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Anatomy Block 3 > Anterolateral Abdominal wall > Flashcards

Anterolateral Abdominal wall Flashcards

1
Q

What is the most prominent feature of the skin of the abdomen and where is it located relative to vertebrae

A

umbilicus

midway between xiphoid and pubic symphysis (approx between 3rd and 4th lumbar)

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2
Q

What are the two layers of fascia inferior to the umbilicus

A 
superficial fatty layer (campers)
deeper membranous (scarpas)
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3
Q

What fascia layer is continuous with the deeper membrounous layer as it approches the pubis

A

superficial perineal fascia

also adheres to the fascia lata of thigh

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4
Q

What fascia thickens in males over the midline of the pubic symphysis

A

deeper membranous (also then passes infeiorly on each side of the penis)

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5
Q

What makes up the fundiform ligament of the penis

A

thickening of the deeper membranous fascia

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6
Q

WHat muscles and their aponeuroses provide the main support and prootection for abdominal viscera

A

External oblique
internal oblique
transversus abdominis
rectus abdominis

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7
Q

What are the main roles to the flat muscles of the trunk

A

lateral flexors
rotators
incease intrabdominal presusure (defecation, urination, parturition {child birth})

(rectus abdominus also powerful flexor)

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8
Q

What is the largest and most superficial flat muscle an where does it originate and insert

A

External oblique
origin: lower 8 ribs
insert illiac crest, pubic tubercle, and linea alba

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9
Q

What is the name for the intertwining of aponeurotic fibers of the 3 flat muscles at the midline

A

Linea alba

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10
Q

What is the main orientation for the muscle fibers of the external oblique

A

medial and inferior

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11
Q

What forms the inguinal ligament

A

inferior thickened border of the muscle aponeurosis of the external oblique

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12
Q

Which muscle lies deep to the external oblique

A

Internal oblique

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13
Q

Where does the internal oblique originate and insert

A

originates: illiac crest and inguinal ligament
Insert:

Superior and middle fibers: lower 3 ribs and the linea alba (lie perpendicular to external oblique)

Inferior: insert with aponeurotic fibers of transversus abdominis into pubis

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14
Q

Which is the deepest of the flat muscles and its origin insertion

A

Transversus abdominis
Originates: lower 6 costal cartilages, iliac crest, and inguinal ligament
Insets:inferior onto pubs others into linea alba

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15
Q

what tow muscles combine to form the conjoint tendon and where does it insert

A

Infeior fibers of transversus abdominus and inferior fibers of internal oblique

insertinto pubis

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16
Q

Where do most fibers of transversus abdominis run

A

transversely into linea alba

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17
Q

What forms a sheath around the rectus abdominis

A

aponeurotic fibers of the three flat muscles

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18
Q

What are considered the 3 flat muslces

A

External oblique
internal oblique
transversus abdominis

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19
Q

Where does rectus abdominis insert and originate

A

lies on either side of linea alba
originates: superior ramus of pubus
inserts xiphoid process and costal cartilage of ribs 5-7

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20
Q

What membrane covers the deep surface of the transversus abdominis and ts aponeurosis

A

Transversallis fascia

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21
Q

what is the name for the serous membrane that lines the abdominal cavity

A

peritoneum

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22
Q

What is present in the rectus sheath at the level of the xiphoid process

A

the aponeurosis of the external oblique

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23
Q

What forms the superior portion of the anterior rectus sheath

A

the aponeurosis of the external oblique at the level of the xiphoid process

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24
Q

What in general forms the sheath of the rectus abdominis

A

the aponeuroses and fasciae of the 3 flat musces

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25
Q

What forms the sheath of the ructus abdominis at the level between the halway mark of the pubic symphasisis and the umbilicis and just above the umbilicis

A

anterior: external obliuqe and anterior aponorosisis of the interinal oblique
Posterior transveruss abdominius and the posterior layer of the internal oblique

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26
Q

What is the arcuate line

A

the shift in the arrangement of the rectus sheath below the midleine between the ubilicis and the pubic symphasis

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27
Q

What forms the sheath of the rectus abdominis below the arcuate line

A

Internal obliuqe does not split
Anterior has internal oblique external oblique and trasnversus abdominus

posterior has transversalis fascia and peritoneum

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28
Q

what is the pyramidalis

A

An insignificant small triangular muscle which frequently lies on the anterior inferior surface of the rectus muscle

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29
Q

What interupts the contnuity of the muscle fibers of the rectus abdominus

A

three to for tendinous intersections attaching it to the anterior wall of the sheath

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30
Q

what nerves supplies the skin and muscle of the abdominal wall

A

continuations of the lower intercostal nerves (7-11) and subcostal nerves t 12.

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31
Q

Where do the nerves which supply the skin and muscle of the abdominal wall run

A

between teh internal oblique and the transversus abdominis (through most of their course)

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32
Q

What supplies the inferior part of the abdominal wall

A

Iliohypogastric (L1)
Iliolinuinal (L1)
branches of lumbar plexus

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33
Q

What dermatome supplies the umbilicus

A

T 10

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34
Q

What dermatome supplies the xiphoid process

A

T 6

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35
Q

What dermutome supplies the pubic symphysis

A

L1

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36
Q

what are the 3 main arteries of the abdominal wall and the other 3 accesory arteries

A

Inferior epigastric
deep circumflex iliac
(branches of external iliac)
superior epigastric (a terminal branch of internal thoracic)

Intercostal arteries,
Lumbar arteries,
superfical branches of femoral (superficial epigastric, superficial circumflexiliac, superficial external pudendal)

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37
Q

What artery runs superiorly toward umilicus into the recuts sheath at the arcuate line and what does it anastomose with

A

Inferior epigastric and anastomoses with branches of superior epigastric and intercostal arteries

38
Q

What is the inferior free border of the external oblique aponeurosis

A

inguinal ligament

39
Q

Where does the inguinal ligament extend

A

from anterior superior iliac spin to pubic tubercle

40
Q

What attaches to the inguinal ligament laterally and medially

A

laterally: internal oblique and transversus abdominus
medially: it flattens and attaches to pictineal ine of puis to form lacunar ligament

41
Q

What is the superficial inguinal ring and where is it located

A

triangluar cleft in the exernal oblique aponeruosis superior to the pubic tubercle

42
Q

IS the superficial inguinal ring larger in males or females

A

Its sizable in the male but small in females

43
Q

What are the strong bands of fibers which border the superficial inguinal ring

A

medial and lateral crura

44
Q

What reinforces the medial and lateral crura of the superficial inguinal ring

A

intercrural fibers along superolateral limit of ring

45
Q

What exits from the Superficial inguinal ring

A

The inguinal canal
transmitting spermatic cord in males
and round ligament of uterus in females

46
Q

Where is the inguinal canal

A

Superior and parallel to inguinal ligament about 2 inches long

47
Q

What is the entrance and exit to the inguinal canal

A

Entrance: deep inguinal ring: above midpoint of inguinal ligament lateral to inferior epigastric vessels

Exit: Superficial inguinal ring: triangular cleft in external oblique aponeruosis superior to pubic tubercle

48
Q

What is the deep inguinal ring and where is it

A

finger like diverticulum of transeralis fascia forming entrance to inguinal canal

above midpoint of inguinal ligament lateral to inferior epigastric vessels

49
Q

What composes the floor of the inguinal canal

A

Inguinal and lacunar ligaments

50
Q

What composes the roof of the inguinal canal

A

arching fibers of internal oblique and transversus abdominis

51
Q

What composes the anterior wall of the inguinal canal

A

aponeruosis of external oblique

52
Q

What composes the posterior wall of the inguinal canal

A

Transversalis fascia and conjoint tendon

53
Q

What is the potential weak area of the abdominal wall and why

A

inguinal triangle, because most of the posterior wallis formed only from transversalis fascia

54
Q

What are the borders of the inguinal triangle

A

Inguinal ligament
Lateral border of rectus abdominis
inferior epigastric vessels

55
Q

What indicates the site of the future inguinal canal

A

gubernaculum ligament

56
Q

What does the gubernaculum ligament do and connect

A

connects and guides developing testis from lumbar region to schrotum

57
Q

What preceeds the testis as it descends

A

evagination of peritoneum calles the processus vaginalis

58
Q

What does the processus vaginalis do

A

preceeds the testis in their descent and carries extensions of abdominal wall layers before it

59
Q

What becomes the coverings of the spermatic cord

A

Extensions of the abdominal wall carried by processus vaginalis

60
Q

What layer of the abdominal wall corresponds to the skin in the scrotum

A

Skin of abdominal wall

61
Q

What layer of the abdominal wall corresponds to the perinial fascia

A

Superficial fascia of abdominal wall

62
Q

What layer of the abdominal wall corresponds to the dartos muscle

A

Superficial fascia of abdominal wall

63
Q

What layer of the abdominal wall does not correspond to a scrotum layer

A

Transversus abdominis

64
Q

What layer of the abdominal wall corresponds to the external spermatic fascia

A

External oblique

65
Q

What layer of the abdominal wall corresponds to the cremaster muscle and fascia

A

Internal oblique

66
Q

What layer of the abdominal wall corresponds to the internal spermatic fascia

A

transversalis fascia

67
Q

What layer of the abdominal wall corresponds to the areolar tissue in the cord

A

extraperitoneal fat

68
Q

What layer of the abdominal wall corresponds to the tunica vaginalis

A

peritoneum

69
Q

What does the cremaster muscle do and what type of action is it

A

draws testis to more superior position in scrotum

reflex action

70
Q

What nerve mediates the reflex action of the cremaster

A

genitofemoral (L1,L2) branch of lumbar plexus

71
Q

Give the covering order of internal spermatic fascia, cremaster muscle/fascia, and external spermatic fascia, around the spermatic cord and when they arise

A

Innermost to outer
Inernal spermatic fascia: invests throughout inguinal canal

Cremaster/fascia: invests in middle of canal

External spermatic fascia: covers as exits superficial ring

72
Q

What are the 7 components of the spermatic cord (ignoring coverings

A

Ductus deferens

Diferential artery and vein

Testicualr artery

pampiniform plexus of vains

lymphatics

Autonomic nerves

(Tiny) genital branch of genitofemoral nerve

GT PADDL

73
Q

What nerve accompanies the cord in the inguinal canal

A

Illioinguinal nerve

74
Q

Which nerves provide anterior scrotal or labial cutaneous nerves

A

Genitofemoral and ilioinguinal

75
Q

What is the gubernacula in females

A

round ligaments of uterus

76
Q

what in females is homologous to the scrotum

A

labia majora

77
Q

Where do the round ligaments travel and end in females

A

travel same path through inguinal canals but terminate in labia majora

78
Q

What can occur with rupture of the male urethra

A

accumulation of urine between layers in abdominal wall (due to continuity of superficial membranous facia with superficial fascia of perinium)

79
Q

How would you test the integrity of the genitofemoral and ilioinguinal nerves

A

test cremaster reflex

80
Q

In whom is the cremaster reflex more active

A

more active in young boys and deminishes with age

81
Q

What is a hydrocele

A

acumulation of fluid in tunica vaginalis or a patent processus vaginalis

82
Q

What is varicocele

A

condition when pampiniform plexus of veins becomes dilated and tortuous

83
Q

What is ligated in a vasectomy

A

ductus deferens bilaterally

Exposed via incision in superior wall of scrotum

84
Q

what constitutes an inguinal hernia

A

protrusion of abdominal viscera thorugh either inguinal ring

85
Q

What is an indirect inguinal hernia

A

follows route of testis before birth

traverses the deep ring (lateral to inferior epigastric), the inguinal canal and the superficial ring

86
Q

What often causes an indirect inguinal hernia

A

patent processus vaginalis

87
Q

In whom is indirect inguinal hernia more common

A

younger male patients

88
Q

What is a direct inguinal hernia

A

abdominal viscera prodruding through the abdominal wall in the inguinal triangle (medial to inferior epigastric vesssels) and passes through superficial ring

89
Q

in whom is a direct inguinal hernia most common

A

adult males

90
Q

Are hernias more frequent in males or females and why

A

males,
inguinal region in females has fewer and smaller structures which pass through the abdominal wall so its more firmly constructed

Anatomy Block 3 (16 decks)

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