Jan29 M3-Anatomy Lecture 1

Question 1

extraperitoneal fatty tissue location

Answer 1

between peritoneum and transversalis fascia

Question 2

7 layers of the anterior abdomen

Answer 2

skin, superficial fascia, deep fascia, anterolateral wall muscles, transversalis fascia, extraperitoneal fatty tissue, peritoneum

Question 3

superficial fascia components

Answer 3

Camper’s fascia (superficial fatty)
Scarpa’s fascia
(deep membranous)

Question 4

deep fascia def

Answer 4

fascia coating/covering every muscle in the body

Question 5

external oblique runs in what direction

Answer 5

hands in pockets.

starts on rib cage.

Question 6

external oblique: 2 target places where it joins in the bottom

Answer 6

1. inguinal ligament (free lower edge), connected to legs fascia
2. anterior superior iliac spine (ASIS)

Question 7

external oblique: midline extensions + name

Answer 7

beyond midclavicular line, going to midline is only deep fascia. aponeurosis

Question 8

pubic tubercle location

Answer 8

bottom of linea alba (midline)

Question 9

where 2 bands of external oblique fascia end up going

Answer 9

extend to pubic tubercle

Question 10

bump on the hip: what it corresponds to

Answer 10

anterior superior iliac spine

Question 11

internal oblique muscle limited to where and extensions

Answer 11

muscle doesn’t go medially under the ribs (between the costal margins (infrasternal angle)) and is mostly on the side
still aponeurosis

Question 12

transversus abdominis direction and fascia

Answer 12

horizontal. fascia extending to midline

Question 13

rectus abdominis covers name and origin

Answer 13

rectus sheath: formed by fascias of external oblique, internal oblique and transversalis abdominis

Question 14

rectus abdominis origin and insertion and direction

Answer 14

starts on costal cartilage of costal margin. goes down to pubic crest (near pubic tubercles and pubic symphysis)

Question 15

how many pubic tubercles and pubic crests and where

Answer 15

• inguinal ligament extends to pubic tubercle

- pubic crest is from pubic tubercle to midline

Question 16

3 non muscular delineations of the rectus abdominis

Answer 16

• linea alba (middle forward extension of sheaths)
• linea semilunaris (sides)
• tendinous intersections

Question 17

tendinous intersections attach to what structure anteriorly

Answer 17

rectus sheath

Question 18

composition of the rectus sheath right below the xiphoid process (at costal margin level)

Answer 18

deep fascia of EO (external oblique) goes on top of rectus abdominis and makes anterior rectus sheath

Question 19

rectus sheath composition in the middle of the abdomen

Answer 19

anterior: EO + half IO deep fascia
posterior: half of IO, TA, transversalis fascia (TF)

Question 20

lower sheath (low abdomen) composition

Answer 20

anterior: EO + all IO + TA (transversus abdominis)
posterior: TF (transversalis fascia)

Question 21

vessels feeding the rectus abdominis: location in relation to rectus sheath

Answer 21

between rectus abdominis and posterior rectus sheath

Question 22

arcuate line def

Answer 22

(lower edge of posterior rectus sheath) transition line below umbilicus where no more posterior rectus sheath

Question 23

below arcuate line, what is posterior to rectus abdominis

Answer 23

transversalis fascia

Question 24

blood supply to the rectus abdominis

Answer 24

• superior epigastric arteries (from internal thoracic arteries)
• inferior epigastric arteries (from external iliac artery)

Question 25

branchings after abdominal aorta

Answer 25

2 common iliacs. each gives external iliac (becomes femoral artery in the leg) and internal iliac (to the pelvis)

Question 26

blood supply to side of the abdominal wall and origin (2)

Answer 26

- lumbar arteries (L1, L2, L3 and L4) from aorta. as if we had rib cage - deep circumflex iliac artery (from external iliac)

Question 27

link between superior and inferior epigastric artery

Answer 27

they anastomose in the rectus abdominis

Question 28

how inferior epigastric a. reaches the rectus abdominis

Answer 28

pierces through the transversalis fascia and reaches rectus from below arcuate line

Question 29

3 folds visible when looking at abdomen from inside and what causes them/origin

Answer 29

- median umbilical ligament (remnant of embryonic urachus - medial umbilical ligament (remnant of embryonic umbilical artery) - lateral umbilical folds (inferior epigastric vessels)

Question 30

blood supply to abdomen: structure after deep circumflex ilieac

Answer 30

ascending branch of the deep circumflex iliac

Question 31

blood supply to abdomen: branch originating from the femoral artery

Answer 31

superficial epigastric artery

Question 32

venous drainage: 4 deep vessels

Answer 32

- superior epigastric v (to internal thoracic v) - inferior epigastric v (to external iliac v) - superficial CIRCUMFLEX iliac v (to femoral v)

Question 33

venous drainage: 3 superficial vessels

Answer 33

- superficial epigastric v (to iliac v) - thoraco epigastric v - axillary v

Question 34

2 (groups of) lymph nodes important for the abd wall

Answer 34

- axillary lymph nodes | - superficial inguinal lymph nodes

Question 35

thoracic innervation to abd wall and what type of innervation

Answer 35

motor and sensory. anterior and lateral cutaneous branches of lowest five throacoabdominal (or intercostal) nerves (T7-T11) + subcostal nerve (T12)

Question 36

landmark for T10

Answer 36

belly button

Question 37

two L1 level innervation of abdominal wall and position relative to each other

Answer 37

Iliohypogastric nerve (L1) and Ilioinguinal nerve (L1), which is lower than the iliohypogastric n

Question 38

iliohypogastric nerve motor innervation to where and sensory to where

Answer 38

- motor to muscles of abd wall | - sensory to suprapubic region + lateral aspects of the buttocks

Question 39

ilioinguinal nerve motor innervation to where and sensory to where

Answer 39

- motor to muscles of abd wall | - sensory to upper medial part of the thigh, anterior part of the scrotum, mons pubis and labium majus

Question 40

iliohypogastric nerve: how reaches the skin

Answer 40

pierces the EO 3-5 cm above the superficial inguinal ring

Question 41

ilioinguinal nerve: how reaches the skin

Answer 41

emerges from superficial inguinal ring and passes on the surface of the spermatic cord

Question 42

inguinal canal def

Answer 42

canal developed for spermatic cord to get through (since spermatic cord, testes and scrotum are made of layers of abd wall)

Question 43

testes push against which abd layers in development

Answer 43

all layers except TA | so transversalis fascia, internal abd oblique, external abd oblique, Scarpa's fascia, skin

Question 44

how peritoneum relates to the testes

Answer 44

gets sucked in the testes during development even though they don't push on it

Question 45

name of descent of the testes (whole process)

Answer 45

processus vaginalis

Question 46

diff abdo layers names once in the testes (inside to outside)

Answer 46

- obliterated processus vaginalis (perit): descent part - visceral and parietal tunica vaginalis (perit) - internal spermadic fascia (TF) - Cremaster muscle (IO muscle) - External spermadic fascia (EO aponeurosis) - Dartos (Scarpa's fascia) - skin

Question 47

deep inguinal ring def and location

Answer 47

where inguinal canal starts to form and stuff first starts to get through. halfway between ASIS and pubic tubercle

Question 48

superficial inguinal ring def

Answer 48

where we see the spermatic cord coming off

Question 49

3 structures important in hernial repair

Answer 49

conjoint tendon lacunar ligament Cooper's ligament

Question 50

conjoint tendon def

Answer 50

fusion of aponeuroses of TA and IO. Inserts on pubic crest in continuity with pectinal line (middle of pelvis anteriorly) Reinforcement of posteror wall of the inguinal canal

Question 51

lacunar ligament def

Answer 51

backward and lateralward posterior projection of the inguinal ligament on the pectinal line, after it reaches the pubic tubercle

Question 52

Cooper's ligament def

Answer 52

extension of the lacunar ligament that runs on the pectineal line

Question 53

conjoint ligament position relative to rectus abdominis

Answer 53

is where fascias come together in front of rectus

Question 54

inguinal canal content in females

Answer 54

round ligament of the uterus

Question 55

direct hernia def

Answer 55

direct bulging out of the front wall, medially to the inferior epigastric artery, through Hesselbach's triangle

Question 56

indirect hernia def

Answer 56

intestine pushing down into the scrotum (lateral to inferior epigastric artery)

Question 57

3 borders of inguinal triangle or Hesselbach's triangle

Answer 57

medial: lateral margin of rectus abdominis muscle/sheath superlateral: epigastric vessels inferior border: inguinal ligament

Question 58

what is the weakness in the inguinal triangle

Answer 58

no transversalis fascia

Question 59

condition where indirect hernia more likely to happen and explanation

Answer 59

patent processus vaginalis. no closure of the processus vaginalis (which comes from peritoneum) can also have partial closure of the processus vaginalis

Question 60

femoral hernias: occur where

Answer 60

below inguinal ligament, through the femoral canal/ring

Question 61

mnemonic on structures near the femoral canal/ring

Answer 61

NAVEL. nerve, artery, vein, empty, lymphatics

Question 62

condition where an artery sits right in front of the hernial canal (where femoral herniation might happen)

Answer 62

abberant obturator artery

Question 63

abdominal hernias occur where and who can check for these

Answer 63

anterior abdominal wall. phys exam or CT

Question 64

other name for femoral canal

Answer 64

femoral ring