Anterior Abdominal Wall and Inguinal Region Flashcards

1
Q

What is an aponeurosis?

A

Flattened tendinous structure that connects anterolateral abdominal wall muscles to linea alba

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2
Q

What are the functions of the anterior abdominal wall muscles?

A

Movement (flexion and rotation of trunk, control of pelvic tilt)

Increasing intra abdominal pressure

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3
Q

Whatg is the nerve supply to the skin and muscle of the anterior abdominal wall?

A

T7-T11 (Intercostal nerves)

T12 (Subcostal nerve)

L1 (Iliohypogastric and ilioinguinal)

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4
Q

Which dermatome lies at the level of the xiphisternum?

A

T6

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5
Q

Which dermatome lies at the level of the umbilicus?

A

T10

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6
Q

Which dermatome lies at the level of the pubic tubercle?

A

T12/L1

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7
Q

What is Scarpa’s fascia?

A

Membranous layer of superficial fascia on the anterior abdominal wall

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8
Q

Scarpa’s fascia is continuous inferiorly with the membranous layer of superficial fascia of the perineum.

What name is given to this fascia in the perineum?

A

Colle’s fascia

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9
Q

In which direction do the fibres of external oblique run?

A

Downwards and forwards (like external intercostal)

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10
Q

The free inferior border of external oblique forms what structure?

A

Inguinal ligament

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11
Q

What structure is found superior to the pubic tubercle, as a ‘gap’ in the aponeurosis of external oblique?

A

Superficial inguinal ring

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12
Q

As it passes through the superficial inguinal ring, the aponeurosis of external oblique forms which component the spermatic cord?

A

External spermatic fascia

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13
Q

What forms the anterior wall of the inguinal canal?

A

Aponeurosis of external oblique

also has lateral reinforcement by muscle fibres of internal oblique

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14
Q

What forms the posterior wall of the inguinal canal?

A

Transversalis fascia, with medial reinforcement by conjoint tendon

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15
Q

What forms the roof of the inguinal canal?

A

Laterally: transversalis fascia

Centrally: musculoaponeurotic arches of internal oblique and transversus abdominis

Medially: Medial crus

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16
Q

What forms the floor of the inguinal canal?

A

Laterally: iliopubic tract

Centrally: inguinal ligament

Medially: Lacunar ligament

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17
Q

What is the origin(s) of external oblique?

A

External surfaces of ribs 5-12

18
Q

What are the insertions of external oblique?

A

Linea alba

Pubic tubercle

Anterior half of iliac crest

19
Q

What is the origin(s) of internal oblique?

A

Thoracolumbar fascia

Anterior two-thirds of iliac crest

Connective tissue deep to lateral third of inguinal ligament

20
Q

What are the insertions of internal oblique?

A

Inferior borders of ribs 10-12

Linea alba

Pecten pubis (via conjoint tendon)

21
Q

What is the origin(s) of transversus abdominis?

A

Internal surface of 7th-12th costal cartilages

Thoracolumbar fascia

Iliac crest

Connective tissue deep to lateral third of inguinal ligament

22
Q

What are the insertions of transversus abdominis?

A

Linea alba

Pubic crest

Pecten pubis (via conjoint tendon)

23
Q

Where does the neurovascular plane of the anterior abdominal wall lie?

A

Between transversus abdominis and internal oblique

24
Q

What is the origin(s) of rectus abdominis?

A

Pubic symphysis and pubic crest

25
Q

What are the insertions of rectus abdominis?

A

Xiphoid process

5th-7th costal cartilages

26
Q

In which direction do the fibres of internal oblique run?

A

Upwards and forwards

27
Q

How to the fibres of transversus abdominis relate to the inguinal canal?

A

Superior to deep inguinal ring

Roof, then posterior wall as conjoint tendon

28
Q

What and where is the conjoint tendon?

A

Union of internal oblique and transversus abdominis

Located posterior to the superficial inguinal ring

29
Q

What and where is the transversalis fascia?

A

This connective tissue layer, between transversus abdominis and parietal peritoneum.

Thickest at level of inguinal canal

30
Q

Which vessels run through the rectus sheath, deep to rectus abdominis?

A

Inferior and superior epigastric

31
Q

The deep inguinal ring is a defect in which layer of the abdominal wall?

A

Transversalis fascia

32
Q

What is the tunica vaginalis, from where is it derived?

A

Serous covering of the testes, derived from the processus vaginalis (embryonic outpouching of the parietal peritoneum)

33
Q

What is the cremasteric reflex?

A

Reflex observed when the superomedial portion of the thigh is stroked. This tightens the cremaster muscles, elevating the testes on the ipsilateral side

34
Q

What structures are found in the spermatic cord?

A

Mnemonic: Papers Don’t Contribute To A Good Specialist Level

3 arteries, 3 nerves, 3 other things

P: pampiniform plexus
D: ductus deferens
C: cremasteric artery
T: testicular artery
A: artery of the ductus deferens (deferential artery)
G: genital branch of the genitofemoral nerve
S: sympathetic nerve fibers
L: lymphatic vessels
35
Q

Where is the deep inguinal ring located?

A

2cms above the midpoint of the inguinal ligament

36
Q

What are the medial and lateral borders of the deep inguinal ring?

A

Medial: Inferior epigastric artery

Lateral: Transversalis fascia

37
Q

What are the medial and lateral borders of the superficial inguinal ring?

A

Medial and lateral crura of external oblique muscle

38
Q

What is the approximate length of the inguinal canal?

A

4cm

39
Q

Which nerve enters the inguinal canal through the deep inguinal ring and what does it supply?

A

Genital branch of genitofemoral artery

Females: Labia majora and mons pubis

Males: Cremaster and skin of scrotum

40
Q

How does the ilioinguinal nerve enter the inguinal canal and what does it supply?

A

Enters anterior abdominal wall between transversus abdominis and internal oblique

Supplies skin of the upper and medial part of the thigh, and::

Males (“anterior scrotal nerve”): to the skin over the root of the penis and upper part of the scrotum.

Females (“anterior labial nerve”): to the skin covering the mons pubis and labia majora.

41
Q

What is a hernia?

A

Protrusion of a structure through the body cavity in which it is normally contained

42
Q

What is the difference between an indirect and a direct hernia?

A

Direct: Protrudes through anterior abdominal wall via Hesselbach’s triangle

Indirect: Protrusion through deep inguinal ring