Anterolateral Abdominal Wall Flashcards

1
Q

what are the 4 quadrants of the abdomen

A

right upper
left upper
right lower
left lower

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2
Q

what are the 2 planes that divide the abdomen

A

median plane

trans-umbilical plane

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3
Q

what level is the transumbilical plane

A

IV disc between L3 and L4

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4
Q

the abdominal wall can also be divided into __ regions

A

9

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5
Q

what lines divide the abdomen into regions

A

mid-clavicular
subcostal
trans-tubercular

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6
Q

what are the 9 regions of the abdomen

A
  • right and left hypochondria
  • epigastric
  • right and left lumbar
  • umbilical
  • right and left inguinal
  • suprapubic
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7
Q

name the layers of the abdomen from external to internal

A
  • skin
  • superficial fascia
  • muscles of the anterolateral body wall and their assoc. fascial structures
  • extraperitoneal fascia
  • parietal peritoneum
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8
Q

where is the extraperitoneal fascia most evident and why

A

posterior wall

contains retroperitoneal structures e.g. kidneys

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9
Q

what is the superficial fascia

A

fatty layer that contains small cutaneous nerves and vessels

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10
Q

the deepest layer of abdominal wall is the

A

parietal peritoneum

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11
Q

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

A

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

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12
Q

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

A

Superficial (fatty) = Camper’s fascia

Deep (membranous) = Scarpa’s fascia

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13
Q

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…

A

the superficial fascia of the thigh and perineum

continuous over inguinal ligament

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14
Q

how does camper’s fascia behave in the male pelvis

A

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

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15
Q

how does camper’s fascia behave in the female pelvis

A

retains fatty layer and contributes to fascia of the labia majora

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16
Q

compare Camper’s and scarpa’s fascia

A

Camper’s - fatty layer of varying thickness

Scarpa’s - thin, membranous with little fat

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17
Q

scarpa’s fascia is ____ to campers fascia

A

inferior/deep

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18
Q

where does Scarpa’s fasica attach in the midline

A

pubic symphysis and linea alba

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19
Q

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

A

fascia of thigh to form fascia lata

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20
Q

how does Scarpa’s fasica become colles fascia

A

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

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21
Q

Scarpa’s fasica contributes what to males

A

fascia of penis
dartos fascia of scrotum
fundiform ligament of penis

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22
Q

Scarpa’s fasica contributes what to females

A

labia majora

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23
Q

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

A

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

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24
Q

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

A

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

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25
Q

as abdominal pressure increases what groups of muscles contract

A

abdominal wall muscles

pelvic diaphragm

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26
Q

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

A

external oblique

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27
Q

muscle fibres of the external oblique go from where to where

A

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

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28
Q

what is the linea alba

A

formed from the aponeurosis of the left and right external oblique

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29
Q

what is the function of external obliques

A

flex trunk using both

turn to same side using one

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30
Q

why is rectus abdominus hidden from view

A

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

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31
Q

as it reaches the pelvic bones, the aponeurosis forms what

A

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

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32
Q

where does the inguinal ligament pass

A

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

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33
Q

where does the linea alba run

A

from xiphoid to pubic symphysis

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34
Q

the lower border of the linea alba forms what

A

inguinal ligament

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35
Q

nerve supply of external oblique

A

Anterior Rami T7-T12

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36
Q

the anterior rami that supply the external obliques are from

A

intercostal nerves of the thorax

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37
Q

nerve supply of external oblique is often referred to as

A

supply from the lower 6 intercostal nerves

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38
Q

T12 is also referred to as

A

subcostal nerve

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39
Q

compare internal and external oblique

A

internal - deep, smaller and thinner

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40
Q

internal oblique muscle fibres go from where to where

A

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

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41
Q

where does the aponeurosis of internal oblique meet

A

meets in the midline at the linea alba

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42
Q

aponeurosis of internal oblique contributes to …

A

rectus sheath

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43
Q

nerve supply of internal oblique

A

anterior rami T7-T12 and L1

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44
Q

where is transversus abdominis found

A

deep to internal oblique

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45
Q

where do fibres of transversus abdominis run

A

transverse across abdominal wall

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46
Q

what is the function of transversus abdominis

A

support body wall

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47
Q

innervation of transversus abdominis

A

anterior rami of T7 to L1

48
Q

where does transversus abdominis go between

A
thoracolumbar fascia
iliac crest
inguinal ligament
costal cartilages of ribs 7-12
linea alba
pubic crest
pectineal line
49
Q

does transversus abdominis form an aponeurosis

A

yes and contributes to posterior wall of rectus sheath

50
Q

what is the direction of fibres of the rectus abdominis

A

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

51
Q

what is the function of rectus abdominis

A

flexes trunk - sit ups

support/compression of abdominal wall

52
Q

does rectus abdominis form an aponeurosis

A

no - contained within the rectus sheath

53
Q

innervation of rectus abdominis

A

anterior rami of T7 - T12

54
Q

what is the pyramidalis

A

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

55
Q

what does the pyramidalis do

A

tense the linea alba

56
Q

the pyramidalis is found ____ to the rectus abdominis

A

anterior

57
Q

the pyramidalis runs from

A

pubis to linea alba

58
Q

what is the nerve supply of the pyramidalis

A

anterior ramus T12

59
Q

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

A

directly on the surface of the costal cartilages

60
Q

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

A

external oblique

61
Q

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

A

aponeuroses of external and internal oblique

62
Q

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

A

aponeuroses of internal oblique and transversus abdominis

63
Q

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

A

its aponeurosis forms 2 layers which pass around rectus abdominis

64
Q

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

A

all anterior to rectus abdominis

65
Q

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

A

transversalis fascia

66
Q

what is the arcuate line

A

transition point from a strong aponeurosis to the delicate transversalis fascia

67
Q

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

A

directly on transversalis fasica

68
Q

structures in the extraperitoneal fascia are described as

A

retroperitoneal structures as they lie posterior to the peritoneum

69
Q

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

A

parietal peritoneum

70
Q

what is the thin membranous layer that covers the organs

A

visceral peritoneum

71
Q

what is the function of the peritoneum

A

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

72
Q

how does the extraperitoneal fascia protect the kidneys

A

thicker on posterior wall and forms a large renal fat pad

73
Q

what is found deep to transversalis fascia

A

layer of extraperitoneal fascia

74
Q

what is the final wall layer

A

parietal peritoneum

75
Q

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

A

3 folds

76
Q

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

A

median umbilical ligament
medial umbilical ligament
lateral umbilical fold

77
Q

the median umbilical ligament is a remnant of what embryological structure

A

urachus remnant

78
Q

the medial umbilical ligament is a remnant of what embryological structure

A

umbilical artery

79
Q

how many median umbilical ligaments are there

A

1

80
Q

how many medial umbilical ligaments are there

A

2 - one each side

81
Q

how many lateral folds are there

A

2 - one each side

82
Q

what is contained in the lateral folds

A

inferior epigastric artery and vein

83
Q

where do the inferior epigastric artery and vein lie

A

directly inferior to rectus abdominis

84
Q

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

A

the anterior abdominal wall

85
Q

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

A

in the superficial fascia

86
Q

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

A

the superficial fascia and skin

87
Q

the superficial veins drain towards where

A

axilla or femoral vein

88
Q

the superficial arteries arise from the

A
femoral artery (superficial circumflex iliac and superficial epigastric)
internal thoracic (musculophrenic and superior epigastric)
89
Q

the superficial nerves are branches of

A

anterior and lateral branches of the intercostal nerves

90
Q

what nerves supply the anterior abdominal wall

A

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

anterior cutaneous branches of 6-12 intercostal nerves

91
Q

what nerve supplies the wall in the inguinal region

A

iliohypogastric (L1)

92
Q

what are the superficial arteries of the anterior abdominal wall

A

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

93
Q

name 2 superficial veins of the anterior abdominal wall

A

superficial epigastric veins

thoracoepigastric veins

94
Q

the deeper vessels supply what

A

muscles of the abdominal walls

95
Q

what supplies the upper part of the rectus abdominis

A

the superior epigastric artery

96
Q

the superior epigastric artery is a terminal branch of what artery

A

internal thoracic artery

97
Q

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

A

inferior epigastric artery

98
Q

the inferior epigastric artery is a branch of what vessel

A

external iliac artery

99
Q

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

A

L1

100
Q

the ilioinguinal and iliohypogastric nerves supply sensory innervation to where

A

pubic region and medial thigh

101
Q

the ilioinguinal and iliohypogastric nerves supply motor innervation to where

A

internal oblique and transversus abdominis

102
Q

superficial lymphatic drainage above the umbilicus goes where

A

nodes in axilla

103
Q

superficial lymphatic drainage below the umbilicus goes where

A

superficial inguinal nodes

104
Q

deep lymphatic drainage of the upper region goes where

A

parasternal nodes

105
Q

deep lymphatic drainage of the middle areas is to where

A

lumbar nodes

106
Q

deep lymphatic drainage of the lower areas is to where

A

external iliac nodes

107
Q

deep lymph nodes lie near…

A

arteries

108
Q

parasternal nodes lie near what artery

A

internal thoracic artery

109
Q

lumbar nodes lie either side of what artery

A

abdominal aorta

110
Q

external iliac nodes surround what artery

A

external iliac artery

111
Q

dermatome of umbilicus

A

T10

112
Q

what are the main nerves supplying the anterolateral abdominal wall

A

intercostal nerves, with some supply from L1

113
Q

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

A

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

114
Q

what branches supply the skin

A

lateral and anterior cutaneous branches

115
Q

where do the intercostal nerves lie

A

between internal oblique and transversus abdominis, enter rectus sheath