Exam I slides Flashcards
Which is deeper: camper’s fascia or sharper’s fascia?
Scamper’s fascia
Scamper’s fascia is continuous with what important anatomical features?
Penis and scrotum
What is deep/investing fascia an important landmark for?
This is where sutures are held
Where is the potential space in the penis, and why is this space relevant?
Between membranous/Scaper’s facia and deep/investing facia of the abdominal oblique muscle. Important because if the urethra breaks, urine will flow into this area.
What are the soft tissue landmarks of the anterior and lateral abdominal wall?
1) Linea semilunaris: lateral border of rectus abdomens, what forms the six-pack.
2) Linea alba: aka white line. Abdominal midline. Where muscles fro each side meet, and overlap.
3) Umbilicus
4) Superficial inguinal line: around pelvis
Where are the following planes:
1) Transplyloric
2) Subcostal
3) Supracrestal
4) Transtubercular
5) Interspinous
1) Transverse plane midway between the superior borders of the pubic symphysis and the manubrium
2) Plane at the lowest level of the costal margin (the inferior margin of the tenth costal carriage)
3) Plane passing through the summits of the iliac crest
4) Plane at the level of the iliac tubercles (the iliac tubercle lies about 5 cm postolateral to the anterior superior iliac spine)
5) Plane at the level of the anterior superior iliac spine
What are the muscles of the anterior abdominal wall?
External obliques, internal obliques, transversus abdominal, and rectus abdominus
What are the muscles of the posterior abdominal wall?
Iliacus, psoas major, psoas minor, and quadratus lumborum
What are the layers of fascia, muscle, and skin above an below the arcuate line?
Above: skin, fatty layer of superficial fascia, membranous layer of superficial fascia, aponeurosis of external abdominal oblique fascia (2 layers), one layer of internal abdominal oblique aponeurosis, rectus abdominis muscles, one layer of internal abdominal oblique aponeurosis, aponeurosis of transverses abdominus (2 layers), transversals fascia, extraperitoneal tissue, and parietal peritoneum.
Below: skin, fatty layer of superficial fascia, membranous layer of superficial fascia, aponeurosis of external abdominal oblique fascia (2 layers), aponeurosis of internal abdominal oblique (2 layers), aponeurosis of transverses adsominus (2 layers), rectus abdominis muscles, transversals fascia, extraperitoneal tissue, and parietal peritoneum.
Which muscles form the inguinal line?
The external obliques, attach from superior iliac spine to pubic tubercle
Which posterior abdominal muscles goes under the inguinal line and attaches to the less trochanter of the femur?
Iliacus
Describe the deep system of abdominal arteries.
Superiorly: originate from subclavian.
Mid-abdominally: branch to form abdominal aorta
Inferiorly: external iliac artery
Describe the superficial system of abdominal arteries.
Superiorly: Perforating branches
Inferiorly: Branches of the femoral branch
Order of anterior deep arteries from superior to inferior:
musculophrenic, superior epigastric, intercostal, subcostal, lumbar, inferior epigastric, deep circumflex illiac
Order of anterior superficial arteries from superior to inferior:
superficial circumflex iliac, superficial epigastric, external pudendal (superficial and deep branch)
Where does the superficial artery system run?
Camper’s fascia
Most important superficial vein?
Thoracoepigastric, runs from thorax to femoral vein. Used for bypasses.
Sensory dermatomes of the anterior abdominal wall
T7-L1
T7 - xiphoid region
T10 - umbilical region
L1 - inguinal fold
Iliohypogastric nerve
L1 (sometimes T12)
Lateral cutaneous branch, anterior cutaneous branch
Supplies suprapubic region
Ilioinguinal nerve
L1
Enters inguinal canal and emerges through superficial inguinal ring.
Supplies groin, scrotum, and labia majus
Genitofemoral Nerve
L1 and 2
Genital branch: exits inguinal canal through superficial inguinal ring. Innervates the cremaster muscle or is cutaneous to the labia magus.
Femoral branch: cutaneous to femoral triangle area.
Compare direct and indirect inguinal hernias
Both are more common in males
Direct: does not go through inguinal canal, protrudes in lower anterior abdominal wall
Indirect: travels through entire inguinal canal, may go all the way to scrotum. Most common in small children.
Compare femoral hernias to inguinal hernias
Femoral are inferior to inguinal ligament, while others are superior.
Originates in the femoral triangle, and occurs in upper thigh.
Where are the posterior abdominal wall nerves located?
Subcostal - T12 Iliohypogastric - T12 Lateral cutaneous - L2+3 Genitofemoral - L1+2 (at psoas) Femoral - L2+4
What is a common place for aneurisms to occur in the posterior abdominal wall?
The aortic bifurcation
Where do the right and left testicular/ovarian veins supply respectively?
Right - vena cava
Left - renal vein
Which kidney is slightly lower and why?
Right, because the liver push down on it
Which muscle do you have to go through to get to the kidney?
Quadratus lumborum
Where is peri vs paranephric fascia located?
Peri: inferior to renal fascia
Para: superior to renal fascia
What are the five segments of the kidney?
Superior, anterosuperior, anteroinferior, inferior, and posterior
What does white and red tissue of the kidney make up?
White: cortex
Red: pyramids
Flow of urine through kidneys
Pyramids –> papilla (tip) –> minor calyx –> major calyx –> renal pelvis –> ureter –> bladder
Where are the three constriction points in the ureter?
1) where the pelvis joins the ureter proper
2) crossing internal iliac at pelvic brim
3) right as the ureter go into bladder
What organ does the ventral mesentary surround?
The liver
Differentiate parasympathetic innervation for foregut, hindgut, and midgut
Fore+Mid: vagus
Hind: splanchnic
What become the urachus?
Allantois
Describe the development of the stomach
The straight tube turns dorsally or to the left 90 degrees clockwise. The left side is now anterior, while the right side is now posterior. Same with the vagal trunk.
Stomach goes ______, while liver goes ______
left, right
What brings the ventral and dorsal parts of the pancreas together?
Rotation of the stomach
Omphalocele v. gastroschisis
O: herniation into umbilical cord, covered
G: herniation into amniotic cavity, uncovered
When would a patient present with fecal matter leaking from umbilicus?
Vitelline fistula
High v. low anal malformations
In relation to where anal canal ends, either below pelvic diaphragm or above. High is more difficult to treat, because there is no muscle available to form a sphincter.
