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Musculoskeletal System > Anterior Abdominal Wall & Inguinal Region > Flashcards

Anterior Abdominal Wall & Inguinal Region Flashcards

1
Q

What are the 9 regions of the body and the body parts?

A

Right hypogastric: liver, gallbladder

Epigastric: pancreas, stomach, celiac, trunk

Left hypochondriac: spleen, left colic flexure, splenic vessels

Right lumbar: cecum

Umbilical: small intestine, SMA, renal arteries.

Left lumbar: descending colon

Right iliac: appendix, right ovary bladder (when full), MA

Left iliac: left ovary, sigmoid colon

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2
Q

What are the planes of the body?

A

2 vertical planes: midlingual (left & right)

2 horizontal planes:
Subcostal/trabspyloric(below costal margin, L1)
Transtubercular(L5, iliac tubercles)

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3
Q

What are the layers of the superficial abdominal fascia?

A

The superficial fascia of the thorax, abdomen and perineum, are all continuous

Lower abdomen-2 layers
Camper’s fascia
-external, fatty
-males: losses most of its fat, fuses with Scarpa’s layer to form Dartos fascia
-females: retains the fat, forms part of labia majora

Scarpa’s fascia
-deeperlocated aand membranous

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4
Q

Describe Scarpa’s fascia

A

Continues into the thigh and fuses with the fascia pata(deep fascia of thigh)

Attached firmly to Linea alba and public symphysis on the midline

-It continues into the anterior part of the perineum —> attached to the ischiopubic rami+ perineal membrane /(posteriorly). It is now called the superficial perineal (Colle’s) fascia

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5
Q

What is the action of the external oblique?

A

Bilateral- anterior flexure of trunk

Unilateral- lateral flexion, rotation

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6
Q

Describe structures of external oblique

A

Fibers travel downward-medially

The aponeurosis forms part of the anterior layer of the rectus sheath

The inferior free edge forms the inguinal ligament

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7
Q

What is the innervation of the external oblique?

A

Innervated by segmental nerves

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8
Q

What is the inguinal ligament?

A

From anterior superior iliac spine(ASIS) to pubic tubercle

Medial part reflected laterally = lacunar ligament

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9
Q

What are the actions of the internal oblique?

A

Action:
Bilateral- anterior flexion of trunk

Unilateral- lateral flexion, rotation

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10
Q

How are internal oblique muscle organized?

A

Fibers travel upward-medially, at right angles to the external oblique muscle

-The aponeurosis forms a different portion of the rectus sheath above and below the arcuate line

The inferior portion joins with the aponeurosis of transversus abdominis to form the conjoint tendon

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11
Q

What is the innervation of the of the internal oblique?

A

Innervated by segmental nerve

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12
Q

What is the action of the transverse Abdominis?

A

Compress and support abdominal viscera

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13
Q

How are transverse Abdominis muscles organized?

A

Fibers travel transversely

The aponeurosis forms a different portion of the rectus sheath above and below the arcuate line

The inferior portion joins with the internal oblique to form the conjoint tendon

Deep surface lined by transversalis fascia

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14
Q

How are transverse Abdominis innervated?

A

Segmental nerves

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15
Q

What are the anterior abdominal wall muscles?

A

Rectus Abdominis.

Pyramidilis

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16
Q

What is the action and innervation of the rectus Abdominis?

A

Action: flexion, tenses wall

Innnervated: segmental nerves (T7-12)

17
Q

What is the innervation and action of the Pyramidalis?

A

Action: tenses the linea alba

Innervation: T12

18
Q

What is the function of the rectus sheath?

A

The aponeurosis of the lateral abdominal muscles forms a thick sheath that encloses the rect7s Abdominis

All aponeurosis fuse in the midline(linea alba) to separate the left and right muscles

The lateral border of the rectus sheath is another region of fusion demarcating the linea semiluaris

The anterior and posterior rectus sheath is comprised of different combinations of the aponeuroses depending on the level

19
Q

What is the function of the abdominal wall muscles?

A

Contraction of the wall abdominal muscles increases intra abdominal pressure, especially when the diaphragm is fixed and allows for:

  • defecation
  • mictruition
  • parturition

When the abdominal muscles contract and diaphragm relaxes simultaneously it allows for forced expiration

20
Q

Describe the superficial muscle of the abdominal wall blood supply

A

Superficially-

  1. Superior part of the wall- musculophrenic (terminal branch of internal thoracic)
  2. Inferior part of the wall- superficial epigastric artery+ superficial circumflex iliac artery (both branches of the femoral artery)
21
Q

What is the blood supply of the deep muscles of the abdominal wall?

A
  1. Superior part of the wall-superior epigastric artery (terminal branch of the internal thoracic artery)
  2. Lateral part of the wall- intercostal arteries + subcostal artery
  3. Inferior part of the wall- inferior epigastric artery + deep circumflex iliac artery (both branches of the iliac artery). The superior + inferior epigastric arteries both enter the rectus sheath. They anastomose with each other.
22
Q

Summarize veinous drainage in he abdominal muscles

A

Follows arterial supply.

Veins clinically important in Porto-caval anastomosis.

And

Cavo-caval anastomosis (with azygos vein)

23
Q

What are the cutaneous lymphatic drainage?

A

Lymphatic drainage follows veinous drainage

Different above and below the umbilicus
-Area above the umbilicus drain to the axilla or parasternal nodes

-Areas below the umbilicus drain into the superficial inguinal nodes

24
Q

Summarize the innervation of the abdominal wall and inguinal region

A

Innervation is segmental

  • Motor supply to muscles
  • Cutaneous supply to skin (think dermatomes)

Nerves travel between internal oblique and transversus Abdominis (compare with intercostal nerves)

Give off lateral and anterior cutaneous branches

25
Q

What is an abdominal incision determined by?

A
  • organs of interest
  • surrounding structures
  • location of blood vessels and nerves
  • strength of tissue for suture placement
  • clinical information
26
Q

What are the considerations of abdominal incisions ?

A

Access, ability to enlarge site when necessary

27
Q

What are laparoscopic incisions?

A
  • Ports are placed through small incisions
  • Umbilicus is used for 1 degree port= camera
  • Additional ports are placed at 60 degree angles and atleast 5 cm from each other
  • Depends highly on area of exploration or procedure
28
Q

What are the types of abdominal incisions?

A
  • median
  • para-median
  • pfannenstiel
  • Mc Burney’s point
  • Linea semilunaris
  • Kocher
29
Q

Where is the purpose for a median abdominal incisions being made?

A

At the linea alba good for exploratory laparotomy; advantage is that no blood vessels cross the area, good suture repair

30
Q

Where is para-median abdominal incisions made?

A

Laterally to the linea alba

31
Q

Where is the Pfannenstiel found? What is the main purpose ?

A

Above the pubic symphysis (bikini line through external abdominal oblique and rectus Abdominis muscles)
Caesarean section

32
Q

Where is McBurney’s point made? What is it used for?

A

2/3 between the umbilicus and ASIS

-appendectomy

33
Q

What is the linea semilunaris used for? Where is it found?

A

Incision made in the linea semilunaris

34
Q

What is the kocher abdominal incision? What is it used for?

A

Subcostal

-for access to the gall bladder

35
Q

Explain in detail: the workings of McBurney’s point

A

2/3 distance from the umbilicus to the anterior superior iliac spine

  • locate the base of the cecum
    • origin of the appendix
  • Incision is made through subcutaneous tissue
  • The transversalis fascia, extraperitoneal fascia, and parietal peritoneum is also cut
  • Avoids ilioinguinal nerve (#12) and iliohypogastric nerve
36
Q

What are the boundaries of the inguinal canal?

A

Anterior wall- external abdominal oblique aponeurosis

Floor- inguinal ligament, lacunar ligament

Posterior wall- transversalis fascia

Roof- inferior edge of anterior abdominal oblique, transverse abdominal and conjoint tendon

Musculoskeletal System (41 decks)

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