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Anatomy Block 2 > Block 2 Anterolateral Abdominal Wall and Inguinal Region > Flashcards

Block 2 Anterolateral Abdominal Wall and Inguinal Region Flashcards

1
Q

Anterolateral Abdominal Wall

A

General Features:

  • Composed by the abdomen, pelvis and perineum.
    - these structures are open and connected.
    - commonly called the abdomino-pelvic cavity
  • Abdominal cavity forms the inferior aspect of the thoracic trunk.
  • Diaphragm forms the superior aspect of the thoracic trunk.
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2
Q

Nine regions by two horizontal and two vertical imaginary planes

A

Horizontal planes

  1. Subcostal plane: Drawn through the 10th rib in the costal margins, passes through the upper part of L3 vertebra
  2. Transtubercular plane: Between the tubercles of the iliac crest of ileum bone. Lies at the level of T5

Vertical planes

  1. Right and 2. Left lateral planes

Extends from mid-inguinal point below to the mid-clavicular plane (mammary line) above.

Nine regions:

  1. Epigastric
  2. Right hypochondriac region
  3. Left hypochondriac region
  4. Umbilical region
  5. Right Lumbar region
  6. Left lumbar region
  7. Hypogastric region
  8. Right iliac region
  9. Left iliac region

Note: Transpyloric plane of Addison : passes in front through the tips of both 9th costal cartilages, and through the lower border of L1 vertebra.

Structures that lie at this level :

  • Pylorus of the stomach
  • Fundus of the Gall bladder
  • Hila of both kidneys
  • Origin of the Superior Mesenteric Artery
  • Lower end of the Spinal Cord
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3
Q

Quadrant of the Abdominal cavity

A

Quadrant of the Abdominal cavity

  • 4 Quadran useful for identifying structures lying beneath the abdominal wall:
  • 4 Abdominal quadrants formed as a result of a Vertical (medial plane) and a horizontal line (transumblical plane) that intersect at the umbilicus.
  1. Right Upper Quadrant (RUQ): liver, gall bladder, first 3 parts of the duodenum, head of the pancreas, pyloric portion of the stomach, right kidney, ureter and suprarenal gland, upper position of
    the ascending colon, right half of the transverse colon
  2. Left Upper Quadrant (LUQ): cardiac and fundic regions of the stomach, right half of the transverse colon, upper position of the descending colon, body and tail of the pancreas, spleen, left kidney, ureter and suprarenal gland.
  3. Right Lower Quadrant (RLQ): lower portion of the ascending colon, appendix, right ureter
  4. Left Lower Quadrant (LLQ): lower portion of the descending colon, sigmoid colon, left ureter
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4
Q

Name the structures shown by the arrows

A

Rectus abdominis, Lina Alba, Semilunar line

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5
Q

Surface anatomy of the Abdominal Cavity

Say the landmarks and areas defined for clinical use in the surface of the abdominal cavity.

A

1) linea alba – midline structure noting left and right halves
2) rectus abdominus muscles – connects the ribs to the pelvis
3) umbilicus – marks entrance of the umbilical cord, commonly associate with the 10th thoracic level
4) linea semilunaris – the lateral edge of the rectus abdominus (a.k.a. semilunar line)
5) tendinous insertions – interruptions in the rectus abdominus (a.k.a. transverse lines)

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6
Q

Name the boundaries of the abdomen

A

Superiorly: by the diaphragm,

Anteriorly, by the lower part of the thoracic cage and by muscles of anterior abdominal wall

Posteriorly,
- 5th lumbar vertebrae and by the twelfth rib.
- muscles of the posterior abdominal wall
upper part of bony pelvis.

The abdominal walls are lined by the parietal peritoneum.

Inferiorly, the abdominal cavity is continuous with the pelvic cavity through the pelvic inlet (iliac crest, anterior superior iliac spine, inguinal ligament, pubic symphysis).

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7
Q

Name the structures

A

Anterior Superior Iliac Spine, Pubic tubercle

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8
Q

Lymphatics and Superficial Veins of Anterolateral Abdominal wall

Name where an imaginary line is drawn for orientation of lymphatics on the anterolateral abdominal wall. Where does the lymph drain superiorly and inferiorly?

A
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9
Q

Innervations Of the Anterolateral Abdominal wall

A

Innervations Of the Anterolateral Abdominal wall

Thoracic intercostal nerves 7-12 and the 1st lumbar nerve (also called the iliohypogastric and ilioinguinal nerves.)

Middle landmark is the umbilicus which marks the 10th thoracic level.

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10
Q

Vascular supply of Ant Lateral wall.

A

Vascular supply:

  • superior epigastric artery: (via the internal thoracic artery)
  • inferior epigastric artery
  • lower posterior intercostal arteries
  • lumbar arteries
  • branches of the femoral artery: superficial epigastric, superficial circumflex iliac, and superficial external pudendal.
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11
Q

Identify the arterial structures

A

superior epigastric artery: (via the internal thoracic artery)
inferior epigastric artery
lower posterior intercostal arteries
lumbar arteries
branches of the femoral artery: superficial epigastric, superficial circumflex iliac, and superficial external pudendal

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12
Q

Fascia of the Abdominal Wall

A

Fascia of the Abdominal Wall

below the umbilicus it divides into 2 layers:

  • 1) outer fatty layer is called Camper’s fascia
  • 2) deeper fibrous layer known as Scarpa’s fascia
  • extends below the inguinal ligament to the fascia lata of the thigh
  • continues to the scrotum to becomes dartos tunic
  • continues into the perineum where it is identified as Colles’ fascia
  • continues onto the penis as the superficial penile fascia
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13
Q

Muscles of the Abdominal Wall

A

ANTERIOR ABDOMINAL WALL

from outside to inside:

  • 1) Skin
  • 2) Superficial fascia ( subcutaneous fat)
  • 3) External oblique muscle and its aponeurosis
  • 4) Internal oblique muscle and its aponeurosis
  • 5) Transversus abdominus muscle and its aponeurosis
  • 6) Fascia transversalis
  • 7) Extra-peritoneal tissue
  • 8) Parietal peritoneum
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14
Q

Identify the muscles of the abdominal wall

A
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15
Q

Muscles of the anterior abdominal wall (what are these?)

A

Abdominal Wall Muscles

  • rectus abdominus - from the ribs and sternum to the pubis
  • psoas major and iliacus - cross the hip joint
  • quadratus lumborum
  • pyramidalis - near attachment site of the rectus abdominus.
  • internal oblique
  • external oblique
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16
Q

Other Abdominal Fascia and the Peritoneum

A

Other Abdominal Fascia and the Peritoneum

  • transversalis fascia - deep to the muscles of the abdominal wall
  • extraperitoneal fascia - deep to the transversalis fascia
    • preperitoneal fascia - toward the anterior side of the body
    • retroperitoneal fascia - fascia in the posterior side of the body
  • peritoneal membrane - deep to all of this (equivalent to the pleural membrane)
    • visceral peritoneum - covers and suspended organs by mesenteries
    • parietal peritoneum – lines the walls of the peritoneal cavity
17
Q

external oblique

A

external oblique

  • Attachment: ribs and linea alba
  • forms a portion of external spermatic fascia of the spermatic cord
  • free lower region helps form the inguinal ligament
18
Q

internal oblique

A

internal oblique

  • internal oblique attaches to the ribs, pubic crest, pectineal line, thoracolumbar
  • fascia, lateral 2/3 of the inguinal ligament and linea alba
  • forms part of the rectus sheath
  • fuses with the transversus abdominus to form the conjoined tendon
  • forms the cremasteric fascia in the spermatic cord.
19
Q

internal oblique
transversus abdominus

A

internal oblique
transversus abdominus

  • internal oblique transversus abdominus attachments to the thoracolumbar fascia, iliac crest, lateral 1/3 of the
  • inguinal ligament, linea alba, pubic crest and pectineal line
  • fuses with the transversus abdominus to form the conjoined tendon
  • forms the cremasteric fascia in the spermatic cord.
  • fuses with the internal oblique to form the conjoined tendon
20
Q

Identify External and Internal obliques, and transversus abdominus

A
21
Q

The Rectus Sheath

A

The Rectus Sheath

  • Is a deep fascial envelope enclosing the rectus abdominus muscle.
  • Formed: by a fusion of the aponeuroses of the external oblique, internal oblique and transverse abdominus.
  • important: rectus sheath is the arcuate line
    • Site of transition where the aponeuroses of the internal oblique and transverse abdominus muscles pass to the anterior side of the rectus sheath and the rectus abdominus passes deep to insert on the pubic symphysis.
22
Q

Identify the areas of the rectus sheat

A

Anatomy Block 2 (5 decks)

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