Anterior Abdominal Wall & Inguinal Region Flashcards
whats in the Rt hypochondriac region
liver, gallbladder
whats in the Epigastric region
pancreas, stomach, celiac trunk
whats in the Lt hypochondriac region ?
spleen, left colic flexure, splenic
vessels
whats in the right lumbar region
cecum
whats in the umbilical region ?
small intestine, SMA, renal
arteries
whats in the left lumbar region
descending colon
whats in the right iliac and hypogastric regions :
appendix, right ovary, bladder (when full), IMA
whats in the L iliac region
left ovary, sigmoid colon
Camper’s fascia
external, fatty
males fat fuses with the scarpas layer to form dartos fascia
females retain and form labia majora
Scarpa’s fascia
• Deeper located and membranous
-continues into the superficial perineal fascia (Colles )
external oblique function and innervation
-Bilateral - anterior flexion of trunk
-Unilateral - lateral flexion, rotation
-Segmental nerves
-aponeurosis forms part of the
anterior layer of the rectus sheath
internal oblique
-Bilateral - anterior flexion of trunk
Unilateral - lateral flexion, rotation
-segmental nerve
transversus abdominus
- Compress and support abdominal viscera
- innervated by segmental nerves
what forms the conjoint tendon
-The inferior portion of the IO joins with the
aponeurosis of transversus abdominis
-The inferior portion of TA joins with the internal
oblique
Rectus abdominis
Action: flexion, tenses wall
Innervation: segmental nerves
Pyramidalis
Action: tenses the linea alba
Innervation: T12
Rectus Sheath
The aponeuroses of the lateral abdominal muscles forms a thick sheath that encloses the rectus
abdominis
Describe the midline of the rectus sheath :
-All aponeuroses fuse in the midline (linea alba) to separate the left and right rectus muscles
Describe the lateral border of the rectus sheath
This is another region of fusion demarcating the linea semiluaris
describe the ant. and post . of the rectus sheath :
comprised of different combinations of the aponeuroses
depending on the lev
what does contraction of the abdominal wall muscles allow :
- Defecation
- Micturition
- Parturition
when do we have forced expiration
When the abdominal muscles contract
and diaphragm relaxes simultaneously
Blood supply of the anterior abdominal wall : superficial superior
. Superior part of the wall –
musculophrenic (terminal
branch of internal thoracic)
Blood supply of the anterior abdominal wall : superficial inferior
superficial epigastric artery +
superficial circumflex iliac artery
Blood supply of the anterior abdominal wall;
superior deep
superior epigastric artery (terminal branch of the internal thoracic artery)
Blood supply of the anterior abdominal wall;deep lateral
intercostal
arteries + subcostal artery
Blood supply of the anterior abdominal wall;deep inferior
inferior
epigastric artery + deep circumflex
iliac artery (both branches of the
external iliac artery)
which two abdominal arteries anastomose and enter the rectus sheath
The superior +
inferior epigastric arteries
which two abdominal arteries anastomose and enter the rectus sheath
The superior +
inferior epigastric arteries
lymphatic drainage of abdominal wall : areas above the umbiicus drain to ?
to the
axilla or parasternal
nodes
lymphatic drainage of abdominal wall:areas below the umbilicus drain into
superficial inguinal
nodes
Median abdominal incision
At the linea alba good for exploratory
laparotomy; advantage is that no blood vessels
cross the area, good suture repair
Pfannenstiel abdominal incision
- Above the pubic symphysis
- Caesarean section
Mc Burney’s point abdominal incisions
-2/3 between the umbilicus and ASIS •Appendectomy • Avoids ilioinguinal nerve (#12) and iliohypogastric nerve
Kocher abdominal incision
- Subcostal
• For access to the gallbladder
Arcuate line
Termination of the aponeurotic portion of rectus sheath
Transversalis fascia continues
Hesselbach’s triangle
Medial border: lateral edge of the rectus sheath
Inferior border: inguinal ligament
Lateral border: inferior epigastric artery
Inguinal region
-Provides passage from the abdominal
cavity to the lower limb and perineum
-Males: spermatic cord, ilioinguinal nerve
-Females: round ligament, ilioinguinal nerve
How do the testes develop:
-Descends into the scrotum by passing through the
abdominal wall
-Creates the inguinal canal
-Spermatic cord is formed as the testes pass through
the different layers, obtaining a portion of each
what forms the External spermatic
fascia
formed by external abdominal
oblique aponeurosis
what form the Internal spermatic fascia
formed by transversalis fascia
what forms the Tunica vaginalis
formed by parietal peritoneum contains a small amount of fluid that gets reabsorbed when proximal part becomes obliterated
what forms the Cremaster muscle
formed by internal
abdominal oblique muscle
and aponeurosis
function of the Dartos muscle
muscle layer that allows for
puckering of the skin
Inguinal hernias
protrusion of parietal peritoneum, gastrointestinal
viscera (small and/or large intestines), fat through
inguinal canal and possibly into the scrotum
Direct Inguinal hernias
- Medial to the inferior epigastric vessels
- Only through the superficial ring
- Acquired
- Strain - picking up a heavy object
Indirect inguinal hernias
• Lateral to the inferior epigastric vessels
• Passes through both deep and superficial
rings
• Congenital
• Patent processus vaginalis
Hydrocele
Collection of fluid in the tunica vaginalis
Usually in infants
