GA1. Anterior Abdominal Wall Flashcards
Transpyloric plane is at _____ vert.
L1
Subcostal plane is at _______ vert.
L3
Supracristal plane is at ____ vert
L4
Intertubercular plane is at _____ vert
L5
_______ plane is found mid way btw Jugular notch and symphysis pubis
Transpyloric Plane
The pyloric of the stomach is found in ______ plane
transpyloric PLane
_______ plane is at the hightest point of the iliac crest
supracristal plane
________ plane passes through L/R iliac tubercles
Intertubercular plane
________ plane is found midway btw transpyloric plane and symphysis pubis
Intertubercular plane
Name the 3 planes that make up the various regions of the body
- miclavicular line - vertical
2.Subcostal - (L3) Lowest edge of the 10th
costal cart. - transtubericle Plane - (L5)
Another name for the L/R flank region
Lumbar region
Another name for the pubic region
Hypogastric
Another name for the L/R groin
Iliac or inguinal
Organs in the RUQ
Liver
GB
Organs in the LUQ
Stomach
Spleen
(2 S.S. on the left)
When drawing the quadrant system where are the lines drawn through?
umbilicus
How do you locate McMurphy’s pt?
Intersection of the R. Midclavicular Line & R. Subcostal margin
= GB disease
Pt. at which we find tenderness for GB disease
McMurphy’s pt.
Describe how to find McBurney’s Pt.
-From the umbilicus to R. ASIS
-Subdivide into 3 parts
Jxn btw medial 2/3rds and lateral 1/3
______ pt is found drawing a line from the umblicus to R. ASIS . Subdivide into 3 parts and it is the jxn btw medial 2/3rds and lat. 1/3rd
McBurney’s Pt
Another name for the fatty layer of the superficial fascia membranous layer
camper’s fascia
Name the order of layers that are cut when cutting for an exploratory surgery
skin–> Camper’s fascia–> scarpas fascia–> linea alba –> transversalis fascia –> extraperitoneal fascia –> parietal peritoneum
Layers that are cut when doing surgery for a McBurneys pt incission
Skin–> camper’s fascia–> scarpas fascia–> eternal obl. –> internal obl. transverse ab. –> transversalis fascia–> extraperitoneal fascia –> parietal peritoneum
The inguinal lig. is formed by_______
external abdominal obliq. aperneurosis that rolls up
What are the attachments of the inguinal lig.
ASIS and pubic tubericle
O & I External abd. Obliq
O: lower 8 ribs
I: Lat. lip of the iliac crest;
aponeurosis ending in linea alba
O & I Internal Abd. Obliq.
O: Thoracolumbar fascia;
iliac crest;
lat. 2/3 of inguinal lig.
I: Inferior border of lower 3-4 ribs;
aponeurosis ending in linea alba;
pubic crest
pectineal line
O & I Transversus Abd.
O: Thoracolumbar fascia;
med. lip of iliac crest;
lat. 1/3 of inguinal lig.;
costal cart. of lower 6 ribs
I: Aponeurosis ending in linea alba;
pubic crest
pectineal line
O & I Rectus Abdominis
O: Pubic Crest
Pubic tubercle
Pubic symphysis
I: Costal cart. of ribs 5-7
O & I Pyramidalis
O: front of pubis and pubic symphysis
I: into linea alba
The spermadicord exits out of what structure _____ through the ________ muscle
Superficial inguanal ring
Throught the external abd. oblique M.
Name the two lig. in the anterior abdominal wall
- funiform lig.
2. Suspensory lig
The fundiform lig. runs from the membranous layer of superficial fascia extending from the ________ to the _______
symphysis pubis to the linea alba
The suspensory lig that runs from the deep fascia extending from the ______ to the base of the _______
pubis symphysis to the penis or clit
_____ ligament runs from the deep fascia extending from the pubis symphysis to the penis or clit
suspensory lig
______ lig. runs from the membranous layer of superficial fascia extending from the symphysis pubis to the linea alba
Fundiform lig.
Abdominal muscles support the abdominal _____ as a corset
viscera
4 fxn of the abdominal muscles
- support abdom. viscera
- Breathing
- Valsalva maneuver
- movement of the trunk and posture
__________ is when the abdominals contract and cause an increase in intraabdominal pressure to go to the restroom
Vasalv’a Maneuver
______ is the inferior edge of the posterior rectus sheath
Arcuate line
In btw what two structures does the posterior rectus sheath end?
Mid way btw the umbilicus and pubis
Name the aponeurosis that actually splits and goes around the rectus abdominus anteriorly and posteriorly
Laminae of aponeurosis of the internal oblique
______ line is the lateral boarder of the rectus abdominus
semilunar line
____ is the fusion of all the aponeurosis of the abdominal muscles
linea alba
4 fxn of the anterolateral Abdominal Muscles
- Support
- Support viscera and protects them from injuries
- Compress contents and increases the intra-abdominal pressure by opposing the diaphragm
- Movement and maintain posture
Increase tone of the abdominals = _____ pelvic tilt
posterior
decrease tone in the rectus abdominals = ________ pelvic tilt
anterior
Thoracoabdominal N. derive from what level?
T7-T11
Origin of thoracoabdominal N. (T7-T11)
Continuation of lower intercostal N
7-9th lateral cutaneous N branches orgin
From T7-T9 intercostal N
Origin of the Subcostal N (T12)
Spinal nerve T12
What are two branches of the lumbar plexus
Iliohypogastric (L1)
Ilioinguinal (L1)
Distribution of the thoracoabdominal N (t7-T11)
Muscles and overlying skin
dermatomes
Distribution of 7-9th lateral cutanoeous branches
Skin of R. and L. hypochondriac region
Subcostal N (T12) distribution
(dermatome) muscles and overlying skin superior to iliac crest and inferior to umbilicus
Distribution of the Iliohypogastric (L1) N.
Skin overlying iliac crest, upper inguinal, and hypogastric regions; internal oblique and transversus abdominals
Ilioinguinal (L1) N distribution
Skin of lower inguinal region, mons pubis, anterior scrotum or labium majus, and adj medial thigh; inferiormost internal oblique and transversus abdominal
Vertebral level of subcostal N
T12
Iliohyogastric N. vertebral level
L1
Ilioinguinal N vertebral level
L1
Name the 3 peritoneal umbilical folds of the anterior wall
- Median umbilical fold
- Medial umbilicus lig
- Lateral fold
Where does the median umbilical fold attach
Run from the apex of the bladder to the umbilicus
The median fold is a remnant of _____
urachus
was the development of the urinary bladder
______ joined the apex of fetal bladder to the umbilicus
Urachus
______ is a structure that covers the medial umbilical ligaments
Medial umbicical folds
the _________ fold was formed by obliterated umbilical art.
Medial Lig.
The _____ fold covers the inferior epigastric vessels - artery and vein
Lateral fold
__________- an opening in the aponeurosis of the external abdominal oblique muscle
Superficial inguinal ring
______- opening in the transversalis fascia
Deep inguinal ring
Superficial inguinal ring and deep inguinal ring are covered by_______
parietal peritoneum
The floor of the inguinal canal is formed by ____________ and __________
inguinal ligament and lacunar ligament
The roof of the inguinal canal is the arching fibers of ________ and _________
internal oblique and transversus abdominis muscle
The anterior wall of the inguinal canal is formed by the aponeurosis of the _______ muscle
aperneurosis of the external abdominal oblique muscle, and reinforced by internal oblique M
The posterior wall of the inguinal canal is forme by ______, and reinforced medially by ________ tendon
Transversalis fascia , conjoint tendon
The fxn of the inguinal canal in males is to allow _______
the spermatic cord to pass to and from the testis
The function of the inguinal canal in females permits the passage of ________ ligament of the uterus
round lig
The inguinal canal allows the passage of the round ligament of the uterus from the ______ to the ________
uterus to the labium majus
The _______ nerve runs in the inguinal canal (in both sexes)
( L1) ilioinguinal N
_______ inguinal ring creates the opening where the spermaticord/ round lig. exits the aponeurosis of the external abd. obliq M.
Superficial inguinal ring
________ inguinal ring is the enterance of the inguinal canal
Deep inguinal ring
where the vas deferense/ round lig enters the transversalis fascia
The inguinal canal is formed by the decent of ________ in males
testes
The inguinal N. is derived from _______
L1
______ suspends testis in the scrotum
spermatic cord
The spermatic cord begins at _______
the deep inguinal ring
ends at posterior border of the testis
Testis originate from what type of tissue?
intermediate mesoderm (in the post. abd. wall)
The processus vaginalis is an invagination of ________ during testis decent
Parietal peritoneum
C.C. Indirect type of inguinal hernia is caused by _______ failing to close at birth
processus vaginalis
c.c. : The processus vaginalis failed to closed during birth, and now there is abd. contents in the scrotum . This is called ______
indirect type of inguinal hernia
_____ is an opening in the processus vaginalis on the Anterior aspect of the testis
tunica vaginalis
Name the 4 structures that get pulled down when the testis descend making the spermaticord
- Testicular art. & veins
- vas deferens
- Nerves
- Lymphatic
Name the 3 coverings of the spermatic cord
- External spermatic fascia
- cremasteric fascia
- internal spermatic fascia
Muscle that draws testis up in cold or relaxes during hot temps
Cremasteric muscle
Cermasteric muscle nerve innervation
genital branch of genitofermoral N
–> A part of the Lumbar plexus (L1, L2)
3 arteries in the spermatic cord
- testicular aa.
- deferential aa
- cremasteric aa.
_______ plexus makes up the testicular plexus of veins
pampiniform plexus
Genital branch of the ____________ N. innervates the cremaster M.
genitalfemoral N.
branch of Lumbar plexus L1, L2
What layer of the superficial fascia desend down into the spermatic cord?
Scarpus
campers does not desend - there is no fat in the scrotum
What is the layer of the superficial fascia that does not desend with the spermatic cord?
Campers- there is no fat in the scrotum
The scarpus fascia is a derivative of the _____ fascia in the spermatic cord
Colle’s fascia
_______ muscle is responsible for the wrinkling of the scrotum
Dartos Muscle
The external obliq M. gives of the ______ in the spermatic cord
External spermatic fascia
__________ covers the spermatic cord itself
external spermatic fascia
The internal obliq muscle gives off the _______ in the spermatic cord
cremasteric fascia and muscle
________ muscle is responsible for pulling the testis close to the body (for optimal spermatogenesis)
Cremasteric Muscle
______ reflex brings the testis closer to the body
cremasteric reflex (L1)
Transversalis fascia gives off the _____ in the spermatic cord
internal spermatic fascia
Where does the only fat in the spermatic cord come from ?
extraperitoneal fat
The parietal peritoneum gives off the ______ in the spermatic cord
tunica vaginalis
Direct inguinal hernias are common in ____ males. caused by?
elderly
Cause: weakening of the abdominal muscle
indirect inguinal hernias are common in _____ males
Younger males / male children
Causes: an opening (patency) of the processus vaginalis
Indirect hernias will be ______ to the inferior epigastric vessels
Lateral
younger males
Direct hernias will be ______ to the inferior epigastric vessels
Medial
older males
An indirect hernia enters into the _______
spermatic cord & inguinal canal
it is a opening in the processus vaginalis
A direct hernia protrudes through the _____
hesselbach’s triangle
Give the three boundaries of the hesselbach triangle
- Medial: Rectus Abdominus
- Inferior: inguinal lig
- lateral: Inferior Epigastric vessel
What is the medial border of the hesselbach triangle
rectus abd.
What is the inferior border of the hesselbach triangle
inguinal lig
What is the laterial border of the hesselbach triangle
inferior epigastric vessels
inferior epig. vessel is lateral –> therefore the protrusion will be medial to this vessel in direct hernias
What nerves can be injured when a McBurney’s incision is done?
SN T11 & T12 (ant. subcutaneous branches)
Decrease sensation
When an incision is made in the bikini line for a ceasarian section what vascular structure can be damaged?
Inferior epigastric vessels
What is the sensory component of the cremasteric reflex?
Ilioinguinal N. from L1
What is the motor component of the cremasteric reflex?
genital branch of genitalfemoral N
below umbilicus all aponeurosis ___ to the rectus abdominis
anterior
No ____ rectus sheath below the arcuate line
posterior
if abdominal muscles are strong, they overlap the Hasselback’s triangle _____ and if the muscles are weak the triangle is ____
protecting
exposed
femoral hernia
most common in women
incisional hernia
when incisions do not properly heal
________ pt is at the intersection of the R. Midclavicular Line and R. Subcostal Margin
McMurphy’s Pt
= GB disease
