AP08 - trunk and pelvic floor Flashcards
What are the layers of the antero-lateral abdominal wall?
skin Camper's fascia Scarpa's fascia deep fascia external oblique internal oblique transversus abdominus rectus abdominis pyramidalis transversalis fascia extraperitoneal fat parietal peritoneum
What is the difference between camper’s and scarpa’s fascia?
camper’s - fattty
scarpa’s - deep membranous
Where does the external oblique attach?
originates ribs 5-12, inserts into iliac crest and pubic tubercle
What does the aponeurosis of the external oblique form?
the linea alba
What are the openings of the inguinal canal?
superficial inguinal ring
deep inguinal ring
what is the superficial inguinal ring?
triangular opening in the aponeurosis of the external oblique
what is the deep inguinal ring?
opening in transversalis fascia
What nature of the inguinal region prevents herniation?
the oblique angle of the inguinal ligament
What two holes penetrate the pelvic floor?
urogenital hiatus
rectal hiatus
name 3 functions of the muscles of the pelvic floor?
support of viscera
resistance to pressure
urinary and faecal incontinence
What 3 collections of muscles are in the levator ani?
pubococcygeus
puborectalis
iliococcygeus
What is levator ani innervated by?
anterior ramus of S4
bracnhes of pudendal nerve (S2, S3, S4)q
How does the rectus sheath look superiorly?
the aponeurosis of the transversus abdominis passes underneath the abdominal rectus, and that of the internal oblique surounds the rectus abdominus
How does the rectus sheath look inferiorly?
all the aponeuroses pass anteriorly to the rectus abdominus
What is the relationship between the spermatic chord and the inguinal canal?
The inguinal canal is the embryological pathway for the migration of the testes.
the layers of the spermatic chord are analogous to the antero-lateral abdominal wall, which it punches through
Name 4 potential contents of the inguinal canal
spermatic chord (males, and hence neurovascular and reproductive structures)
round ligaments (females)
ilioinguinal nerve
genital branch of
genitofemoral nerve
What is the round ligament?
only present in females
connects the uterine horn and labia majora
What is the ilioinguinal nerve?
provies sensory innervation to the genitalia
What is odd about the passage of the ilioinguinal nerve through the inguinal ring?
it exits through the superficial inguinal ring, with no association with the deep inguinal ring
What comprises the anterior wall of the inguinal canal?
aponeurosis of external oblique, reingforced by internal oblque
What compromises the posterior wall ofthe inguiuinal canal?
the transversalis fascia
What comprises the floor of the inguiinal canal?
inguinal ligaments (with lacunar ligament) rolled free border of the external oblique
What comprises the roof of the inguinal canal?
transversalis fasia…. alll those muscles
conjoint tendon
What are the attchment points of the inguinal ligament?
ASIS
pubic tubercle
Name the 3 bony components of the pelvis
pubis
ischium
ilium
What is the hip socket called?
acetabulum
what do the pubis and ischium form?
the obturator foramen
What bony structure do we sit on?
ischial tuberosities
Which 2 important ligaments attach to the ischium?
sacrospinous ligament
sacrotuberous ligament
What does the sacrospinous ligament form?
greater sciatic foramen
What does the sacrotuberous ligament form?
the lesser sciatic foramen
What 2 triangles are associated with the pelvic diaphragm?
What divides them?
urogenital triangle
anal triangle
the perineum
How might the perineum be damaged?
ruptured during childbirth
leads to uterine prolapse and other stuffs
What are the borders of hasselbach’s triangle?
medial - rectus abdominis
lateral - inferior epigastric vessels
inferior - inguinal ligament
Where would a direct hernia occur?
through hasselbach’s triangle, medial to inferior epigastric vessels
Where would an indirect hernia occur?
lateral to inferior epigastric vessels
What are the contents of the inguiunal canal?
Males
Spermatic cord
ilioinguinal nerve
Females
round ligament
ilioinguinal nerve
