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Anatomy - Abdomen and Pelvis > Chapter 1 - Anterior Abdominal Wall(from pyramidalis) > Flashcards

Chapter 1 - Anterior Abdominal Wall(from pyramidalis) Flashcards

1
Q

Deep N of AAW

A

lower 6 thoracic N, iliohypogastric and ilioinguinal N

they finally emerge as cutaneous N

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2
Q

Deep arteries of AAW

A

2 from above - superior epigastric, musculophrenic
2 from below - inferior epigastric, deep circumflex iliac
Branches of intercostal, subcostal and lumbar

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3
Q

Superior epigastric A

A
  • from internal thoracic A
  • begins in 6th intercostal space
  • enters rectus sheath
  • runs vertically down
  • supplies rectus
  • ends by anastamosing with inferior epigastric A
  • gives muscular, cutaneous banches
  • gives hepatic branch for falciform ligament
  • gives anastamotic branch at level of xiphoid process
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4
Q

Musculophrenic A

A
  • from internal thoracic A
  • runs downwards and laterally
  • pierces diaphragm b/w 7th-8th cartilages
  • gives branches to diaphragm, AAW and 7, 8, 9 intercostal spaces
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5
Q

Inferior epigastric A

A
  • from external iliac A
  • arises from just above inguinal ligament
  • passes medial to deep inguinal ring
  • pierces fascia transversalis
  • enters rectus sheath
  • supplies rectus muscle
  • anastamoses with sup. epigastric A
  • gives:
    cremasteric branch
    pubic branch
    muscular branch
    cutaneous branch
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6
Q

Deep circumflex iliac A

A
  • from external iliac A
  • runs behind inguinal ligament
  • continues along iliac crest
  • pierces transversus abdominis
  • anastamoses with superior gluteal, lateral circumflex femoral and superficial circumflex iliac A
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7
Q

Definition of rectus sheath

A

Aponeurotic sheath covering rectus abdominis

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8
Q

Features of rectus sheath

A

ANTERIOR WALL
- complete
- adherent to tendinous intersections of muscle
POSTERIOR WALL
- incomplete
- deficient above costal margin and below arcuate line
- free from muscle

Both walls extend till linea semilunaris

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9
Q

Formation of rectus sheath

A

ABOVE COSTAL MARGIN
AW: ext. oblique aponeurosis
PW: deficient

B/W COSTAL MARGIN, ARCUATE LINE
AW: ext. oblique aponeurosis + anterior lamina of int. oblique aponeurosis
PW: posterior lamina of int. oblique aponeurosis + aponeurosis of transversus

BELOW ARCUATE LINE
AW: Aponeurosis of all 3 flat muscles
PW: deficient

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10
Q

Contents of rectus sheath

A
  1. Rectus abdominis
  2. Pyramidalis
  3. Sup. epigastric A
  4. Inf. epigastric A
  5. Sup., Inf. epigastric venae comittantes
  6. Terminal parts of lower 6 thoracic N
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11
Q

Functions of rectus sheath

A
  1. Checks bowing of rectus muscle
  2. Increases efficiency of muscle
  3. Maintains strength of AAW
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12
Q

Define fascia transversalis

A

Part of fascia that lines inner surface of transversus abdominis

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13
Q

Extent of fascia transversalis

A

A: adheres to linea alba
P: merges with anterior layer of thoracolumbar fascia. continues with renal fascia
Sup: continuous with diaphragmatic fascia
Inf: attached to inner lip of iliac crest and inguinal ligament
Med: attached to pubic tubercle

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14
Q

Deep inguinal ring

A
  • oval opening in fascia transversalis 1.2cm above midinguinal point
  • lies lateral to inferior epigastric A
  • transmits spermatic cord/round ligament of uterus
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15
Q

Prolongations of fascia transversalis

A
  1. Tubular prolongation surrounds spermatic cord - internal spermatic fascia
  2. Forms anterior wall of femoral sheath
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16
Q

Definition of spermatic cord

A
  • oblique intermuscular passage in lower part of abdominal wall
  • directed downwards, forwards, medially
  • extends from deep inguinal ring to superficial inguinal ring
17
Q

Anterior boundaries of inguinal canal

A 
Whole extent:
1. Skin
2. Superficial fascia
3. Ext. oblique aponeurosis
Lat 1/3:
1. Int. oblique muscle
18
Q

Posterior boundaries of inguinal canal

A 
Whole extent:
1. Fascia transversalis
2. Extraperitoneal tissue
3. Parietal peritoneum
Medial 2/3
1. Conjoint tendon
2. Reflected part of inguinal ligament
19
Q

Roof and floor of inguinal canal

A

Roof: int. oblique, transversus abdominis
Floor: inguinal, lacunar ligament

20
Q

Structures passing through inguinal canal

A
  1. Spermatic cord/round ligament of uterus. It enters through deep IR and goes out through SIR
  2. Ilioinguinal N. It enters b/w ext. and int. oblique and passes out through SIR.
21
Q

Constituents of spermatic cord

A
  1. Testicular A
  2. Cremasteric A
  3. A to ductus deferens
  4. Genital branch of genitofemoral N
  5. Ilioinguinal N
  6. Autonomic N
  7. Ductus deferens
  8. Pampiniform plexus
  9. Remains of processus vaginalis
22
Q

Coverings of spermatic cord

A
  1. Internal spermatic fascia from fascia transversalis
  2. Cremasteric fascia from muscle loops of cremaster M. Derived from int. oblique and transversus abdominis
  3. External spermatic fascia from ext. oblique
23
Q

Describe hernia

A
  • protrusion of abdominal contents through any of its walls or into ‘no entry’ zone within abdominal cavity
  • consists of sac, contents, and coverings.
  • sac consists of neck and body.
24
Q

Complications of hernia

A
  1. Irreducibility - loop goes out but does not return
  2. Obstruction - loop may get narrowed in parts and contents cannot move forward.
  3. Strangulation - arterial supply is blocked and loop gets necrosed
25
Q

Internal hernia

A
  • protrusion of loop of intestine within ‘no entry’ zone of abdominal cavity
  • usually in epiploic foramen/lesser sac/foramen of Winslow
  • mostly gets strangulated
26
Q

Congenital umbilical hernia

A

due to non-return of midgut loop into abdominal cavity

27
Q

Acquired infantile umbilical hernia

A

due to weakness of umbilical scar, a part of gut protrudes out.
disappears as infant grows

28
Q

Paraumbilical hernia

A

loop of intestine protrudes through linea alba around umbilicus

29
Q

Femoral hernia

A
  • seen more in females due to large pelvis, smaller blood vessels and larger femoral canal
  • neck lies below and lateral to pubic tubercle
30
Q

Inguinal hernia

A
  • protrusion of loop of intestine through inguinal canal
    Indirect/Oblique
  • protrudes through DIR, inguinal canal, SIR, into scrotum.
    Direct - protrudes through posterior abdominal wall/ Hesselbachs triangle
31
Q

Coverings of indirect inguinal hernia

A
  1. Extraperitoneal tissue
  2. Internal spermatic fascia
  3. Cremasteric fascia
  4. External spermatic fascia
  5. Skin
32
Q

Boundaries of Hesselbach’s triangle

A

Inferior epigastric A
Lateral border of rectus abdominis
Inguinal ligament

33
Q

Coverings of lateral direct inguinal hernia

A
  1. Extraperitoneal tissue
  2. Fascia transversalis
  3. Cremasteric fascia
  4. External spermatic fascia
  5. Skin
34
Q

Coverings of medial direct inguinal hernia

A
  1. Extraperitoneal tissue
  2. Fascia transversalis
  3. Conjoint tendon
  4. External spermatic fascia
  5. Skin
35
Q

Epigastric hernia

A

occurs through upper part of linea alba

36
Q

Divarication of recti

A
  • occurs in multiparous females with weak anterolateral abdominal muscles
  • loops of intestine protrude during coughing but return back
37
Q

Lumbar hernia

A

protrudes through lumbar triangle in posterior abdominal wall

38
Q

Boundaries of lumbar triangle

A

Iliac creat
Anterior border of latissimus dorsi
Posterior border of ext. oblique

Anatomy - Abdomen and Pelvis (8 decks)

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