Anterior abdominal wall, inguinal canal and testis Flashcards
What are the semilunar lines of surface anatomy of anterior abdominal wall?
curved lines marking lateral limit of rectus abdominis
What are tendinous intersections
segment rectus abdominus and connect to anterior wall of aponeurotic coverings
What do the tendinous intersections prevent?
Bowstringing
What is the linea alba?
Midline tendinous line from xiphoid of sternum to pubic symphysis
Where aponeuroses of abdominal muscles meet
Why is the umbilicus important?
All layers of the wall fuse at this point (around L3-L4)
What do the thoracoabdominal nerves innervate?
T7-T11
T12 is a subcostal nerve
What nerves come from the lumbar plexus?
Iliohypogastric (L1)
Ilioinguinal (L1)
What does the ilioinguinal nerve go down to?
Spermatic cord and ends up in scrotum and labia majora for females
Describe the layers of the abdominal wall
Skin
Fattey layer of superficial fascia (Camper’s)
Membranous layer of superficial fascia (Scarpa’s)
External oblique muscle
external oblique muscle
transversus abdominis muscle
(fascia in between each muscle)
transversalias fascia
parietal peritoneum
Rectus abdominis sheath above umbilicus
External abdominal oblique aponeurosis above rectus abdominus muscle
internal abdominal oblique aponeurosis both anterior and posterior to RA muscle
Transverse abdominal aponeurosis, transversalis fascia and posterior rectus sheath posterior to RA muscle
What is the anterior rectus sheath above the umbilicus composed of?
External abdominal oblique aponeurosis
Internal abdominal oblique aponeurosis
What is the posterior rectus sheath above the umbilicus composed of?
Internal abdominal oblique aponeurosis
Transverse abdominal aponeurosis
Transversalis fascia
parietal peritoneum
What is the anterior rectus sheath below the umbilicus composed of?
External abdominal oblique aponeurosis
Internal abdominal oblique aponeurosis
Transverse abdominal aponeurosis
What is the posterior rectus sheath below the umbilicus composed of?
Transverse abdominal aponeurosis
transversalis fascia
Where are most of the direct inguinal hernias happen?
Inguinal triangle of Hesselbach
What are the inguinal triangle of Hesselbach borders?
lateral border of rectus muscle
inguinal ligament
inferior epigastric vessels
What does the lateral umbilical fold have with it?
Inferior epigastric artery and vein
What does the medial umbilical fold have with it?
Medial umbilical ligament
What does the median umbilical gold have with it?
Median umbilical ligament
What is the course of the inguinal canal?
Goes through deep inguinal ring and through superficial inguinal ring (oblique route)
Why is the inguinal canal important?
Allows the scrotum to move outside of the body without letting other structures to leave
What is the transversalis fascia within the scrotum?
Internal spermatic fascia
What is the cremaster muscle and fascia function?
elevate the testes
What is the cremaster muscle and fascia formed by?
Internal abdominal oblique muscle
What does the external abdominal oblique aponeurosis from once in the scrotum?
External spermatic fascia
What dose the dartos muscle do?
Wrinkles skin of the scrotum
What does the dartos muscle come from?
Scarpa’s fascia
Is the camper’s fascia found in scrotum?
NO
From outside to inside describe the testis
External spermatic fascia
Cremaster muscle
Internal spermatic fascia
What is found inside the spermatic cord?
Pampiniform plexus of veins
testicular artery
ductus deferens
Define a hernia
Protrusion of a structure outside the compartment of the anatomic location
What is the herniated sac
outpouching of peritoneum
What are inguinal hernias?
Protrusion of a portion of an abdominal structure through the superficial inguinal ring
Indirect hernias are
oblique and travel through entire length of inguinal canal
from deep inguinal ring to superficial inguinal ring
Direct hernias are
pushes structures directly though the wall and end up through superficial inguinal ring
What is a reducible hernia
see the bulge and able to push it back into the abdomen
What is a irreducible hernia
not able to be pushed back
What is a incarcerated hernia
Affecting blood supply
What are the types of incarcerated hernias?
Obstructed (trapped tissue)
Strangulated (resulting in gangrene)
Which type of hernia is always within the internal spermatic fascia?
Indirect inguinal hernia
Which type of hernia is always outside the internal spermatic fascia?
Direct inguinal hernia
Are direct inguinal hernias medial or lateral to inferior epigastric vessels?
Medial
Are indirect inguinal hernias medial or lateral to inferior epigastric vessels?
Lateral
What type of inguinal hernia are most commonly present in infants, children, and young adults?
Indirect
What type of inguinal hernia are most commonly present in older men?
Direct
What type of hernia protrudes directly through the abdominal wall?
Direct
What type of hernia exit through superficial inguinal ring?
BOTH direct and indirect
What type of inguinal hernia is acquired as a result of a developed weakness of the transversalis fascia?
Direct
Herniorrhaphy
surgical repair of hernia
Tension free (mesh) repairs
use of synthetic sheets
what is the capsule of the testes?
Tunica albuginea
Where is the primary site where sperm begins to develop?
Seminiferous tubules
Layers of tunica vaginalis
Parietal layer
cavity
Visceral layer (inner most right on testes)
Explain hydrocele
Presence of fluid of cavity in the tunica vaginalis
enlargement of testes
able to hold a light behind scrotum and see clear fluid through testis
Varicocele is what?
Enlarges veins around scrotum
worm like
anechoic ultrasound
Show black in US image
Hypoechoic ultrasound
Reflect back but doesnt reflect as much compared to surrounding tissues
Hyperechoic ultrasound
More reflective – shows up brighter
