis of the external oblique, internal oblique and the transversus abdominis
What are the inferior attachements of the External oblique, internal oblique and transver abdominis?
Iliac crest and ASIS
down to pubic tubercle
What is the conjoined tendon?
Where the internal oblique and transversus abdominis meet to attach onto the pubic tubercle
Which arteries supply blood to the anterior abdominal wall?
Superior epigastric artery (branch of internal thoracic)
Inferior epigastric artery (branch of external iliac)
These run within the rectus cheath
Lower intercostal
and lumbar arteries
Supply lateral abdominal muscles
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What is McBurneys Point?
Surface anatomy land mark for the appendix
Right side of the body. Two-thirds the distance between the umbilicus and anterior superior iliac spine (ASIS)
Which dematomes correlate with the Umbillicus, subcostal nerve, Iliohypogastric nerve and Ilioinguinal nerve?
Umbillicus- T10
subcostal nerve- t12
Iliohypogastric nerve and Ilioinguinal nerve- L1
What is the ingunal ligament composed of?
The free boarder of the external oblique muscle
In which order is the nerve, vein and artery found in the femoral triangle?
NAV
Nerve, Artery, vein
What can be foudn in the femoral canal?
efferent lymphatic vessels and a lymph node
Which ligament reinfoces the inguinal ligament and formes the medial border of the femoral canal?
Lacunar ligament
The deep inguinal ring is lateral to which artery?
Inferior epigastric artery
At which fascia does the deep inguinal ring originate?
Transversalis Fascia
Where does the testicular artery originate from?
Abdominal aorta - L2-L3 region
Below the renal arteries
Which muscle does the cremaster muscle come from? What is its nerve supply? Where the cremaster muscle loacted?
Internal oblique
genital branch of the genitofemoral nerve (L1,2)
It surrounds the spertic cord
Name the 4 different layers of the spertaic cord and list their origin
- Transversalis fascia → internal spermatic fascia
- Internal oblique muscle → cremasteric muscle and fascia
- External oblique aponeurosis → external spermatic fascia
- Superficial fascia (Scarpas fascia – membranous layer of fascia) → dartos muscle (smooth muscle)
Which nerves can be found within the spermatic cord? In which layer of the spertaic cord are they located?
Ilioinguinal- Outside the external spertci fascia , in superficial fascia
Genitofemoral (cremaster never)- cremasteric fascia
What is the function of the dartos and cremaster muscle?
They both contract for temperature control
Dartos muscle- ilioinguinal (L1)- autonomic control
Cremaster- genitofemoral (L1 and L2) somatic control
What are the nerve routes for the cremasteric reflex? How can it be activated?
L1 and L2- genitofemoral nerve
By striking the superior/medial aspect of the thigh near the testicals. Contraction should occur
Which lymphatic vessels drain into the superficial inguinal lymph nodes?
Lympahtics from the penis, scrotum, labium and anal canal
From where do the testes decend?
Posterior abdominal wall
Where does testicular cancer often metastasis to and why?
The para aortic lymph nodes next to the kidneys
because testis originate from the posterior abdominal wall near the kidneys and there lymphatics and blood supply comes from the same area
What is a hernia?
•A hernia is an abnormal weakness or hole in an anatomical structure which allows something inside to protrude through.
Hernias are usually harmless, when do they become harmful?
When they become strangulated- blood supply us cut off
What is an inguinal hernia?
hernia passes through the inguinal canal for a variable distance and exits through the superficial inguinal ring.
What are the risk factors for the development of a hernia? Explain the rational behind these risk factors
Any condition that increases the pressure of the abdominal cavity may contribute to the formation or worsening of a hernia.
Obesity
Heavy lifting
Coughing
Straining during a bowel movement or urination
Chronic lungg disease
Fluid in the abdominal cavity
Hereditary
What is the difference between a direct and indirect inguinal hernia
Direct- through adominal wall straight down. Passes inferior to the epigastric artery in the inguinal triangle. May pass through the superficial inguinal ring.
Rarely enters the srotum
Indircet- through the inguinal canal. Enters the deep inguinal ring, lateral to the inferior epigastric artery, travels down the external inguinal ring. Hernia lies within the coverings of the sperpatic cord
Often enters the scrotum
What is the difference between congenital and aquired inguinal hernias?
Congenital- through patent processus vaginalis Follows pathway that testes made during pre-birth development.
Acquired passes through deep inguinal ring initially and exits through the superficial ring.
What is the mid inguinal point? Which pulse is it lateral to?
Mid-point of the inguinal ligament
Lateral to the femoral pulse
What is a hydocele?
Patent processus vaginalis
At what age do direct inguinal hernias often occur and why?
Middle aged and elderly
•their abdominal walls weaken as they age.
At what age does an indirect inguinal hernia occur?
Can occur at ang age but becomes more common as people age
What is the exact tract of the direct inguinal hernia?
- Bulges through Hesselbach’s Triangle in hernial sac formed by transversalis fascia
- inferior to the epigastric artery
- Traverses the medial portion of the inguinal canal
•
•Emerges around conjoint tendon to reach the superficial inguinal ring
•
•Gains an outer covering of external spermatic fascia
Why is a direct hernia likely to occur at the Hasselbach triangle?
Muscles layers are weak here
What are the borders of the hasselback triangle?
Superior - inferior epigastric vessels
Lateral- inguinal ligament
lmedial- lateral border of rectus abdominis
Where does a femoral hernia occur?
Where can it be sean
Femoral canal-
bulge below the inguinal crease in roughly the middle of the thigh.
Why do umbilical hernias occur?
•caused when an opening in the abdominal wall, which normally closes before birth, doesn’t close completely.
