Clinical Anatomy (Lab LOs)

Question 1

Dermatomes of xiphoid process, umbilicus, and inguinal ligament

Answer 1

Xiphoid process: T7

Umbilicus: T10

Inguinal ligament: L1

Question 2

Arteries supplying anterolateral abdominal wall

Answer 2

Question 3

Layers of the rectus sheath

Answer 3

Question 4

Course of inguinal canal

Answer 4

Anterior superior iliac spine (ASIS) to pubic tubercle

Question 5

Landmark for deep inguinal ring

Answer 5

Just lateral to inferior epigastric artery in transversalis fascia

Question 6

Landmark for superficial inguinal ring

Answer 6

It is found within the aponeurosis of the external oblique, immediately above the pubic crest

Question 7

Nerves that innervate anterolateral abdominal wall skin and muscle (and plane they run through)

Answer 7

Intercostal nerves T7-T11 and subcostal nerve T12

Run in plane between transversus abdominus and internal oblique muscles

Question 8

Nerves that innervate pelvic and suprapubic regions (and plane they run through)

Answer 8

Ilioinguinal and iliohypogastric nerves (from lumbar plexus)

Run in plane between transversus abdominus and internal oblique muscles

Question 9

Arcuate line

Answer 9

Inferior to the arcuate line, the transversus abdominus and posterior layer of internal oblique apneuroses go anterior to the rectus abdomins and join the anterior layer of the rectus sheath (instead of the posterior layer)

Question 10

Structures transmitted through inguinal canal in men and women

Answer 10

Men: spermatic cord

Women: round ligament of uterus

Question 11

Fascias of the spermatic cord and their abdominal tissue layers of origin

Answer 11

ICE = TIE (deep to superficial)

Internal spermatic fascia - Transversalis fascia

Cremasteric muscle and fascia - Internal oblique

External spermatic fascia - External Oblique

Note that the transversus abdominis muscle does not contribute to the spermatic fascias

Question 12

Direct inguinal hernia

Answer 12

Loops of bowel push on a weak point in the fascia of the anterior abdominal wall (inguinal triangle) and herniate through the inguinal canal

Protrusion occurs medial to the inferior epigastri vessels

Question 13

Indirect inguinal hernia

Answer 13

Loops of bowel enter through the deep inguinal ring and push inot the inguinal canal

Most common hernia

Pertrusion occurs lateral to inferior epigastric vessels

Question 14

Femoral hernia

Answer 14

Occurs just below the inguinal ligament which abdominal contents push into femoral canal

Question 15

Inguinal triangle

Answer 15

Direct hernias rip through this triangle

Question 16

Nerves potentially harmed in hernia repair surgery

Answer 16

• Inferior intercostal nerve
• Iliohypogastric nerve
• Ilioinguinal nerve