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Year 1: 10. GIGU Exam > Lecture 1: Anterior Abdominal Wall > Flashcards

Lecture 1: Anterior Abdominal Wall Flashcards

1
Q

What are the nine quadrants the abdomen can be split into?

A

Right Hypochondriac
Epigastric
Left Hypochondriac

Right Flank
Umbilical
Left Flank

Right Inguinal
Pubic
Left Inguinal

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2
Q

Where is the transpyloric plane found?

A

Level of L1: inferior border of rib 8

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3
Q

What structures are found at the transpyloric plane?

A 
Gallbladder fundus
Pylorus of stomach
Pancreatic neck
SMA origin
Hepatic Portal Vein
Root of transverse mesocolon
Hila of kidneys
Right and left colic flexures
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4
Q

Where is the subcostal plane found?

A

Level of L3: right below rib 12 and inferior border of 10th costal cartilage

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5
Q

What structures are found at the subcostal plane?

A

Transverse Colon

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6
Q

Where is the transtubercular plane found?

A

Level of L5

-between iliac tubercles

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7
Q

What structures are found at the transtubercular plane?

A

Ileocecal junction

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8
Q

Where is the interspinous plane found?

A

Level of S2: between ASIS

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9
Q

What structures are found at the interspinous plane plane?

A

Appendix

Sigmoid Colon

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10
Q

What are the superior and inferior borders of the peritoneal cavity?

A

Between thoracic and pelvic diaphragm

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11
Q

What is the imaginary border that separates the abdomen and pelvis?

A

Pelvic Inlet

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12
Q

What lines the peritoneal cavity?

A

Serous membrane

-mesothelium

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13
Q

What composes the outer layer of the anterolateral abdominal wall?

A

Skin
Camper’s fascia (fat)
Scarpa’s fascia (backing of fat)
Aponeurosis: tough, thick, tendon-like

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14
Q

From superficial to deep, how the muscles of the anterolateral abdominal wall organized?

A

External Oblique
Internal Oblique
Transversus abdominis

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15
Q

What makes up the inner layer of the anterolateral abdominal wall?

A

Transversalis fascia
Extraperiotneal fat
Parietal peritoneum

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16
Q

What is Scarpa’s fascia continuous with?

A

Colle’s fasica of perineum but fused with fascia lata of lower limb

  • imp so fluid cannot go from abdominal wall into leg
  • fluid can flow into or out of superficial perineum
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17
Q

What is the origin and insertion of the external oblique muscle?

A

Origin: outer surface of lower 6 ribs
Insertion: aponeurosis and linea alba & anterior iliac crest and pubic tubercle

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18
Q

What is the innervation of the external oblique muscles?

A

ventral rami of T7-T12 of intercostal nerves

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19
Q

What is the action of the external oblique muscles?

A

Compresses abdomen and increases intra-abdominal pressure

-moves trunk and retains posture

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20
Q

The lower portion of the external oblique muscles are rolled under to make what?

A

Inguinal ligament

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21
Q

What is the origin and insertion of the internal oblique muscle?

A

Origin: iliac crest and some of thoracolumbar fascia
Insertion: lower part of ribs 10-12 , aponeurosis, linea alba and pubic crest

22
Q

What is the innervation of the internal oblique muscles?

A

T7-T12 and L1

23
Q

What is the action of the internal oblique muscles?

A

Compresses and supports viscera

Lateral flexes and rotates

24
Q

The lower portion of the internal oblique muscles make what?

A

Part of conjoint tendon

25
Q

What is the origin and insertion of the transversus abdominis muscle?

A

Origin: lower 7-12 ribs, thoracolumbar fascia, iliac crest, and some even off upper inguinal ligament
Insertion: linea alba, pecten pubis and pubic crest

26
Q

What is the innervation of the transversus abdominis muscles?

A

T7-T12

27
Q

What is the action of the transversus abdominis muscles?

A

Compresses and supports visceral

28
Q

What is the origin and insertion of the rectus abdominis muscle?

A

Origin: pubic symphysis and pubic crest
Insertion: xiphoid process and outer surface of 5-7th intercostal cartilages

29
Q

What is the innervation of the rectus abdominis muscles?

A

ventral rami of T7-T12

30
Q

What is the action of the rectus abdominis muscles?

A

Flexes abdomen and compresses it

31
Q

What is the arcuate line?

A

Transition point of the composition of the rectus sheath

-normally at the umbilicus

32
Q

Superior to the arcuate line, what structures are anterior and posterior to the rectus abdominis muscles?

A

Anterior:
External Oblique
Internal Oblique

Posterior:
Internal Oblique
Transversus Abdominis
Transversalis fascia

33
Q

Inferior to the arcuate line, what structures are anterior and posterior to the rectus abdominis muscles?

A

Anterior:
External Oblique
Internal Oblique
Transversus Abdominis

Posterior:
Transversalis fascia

34
Q

Where is the iliohypogastric nerve found?

A

L1: Runs between 2nd and 3rd muscle layers

-more superior

35
Q

What is the function of the iliohypogastric nerve?

A
  • Motor to Internal Oblique Muscle and Transversus Abdominis Muscle
  • Sensory to upper inguinal and hypogastric region
36
Q

Where is the ilioinguinal nerve found?

A

L1

  • more lateral
  • exits superficial ring
37
Q

What is the function of the ilioinguinal nerve?

A
  • Motor to lower Internal Oblique Muscle and Transversus Abdominis Muscle
  • Sensory to lower inguinal, anterior scrotum/labia, and near medial thigh
38
Q

What results in the median umbilical fold?

A

Fold due to obliterated urachus from allantois

39
Q

What results in the medial umbilical fold?

A

Fold due to obliterated umbilical artery

40
Q

What results in the lateral umbilical fold?

A

Due to inferior epigastric artery

41
Q

Where is the supravesicular fossa found?

A

Gutter on either side of upper bladder

42
Q

Where is the medial inguinal fossa found?

A

Gutter lateral to medial umbilical folds

43
Q

Where is the lateral inguinal fossa found?

A

Gutter lateral to lateral umbilical folds

44
Q

Superficial lymphatic vessels superior to the umbilicus drain where?

A

Axillary nodes

45
Q

Superficial lymphatic vessels inferior to the umbilicus drain where?

A

Superficial inguinal nodes

46
Q

Deep lymphatic vessels drain where?

A

Deep veins of abdominal walls

47
Q

Describe the subcostal incision.

A

About 2.5 cm inferior from margin

  • access to gallbladder, biliary tract, and spleen
  • risk of nerve damage at L1
48
Q

Describe the midline incision.

A

Midline of abdomen

  • can be made quickly
  • long recovery time due to CT and muscles
  • not much blood supply (good for surgery and bad for recovery)
49
Q

Describe the paramedian incision.

A

Costal margin to iliac crest along linea semilunaris

  • opens anterior sheath
  • should be used for life saving only
50
Q

Describe the suprapubic incision.

A

Pubic hair line

-used in most gynecological/obstetrical surgeries

51
Q

Describe gridline incision.

A

At McBurney’s point

-typical in appendectomy

Year 1: 10. GIGU Exam (24 decks)

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