Exam III Flashcards
These are vertical planes which extend inferiorly from the midpoints of the clavicles to the midpoints of lines joining the anterior superior iliac spine to the pubic symphysis.
Midclavicular planes
This is a horizontal plane jointing the lowest point of the costal margin on each side. It lies at the inferior margin of rib 10 (L3 level).
Subcostal plane
This is a horizontal plane which joins the tubercles of the iliac crests (L5 level).
Transtubercular plane
What are the nine regions of the abdomen?
- Right hypochondrium
- Epigastric
- Left Hypochondrium
- Right Flank (Lateral)
- Umbilical
- Left Flank (Lateral)
- Right Groin (Inguinal)
- Pubic
- Left Groin (Inguinal)
Which organ lies mostly in the right hypochondrium and epigastric region?
Liver
Which organs are found in the left hypochondrium?
Spleen and the fundus and body of the stomach
Which planes are used to create the quadrant system of the abdomen?
- Median Plane
- Transumbilical plane
The umbilicus is a variable landmark which lies between which vertebral levels?
L2-L5
-It is lower in children and the elderly than in young adults
What are the layers of the anterior abdominal wall from superficial to deep?
- Skin
- Superficial layer of superficial fascia (Camper’s fascia)
- Deep layer of superficial fascia (Scarpa’s fascia)
- Deep (investing) fascia
- External oblique muscle
- Internal oblique muscle
- Transversus abdominis muscle
- Transversalis fascia
- Extraperitoneal fascia
- Parietal Peritoneum
- Peritoneal Cavity
- Visceral Peritoneum
- Abdominal Organs
Super Silly Dogs Dance Excessively Inside To Take down Extremely Pessimistic People in VA
This subdivision of superficial fascia is a thin fatty layer which is continuous with the superficial fascia of the perineum and thigh.
Superficial layer (Camper’s Fascia)
This subdivision of superficial fascia is a membranous layer which is firmly fastened to the fascia lata of the thigh, just below the inguinal ligament.
Deep layer (Scarpa’s Fascia)
Between what two layers of fascia is there a potential space where a leakage of urine can accumulate?
Scarpa’s fascia and the deep fascia of the abdomen
This structure is a median tendinous raphe which extends from the xiphoid process to the pubic symphysis . Anterior abdominal wall muscles insert into this raphe via their aponeuroses.
Linea alba
What is the origin of the external oblique muscle?
Lower 8 ribs
What is the insertion of the external oblique muscle?
Iliac crest, anterior iliac spine, pubic tubercle, and linea alba by aponeurosis
What is the innervation of the external oblique muscle?
Anterior primary rami of the lower 6 thoracic nerves
What is the action of the external oblique muscle?
Compresses the abdomen, supports abdominal viscera, and is a lateral flexor of the trunk
In which direction do the fibers of the external oblique muscle run?
Downward and forward
What is the origin of the internal oblique muscle?
Lumbar fascia, iliac crest, lateral 2/3 of inguinal ligament
What is the insertion of the internal oblique muscle?
Lower 3 ribs, linea alba by aponeurosis
What is the innervation of the internal oblique muscle?
Anterior primary rami of the lower 6 thoracic and first lumbar nerves
What is the action of the internal oblique muscle?
Compresses the abdomen, supports abdominal visceral, and is a lateral flexor of the trunk
In which direction do the fibers of the internal oblique muscle run?
Downward and backward
What is the origin of the transversus abdominis muscle?
Lower 6 costal cartilages, lumbar fascia, iliac crest, and the lateral third of the inguinal ligament
What is the insertion of the transversus abdominis muscle?
Into the linea alba by aponeurosis
What is the innervation of the transversus abdominis muscle?
Anterior primary rami of the lower 6 thoracic and first lumbar nerves
What is the action of the transversus abdominis muscle?
Compresses the abdomen, supports abdominal viscera, and acts as an internal back brace to support the spine
In which direction do the fibers of the transversus abdominis muscle run?
Horizontally across the abdomen
What is the origin of the rectus abdominis muscle?
Pubic crest and pubic symphysis
What is the insertion of the rectus abdominis muscle?
Xiphoid process and the costal cartilages of ribs 5-7
What is the innervation of the rectus abdominis muscle?
Anterior primary rami of the lower 6 thoracic nerves
What is the action of the rectus abdominis muscle?
Compresses the abdomen, supports abdominal viscera, and is an anterior flexor of the trunk
The linea alba lies between which two muscles?
The left and right rectus abdominis muscles
This is a curved line along the lateral border of the rectus abdominis muscle.
Linea semilunaris
What is the origin of the pyrimidalis muscle when present?
Body of the pubis
What is the insertion of the pyramidalis muscle when present?
Linea alba
What is the innervation of the pyramidalis muscle when present?
Subcostal nerve
What is the action of the pyramidalis muscle when present?
Tenses the linea alba
Anterior abdominal wall muscles are active in which functions?
- Coughing
- Sneezing
- Vomiting
- Defecation
- Micturation
- Parturition
This structure is formed by the aponeuroses of the external oblique, internal oblique, and transversus abdominis muscles.
Rectus sheath
What does the rectus sheath enclose?
- Rectus abdominis muscle
- Pyramidalis muscle (when present)
- Superior epigastric artery and vein
- Inferior epigastric artery and vein
- Anterior primary rami of lower 6 thoracic nerves
This is a crescent shaped line in the posterior layer of the rectus sheath located midway between the umbilicus and pubic crest.
Arcuate line
What lies above the arcuate line?
- Anterior layer of the rectus sheath composed of the aponeuroses of the external and internal oblique muscles
- Posterior layer of the rectus sheath composed of the aponeuroses of the internal oblique and transversus abdominis muscle
What lies below the arcuate line?
- Anterior layer of the rectus sheath composed of the aponeuroses of the external oblique, internal oblique, and transversus abdominis muscles
- Posterior layer of the rectus sheath formed by the transversalis fascia
Five folds are present on the posterior surface of the anterior abdominal wall, below the umbilicus. What are they?
- Median umbilical fold
- Medial umbilical fold (left and right)
- Lateral umbilical fold (left and right)
This umbilical fold extends from the apex of the bladder to the umbilicus. It contains the urachus.
Median umbilical fold
This umbilical fold extends from the side of the bladder to the umbilicus. It contains the obliterated umbilical artery.
Medial umbilical fold
This umbilical fold extends from the deep inguinal ring to the arcuate line. It contains the inferior epigastric vessels.
Lateral umbilical fold
What is each umbilical fold on the posterior surface of the anterior abdominal wall formed from?
Parietal peritoneum overlying a structure
The umbilical folds form the boundaries between three paired fossae. What are they and where are they located?
- Supravesical fossa: between the median and medial umbilical folds
- Medial inguinal fossa: between the medial and lateral umbilical folds
- Lateral inguinal fossa: lateral to the lateral umbilical fold
This structure lies above the umbilicus and contains the obliterated umbilical vein. It is the free edge of the falciform ligament, which is attached to the liver.
Ligamentum teres
What is the blood supply of the anterior abdominal wall?
- Superior epigastric artery (from the internal thoracic artery)
- Inferior epigastric artery (from the external iliac artery)
- Lumbar arteries (from the abdominal aorta)
- Deep circumflex iliac artery (from the external iliac artery)
What is the innervation of the anterior abdominal wall?
Lower 6 thoracic nerves
Which nerves run between the internal oblique and transversus abdominus muscles?
7th to 12th thoracic nerves
This structure is formed by the lower edge of the external oblique aponeurosis. It extends from the anterior superior iliac spine to the pubic tubercle.
Inguinal ligament
These are the most medial fibers of the inguinal ligament which are inserted into the superior pubic ramus.
Lacunar ligament
This is a lateral extension of the lacunar ligament along the pecten pubis (pectineal line).
Pectineal ligament
This structure is an oblique passage 3-5 cm in length through the anterior abdominal wall. It begins at the deep inguinal ring and ends at the superficial inguinal ring.
Inguinal canal
The inguinal canal is much larger in the male than the female. What does it transmit?
- Spermatic cord (in the male)
- Round ligament of the uterus (in the female)
- Ilioinguinal nerve (in both sexes)
This is formed by the fusion of the aponeuroses of the internal oblique and transversus abdominis muscles as they insert into the pubic crest and pecten pubis deep to the inguinal ligament. This structure strengthens the posterior wall of the medial half of the inguinal canal.
Conjoint tendon (inguinal falx)
What are the boundaries of the inguinal canal?
- Anterior wall: formed by the aponeurosis of the external oblique muscle
- Posterior wall: formed by the conjoint tendon and transversalis fascia
- Roof: formed by the arching fibers of the internal oblique and transversus abdominis muscles
- Floor: formed by the inguinal and lacunar ligaments
This is a triangular opening in the external oblique aponeurosis. It lies immediately lateral to the pubic tubercle.
Superficial inguinal ring
The superficial inguinal ring is formed by the splitting of the external oblique aponeurosis into two crura. What are they?
- Lateral crus: inserts into the pubic tubercle
- Medial crus: inserts into the pubic crest
These fibers strengthen the apex of the superficial inguinal ring.
Intercrural fibers
This is an opening within the transversalis fascia. It is located above the inguinal ligament midway between the anterior superior iliac spine and the pubic symphysis. It lies just lateral to the inferior epigastric vessesls.
Deep inguinal ring
This is an area of potential weakness in the anterior abdominal wall. Direct inguinal hernias occur here.
Inguinal triangle
What are the boundaries of the inguinal triangle?
- Medially by the lateral edge of the rectus abdominis muscle
- Laterally by the inferior epigastric vessels
- Inferiorly by the inguinal ligament
What is the orientation of the inguinal canal before birth? Adulthood?
The inguinal canal is much shorter and less oblique before birth. The superficial ring lies almost directly anterior to the deep inguinal ring. In the adult the canal lengthens and assumes its characteristically oblique position
What two anatomical adaptations function to strengthen the inguinal canal?
- Its oblique nature allows it to be compressed by the muscles of the anterior abdominal wall when they contract
- Conjoint tendon reinforces the posterior wall of the inguinal canal
This condition is an abnormal protrusion of tissue through an opening.
Hernia
Inguinal hernias are more common in males than females. Why?
- The large diameter of the inguinal canals in males
- The scrotum is an outpouching of the anterior wall. It creates a large potential space for abdominal viscera to fill.
What are the two types of inguinal hernias?
- Indirect inguinal hernia
- Direct inguinal hernia
This type of inguinal hernia passes through the deep inguinal ring, inguinal canal, and superficial inguinal ring before descending into the scrotum (or labia majora), it passes lateral to the inferior epigastric vessels, and accounts for 75% of inguinal hernias.
Indirect inguinal hernia
This type of inguinal hernia passes directly through the posterior wall of the inguinal canal, bypassing the deep inguinal ring. It passes medial to the inferior epigastric vessels, through the inguinal triangle, causes a general bulging of the anterior abdominal wall, but does not descend into the scrotum, and is always acquired.
Direct inguinal hernia
This is an embryological outpouching of peritoneum which forms the inguinal canal and the tunica vaginalis of the scrotum. It normally obliterates. When it does not, it leaves a sizable passageway for intestines to pass into the scrotum.
Processus vaginalis
This other kind of hernia passes through the femoral canal, occurs inferior to the inguinal ligament, and is more common in females than men.
Femoral hernia
This other kind of hernia usually results from incomplete closure of the anterior abdominal wall after ligation of the umbilicus at birth. It can also occur due to defects in the linea alba.
Umbilical hernia
What are the three concentric layers of fascia derived from the anterior abdominal wall that cover the spermatic cord?
- External spermatic fascia
- Cremasteric fascia
- Internal spermatic fascia
What is the origin of the cremaster muscle?
Internal oblique muscle, inguinal ligament, pubic tubercle, pubic crest
What is the insertion of the cremaster muscle?
Spermatic cord
What is the innervation of the cremaster muscle?
Genital branch of the genitofemoral nerve (L1, L2)
What is the action of the cremaster muscle?
To retract the testis
A subluxation of what vertebral levels can decrease sperm levels?
L1 and L2
What structures does the spermatic cord contain?
- Ductus deferens
- Testicular artery
- Pampiniform plexus of veins
- Artery to the ductus deferens
- Cremasteric artery
- Genital brach of genitofemoral nerve
- Remnant of processus vaginalis
- Autonomic nerves
- Lymphatics
This is a muscular duct which transports sperm from the epididymis to the ejaculatory duct.
Ductus deferens
This is an extensive network of veins which makes up the bulk of the spermatic cord. These veins join together at the deep inguinal ring to form the testicular vein.
Pampiniform plexus of veins
This term is used to describe varicose veins in the pampiniform plexus.
Varicocele
The ilioinguinal nerve runs through the inguinal canal and superficial inguinal ring. It accompanies the spermatic cord but is not part of it. What are its two branches?
- Femoral branch: supplies the upper medial part of the thigh
- Anterior scrotal or anterior labial nerve: anterior scrotal nerve supplies the root of the penis and anterior part of the scrotum. Anterior labial nerve supplies the mons pubis and anterior part of the labia majora
This is an outpouching of the anterior abdominal wall. Its skin is thin with little or not fat and it is important for maintaining a temperature below body temperature.
Scrotum
What structures does the scrotum contain?
- Testes
- Epididymis
- Lower part of the spermatic cord
These are smooth muscle fibers which are firmly adherent to the skin of the scrotum. It functions in temperature regulation.
Dartos muscle
This layer of the scrotum is the continuation of peritoneum and contains both a parietal (superficial, lies internal spermatic fascia) and visceral layer (deep, firmly adherent to the testis and epididymis).
Tunica Vaginalis
What are the functions of the testes?
- Production of spermatozoa
- Secretion of androgens
This is the fibrous outer covering of the testis. It lies deep to the visceral layer of the tunica vaginalis, which is the deepest layer of the stcrotum.
Tunica Albuginea
This is a fibrous compartment in the posterior part of the testis where the septa converge.
Mediastinum testis
This is the functional, sperm producing portion of the testis. Each lobule contains 2 to 3 of these and they unite to form straight tubules.
Seminiferous tubules
This is an elaborate network of canals located within the mediastinum testis into which the straight tubules empty.
Rete testis
These are ducts which connect the rete testis to the head of the epididymis.
Efferent ductules
This is a C-shaped structure attached to the superior and posterior aspect of the testis. It functions to store sperm until they mature.
Epididymis
What are the three parts of the epididymis?
- Head: connected to the superior surface of the testis by the efferent ductules
- Body: located along the posterior surface of the testis
- Tail: ends in the ductus deferens