Goal 4: Anterior Abd Wall And Inguinal Canal Flashcards
From superficial to deep, list the contents of the Anterolateral abdominal wall.
- skin
- Camper’s fascia
- Scarpa’s fascia
- investing fascia layer superficial
- external oblique
- investing fascia layer intermediate
- internal oblique
- investing fascia layer deep
- transverse abdominis
- transversalis fascia
- extraperitoneal fat
- parietal peritoneum
What does the linea Alba connect? Where is the linea Alba located? What is the linea Alba derived from?
- connect the two rectus sheaths
- located vertically midline of the abdomen
- derived from the aponeurosis of where the transverse abdominalis and obliques meet
At what spinal cord level is the umbilicus located? What is the significance of this?
- at L4 spinal cord level
- between L3 and L4 vertebrae
- used as a landmark for spinal taps
Scarpa’s fascia continues into the peritoneum under a different name. What is it called and what does it connect to? Why is this significance of this?
- Colles Fascia, connects to the perineal membrane
- if the urethra ruptured, since the fascia covers it, leaking urine can go up to the Scarpa’s fascia as well
What does the Darto’s fascia cover? Where is it derived from? What does it help with?
- fascia layer that covers the scrotum
- derived from the subq tissue of the scrotum and base of penis
- helps with temperature control
Where is Buck’s fascia located and what does it cover?
- located at the penis
- covers the corpora cavernosa and corpus spongiosum
What are the flat muscles of the abdominal wall? What are the longitudinal muscles?
Flat: external oblique, internal oblique, transverse abdominis
-longitudinal: rectus abdominis, pyramidalis
Where is the inguinal ligament derived from?
From the external obliques’ aponeurosis
What exits through the superficial inguinal ring?
- males: spermatic cord
- female: round ligament of the uterus
What nerve roots innervate the muscles of the abdomen?
T7-T12
Where does the rectus abdominis originate from?
Pubic symphysis and pubic crest
What two layers of abdominal muscles are derived from the iliac crest?
Internal oblique and transverse abdominis
What antereolateral layer has no layer around the spermatic cord?
Transverse abdominis
When the peritoneum goes into the perineal sac, what is it called? What doss it cover?
- tunica vaginalis
- testis and epididymis
What are the layers of the spermatic cord from superficial to deep?
- dartos fascia
- external spermatic fascia
- cremaster muscle
- cremasteric fascia
- internal spermatic fascia
- vestige of processus vaginalis
What is the ICE TIE pneumonic?
- derivatives of the spermatic cord from the abdominal layers
- Internal spermatic cord (Transversalis fascia)
- Cremaster muscle (Internal oblique)
- External spermatic cord (external oblique)
How do the abdominal layers spread down to the peritoneal cavity?
-descent of the testes pulls the layers down
What 3 things does the external oblique and aponeurosis form?
- inguinal ligament
- superficial inguinal ring
- external spermatic fascia
What makes up the rectus sheath?
The aponeurosis of all three abdominal muscles
Where is the actuate line located?
-between the rectus sheath covering the superior 3/4s of the rectus abdominis and transversalis fascia covering the inferior 1/4
What is the cremester reflex? What is the afferent and efferent limb of this reflex?What supplies the cremester muscle? What is the nerve root?
- when you stroke the medical side of a male’s thigh, the testes elevate
- afferent- ilioinguinal nerve, efferent-genitofemoral nerve
- supplied by the genitofemoral nerve
- L1 is tested with this reflex
Where does the Subcostal nerve run over? What is it’s nerve root?
- under 12th rib to below the umbilicus
- T12
Where does the Iliohypogastric nerve drum through? What is it’s nerve root?
- gosh through the transversus abdominis and through the external oblique aponeurosis
- L1
What is the nerve root for Thoraco-abdominal nerve? Ilio-inguinal nerve?
- T7-T11
- L1
What vein is the thoraco-epigastric and superficial epigastric vein derived from?
Femoral vein
Lymphatic nodes below the umbilicus drain to what group of nodes? How about if they’re above the umbilicus?
- below: superficial inguinal lymph nodes
- above: axillary lymph nodes
What makes up the collateral pathway used to get blood back to the heart when the IVC is blocked? What main vein does this anastomosis drain into instead to get to the heart?
- Superficial epigastric (femoral) vein land lateral(axillary) veins = THORACO-EPIGASTRIC VEIN
- drain into the SVC or superior vena cava
What is the difference between indirect and direct hernias?
- indirect: herniation is lateral to inferior epigastric vessels, go through external inguinal ring ONLY, covered by external fascia
- direct: (Hesselbach triangle) herniation is medial to inferior epigastric vessels, go through internal and external inguinal rings, covered by all 3 layers of the spermatic cord
Where is the inguinal canal located?
Lies parallel and above medial 1/2 of the inguinal ligament
What do the testes relocated from the lumbar region to deep inguinal ring (decent of testes)? Between what weeks does this happen?
- increased abdominal temp and pressure, vertebral column growth, gubernaculum (cord that connect testes with scrotum and it fails to elongate and leads to descent)
- 9-28 weeks
What is the difference between a femoral hernia and an inguinal hernia?
- inguinal: located ABOVE inguinal ligament
- femoral: located BELOW inguinal ligament
What is Hydrocele of testes? Hematocele? Vasectomy? Varicocele?
- hydrocele: fluid in the persistent processus vaginalis(tunica vaginalis), large scrotum, transmits light, doesn’t change in size when lying down
- hematocele: blood in tunica vaginalis, no light transmission since isn’t water
- vasectomy: ligated vas deferens, can be reversed
- varicocele: engorgement of blood in pampiniform plexus of veins, no light but shrinks when lying down, causes low sperm count
