Class 1 Flashcards by Nicholas Strachan

Identify

Xiphoid process
R+L costal margin
12th Rib
Iliac crest
Anterior superior iliac spine
Pubic tubercle
Pubic crest
Pubic symphysis
Sacroiliac joint

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Identidy the quadrants

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On the left diagram, identify the lines that form the borders and the name of each area.

Lines

Superior to inferior
> Left and right mid clavicular lines
Sideways
> Transpyloric line (sup.)
> Transtubercular line (inf.)

Areas right to left

UPPER = right hypochondriac, epigastric, left hypochondriac

MIDDLE = Right lumbar, umbillical, left lumbar

LOWER = RIF, hypogastric, LIF

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What structures can be found in the right hypochondriac?

Liver
Gallbladder
Costal margin
Duodenum

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What structures can be found in the epigastric?

Gallbladder
Greater curvature of stomach
Xiphoid process

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What structures can be found in the left hypochondriac?

Spleen
Stomach
Pancreas tail

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What structures can be found in the right lumbar?

Ascending colon
Ileum
R iliac crest

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What structures can be found in the umbillical?

Transverse colon
Umbillicus
Jejunum

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What structures can be found in the left lumbar?

Descending colon
Jejunum
L iliac crest

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What structures can be found in the RIF?

Caecum
Appendix
Ileum

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What structures can be found in the hypogastric?

Ileum
Recutm
Bladder

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What structures can be found in the LIF?

Descending colon
Ileum

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What is the action of the external oblique?

Pulls chest downward

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What is the innervation of the external oblique?

Thoracoabdominal nerves T7-T11

Subcostal T12

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What is the action of the internal oblique?

Accessory resp muscle
Antagonist to diaphragm

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What is the nerve supply of the internal oblique?

Thoracoabdominal T7 - T11

Subcostal T12

Iliohypogastric and ilioinguinal (L1)

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What is the action of the transversus abdominis?

Thoracic and pelvic stability
Abdominal movement

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What is the nerve supply of the transversus abdominis?

Thoracoabdominal T7 - T11

Subcoastal T12

Iliohypogastric and ilioinguinal (L1)

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What is the action of the rectus abdominis?

Postural
Respiration

What is the nerve supply of the rectus abdominis?

Thoracoabdominal T6 - T11

Subcostal T12

What is the difference between the arrangement of the rectus sheath above and below the arcuate line?

Above

External and 1/2 of the internal oblique aponeurosis run ANTERIOR to the rectus
The rest run posterior

Below

All aponeurosis lie anterior to rectus abdominis

What is the rectus sheath?

Aponeurosis

of transverse abdominis and external/internal oblique

What muscles are contained in the rectus sheath?

Rectus abdominis

Pyramidalis

Vertebral level of umbillicus

L3/L4

What can the umbilicus be used to identify?

Bifurcation of abdominal aorta

Dermatome map

When does the inguinal canal form?

During fetal development due to the relocation of the gonads

What forms the inguinal canal?

Layers of the anterior abdominal wall pushing through to form a canal. It is approx 4cm long and lies parallel and superior to the medial half of the inguinal ligament

What two points are the inguinal ligament attached to?

ASIS Pubic tubercle

Formation of the inguinal canal

What forms the anterior wall of the inguinal canal?

Aponeurosis of the internal/external oblique

What forms the posterior wall of the inguinal canal?

Transversalos fascia

What forms the roof of the inguinal canal?

- Transversalis fascia - Internal oblique - Transversus abdominis

What forms the floor of the inguinal canal?

Inguinal ligament

MALT

- M = muscles (roof) - A = Apoeurosis (anterior) - L = ligamet (floor) - T = Transversalis (posterior)

What is the relationship between the deep inguinal ring and the inferior epigastric vessels?

They sit lateral and cross over eachother

What are the inferior epigastric vessels branches of superiorly?

- Internal thoracic artery

What are the inferior epigastric vessels branches of inferiorly?

External iliac artery

What are the contents of the male inguinal canal?

- Ilioinguinal nerve (L1) - Genital branch of the genitofemoral nerve - Spermatochord - testicular artery

What are the contents of the female inguinal canal?

- Ilioinguinal nerve (L1) - Genital branch of the genitofemoral nerve - Roung ligament - Blood and lymph vessels

What are the two ways of classifying inguinal hernias?

Direct Indirect

What hernia is this and how can you tell?

=direct hernia - Abdominal contents not in the deep inguinal ring - They simply push through a weak spot in the muscles that make up the wall of the inguinal canal - Contents can pass through the external ring

What hernia is this and how can you tell?

Indirect - Congenital weakness in the deep inguinal ring - Abdo contents in the canal lateral to the inferior epigastric vessels - Occasionally the abdo contents can also enter through the deep ring into the scrotum

What are femoral hernias?

- Occur below inguinal ligament - Abdo contents pass into the femoral canal - Can cause strangulation in the vessels

What is an umbilical hernia?

- Abdo contents pass through weakness in the wall at the site of the umbilical cord passage