Anterolateral Abdominal Wall

Question 1

what are the 4 quadrants of the abdomen

Answer 1

right upper
left upper
right lower
left lower

Question 2

what are the 2 planes that divide the abdomen

Answer 2

median plane

trans-umbilical plane

Question 3

what level is the transumbilical plane

Answer 3

IV disc between L3 and L4

Question 4

the abdominal wall can also be divided into __ regions

Answer 4

9

Question 5

what lines divide the abdomen into regions

Answer 5

mid-clavicular
subcostal
trans-tubercular

Question 6

what are the 9 regions of the abdomen

Answer 6

• right and left hypochondria
• epigastric
• right and left lumbar
• umbilical
• right and left inguinal
• suprapubic

Question 7

name the layers of the abdomen from external to internal

Answer 7

• skin
• superficial fascia
• muscles of the anterolateral body wall and their assoc. fascial structures
• extraperitoneal fascia
• parietal peritoneum

Question 8

where is the extraperitoneal fascia most evident and why

Answer 8

posterior wall

contains retroperitoneal structures e.g. kidneys

Question 9

what is the superficial fascia

Answer 9

fatty layer that contains small cutaneous nerves and vessels

Question 10

the deepest layer of abdominal wall is the

Answer 10

parietal peritoneum

Question 11

describe the difference in the superficial fascia above and below the umbilicus

Answer 11

above umbilicus superficial fascia is similar to that found elsewhere in the body
below the umbilicus superficial fascia divides into 2 layers

Question 12

what 2 layers does the superficial fascia below the umbilicus divide into

Answer 12

Superficial (fatty) = Camper’s fascia

Deep (membranous) = Scarpa’s fascia

Question 13

Camper’s fascia is a continuation of the fatty layer of superficial fascia across the abdominal wall and passes from the abdominal wall to blend with…

Answer 13

the superficial fascia of the thigh and perineum

continuous over inguinal ligament

Question 14

how does camper’s fascia behave in the male pelvis

Answer 14

continues onto fascia of penis - loses fatty layer and fuses with deeper layer of superficial fascia to become dartos fascia of the scrotum

Question 15

how does camper’s fascia behave in the female pelvis

Answer 15

retains fatty layer and contributes to fascia of the labia majora

Question 16

compare Camper’s and scarpa’s fascia

Answer 16

Camper’s - fatty layer of varying thickness

Scarpa’s - thin, membranous with little fat

Question 17

scarpa’s fascia is ____ to campers fascia

Answer 17

inferior/deep

Question 18

where does Scarpa’s fasica attach in the midline

Answer 18

pubic symphysis and linea alba

Question 19

below the inguinal ligament, Scarpa’s fasica fuses with… to form…

Answer 19

fascia of thigh to form fascia lata

Question 20

how does Scarpa’s fasica become colles fascia

Answer 20

attaches to posterior part of perineal membrane (superficial perineal membrane - colles)

Question 21

Scarpa’s fasica contributes what to males

Answer 21

fascia of penis
dartos fascia of scrotum
fundiform ligament of penis

Question 22

Scarpa’s fasica contributes what to females

Answer 22

labia majora

Question 23

what is the advantage of the muscle layers of the abdominal wall having fibres that run in different directions

Answer 23

forces run in different directions across the different layers which helps to spread stresses out across the wall during movement and allows the wall to be strong and flexible

Question 24

why can you get a sore abdominal wall when you have a cold

Answer 24

abdominal wall supports the viscera when abdominal pressure increases - when you breathe the diaphragm descends pushing the abdominal viscera down - particularly noticable when you cough or sneeze and the abdominal wall contracts in response to sudden strong respiratory movements

Question 25

as abdominal pressure increases what groups of muscles contract

Answer 25

abdominal wall muscles | pelvic diaphragm

Question 26

as you dissect the abdominal wall what is the first muscle you will uncover

Answer 26

external oblique

Question 27

muscle fibres of the external oblique go from where to where

Answer 27

fibres run infero-medial from ribs 5-12 to iliac crest and linea alba

Question 28

what is the linea alba

Answer 28

formed from the aponeurosis of the left and right external oblique

Question 29

what is the function of external obliques

Answer 29

flex trunk using both | turn to same side using one

Question 30

why is rectus abdominus hidden from view

Answer 30

aponeurosis forms the anterior wall of the rectus sheath which hides rectus abdominus from view

Question 31

as it reaches the pelvic bones, the aponeurosis forms what

Answer 31

fold over as it reaches the pelvic bones to form the anterior wall and floor of the inguinal canal - as it forms the floor of the inguinal canal it thickens and is described as the inguinal ligament

Question 32

where does the inguinal ligament pass

Answer 32

between the ASIS and the pubic tubercle (one on each side)

Question 33

where does the linea alba run

Answer 33

from xiphoid to pubic symphysis

Question 34

the lower border of the linea alba forms what

Answer 34

inguinal ligament

Question 35

nerve supply of external oblique

Answer 35

Anterior Rami T7-T12

Question 36

the anterior rami that supply the external obliques are from

Answer 36

intercostal nerves of the thorax

Question 37

nerve supply of external oblique is often referred to as

Answer 37

supply from the lower 6 intercostal nerves

Question 38

T12 is also referred to as

Answer 38

subcostal nerve

Question 39

compare internal and external oblique

Answer 39

internal - deep, smaller and thinner

Question 40

internal oblique muscle fibres go from where to where

Answer 40

fibres run supero-medial from thoracolumbar fascia, inguinal ligament and iliac crest to ribs 10-12

Question 41

where does the aponeurosis of internal oblique meet

Answer 41

meets in the midline at the linea alba

Question 42

aponeurosis of internal oblique contributes to ...

Answer 42

rectus sheath

Question 43

nerve supply of internal oblique

Answer 43

anterior rami T7-T12 and L1

Question 44

where is transversus abdominis found

Answer 44

deep to internal oblique

Question 45

where do fibres of transversus abdominis run

Answer 45

transverse across abdominal wall

Question 46

what is the function of transversus abdominis

Answer 46

support body wall

Question 47

innervation of transversus abdominis

Answer 47

anterior rami of T7 to L1

Question 48

where does transversus abdominis go between

Answer 48

``` thoracolumbar fascia iliac crest inguinal ligament costal cartilages of ribs 7-12 linea alba pubic crest pectineal line ```

Question 49

does transversus abdominis form an aponeurosis

Answer 49

yes and contributes to posterior wall of rectus sheath

Question 50

what is the direction of fibres of the rectus abdominis

Answer 50

superior from pubic tubercle, crest and symphysis to xiphoid process and costal cartilages of ribs 5-7

Question 51

what is the function of rectus abdominis

Answer 51

flexes trunk - sit ups | support/compression of abdominal wall

Question 52

does rectus abdominis form an aponeurosis

Answer 52

no - contained within the rectus sheath

Question 53

innervation of rectus abdominis

Answer 53

anterior rami of T7 - T12

Question 54

what is the pyramidalis

Answer 54

small triangular muscle that may be found attaching to the linea alba - many individuals do not have it

Question 55

what does the pyramidalis do

Answer 55

tense the linea alba

Question 56

the pyramidalis is found ____ to the rectus abdominis

Answer 56

anterior

Question 57

the pyramidalis runs from

Answer 57

pubis to linea alba

Question 58

what is the nerve supply of the pyramidalis

Answer 58

anterior ramus T12

Question 59

at the level of attachment of the rectus abdominis to the rib cage, where does the rectus abdominis lie (above the costal margin)

Answer 59

directly on the surface of the costal cartilages

Question 60

the aponeurosis of what muscle forms the anterior wall of the rectus sheath

Answer 60

external oblique

Question 61

above the umbilicus, the anterior wall of the sheath is composed of what

Answer 61

aponeuroses of external and internal oblique

Question 62

above the umbilicus, the posterior wall of the rectus sheath is composed of what

Answer 62

aponeuroses of internal oblique and transversus abdominis

Question 63

how does internal oblique contribute to both walls of the rectus sheath above the umbilicus

Answer 63

its aponeurosis forms 2 layers which pass around rectus abdominis

Question 64

Below the umbilicus (half way between the umbilicus and pubic bones) where do the aponeuroses of the abdominal wall muscles lie

Answer 64

all anterior to rectus abdominis

Question 65

Below the umbilicus (half way between the umbilicus and pubic bones), what forms the posterior wall of the rectus sheath

Answer 65

transversalis fascia

Question 66

what is the arcuate line

Answer 66

transition point from a strong aponeurosis to the delicate transversalis fascia

Question 67

Below the umbilicus (half way between the umbilicus and pubic bones) what does the rectus abdominis lie on

Answer 67

directly on transversalis fasica

Question 68

structures in the extraperitoneal fascia are described as

Answer 68

retroperitoneal structures as they lie posterior to the peritoneum

Question 69

what is the thin membranous layer that lines the inner walls of the abdominal cavity

Answer 69

parietal peritoneum

Question 70

what is the thin membranous layer that covers the organs

Answer 70

visceral peritoneum

Question 71

what is the function of the peritoneum

Answer 71

smooth lining for movement of the abdominal organs against the abdominal wall

Question 72

how does the extraperitoneal fascia protect the kidneys

Answer 72

thicker on posterior wall and forms a large renal fat pad

Question 73

what is found deep to transversalis fascia

Answer 73

layer of extraperitoneal fascia

Question 74

what is the final wall layer

Answer 74

parietal peritoneum

Question 75

what is found on the posterior surface of the anterior abdominal wall

Answer 75

3 folds

Question 76

what are the 3 folds on the posterior surface of the anterior abdominal wall

Answer 76

median umbilical ligament medial umbilical ligament lateral umbilical fold

Question 77

the median umbilical ligament is a remnant of what embryological structure

Answer 77

urachus remnant

Question 78

the medial umbilical ligament is a remnant of what embryological structure

Answer 78

umbilical artery

Question 79

how many median umbilical ligaments are there

Answer 79

1

Question 80

how many medial umbilical ligaments are there

Answer 80

2 - one each side

Question 81

how many lateral folds are there

Answer 81

2 - one each side

Question 82

what is contained in the lateral folds

Answer 82

inferior epigastric artery and vein

Question 83

where do the inferior epigastric artery and vein lie

Answer 83

directly inferior to rectus abdominis

Question 84

the inferior epigastric artery and vein supply blood to/drain what

Answer 84

the anterior abdominal wall

Question 85

where do the superficial nerves and vessels of the anterior abdominal wall run

Answer 85

in the superficial fascia

Question 86

what do the superficial nerves and vessels of the anterior abdominal wall supply

Answer 86

the superficial fascia and skin

Question 87

the superficial veins drain towards where

Answer 87

axilla or femoral vein

Question 88

the superficial arteries arise from the

Answer 88

``` femoral artery (superficial circumflex iliac and superficial epigastric) internal thoracic (musculophrenic and superior epigastric) ```

Question 89

the superficial nerves are branches of

Answer 89

anterior and lateral branches of the intercostal nerves

Question 90

what nerves supply the anterior abdominal wall

Answer 90

lateral cutaneous branches of 6-12 intercostal nerves and iliohypogastric nerve (L1) anterior cutaneous branches of 6-12 intercostal nerves

Question 91

what nerve supplies the wall in the inguinal region

Answer 91

iliohypogastric (L1)

Question 92

what are the superficial arteries of the anterior abdominal wall

Answer 92

musculophrenic branch of internal thoracic; superficial epigastric and superficial circumflex iliac branches of femoral artery

Question 93

name 2 superficial veins of the anterior abdominal wall

Answer 93

superficial epigastric veins | thoracoepigastric veins

Question 94

the deeper vessels supply what

Answer 94

muscles of the abdominal walls

Question 95

what supplies the upper part of the rectus abdominis

Answer 95

the superior epigastric artery

Question 96

the superior epigastric artery is a terminal branch of what artery

Answer 96

internal thoracic artery

Question 97

what artery supplies the rest of the rectus abdominis (not the upper part)

Answer 97

inferior epigastric artery

Question 98

the inferior epigastric artery is a branch of what vessel

Answer 98

external iliac artery

Question 99

from what nerve roots do the ilioinguinal and iliohypogastric nerves come from

Answer 99

L1

Question 100

the ilioinguinal and iliohypogastric nerves supply sensory innervation to where

Answer 100

pubic region and medial thigh

Question 101

the ilioinguinal and iliohypogastric nerves supply motor innervation to where

Answer 101

internal oblique and transversus abdominis

Question 102

superficial lymphatic drainage above the umbilicus goes where

Answer 102

nodes in axilla

Question 103

superficial lymphatic drainage below the umbilicus goes where

Answer 103

superficial inguinal nodes

Question 104

deep lymphatic drainage of the upper region goes where

Answer 104

parasternal nodes

Question 105

deep lymphatic drainage of the middle areas is to where

Answer 105

lumbar nodes

Question 106

deep lymphatic drainage of the lower areas is to where

Answer 106

external iliac nodes

Question 107

deep lymph nodes lie near...

Answer 107

arteries

Question 108

parasternal nodes lie near what artery

Answer 108

internal thoracic artery

Question 109

lumbar nodes lie either side of what artery

Answer 109

abdominal aorta

Question 110

external iliac nodes surround what artery

Answer 110

external iliac artery

Question 111

dermatome of umbilicus

Answer 111

T10

Question 112

what are the main nerves supplying the anterolateral abdominal wall

Answer 112

intercostal nerves, with some supply from L1

Question 113

what supplies the skin, muscle and parietal peritoneum of the anterolateral abdominal wall

Answer 113

anterior rami from T7-T11 (intercostal), T12 (subcostal) and L1 (iliohypogastric and ilioinguinal)

Question 114

what branches supply the skin

Answer 114

lateral and anterior cutaneous branches

Question 115

where do the intercostal nerves lie

Answer 115

between internal oblique and transversus abdominis, enter rectus sheath