anterior abdominal wall and inguinal region

Question 1

what are the 3 layers of muscles that make up the lateral abdominal wall?

Answer 1

external oblique
internal oblique
transversus abdominis

Question 2

what is the most superficial layer of the abdominal wall?

Answer 2

external oblique

Question 3

where do the muscle fibres of the abdominal wall muscles end?

Answer 3

end at the MCL to become the linea alba

Question 4

where does the rectus abdominis run?

Answer 4

from the xiphoid process to the pubic symphysis

Question 5

what splits up the rectus abdominis?

Answer 5

tendinous intersections

Question 6

what is the rectus sheath?

Answer 6

Rectus abdominis muscle is enclosed by an aponeurotic sheath, which is derived from the aponeuroses of external oblique, internal oblique and transversus abdominis.

Question 7

describe the rectus sheath above the arcuate line

Answer 7

innermost - transversalis fascia
transversalis abdominis
internal oblique - aponeurosis splits in half so half runs behind the rectus abdomonis and half runs in front
external oblique

all insert onto the linea alba

Question 8

describe the rectus sheath below the arcuate line

Answer 8

All aponeurotic layers of the muscles run anterior to RA

Only the fascia that runs behind

Question 9

where do the posterior intercostals branch off from?

Answer 9

descending aorta

Question 10

where do the anterior intercostals branch off from?

Answer 10

internal thoracic artery either side of the sternum

Question 11

what does the internal thoracic artery become?

Answer 11

superior epigastric artery

Question 12

what does the superior epigastric artery supply?

Answer 12

superior portion of the rectus abdominis

Question 13

what does the inferior epigastric artery branch off from?

Answer 13

external iliac artery

Question 14

what is the final intercostal nerve?

Answer 14

T11

Question 15

what level is the subcostal nerve?

Answer 15

T12

Question 16

what is the subcostal nerve motor and sensory to?

Answer 16

Motor and sensory to abdominal wall not to the thoracic wall.

Question 17

what are the 2 branches of L1?

Answer 17

Iliohypogastric nerve

Ilioinguinal nerve

Question 18

what is L1 motor and sensory to?

Answer 18

Motor to abdominal wall and sensory to the lowest part of the abdomen and mainly the inguinal wall.

Question 19

what makes the inguinal ligament?

Answer 19

The inferior border of external oblique’s aponeurosis rolls under itself to create the inguinal ligament

Question 20

what passes through the inguinal canal?

Answer 20

allows passage for spermatic cord in males and round ligament of the uterus for women

Question 21

what structures run in the spermatic cord?

Answer 21

Testicular artery
Ductus/Vas deferens
Pampiniform venous plexus
Genital branch of genitofemoral nerve
Ilioinguinal nerve (runs with cord)

Question 22

what layers surround the spermatic cord (in order of innermost to outermost)?

Answer 22

Internal spermatic fascia
Cremaster muscle
External spermatic fascia

Question 23

what is the superficial inguinal ring?

Answer 23

The superficial inguinal ring is the point at which the spermatic cord emerges from the abdominal wall.

Question 24

what is the deep inguinal ring?

Answer 24

The deep inguinal ring is the point at which the contents of the spermatic cord enter the abdominal wall.

Question 25

at what age have the testes descended to the scrotum?

Answer 25

9 months

Question 26

where do the testes develop?

Answer 26

posterior abdominal wall

Question 27

what is the internal spermatic fascia derived from?

Answer 27

tunica vaginalis

Question 28

what is the cremaster muscle derived from?

Answer 28

internal oblique muscle

Question 29

what nerve innervates the cremaster muscle?

Answer 29

genitofemoral nerve

Question 30

what is the cremasteric reflex?

Answer 30

if you stroke the internal aspect of the male thigh, scrotum should go up a bit

Question 31

are the branches of the genitofemoral nerve and what do they innervate?

Answer 31

femoral branch which goes to skin of the internal aspect of the thigh (purely sensory) and the genital branch which is purely motor (linked to the cremaster muscle)

Question 32

what is the external spermatic fascia derived from?

Answer 32

the external oblique muscle

Question 33

what is the processus vaginalis?

Answer 33

an in-folding of the peritoneum

Question 34

what is a hernia?

Answer 34

is a protrusion of peritoneum and viscera such as small intestine through a opening or weakness

Question 35

what is the risk with hernias?

Answer 35

have the risk to have their blood supply cut off | if the blood supply is cut off at the abdominal wall, it becomes a medical and surgical emergency

Question 36

which hernias are acquired and which are congenital?

Answer 36

direct - acquired | indirect - congenital

Question 37

who commonly gets direct hernias?

Answer 37

males over 40 years

Question 38

are direct or indirect hernias more common?

Answer 38

indirect

Question 39

where do direct hernias occur?

Answer 39

passes directly through abdominal wall (Hasselbach's triangle) rarely enters scrotum medial to inferior epigastric vessels

Question 40

where do indirect hernias occur?

Answer 40

transverses canal with processus vaginalis commonly enters scrotum lateral to inferior epigastric vessels

Question 41

what are the borders of Hasselbach's triangle?

Answer 41

inferior epigastric vessels inguinal ligaments lateral border of rectus abdominis

Question 42

when and why do incisional hernias occur?

Answer 42

occur following a surgery to the abdomen bc the scar creates a weakness in the abdominal wall

Question 43

where do inguinal hernias occur?

Answer 43

above and medial to the pubic tubercle

Question 44

who do umbilical hernias commonly occur in?

Answer 44

babies, when the rectus abdominis is not fully joined in the midline

Question 45

who is femoral hernias most common in?

Answer 45

females

Question 46

where do femoral hernias occur?

Answer 46

Herniation into the femoral canal (beneath the inguinal ligament so below and lateral to pubic tubercle)