Anterior Abdominal Wall and Inguinal Region Anatomy

Question 1

Superficial layer of facia over abdomen

Answer 1

Camper’s fascia

Question 2

Layer of fascia directly below Camper’s fascia

Answer 2

Scarpa’s fascia

Question 3

Scarpa’s fascia is continuous with

Answer 3

dartos layer in scrotum

fat is replaced with sm. muscle

Question 4

Conjoint tendon made up of

Answer 4

interal oblique

transverse abdominus

Question 5

Conjoint tendon inserts into

Answer 5

pectineal ligament

Question 6

Rectus sheath is made up of tendons of

Answer 6

aponeurotic portions of oblique muscles

Question 7

Layer superficial to parietal peritoneum

Answer 7

transversalis fascia

Question 8

Layers over the abdominal cavity

deep → superficial

Answer 8

parietal peritoneum → transversalis fascia → Scarpa’s → Camper’s → transversalis fascia → internal oblique → external oblique

Question 9

Arcuate defines

Answer 9

lower border of posterior layer of the rectus sheath

Question 10

CT differences above and below the arcuate line

Answer 10

above: internal oblique and transverse abdominus tendons run deep to rectus

below: tendons from all abdominal muscles run superficial to rectus

*this makes the area below the abdomen weaker

Question 11

Superior epigastric artery arises from…

Answer 11

internal thoracic artery

Question 12

Inferior epigastric artery arises from…

Answer 12

external iliac artery

(just above inguinal ligament)

Question 13

Main blood supply in the anterior abdominal wall

Answer 13

superior epigastric artery

inferior epigastric artery

*form anastomoses

Question 14

Umbilical hernias

etiology in newborns

Answer 14

incomplete closure of anterior abdominal wall

increased intrabdominal pressure after cutting umbilical cord

Question 15

Epigastric heria

where does it go through?

Answer 15

linea alba

Question 16

Spigelian hernia

location

Answer 16

semilunar lines

(tendenous intersections of rectus abdominus)

Question 17

Incisional hernia

Answer 17

protusion of omentum or an organ through a surgical incision

Question 18

Inguinal ligament is made up of

Answer 18

lower border of external oblique aponeurosis

Question 19

Inguinal ligament extends between

Answer 19

anterior superior iliac spine

pubic tubercle

Question 20

Processus vaginalis

Answer 20

protrusion of peritoneum through abdomen

forms inguinal canal

Question 21

How do the testes “descend”

Answer 21

differential growth of undifferentiated gonads

Question 22

Gonads: peritoneal or retroperitoneal

Answer 22

retroperitoneal

Question 23

Gubernaculum testes

Answer 23

band of CT attaching to inferior pole of gonad and to labioscrotal fold

Question 24

Cremasteric muscle

extension of

Answer 24

internal oblique

Question 25

External spermatic fascia extension of

Answer 25

external oblique

Question 26

Contents of spermatic cord

Answer 26

spermatic cord (male) round ligament of uterus (female) ilioinguinal nerve (L1)

Question 27

Contents of spermatic cord

Answer 27

van deferens testicular artery testicular vein lymph vessels genital branch of genitofemoral nerve

Question 28

Dartos muscle is extension of

Answer 28

Scarpa's fascia

Question 29

Covering of testes

Answer 29

tunica vaginalis covers anterior and lateral sides, remnant of processus vaginalis

Question 30

Indirect inguinal hernia

Answer 30

deep inguinal ring defect patent processus vaginalis lateral to inferior epigastic artery

Question 31

Indirect hernia where does the bowel go?

Answer 31

follows route of testicular descent bowel can get into scrotum

Question 32

Direct inguinal hernia pathology

Answer 32

defect though posterior abdominal wall of inguinal canal \*fascia transversalis laterally, conjoint tendon medially

Question 33

What are the borders of the inguinal canal?

Answer 33

**_anterior_**: aponeurosis of external oblique **_posterior_**: transversalis fascia (lateral), conjoint tendon (medial) **_floor_**: rolled under endge of external oblique aponeurosis **_roof_**: arching lowest fibers of conjoint tendon

Question 34

Borders of Hesselbach's/inguinal triangle

Answer 34

**_lateral_**: inferior epigastric artery **_medial_**: rectus abdominus **_inferiorly_**: inguinal ligament

Question 35

Femoral hernias are more common in women/men

Answer 35

women

Question 36

Femoral hernias are the most common cause of...

Answer 36

incarcerated bowel

Question 37

Varicocele

Answer 37

dilation of pampiniform plexus of veins

Question 38

Hydrocele

Answer 38

excess fluid made by visceral layer of tunica vaginalis

Question 39

Hydrocele association

Answer 39

indirect inguinal hernia