Gross 2 Abdominal Wall Flashcards

1
Q

What are the boundaries of the abdominal area?

A

Superiorly: Diaphragm

Inferiorly: Iliac Crest down to inguinal Lig. to pub. symphysis, pelvic floor muscles

Anteriorly: Abdominal Musculature

Posteriorly: Lumbar Vertebrae / QL

Laterally: Abdominal Musculature

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2
Q

What are the four Abdominal Regions Planes of the Abdomen? What are the structures associated with each plane?

A
  • Subcostal {Vert. Lvl. L2/L3 disc}: Costal Cartilage Lowest level
  • Transtubercular {Vert. Lvl. L5 body}: Iliac Tubercles
  • Right Mid-Clavicular: Mid-Clavicle to Inguinal Ligament
  • Left Mid- Clavicular: Mid-Clavicle to Inguinal Ligament
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3
Q

What are the two Abdominal Quadrant Planes in the abdomen? What are the structures associated with each plane?

A
  • Transumbilical {Vert. Lvl. L3/L4 disc}: Umbilicus
  • Median Plane: Midline of body through umbilicus
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4
Q

What are the 9 regions of the Abdomen?

A
  • R. Hypochondrium / Epigastric / L. Hypochondrium
  • R. Lumbar (Flank) / Umbilical / L. Lumbar (Flank)
  • R. Inguinal / Pubic / L. Inguinal
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5
Q

What are the 4 Quadrants of the Abdomen?

A

Right Upper Quadrant / Left Upper Quadrant

Right Lower Quadrant / Left Lower Quadrant

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6
Q

The Abdomen can be divided into 4 areas, what are those areas and what do they contain?

A
  • Anterior/Lateral Abdominal Wall: formed by the abdominal walls
  • Inguinal: Containing the inguinal ligament and canal
  • Posterior Abdominal Wall: Containing the lumbar spine and their disc, the lumbar nerve plexus, fascia, diaphragm, iliopsoas, QL, transverse abdominis, Internal and External oblique
  • Abdominal Cavity: Containing the abdominal organs and BVs
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7
Q

One of the areas of the Abdomen is the Anterior/Lateral Abdominal Wall, what are the boarders to this area?

A

Superiorly: 7th - 10th costal cartilage, Xiphoid

Inferiorly: Upper Pelvis

Anteriorly: Rectus Abdominis

Laterally: External/Internal Oblique, Transverse abdominis

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8
Q

What are the layers of the Anterolateral Wall?

A

Superficial to deep
- Skin
- Subcutaneous Tissue
–Campers (Superficial fatty layer)
–Scarpa (Deep membranous layer)
- Muscles and Associated fascia
- Transverse Fascia
- Extraperitoneal Fat
- Parietal Peritoneum

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9
Q

What are the muscles of the Anterior Wall and Anterolateral Wall?

A

Anterior Wall: Rectus Abdominus, and this muscle is on both sides of the midline

Anterolateral Wall: 3 broad muscles and thin sheets of muscle that are aponeurotic anteriorly
(External Oblique, Internal Oblique, Transverse Abdominus)

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10
Q

What are the functions of the Anterolateral Abdominal Muscles?

A
  • Increases intra-abdominal pressure
  • Protects the abdominal viscera
  • Expands walls during inspiration
  • Helps maintain posture
  • Movement of the trunk/turning
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11
Q

One of the areas of the Abdomen is the Posterior Abdominal Wall, what are the boarders to this area?

A

Medially: Lumbar vertebrae and disc, and Psoas M.

Laterally: QL, IO and EO, and Transverse Abdomens

Superiorly: Diaphragm

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12
Q

One of the areas of the Abdomen is the Inguinal, what are the borders to this area?

A

Superior-Lateral: ASIS

Inferior-Medial: Pubic Tubercle

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13
Q

What are the contents in the Inguinal Region?

A
  • Inguinal Ligament
  • Iliopubic Tract
  • Inguinal Canal
  • Spermatic Cord (Males)
  • Round Ligament of the Uterus (Female)
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14
Q

What is the Inguinal Ligament? What is the Subinguinal Space?

A

A ligament formed by the thickened infolding of the External Oblique (EO), also has:
–Lacunar Ligament: Medial boundary of the subinguinal space
–Pectineal Ligament

The Subinguinal Space is a passage way for neurovasculature for the lower limb

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15
Q

What is the Iliopubic Tract created by and what does it reinforce?

A

This is created by the inferior margin of the Transverse Fascia
- This reinforces the posterior wall and floor of the inguinal canal

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16
Q

What are the boundaries of the Inguinal Canal?
(Anterior wall, Posterior wall, roof, and floor)

A

Anterior Wall: External Oblique and fibers of the Internal Oblique Laterally

Posterior Wall: Transverse Fascia

Roof: Musculo-aponeurotic arcades (Internal Oblique + Transverse ABdominis)

Floor: Iliopubic Tract, Inguinal Lig., Lacunar Lig.

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17
Q

What are the Superficial and Deep Inguinal Rings? What are they formed/created by?

A

These serve as an entrance and exit

Superficial Ring:
- Formed by a split in the External Oblique Aponeurosis
- Held together by the internal crural fibers

Deep Ring:
- Created by an invagination of the Transversalis Fascia
- Located ~1 cm superior to the middle portion of the inguinal ligament

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18
Q

What contents would we find in the Inguinal Canal in a Male?

A
  • Ilioinguinal Nerve
  • Spermatic Cord
    –This Cord contains:
    Ductus Deferenes, Testicular A., Pampiniform Venous Plexus, Cremaster A., Genitofemoral N.
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19
Q

What contents would we find in the Inguinal Canal in Females? What is the function of the found ligament of the uterus?

A
  • Round Ligament of the Uterus
  • Ilioinguinal N.
  • Genital Branch of the Genitofemoral N.

The round ligament maintains the position of the uterus

20
Q

One of the areas of the Abdomen is the Posterior Abdomen Wall, what are the borders to this area?

A

Medially: Lumbar Vertebrae

Laterally: Quadratus Lumborum (QL)

21
Q

One of the areas of the Abdomen is the Abdominal Cavity, what are the border to this area?

A

The space within the abdominal areas

22
Q

What are the muscle(s) of the anterior wall?

A

The rectus abdominis (A wide vertical muscle on both sides of the mid-line)

23
Q

What are the muscle(s) of the anterolateral wall?

A

Three broad and thin sheets of muscle that are aponeurotic anteriorly

  • External Oblique (Most superficial)
  • Internal Oblique
  • Transverse Abdominis (Deepest)
24
Q

If a person is doing a diagonal sit-up to the left side, what muscles are being activated?

A
  • Left Rotation:
    Right External Oblique + Left Internal Oblique
    (EO=Contralateral rot.) (IO=Ipsilateral rot.)
  • Trunk Flexion:
    Rectus Abdominus
25
Q

If a person is doing a diagonal sit-up to the left side, what muscles are activated during the eccentric component? (Lowering trunk to floor)

A
  • Right Rotation occurring Eccentrically:
    Right External Oblique + Left Internal Oblique

-Trunk Flexion:
Rectus Femoris

Same as concentric

26
Q

What muscles are activated during anterior and posterior tilt?

A
  • Anterior Tilt:
    —-Multifidi and Erector Spinae (Lumbar Extension)
    —-Iliopsoas (Hip Flexor)
  • Posterior Tilt:
    —-Rectus Abdominus (Abdominals)
    —-Hamstrings (Hip Extensors)
27
Q

What makes up the Rectus Sheath?

A

All the muscles (External/Internal Oblique, and Transverse Abdominis) are encapsulated by fascia/sheath. They encapsulate the Rectus Abdominis and attach at the midsagittal line to form the linea alba.

The muscels encapsulating the rectus will very by location

28
Q

What muscle(s) encapsulate the Rectus Abdominis in the Epigastric Region?

A
  • External Oblique forms the Anterior and Posterior part
29
Q

What muscle(s) encapsulate the Rectus Abdominis in the Umbilical Region?

A

Anterior Part by External and Internal Oblique

Posterior Part by Internal Oblique, Transverse Abdominis and Transversalis Fascia

30
Q

What muscle(s) encapsulate the Rectus Abdominis in the Hypogastric Region?

A

Anterior Part by External and Internal Oblique, and Transverse Abdominis

Posterior Part by Transversalis Fascia

31
Q

What is the dysfunction of the Linea Alba? When is it most common?

A

Diastasis Recti: The Splitting of the Linea Alba

Most common in:
- Pregnancy
- Valsalva (Forces Exhalation against closed airway)

32
Q

What are common causes of Abdominal Protuberance?

A
  • Food
  • Fluid
  • Fat
  • Feces
  • Flatus (Gas)
  • Fetus
33
Q

How will an abdominal protuberance affect posture?

A

It’ll shift the Center Of Mass (COM) anteriorly, and this can lead to increased lumbar lordosis

34
Q

What are abdominal pathologies?

A

Abdominal Hernias, and these hernias are names according to their region/area

35
Q

What is the difference between Direct Hernias and Indirect Hernias?

A

Direct Hernia: Result of weakening in the Abdominal wall

Indirect Hernia: Passes through Inguinal Ring

36
Q

What is the Neurovascular plane? Where does it lie?

A
  • This contains the nerves and arteries supplying the anterolateral abdominal wall
  • This lies between the internal oblique and transverse abdominus
37
Q

What are the arteries that supply the Anterolateral Abdominal Wall? (8)

A
  • Musculophrenic A.
  • Superior Epigastric A.
  • 10th and 11th posterior intercostal A.
  • Subcostal A.
  • Inferior Epigastric A.
  • Deep Circumflex Iliac A.
  • Superficial Circumflex A.
  • Superficial Epigastric A.
38
Q

What are the Primary Arteries the supply the Anterior Abdominal Wall? What regions will they supply?

A
  • Superior Epigastric A. (Epigastric region)
  • Inferior Epigastric A. (Pubic region)
  • Superficial Epigastric A. (Pubic region)

The Superior and Inferior Epigastric will anastomose and will also supply the Umbilical region

39
Q

What arteries supply the Hypochondriac Region?

A

Musculophrenic A.

40
Q

What arteries supply the Lumbar Region?

A

Intercostal A.
Subcostal A.

41
Q

What arteries supply the Inguinal Region?

A

Deep Circumflex Iliac A.
Superficial Circumflex Iliac A.

42
Q

What is the pathway from the heart to the Right Superior Epigastric Artery?

A

Heart -> Aorta -> Brachiocephalic -> Subclavian A. -> Internal Thoracic -> Superior Epigastric A.

(If it were the left superior epigastric, it wouldnt go through brachiocephalic, it’ll go straight to subclavian)

43
Q

What is the pathway from the heart to the Deep Circumflex Iliac Artery?

A

Heart -> Thoracic Aorta -> Abdominal Aorta -> Common Iliac A. -> External Iliac -> Deep Circumflex Iliac A.

Same pathway for Inferior Epigastric A.

44
Q

Which nerve(s) innervate the muscles of the Anterolateral Abdominal Wall?

A
  • Intercostal N.
  • Subcostal N.
  • Iliohypogastric N.
  • Ilioinguinal N.
45
Q

What are the layers of the internal surface of the Anterolateral Wall?

A

From Deep to Superficial
- Parietal Peritoneum
- Extra-Peritoneal Fat
- Transverse Fascia

46
Q

What are the Parts of the Internal Surface of the Anterolateral Wall? What are in these parts?

A
  • Supra-Umbilical
    –Falciform Ligament (Attaches the liver to abdominal wall
  • Infra-Umbilical (3 Folds, 3 Fossas)
    –Folds: Median, Medial, Lateral
    –Fossas: Supravesical Fossae, Medial Inguinal Fossae, Lateral Fossae