Lec3AnteriorAbdominalWall Flashcards
What is contained in the anterior abdomen Right UPPER quadrant (RUQ)?
liver and gallbladder
stomach
duodenum
pancreas
right kidney +suprarenal gland
right colic (hepatic) flexure
ascending (superior portion) and transverse colon
What is contained in the anterior abdomen Right LOWER quadrant (RLQ)?
cecum
ileum
vermiform appendix
ascending colon (inf. part)
right ovary
right uterine tube
right ureter
uterus
urinary bladder
right spermatic cord
What is contained in the anterior abdomen Left UPPER quadrant (LUQ)?
Liver
stomach
jejunum+proximal ileum
pancreas
left kidney+suprarenal gland
left colic (splenic) flexure
What is contained in the anterior abdomen LEFT LOWER quadrant (LLQ)?
sigmoid colon
descending colon (inf. portion)
left ovary
left uterine tube
left ureter
uterus
urinary bladder
left spermatic cord
What is the venous drainage of the anterior abdominal wall?
Paraumbilical vein drains the abdomen into the portal vein (of the liver)
Superficial epigastric vein branches to what vein
femoral vein
What is caput medusae
its caused by portal hypertension (HTN) and you get swelling of paraumbilical veins
What is the order of the anterior abdominal wall layers?
skin, superficial fascia, deep fascia, flat muscles, transversalis fascia, fat, peritoneum
The superficial fascia of the ant. abdominal wall has 2 layers. What are they?
Campers (fatty later) is superficial
Scarpa’s (membranous layer) deep
What are the flat muscles of the anterior abdominal wall?
external oblique
internal oblique
transversus abdominus
What is the rectus abdominis muscle?
paired muscles running on both sides of the linea alba.
What structure gives a “6 pack” appearance
tendinous intersections
Where is the rectus abdominis located superficial to and deep to?
Superficial to trans abdominis, trans fascia, peritoneum
Deep to external and internal oblique muscle
What is the PA and DA of the external oblique muscle?
PA: ribs 6-12
DA: linea alba, pubic tubercle, ant iliac crest
What do the external oblique contribute to and how do the fibers run?
contributes to inguinal ligament and ext. spermatic fascia
Fibers run infero-medially
What do the internal oblique contribute to and how do the fibers run?
contributes to cremaster muscle
Fibers run supero-medially
What is the PA and DA of the internal oblique muscle?
PA: thoracolumbar fascia, ant iliac crest, lat inguinal ligament
DA: linea alba, ribs 10-12, pubis (via conjoint tendone)
Which two muscles create a conjoint tendon?
Internal oblique and transversus abdominis
How do the transversus abdomnius run?
transversely
How do the transversus abdomnius run?
transversely
What are the pa for transversus abdominus?
ribs 7-12, thoracolumbar fascia, iliac crest, lat inguinal ligament
What are the muscle actions for the flat anterior abdominal muscles?
assists in vomiting, sneezing, and defection
The rectus abdominis muscle divides what?
ant and post rectus sheath
The rectus sheath is formed by what?
aponeurosis of ant abdominal wall muscles
Above the arcuate line, the rectus sheath has an anterior and posterior sheath. What muscles are within the anterior sheath?
external oblique m, internal oblique m (1/2)
Above the arcuate line, the rectus sheath has an anterior and posterior sheath. What muscles are within the posterior sheath?
internal oblique m (1/2), transversus abdominis m, transversalis fascia, peritoneum
Below the arcuate line, the rectus sheath has an anterior and posterior sheath. What muscles are within the anterior sheath?
external oblique m, internal oblique m, tranversus abdominis m
Below the arcuate line, the rectus sheath has an anterior and posterior sheath. What muscles are within the posterior sheath?
tranversalis fascia, peritoneum
Where is the transversalis fascia located?
Deep to the flat muscles
The transversalis fascia continues as which structure?
internal spermatic fascia which is the inner layer of spermatic cord
the internal oblique muscle continues as which structure?
cremaster muscle which is the middle layer of spermatic cord
The external oblique muscle continues as which structure?
external spermatic fascia which is the outer layer of spermatic cord and the inguinal ligament
For the spermatic cord, the ant abdominal wall layers are dragged down with the ____ when they descend into the ______
testes, scrotum
The spermatic cord runs from
deep inguinal ring to testis
The spermatic cord contains
vas deferens and testicular art and vein
What are the 4 inguinal canal structures
inguinal ligaments, inguinal rings, inguinal canal borders, inguinal canal contents
What is the PA, DA, and contributions of the inguinal ligament?
PA: ASIS
DA: pubic tubercle
Contributions: lacunar ligament
Where does the superficial ring and deep ring come from?
(SUP APE) Superficial: from external oblique aponeurosis *bordered by lateral and medial crus
(DEEP TF) deep: from transversalis fascia
The inguinal canal (M.A.L.T.) has what
roof: internal oblique + transversus abdominis m
ant wall: external + interbal oblique apneurosis
floor: inguinal + lacunar ligaments
post wall: conjoint tendon+ transversalis fascia
What are the inguinal canal contents?
inguinal nerve
genital br off genitofemoral nervce
spermatic cord (male) or round ligament of uterus (female)
What are the 5 peritoneal folds of the peritoneum?
median umbilical fold (1)-over remnant of urachus
medial umbilical folds (2)-over fetal umbilical arteries
lateral umbilical folds (2)- over inferior epigastric vessels
What are the borders of the inguinal triangle?
lateral: lateral umbilical fold
medial: medial umbilical fold
base: inguinal ligament
Where is the site of direct hernias?
inguinal triangle (between med and lateral fold)
A direct hernia goes through
a weak spot on posterior wall of inguinal canal
An indirect hernia goes through
deep inguinal rings of inguinal canal
An indirect hernia is most common or less common, is less prone or more prone to strangulation, and what is the hernia covered by?
more common (in males)
more prone
covered by peritoneum and spermatic cord layer
A direct hernia is most common or less common, is less prone or more prone to strangulation, and what is the hernia covered by what?
less common
less prone
covered by peritoneum
During a surgical procedure, a transverse incision is made below the arcuate line
that goes through the anterior rectus sheath, rectus abdominis muscle and
posterior rectus sheath. If the surgeon were not careful, which of the following
structures would likely be damaged if the surgeon cut too deep?
a. Umbilical artery
b. Inferior epigastric artery
c. Lumbar vein
d. Thoracoepigastric vein
b
Which statement about the scarpa’s and camper’s fascia is true?
a. They are the superficial and deep layers of the abdominal wall
b. They form the anterior and posterior layers of the rectus sheath
c. They make the superficial layer of the abdominal wall deep to peritoneum
d. They are the membranous and fatty superficial layers of the abdominal
wall
d
Stimulation of the anterior abdominal wall muscles does NOT result in which
action?
a. Inspiration
b. Vomiting
c. Defecation
d. Sneezing
a
A 36-year old patient developed a direct inguinal hernia. If the hernia extended
through the superficial inguinal ring, it would be surrounded by all of the
abdominal layers EXCEPT:
a. External spermatic fascia
b. Peritoneum
c. Internal spermatic fascia
d. Transversalis fascia
c
An obstetrician decides to perform a caesarean section on a pregnant 29-year-old. An incision is made below the indicated structure. All of the following abdominal wall layers will be encountered in the anterior rectus sheath EXCEPT:
a. Internal oblique muscle
b. Transversalis fascia
c. External oblique muscle
d. Transversus abdominis muscle
b
You have superficial layers of fascia and its divided into Camper’s and Scarpa’s, which is true about these?
A. Camper’s is internal and Scarpa’s is external
B. Camper’s is fatty and Scarpa’s is membranous
C.Camper’s is membranous and Scarpa’s is fatty
D. Camper’s is deep and Scarpa’s is superficial
B
