Anterior Abdominal Wall and Inguinal Region

Question 1

What are the abdominal horizontal planes and the vertebral levels they go through?

Answer 1

Tits Sag Too True

• Transpyloric just under T12/aboveL1
• Subcostal through L3
• Transumbilical on top of L4
• Transtubercular on bottom of L5 through the iliac tubercles

Question 2

What do we find in the upper right quadrant?

Answer 2

gallbladder, duodenum, right pleura, liver (right lobe), and right kidney

Question 3

Upper left quadrant contents

Answer 3

spleen, stomach, left pleura, tail of pancreas, left kidney

Question 4

Right lower quadrant

Answer 4

right ureter, cecum, ileal diverticulum, vermiform appendix

Question 5

Left lower quadrant

Answer 5

left ureter, descending sigmoid colon

Question 6

What makes up the superficial inguinal ring?

Answer 6

external abdominal oblique m.

Question 7

What two things to the inguinal ligament attach to?

Answer 7

Asis and the pubic tubercle

Question 8

What is the sharp extension of the inguinal ligament?

Answer 8

The lacunar ligament

Question 9

What is the lateral-posterior extension of the lacunar ligament that runs along the pectineal line?

Answer 9

The pectineal ligament

Question 10

What 2 muscles join up to make the conjoint tendon?

Answer 10

Internal oblique and transversus abdominis

Question 11

Where does the cremaster m. originate from?

Answer 11

the internal oblique m.

Question 12

between what 2 muscles do the nerves and the vessels run?

Answer 12

internal oblique and transvers abdominis

Question 13

which superficial fascia layer is the fatty one?

Answer 13

camper’s fascia

Question 14

Which superficial fascia layer is the membranous one?

Answer 14

scarpa’s

-continuous with fascia lata in the thigh

Question 15

Which superficial layer of the anterior abdominal wall do the blood vessels run in?

Answer 15

Camper’s

Question 16

ALLEGEDLY SUPER IMPORTANT! Which of the superficial layers of the anterior abdominal wall is continuous over the penis and the scrotum?

Answer 16

Scarpa’s fascia

Question 17

Where is the potential space that fluid can leak into on the anterior abdomen?

Answer 17

between the scarpa’s and deep fascia of the external abdominal oblique m.

Question 18

from superficial to deep, put these muscles in order: External oblique, transversus abdominis, rectus abdominis, and internal oblique

Answer 18

External, internal, transverse, then rectus abdominis (with pyramidalis)

Question 19

What is the arcuate line?

Answer 19

1/2 way between umbilicus and pubic symphiysis

-under this, the rectus abdominis doesn’t have a back sheath

Question 20

Where does the deep abdominal artery system arise from?

Answer 20

Subclavian Superiorly and external iliac inferiorly

Question 21

Where does the superficial artery system arise from?

Answer 21

perforating branches superiorly and branches from femoral A. inferiorly

Question 22

With the veins, what are some things that do deep drainage?

Answer 22

sublcavian v.
external iliac
lumbar and intercostal v.

Question 23

things contributing to superficial drainage

Answer 23

thoracoepigastric
lateral thoracic
superficial epigastric
*** within CAMPER’s fascia

Question 24

What are the sensory dermatomes of this region?

Answer 24

T7 is xiphoid
T10 is umbilical
L1 is inguinal fold

Question 25

What nerve comes off of the lumbar plexus and comes from L1 and sometimes T12?

Answer 25

Iliohypogastric n.

Question 26

Which nerve comes out under the iliohypogastric n.?

Answer 26

Ilioinguinal n.

-this one enters and exits the inguinal canal

Question 27

Which nerve is the only one that comes out on top of Psoas Major m.

Answer 27

genitofemoral n.

-gives off genital branch and femoral branch

Question 28

Which branch of gen fem n. enters and exits the inguinal canal?

Answer 28

genital branch

Question 29

Which branch of gen fem exits inferior to the inguinal ligament?

Answer 29

femoral branch

Question 30

For the lymphatics, describe the superficial drainage pattern

Answer 30

to anterior axillary or sternal nodes or to superficial inguinal nodes

Question 31

Describe the deep lymphatic drainage

Answer 31

everything to the deep abdominal nodes

Question 32

What 3 muscle do we go through if we poke through the inguinal canal (in order starting from deep ring)

Answer 32

transversus abdominis, internal oblique, external oblique

Question 33

What are the inguinal canal contents for a male?

Answer 33

ductus deferens, ilioinguinal n., genital branch of gen fem n, testicular a. and pampiniform plexus of veins
-all of this is surrounded by fascial layers

Question 34

what are the inguinal canal contents for a female?

Answer 34

round ligament of uterus, ilioinguinal n., genital branch of gen fem n,

Question 35

Whate embryologic layer do the testes come from?

Answer 35

the urogenital ridge of the MESODERM

Question 36

When the testicles descend, they bring a bunch of shit with them, but what is the one structure that gets left behind?

Answer 36

Transversus abdominis muscle

Question 37

where does dartos come from superiorly?

Answer 37

subcutaneous tissue

Question 38

where does external and internal spermatic fascia come from?

Answer 38

external oblique and transversalis fascia respectively

Question 39

where does the cremaster muscle and the tunica vaginalis come from?

Answer 39

the internal abdominal oblique and the peritoneum respectively

Question 40

What landmark do we use to determine if an inguinal hernia is direct or indirect?

Answer 40

inferior epigastric vessel

-direct is medial and indirect is lateral THROUGH the actual inguinal canal

Question 41

What is the difference between a femoral and inguinal hernia?

Answer 41

femoral hernia’s exit the femoral canal INFERIOR to the inguinal ligament