Anterior Abdominal Wall and Inguinal Canal

Question 1

Borders of the abdominopelvic cavity

Answer 1

From diaphragm above to the pelvic diaphragm below
Superior pelvic aperture divides it into abdominal and pelvic cavities
Walls are made by bone and muscles

Question 2

Boney boundaries of the abdominal cavity

Answer 2

5 lumbar vertebrae
False pelvis (mostly the iliac ala)
11th and 12th ribs
Costal margins
Xiphoid process

Question 3

Muscular boundaries of the abdominal cavity

Answer 3

Anterolaterally, it is bounded by the rectus abdominis, the external and internal oblique, and the transversus abdominis
Posterior wall is formed by the posterior fibers of the diaphragm, the quadratus lumborum, the psoas major, and the iliacus muscles

Question 4

If you want to divide the abdomen into 4 quadrants, where do you draw the lines?

Answer 4

Median (sagittal) plane

Trans umbilicus plane

Question 5

If you want to divide the abdomen into 9 sections, where do you draw the lines?

Answer 5

Two midclavicular lines (vertical)
Subcostal plane (along the inferior border of costal cartilage of rib X/L3)
Intertubercular plane (connects the tubercles of iliac crests and passes through L5)

Question 6

The 9 regions are called

Answer 6

Middle vertical column (top to bottom): epigastric, umbilical, hypogastric
Left: Left hypochondrium, left flank, left groin
Right: right hypochondrium, right flank, right groin

Question 7

Dermatomes of the anterior abdominal wall

Answer 7

Intercostal nerves T6-11
Subcostal nerve T12
L1

Question 8

5 bony landmarks of the anterior abdominal wall

Answer 8

Xiphoid process
Pubic symphysis
Pubic tuberle
Anterior superior iliac spine
Iliac tubercle

Question 9

External oblique

Answer 9

Function: increase intra abdominal pressure, rotates the trunk contralaterally
Innervated by ventral rami of T7 to T12

Question 10

Linea alba

Answer 10

Thick band of CT
Connects xiphoid process to pubic symphysis
Where the aponeuroses meet

Question 11

Internal oblique

Answer 11

Function: increase intra-abdominal pressure, rotates the trunk ipsilaterally
Innervated by ventral rami of T7 to L1

Question 12

Transversus abdominis

Answer 12

Function: increase intra-abdominal pressure

Innervated by ventral rami of T7 to L1

Question 13

Rectus abdominis

Answer 13

Function: increase intra-abdominal pressure, flexes the trunk
Innervated by ventral rami of T7 to T12

Question 14

Tendinous insertions

Answer 14

Horizontal bands that split the rectus abdominis

Question 15

Arcuate line

Answer 15

End of the posterior layer of the rectus sheath

Just below the umbilicus

Question 16

Rectus sheath

Answer 16

Formed by the aponeuroses of the external and internal oblique, and transversus abdominis
Above the umbilicus: External and half of internal go above, transversus and other have of internal go below
Below the umbilicus: all 3 layers go above the rectus abdominis

Question 17

Transversalis fascia

Answer 17

Layer of fascia between the rectus abdominis and the peritoneum

Question 18

Inguinal canal

Answer 18

Oblique canal about 4 cm long
Directed downward and medial
Placed parallel with and a little above the medial half of the inguinal ligament
Extends from the deep inguinal ring to the superficial inguinal ring

Question 19

What is found in the inguinal canal

Answer 19

Ilioinguinal nerve (both genders)
Spermatic cord (males)
Round ligament of the uterus (females)

Question 20

During development, is the
1. Trans-abdominal phase
2. Trans-inguinal phase
active or passive

Answer 20

1. Passive

2. Active

Question 21

Superficial inguinal ring

Answer 21

Triangular gap in the external oblique aponeurosis

Question 22

Deep inguinal ring

Answer 22

Oval shape in the fascia tranversalis

Lateral to the inferior epigastric vessels

Question 23

Conjoint tendon

Answer 23

Formed by the fusion of the lowest aponeurotic fibers of the internal oblique and of the transversus abdominis

Question 24

The cremaster muscle is from what abdominal muscle?

Answer 24

Internal oblique

Question 25

Inguinal hernia

Answer 25

Protrusion or passage of a peritoneal sac, with or without abdominal contents, through a weakened part of the abdominal wall

Question 26

Indirect vs direct hernia

Answer 26

Indirect: through deep and superficial rings (inguinal canal) into the scrotum
Direct: push through the wall, protrude into the canal, and then pass through the superficial ring

Question 27

Where are the inferior epigastric vessels in a

1. Direct hernia
2. Indirect hernia

Answer 27

1. Neck of the hernia is medial to the epigastric arteries

2. Neck of the hernia is lateral to the epigastric vessels

Question 28

Abdominal arterial anastamosis

Answer 28

An arterial anastomosis is formed between the superior and inferior epigastric arteries at the level of the umbilicus
The anastomosis can shunt blood from the subclavian artery to external iliac artery to supply the lower limb