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Gross III Exam 2 > Anterolateral Abdominal Wall > Flashcards

Anterolateral Abdominal Wall Flashcards

0
Q

What makes up the superficial fatty layer

A

campers fascia
superficial fascia just deep to the dermis
–may be several inches thick

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1
Q

What are the two parts of the superficial fascia

A

superficial fatty layer

deep membranous layer

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2
Q

What makes up the deep membranous layer of the anterolateral abdominal wall

A
  • scarpas fascia
  • thin layer of dense irregular connective tissue overlying deep fascia
  • allows for independent movement of superficial and/or deep fasci
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3
Q

What is the deep membranous layer continuous with

A

dartos and colles fascia of scrotum and perineum

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4
Q

What is deep investing fascia

A

dense irregular connective tissue surrounding abdominal muscles and their aponeurosis

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5
Q

What is another name for the endoabdominal fascia

A

Tranversalis fascia on the anterolateral abdominal wall

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6
Q

What is the endoabdominal fascia

A

Loose connective tissue between muscles/aponeuroses and parietal peritoneum

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7
Q

What does the endoabdominal fascia provide

A

potential plane for surgical dissection for extraperitoneal and/or intraperitoneal organs

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8
Q

What is liposuction

A

suction or ultrasound assisted suction to remove unwanted fat from superficial fatty layers

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9
Q

What are the clinical issues regarding fascial layers

A
  • Deep membranous layer is always included when suturing incisions
  • Potential space exists between scarpas and the deep fascia
  • -urine from a ruptured urethra may accumulate here
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10
Q

What direction are the muscles fibers oriented in the external oblique

A

inferolaterally (hands in pocket)

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11
Q

What is the origin for the external oblique

A

Ribs 5-12

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12
Q

What is the insertion of the external oblique

A

Linea alba, pubic tubercle, and anterior 1/2 of iliac crest

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13
Q

What is the action of the external oblique

A

compress abdominal viscera, flex, and rotate trunk

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14
Q

What is the innervation of the external oblique

A

T6-T11 thoracoabdominal nn

subcostal n

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15
Q

Where does the aponeurosis of the external oblique begin

A

approximately midclavicular line–linea semilunaris

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16
Q

Where does the external oblique aponeurosis decussate

A

Midline–at linea alba

–Fibers intertwine with contralateral abdominal wall mm

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17
Q

What does the inferior margin of the external oblique aponeurosis do

A

Thicken and rolls underneath to form the inguinal ligament

  • extends from the ASIS to pubic tubercle
  • anterosuperior attachment point for fascia lata
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18
Q

How are the fibers oriented in the internal oblique

A

Anteromedially from ASIS

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19
Q

What is the origin of the internal oblique

A

Thoracolumbar fascia, anterior 2/3 of iliac crest and inguinal ligament

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20
Q

What is the insertion of the internal oblique m

A

Ribs 10-12, linea alba and pectin pubis

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21
Q

What is the action of the internal oblique m

A

compress abdominal viscera, flex, and rotate trunk

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22
Q

What is the innervation of the internal oblique muscle

A

T6-11 thoracoabdominal nn
subcostal nn
iliohypogastric nn
ilioliguinal nn

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23
Q

Where does the aponeurosis for the internal oblique m begin

A

approximately at midclavicular line (linea semilunaris)

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24
How is the conjoint tendon formed
inferomedial fibers of internal oblique m aponeurosis join with aponeurotic fibers of transversus abdominis m
25
What does the conjoint tendon form
medial part of posterior wall of inguinal canal
26
Which direction do the fibers run for the transversus abdominis
transversomedially
27
What is the origin of the transversus abdominis
Thoracolumbar fascia, ribs 7-12, iliac crest and inguinal ligament
28
Where does the transversus abdominis insert
linea alba, pubic crest, and pectin pubis (via conjoint tendon)
29
What is the action of the transversus abdominis
compress and support abdominal viscera
30
What is the innervation of the transversus abdominis
T6-11 thoracoabdominal nn subcostal nn iliohypogastric nn ilioinguinal nn
31
Where does the Transversus abdominis aponeurosis begin
approximately at midclavicular line (linea semilunaris)
32
What does the transversus abdominis aponeurosis contribute to
rectus sheath | --posterior above arcuate line, anterior below
33
What are the physical characteristics of the rectus abdominis mm
superior: wider and thinner inferior: narrower and thicker
34
How is the rectus abdominis attached to the rectus sheath
3 tendinous intersections | --create six pack, but one or more may be missing
35
Where is the linea alba located
midline between 2 rectus abdominis mm
36
Where is the linea semilunaris located
lateral margin of each rectus abdominis m
37
What is the origin of the rectus abdominis
pubic symphysis and pubic crest
38
What is the insertion of the rectus abdominis
xiphoid process and costal cartilages 5-7
39
What is the action of the rectus abdominis m
flexes the trunk and compresses abdominal viscera
40
What is the innervation of the rectus abdominis
T6-T11 thoracoabdominal nn | subcostal nn
41
What is the pyramidalis m
Small triangular muscle overlapping inferior portion of rectus abdominis m - spans between pubis and linea alba - functions to tense linea alba
42
What are the combined function of the anterior abdominal wall muscles
-move trunk and maintain posture -protect abdominal viscera -compress abdominal viscera assists in: >elevating thoracic diaphragm during forced expiration, coughing >defecation (Jim: That means taking a dump) >Micturition >Partuition
43
What is the rectus sheath
fibrous envelope surrounding rectus abdominis m
44
What forms the rectus sheath
decussation/interweaving of aponeuroses of lateral abdominal wall mm
45
What is the linea alba
midpoint of the decussation of the rectus sheath
46
What is the umbilical ring
defect in libea alba through which fetal umbilical aa an v passed --all lateral abdominal wall aponeuroses fuse at umbilicus
47
What is the linea semilunaris
transition to aponeurosis for each of the lateral abdominal wall mm
48
What is the arcuate line
located on posterior rectus sheath about 1/4 up from pubic crest -landmark for structural change in posterior rectus sheath
49
What is the decussation
aponeurotic fibers intertwine across the midline | --intertwining occurs both within and between aponeurotic strata
50
What is the anterior rectus sheath superior to the arcuate line composed of
aponeurosis of external oblique m | anterior lamina of aponeurosis of internal oblique m
51
What is the posterior rectus sheath superior to arcuate line composed of
``` posterior lamina of aponeurosis of internal oblique m aponeurosis of transversus abdominis m Transversalis fascia extra peritoneal fat parietal peritoneum ```
52
What is the anterior rectus sheath inferior to the arcuate line composed of
aponeurosis of external oblique m aponeurosis of internal oblique m aponeurosis of transversus abdominis
53
What is the internal surface of anterior abdominal wall inferior to arcuate line is composed of
Transversalis fascia extraperitoneal fat parietal peritoneum
54
What is a congenital umbilical hernia
usually small and due to incomplete aponeurotic fusion around umbilical ring
55
What is an acquired umbilical hernia
- most common in women and obese people - may occur as weakness in the anterior abdominal wall arises - -possible causes include aging, obesity, surgery, and trauma
56
What is a epigastric hernia
- occur midline between xiphoid process and umbilicus - usually in obese people over the age of 40 - consists of peritoneal sac covered only by skin and fatty tissue
57
What are and where are the thoracoabdominal nn found
- Anterior abdominal branches of VPR of T6-T11 - In plane between internal oblique and transversus abdominis - --become more superficial while passing anteromedially
58
What does the thoracoabdominal nn innervate
Abdominal wall mm and skin in corresponding dermatomes
59
Where does the thoracoabdominal nn branch from and where does it terminate
branch to form lateral cutaneous nn | terminate as anterior cutaneous nn
60
What is the subcostal n
anterior continuation of VPR of T12
61
What does the subcostal n innervate
lateral abdominal wall mm
62
What dermatome is the subcostal n associated with
sensory for T12 dermatome via lateral or anterior cutaneous nn
63
What is the iliohypogastric n
superior terminal branch of VPR of L1 | --anterior cutaneous component pierces external abdominal oblique m
64
What does the iliohypogastric n innervate
internal oblique and transversus abdominis | hypogastric skin and skin over iliac crest superior to inguinal canal
65
What is the ilioinguinal n
inferior terminal branch of VPR of L1 - -passes through inguinal canal with round l/spermatic cord - -exits via superficial inguinal ring
66
What does the ilioinguinal n innervate
internal oblique and transversus abdominis | skin of anterior scrotum/labia majora, mons pubis, and medial thigh
67
What are the posterior intercostal, subcostal, and lumbar aa
segmental branches from thoracic and/or lumbar descending aorta
68
What are the posterior intercostal, subcostal, and lumbar aa supplying
lateral hypochondriac, right/left lateral (flank), and lumbar regions
69
What is the musculophrenic a
one of two terminal branches of internal thoracic a in 6th intercostal space --descends hypochondriac region and anterolateral thoracic diaphragm
70
What does the musculophrenic a supply
hypochondriac region and anterolateral thoracic diaphragm
71
What is the superior epigastric a
one of two terminal branches of internal thoracic a in 6h intercostal space --descends between posterior rectus sheath and rectus abdominis m
72
What does the superior epigastric a supply
rectus abdominis m, and upper umbilical region | --anastomoses with inferior epigastric a deep to rectus abdominis
73
What is the inferior epigastric a
branches from external iliac a just superior to inguinal l | --ascends in transversalis fascia and enters rectus sheath inferior to arcuate line
74
What does the inferior epigastric a supply
rectus abdominis m and lower abdominal region | --anastomoses with superior epigastric a deep to rectus abdominis
75
What is the deep circumflex iliac a
branches from the external iliac a just superior to inguinal l. --parallels inguinal l. to pass towards ASIS
76
What does the deep circumflex iliac a supply
deep inguinal region | --anastomoses with iliolumbar a
77
What is the superficial circumflex iliac a
branches from femoral a just inferior to inguinal l. | --parallels inguinal l. to pass towards ASIS
78
What does the superior circumflex iliac a
supplies skin inguinal region
79
What is the superficial epigastric a
branches from femoral a just inferior to inguinal l. | --ascends in superficial fascia towards umbilicus
80
What does the superfical epigastric a supply
supply skin in pubic and lower umbilical regions
81
What is the venous drainage superior to umbilicus
lateral thoracic v to axillary v to subclavian v | internal thoracic v to subclavian v
82
What is the venous drainage inferior to umbilicus
inferior epigastric v to external iliac v | superficial epigastric v to femoral v to external iliac v
83
What are the paraumbilical vv
small superficial tributaries of hepatic portal v
84
What is the thoracoepigastric v
sometimes develop between lateral thoracic v and superficial epigastric v --presence may indicate underlying problems with venous return
85
Where do the superficial lymphatics drain
primarily: axillary nodes sometimes: small percentage drain to parasternal nodes
86
Where do the superficial lymphatics drain below the transumbilical plane
superficial inguinal nodes
87
Where do the deep lymphatics of anterlateral abdominal wall drain to
nodes along external iliac a

Gross III Exam 2 (11 decks)

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