Exam #4: Anterior Abdominal Wall Flashcards
How are the four quadrants of the abdomen delineated?
Cross through the umbilicus
How are the nine regions of the abdomen delineated?
- Sagittal (vertical) lines through the midclavicular planes
- Transverse (horizontal) lines through the subcostal & intertubercular planes
Vertebral level of the umbilicus
L3-L4
Umbilicus dermatome
T10
What are the borders of the abdominal cavity?
- Costal arch (ribs 6-10) & xiphoid process
- Iliac crest
- Inguinal ligament
What are the functions of the abdominal wall?
- Protection & stabilization of the abdominal contents
- Maintain posture
- Generation of intra-abdominal pressure necessary for parturition & defecation
- Respiration: opposes the diaphragm during exhalation
Name the nine fascial & muscular layers of the abdominal wall from superficial to deep.
- Skin
- Camper’s Fascia
- Scarpa’s Fascia
- External Oblique
- Internal Oblique
- Transversus abdominus
- Rectus abdominus
- Transversalis Fascia
- Parietal peritoneum
What is Camper’s Fascia?
Adipose layer w/ cutaneous nerves & blood vessels
What is Scarpa’s Fascia?
Membranous layer that becomes Dartos’ Fascia in the scrotum & Colles Fascia in the perineum
What is the clinical significance of the potential space between Scarpa’s Fascia & the aponeurosis of the external oblique?
- Potential space NOT seen in healthy individual
- Trauma to urethra in males–>urine extravasation into this potential space
External Oblique: Origin
External surface of ribs 5-12
External Oblique: Insertion
- Linea Alba
- Pubic tubercle
- Anterior 1/2 of iliac crest
External Oblique: Action
- Compress & support abdominal viscera
- Flex & rotate trunk
External Oblique: Innervation
- Thoraco-abdominal nerves (ant. rami T7-T11)
- Subcostal nerve (T12)
Internal Oblique: Origin
- Thoracolumbar fascia
- Anterior 2/3 of iliac crest
- Connective tissue deep to inguinal ligament
Internal Oblique: Insertion
- Inferior borders of ribs 10-12
- Lina Alba & Pubis via conjoin tendon
Internal Oblique: Action
- Compress & support abdominal viscera
- Flex & rotate trunk
Internal Oblique: Innervation
- Thoraco-abdomina nerves (ant. rami of T7-T11)
- L1
Transversus Abdominis: Origin
- Internal surface of ribs 7-12 costal cartilage
- Thoracolumbar fascia
- Iliac crest
- Connective tissue deep to inguinal ligament
Transversus Abdominis: Insertion
- Linea Alba w/ aponeurosis of internal oblique
- Pubic crest & pectin pubis via conjoin tendon
Transversus Abdominis: Action
Compresses & supports abdominal viscera
Transversus Abdominis: Innervation
- Thoraco-abdominal nerves (ant. rami of T7-T11)
- L1
Rectus Abdominus: Origin
- Pubic Symphysis
- Pubic Crest
Rectus Abdominus: Insertion
- Xiphoid process
- Costal cartilages 5-7
Rectus Abdominus: Action
- Flexes trunk
- Compresses abdominal viscera
- Antagonist to the diaphragm
- Stabilizes & control pelvic tilt (antilordosis)
Rectus Abdominus: Innervation
Thoraco-abdominal nerves (T7-T12)
Arcuate Line
- Horizontal line demarcating the lower limit of the posterior rectus sheath
What is the significance of the arcuate line?
- **Rectus sheath= aponeuroses of the transversus abdominis, external oblique, & internal oblique muscles
- Above, tendons split & envelop the rectus abdominis
- Below, tendons fuse & only wrap anteriorly around the rectus abdominis; thus, the posterior surface of the ant. abdominal wall is only covered by the transversalis fascia & parietal peritoneum–>weak/ prone to hernia
Which fascial layer forms the deep inguinal ring?
Transversalis fascia
What is the function of the parietal peritoneum?
Production of serous fluid that lubricates the abdominal organs
Where are the inferior epigastric arteries & veins found?
Between the transversalis fascia & parietal peritoneum
Falciform Ligament
Remnant of the ventral mesentery
Where is the Ligamentum Teres found? What is the Ligamentum also called? What is the Ligamentum Teres a remnant of?
- Found in the free edge of the Falciform Ligament
- Also called the round ligament
- Remnant of the fetal umbilical vein (oxygenated blood from mother to fetus)
Median Umbilical Fold
Urachus (remnant of the allantois) & paraumbilical veins
Medial Umbilical Fold
Remnant of the umbilical arteries
Lateral Umbilical Fold
Inferior epigastric arteries & veins
A patient has an infection of an abdominal organ. If the organ is above the umbilicus, where will lymphadenopathy present? What about below the umbilicus?
- Above= axillary lymph nodes
- Below= inguinal lymph nodes
A patient is undergoing a cholecystectomy. What type of surgical incision will be utilized for the procedure?
Subcostal
A patient is undergoing surgery to transverse colon (or small intestine). What type of surgical incision will be utilized for the procedure?
Median (through the linea alba)
A patient is undergoing an appendectomy. What type of surgical incision will be utilized for the procedure?
Gridiron (McBurney’s Point)
A patient is undergoing an oophrectomy. What type of surgical incision will be utilized for the procedure?
Transverse (Horizontal incision)
A patient is undergoing a hysterectomy. What type of surgical incision will be utilized for the procedure?
Suprapubic
What are the consequences of corset wear?
- Lung volume compromised & dyspnea present
- Weaken abdominal muscles (fake transversus abdominis)
- Reduce appetite
- Constipation
- Exacerbate prolapsed uterus
- Harmful to fetus during pregnancy
- Does NOT harm the liver
Conjoint Tendon
Fused aponeurosis of the internal oblique & transversus abdominis m.
- Reinforces lower part of the rectus sheath
