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ESA3 > GI 4 - Abdominal Wall + Hernias > Flashcards

GI 4 - Abdominal Wall + Hernias Flashcards

1
Q

Name the 5 muscles which form the anterolateral abdominal wall:

A

1) External obliques
2) Internal obliques
3) Transverse abdominis
4) Rectus abdominis
5) Pyramidalis

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2
Q

What is the function of the anterolateral abdominal wall?

A
  • Forms firm flexible wall
  • Protects abdominal viscera
  • Assists forced expiration
  • Allows increased abdominal pressure for coughing/vomiting etc
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3
Q

Name the straight line down the middle of the rectus abdominis:

A

Linea alba

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4
Q

Where is the arcuate line? What is its significance?

A

1/3rd between the umbilicus and pubic symphysis

  • Above this line = anterior and posterior shealth surrounding rectus abdominis
  • Below this line = only anterior sheath
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5
Q

Why are most abdominal incisions performed through tendond/aponeurosis, not muscle?

A
  • Tendons can be stitched back together to provide strength

- Muscles cannot be stitched - they shred

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6
Q

Where is the incision for an appendicetomy performed? What type of incision is it?

A
  • McBurney’s point = 2/3rds from umbilicus to ASIS

- Grid-iron incision

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7
Q

Why is a C- section performed below the arcuate line?

A

No posterior sheath behind the rectus abdominus

= Better recovery

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8
Q

What is Ectopia cordis?

A
  • Congenital

- Heart either partially or completely outside thorax

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9
Q

What is the presentation of a patent urachus?

A

Urine from umbilicus

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10
Q

What is the presentation of a patent vitelline duct?

A

Faeces from the umbilicus

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11
Q

What is exomphalos?

A
  • Congenital
  • Failure of abdominal contents to move into abdomen after development
  • Viscera covered by peritoneum
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12
Q

What is gastroschisis?

A

Abdominal content’s do not move into abdomen after development
- Viscera not covered by peritoneum

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13
Q

What is the difference between exomphalos and gastroschisis?

A

Exomphalos - abdominal contents covered by peritoneum

Gastroschisis - abdominal contents not covered by peritoneum

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14
Q

What can cause visceral pain?

A
  • Inflammation
  • Ischaemia
  • Stretch
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15
Q

Explain somatic referred pain:

A

Pain caused to proximal part of somatic nerve may be percieved in the distal dermatome of the nerve

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16
Q

What structures divide the peritoneal cavity into the greater and lesser sacs?

A

Greater omentum

Lesser omentum

17
Q

What structure divides the greater omentum into the supra- and infra-colic compartments?

A

Transverse mesocolon

18
Q

What GI structures are present in the supracolic compartment?

A
  • Abdominal oesophagus
  • Stomach
  • Liver
  • Spleen
  • Upper part of duodenum
19
Q

What GI structures are present in the infracolic compartments?

A
  • Small intestine
  • Ascending colon
  • Descending colon
20
Q

Name the structures which connect the supra- and infracolic compartments:

A

Left and right paracolic gutter’s

21
Q

Name the structures in the free edge of the lesser omentum:

A
  • Hepatic artery
  • Hepatic portal vein
  • Common bile duct
22
Q

Name the extensions of the peritoneal membrane, in which fluid can collect:

A
  • Rectouterine pouch (women)
  • Vesicouterine pouch (women)
  • Rectovesicle pouch (men)
  • Paracolic gutters
  • Hepatorenal pouch
23
Q

Where are the main sites of potential weakness in the abdominal wall?

A
  • Umbilical area
  • Femoral cana
  • Inguinal canal
  • Site of previous abdominal surgery
24
Q

What are the anterior and posterior walls of the inguinal canal?

A 
Anterior = External obliques
Posterior = Transversalis fascia + Conjoint tendon (medially)
25
Q

What structures form the roof and floor of the inguinal canal?

A 
Roof = Muscular arches + aponeuroses of internal oblique + transverse abdominus
Floor = Inguinal ligament + lacunar ligament (medially)
26
Q

Which structure lies at the midpoint of the inguinal ligament?

A

Deep inguinal ring

27
Q

What structure lies at the mid-inguinal point?

A

Femoral artery

28
Q

What is the length of the inguinal canal?

A

~ 4 cm

29
Q

Define hernia:

A

Protrusion of organ through a cavity wall of which it is normally contained

30
Q

What is the difference between direct and indirect hernias, in regards to their origin?

A 
Direct = originate medial to inferior epigastric vessels
Indirect = originate lateral to inferior epigastric vessels

ESA3 (48 decks)

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