Anterolateral abdominal Wall (Exam III) Flashcards by Annabella Moody

Abdominal wall layer that is the most external

Skin

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Two layers that comprise the skin

Epidermis & dermis

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Fascia layers that are specific to the anterior abdominal wall and do not extend beyond it

Campers & Scarpas fascia

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Fatty layer of loose connective tissue with cutaneous nerves, lymphatics and vessels running through it; where subcutaneous fat is stored

Campers fascia

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Short term weight loss/gain the abdominal wall layer that responds to this is:

Campers fascia

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Fatty superficial fascial layer

Campers fascia

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Membranous layer of superficial fascia in the anterior abdominal wall

Scarpas fascia

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Scarpas fascia is extremely ____ and gets pierced by lymphatics, vessels and nerve

Extremely thin

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In the abdominal wall layers, the skeletal muscle is organized into:

Three layers

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Names of the layers of skeletal muscle in the abdominal wall

External, Internal, Innermost

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The skeletal muscle layers of the anterior abdominal wall are described as:

Broad, flat sheets

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Connective tissue layer about the thickness of a sheet of paper that lines the entire abdominal cavity just below the skeletal muscle

Transversalis fascia

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Fat located between the tissue layers of the anterior abdominal wall that does not response to short term weight loss/gain & is a fraction of an inch thick

Extraperitoneal fat

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Between Campers fascia and exztraperitoneal fat- what responds most to weight loss or gain

Camper’s fascia

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Deepest layer that lines abdominal and pelvic cavities - a thin slippery secreting membrane

Parietal peritoneum

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Parietal peritoneum is there to form a _____ layer for organs to move over in a ____ environment

Lubricated; frictionless

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The skin, Camper’s fascia, Scarpa’s fascia

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1- Skin
2- Camper’s fascia
3- Scarpia’s fascia
4- Three muscular layers (external, internal, innermost)
5- Transversalis fascia
6- Extraperitoneal fat
7- Parietal peritoneum
8- Abdominal organs

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Parietal peritoneum is extremely:

Pain sensitive

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The abdominal organs are in contact with ____ and located in a space called _____

Parietal peritoneum; Peritoneal cavity

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1- Linea alba
2- Skin
3- Camper’s fascia
4- Scarpa’s fascia
5- Parietal peritoneum
6- Extraperitoneal fascia
7- Transversalis fascia
8- Transversus abdominus muscle
9- Internal oblique muscle
10- External oblique muscle

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Tendonous ribbon connective tissue structure running from the xyphoid process down to the pubic symphysis; a site of insertion for many anterior abdominal wall muscles

Linea alba

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An additional abdominal muscle that does not belong to any of the three basic layers that is only seen in the abdomen; considered the fourth muscle of the abdomen

Rectus abdominis muscle

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Fibers of the rectus abdominis are oriented ______ and run _____ to ______

Vertically
Inferior to superior

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Describe the width of the rectus abdominis

3x wider at top than bottom

Rectus abdominis origin:

Pubis

Rectus abdominus instertion (2):

Costal cartilage Xiphoid process

How does the rectus abdominis function:

Flexes abdomen forward (Xiphiod process and costal cartilages pulled down toward pubic symphysis)

Most important muscle for abdominal flexion

Rectus abdominis

On the anterior surface of the rectus abdominis we will see a tendinous insertion of the muscle to the:

Overlying connective tissue

The overlying connective tissue envelope containing the rectus abdominis

Rectus sheath

Due to there lack of solid structure around the rectus abdominis, it will get some extra mechanical advantage in the form of:

Four tendinous insertions

Four tendinous insertions of the rectus abdominis connect it to:

Overlying connective tissue

There is a spatial relationship of the costal margin and the lateral margin of the rectus abdominis that serve as:

Surface anatomy indicator of where the gallbladder is

Fibers of the external abdominal oblique run:

Downward & inward (hands in pockets)

The external oblique contains a giant flat tendon that is a connective tissue sheath that goes all the way to the midline called:

Aponeurosis

Does the external abdominal oblique muscle itself make it to the midline

External abdominal oblique origin:

Laterally on ribcage

External abdominal oblique insertion of lower fibers:

Anterior superior iliac spine

In the front portion of the external abdominal oblique is where the right and left side muscle attach to each other, knitting together to form:

The linea alba

Describe lower margin of external abdominal oblique

Free, thickened lower margin

Thickened lower margin of external abdominal oblique

Inguinal ligament

The inguinal ligament spans from:

Anterior superior iliac spine down to pubis

The internal abdominal oblique is in the same plane as:

Internal intercostals above

Fibers of the internal abdominal oblique are not parallel because they are in the a:

Fan shape

Internal abdominal oblique's small, restricted origin:

Anterior, superior iliac spine

The lower fibers of the internal abdominal oblique originate from the deep surface of the ______

Inguinal ligament

The internal abdominal oblique contains a ____ as it moves toward the midline

Aponeurosis

The left and right aponeurosis of the the internal abdominal oblique will knit together in the midline and their attachment will stretch the whole linea alba from the ____ to ____

Xiphoid process to pubic symphysis

Innermost muscle of the anterior abdominal wall

Transversus abdominis muscle

The transverus abdominis muscle gets its name from the fact that many of its fiber are:

Horizontal

The origin of the transversus abdominis muscle is posteriorly on the:

Thoracolumbar fascia

Addition fibers of the transverus abdominis have have an origin that includes (3):

Iliac crest Anterior superior iliac spine Inguinal ligament

In the transversus abdominis muscle, going from the midline we will see:

An aponeurosis

The left and right muscles of the transversus abdominis will meet at the _____ and stretch from _____ to _____

Linea alba Xiphoid process to pubis

Describe the lower margin of the transversus abdominis

High arching lower border

What lines the abdominal wall in all places there is overlying abdominal muscle

Transversalis fascia

The bottom free lower margin of the transversalis fascia will correspond with the:

Overlying inguinal ligament

The external and internal abdominal oblique, the rectus abdominus, and transversis abdominis (and transversalis fascia) all stop at the:

Inguinal ligament

A gap forms below the:

Inguinal ligament

What is not present in the gap below the inguinal ligament

Anterior abdominal wall

The purpose of the gap below the inguinal ligament with no abdominal wall is for:

Iliopsoas, big vessels, and parts of the lumbar plexus to pass through to escape body cavity and reach lower limb

The aponeurosis for each of the muscular layers fuse together at the:

Linea alba

The aponeurosis for the three muscle layer that are coming around to the front form a connective tissue envelope containing:

Rectus abdominis muscle

The connective tissue envelope housing the rectus abdominis muscle

Rectus sheath

Describe the relationship between aponeurosis and rectus abdominis in a general sense

Top 3/4 different than bottom 1/4

In the upper 3/4 of the rectus sheath, the external abdominal oblique's aponeurosis runs _____ to the rectus abdominis

Superficial

In the upper 3/4 of the rectus sheath, the internal abdominal oblique's aponeurosis runs _____ to the rectus abdominis

1/2 superficial 1/2 deep

The _____ and _____ aponeurosis combine to form a 1.5 thick layer that runs superficial to the rectus abdominis

EAO & IAO (top 1/2)

In the upper 3/4 of the rectus sheath, the transversus abdominus's aponeurosis runs ____ to the rectus abdominis

Deep

The _____ and _____ aponeurosis combine to form a 1.5 thick layer that runs deep to the rectus abdominis

IAO (Bottom 1/2) & Transversus abdominis

In the lower 1/4 of the rectus sheath, all aponeurosis go ______ to the rectus abdominis

Superficial

What does NOT participate in the rectus sheath & is always deep to everything

Transversalis fascia

The lower margin boundary where the deep half of the rectus abdominis stops; below this boundary we see transversalis fascia and exztraperitoneal fat

Arcuate line

Motor nerve that supplies intercostal muscles

Intercostal nerve

Describe what the path of the lower intercostal nerves:

Extend out of the intercostal spaces and into the anterior abdominal wall

Responsible for most of the motor and sensory innervation for the overlying skin of the anterior abdominal wall

Intercostal nerves

All ventral rami from ______ to ______ will be the ______ supply for the anterior abdominal wall skin

T7-L1 Sensory

Sensory innervation of skin over the anterior abdominal wall is provided by:

Ventral rami

Sensory innervation of the skin over the anterior abdominal wall is provided by ventral rami of the (3):

Lower 5 incostal nerves (T7-11) Subcostal nerve (T12) Iliohypogastric/Ilioinguinal nerves (L1)

The lower 5 intercostal nerves (T7-T11) The subcostal nerve (T12) The iliohypogastric/ilioinguinal nerves (L1) Provide what type of innervation to the anterior abdominal wall and to what:

Somatic sensory innervation to the skin over the anterior abdominal wall Somatic motor innervation to the anterior abdominal wall muscles

Arteries in the rectus sheath run ____ to the muscle

Deep

Epigastric artery that comes down to the rectus abdominis from above and tends to be smaller

Superior epigastric artery

Epigastric artery that comes up to the rectus abdominis from below and tends to be larger

Inferior epigastric artery

Where do the superior and inferior epigastric arteries anastomose

On deep surface of rectus abdominis

The superior epigastric artery is the terminal branch of the:

Internal thoracic artery

The inferior epigastric artery comes from a vessel called the:

External iliac artery

There is an additional anastomosis between the superior and inferior epigastric arteries and:

Intercostal arteries

For lymphatic drainage we draw a horizontal arbitrary line through the:

Umbilicus

Lymph from skin above the umbilicus (including the back and upper limbs) drains into:

Axillary nodes

Lymph from the skin below the umbilicus (Including the back, pelvis, perineum and lower limb) drains into:

Superficial inguinal nodes

The axillary nodes are located in the:

Armpits

The inguinal nodes are located:

Underneath the inguinal ligament and above and infront of the hip joint

The anterior abdominal wall muscles function to based on if they are used:

Unilaterally or bilaterally

Flexion of the trunk (bending it forward) occurs when the anterior abdominal muscles are used:

Bilaterally

Lateral flexion occurs when the anterior abdominal muscles are used:

Unilaterally

When lateral flexion occurs, we will flex toward the side that is:

Actively contracting

Rotation or twisting motion occurs when the anterior abdominal wall muscles are used:

Uniliaterally

When twisting or rotating the trunk will go towards the side in which the muscle are:

Activated

Less obvious functions of the anterior abdominal muscles are related to:

Changes in intraabdominal pressure

Forceful expiration, coughing and sneezing are due to changes in the intraabdominal pressure that force the viscera towards the:

Diaphragm

Urination, defecation as well as a woman bearing down during labor function due to changes in intraandominal pressure that force the viscera:

Downward towards the pelvis

Stabilization of the trunk during strenuous physical effort is accomplished by drawing air into lungs, closing epiglottis and stiffening the trunk to make it more rigid is called:

Valsalva's maneuver