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GIGU Exam 1 > Lecture 1: Anterior Abdominal Wall > Flashcards

Lecture 1: Anterior Abdominal Wall Flashcards

1
Q

What are the four quadrants of the abdominal wall

A

Right upper quadrant

Left upper quadrant

Right lower quadrant

Left lower quadrant

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2
Q

List the structures found in the RUQ

A

View attached image

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3
Q

List the structures found in the LUQ

A

View attached image

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4
Q

List the structures found in the RLQ

A

View attached image

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5
Q

List the structures found in the left lower quadrant (LLQ)

A

View attached image

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6
Q

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

A

Right Hypochondriac (RH)

Epigastric (E)

Left Hypochondriac (LH)

Right Flank (RL)

Umbilical (U)

Left Flank (LL)

Right Inguinal (RI)

Pubic (P)

Left Inguinal (LI)

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7
Q

Where is the transpyloric plane found?

A

Level of L1: inferior border of rib 8

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8
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

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9
Q

Where is the subcostal plane found?

A

L3 - Inferior border 10th costal cartilage

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10
Q

What structures are found at the subcostal plane?

A

Transverse Colon

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11
Q

Where is the transtubercular plane found?

A

Level of L5 - between iliac tubercles

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12
Q

What structures are found at the transtubercular plane?

A

Ileocecal junction

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13
Q

Where is the interspinous plane found?

A

Level of S2: between ASIS

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14
Q

What structures are found at the interspinous plane plane?

A

Appendix & Sigmoid Colon

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15
Q

What is the fatty outter layer of the superficial fascia

A

Camper’s fascia

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16
Q

What is the membranous underlying CT of the superficial fascia

A

Scarpa’s fascia

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17
Q

What is Scarpa’s fascia continuous with and what is it fused with?

What is the implication of this?

A

Continuous - Colle’s fascia of perineum

Fused - Fascia lata of lower limb

Implication - Fluid cannot go from abdomincal wall into leg but it can flow into or out of superficial perineum

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18
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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19
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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20
Q

What is the innervation of the external oblique muscles?

A

Ventral rami of T7-T12 of intercostal nerves

T7-T11: Thoracodabdominal nn.

T12: subcostal n.

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21
Q

What is the action of the external oblique muscles?

A

Compresses and supports abdominal viscera.

Flexes and rotates trunk.

Retains posture

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22
Q

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

A

Inguinal ligament

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23
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

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24
Q

What is the innervation of the internal oblique muscles?

A

T7-T12 and L1

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25
Q

What is the action of the internal oblique muscles?

A
  • Compresses and supports viscera
  • Laterally flexes and rotates trunk
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26
Q

The lower portion of the internal oblique muscles make what?

A

Part of conjoint tendon

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27
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

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28
Q

What is the innervation of the transversus abdominis muscles?

A

T7-T12

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29
Q

What is the action of the transversus abdominis muscles?

A

Compresses and supports visceral

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30
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

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31
Q

What is the innervation of the rectus abdominis muscles?

A

Ventral rami of T7-T12

32
Q

What is the action of the rectus abdominis muscles?

A

Flexes abdomen and compresses it

33
Q

What are the layers of the anterior abdominal wall from superficial to deep

A
  1. Skin
  2. Camper’s fascia
  3. Scarpa’s fascia
  4. Deep fascia
  5. External abdominal oblique m. & deep fascia
  6. Internal abdominal oblique muscle & deep fascia
  7. Transversus Abdominis
  8. Transversalis fascia
  9. Extraperitoneal/Endoabdominal fat
  10. Parietal peritoneum
34
Q

What is the arcuate line?

A

Sharp transition where all EO, IO & TA aponeurosis become anterior to rectus abdominis muscle.

35
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

36
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

37
Q

Where is the iliohypogastric nerve found?

A

L1: Runs between 2nd and 3rd muscle layers

(Superior to Ilio-inguinal nerve)

38
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
39
Q

Where is the ilioinguinal nerve found?

A

L1

(exits superficial ring)

40
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
41
Q

Where is Thoraco-abdominal N. located, what is it a continuation of & what is it’s function?

A

T7-T11

It is the continuation of the intercostal n.

Has both motor and sensory innervation

42
Q

Where is the subcostal n. located

A

T12. Runs along inferior 12th rib

43
Q

What is the function of the subcostal n.

A

motor - innervates muscles of anterior abdominal wall

sensory - superior to the iliac crest

44
Q

Superficial lymphatic vessels superior to the umbilicus drain where?

A

Superiorly into the Axillary lymph nodes with a few going to parasternal nodes

45
Q

Superficial lymphatic vessels inferior to the umbilicus drain where?

A

Inferiorly into the Superficial inguinal lymph nodes

46
Q

Deep lymphatic vessels drain where?

A

Deep veins of abdominal walls (e.g., external and internal iliac veins)

47
Q

What structure is formed by the combined aponeurosis of inferior/medial margins of internal oblique and transversus abdominal m. inserting onto the pubis

A

Conjoint tendon (inguinal falx)

48
Q

What is the inguinal ligament

A

Basically the rolled-under inferior border of external oblique muscle aponeurosis that is attached ti the ASIS and pubic tubercle

49
Q

What is the ligament between the pubic rami and inguinal ligament and anchors the inguinal ligament to the pubis

A

Lacunar ligament

50
Q

List the crural fibers

A

Medial crus

Lateral crus

Intercrural fibers

51
Q

What ligament is the continuation of fibers from the lacunar ligament that runs along pectin pubis

A

Pectineal ligament

52
Q

What is the external opening of the inguinal canal that serves as an exit for the spermatic cord or round ligament

A

Superficial inguinal ring

(Ring is really a partial split in the external oblique m. aponeurosis)

53
Q

What structure is the entrance to the inguinal canal and beginning of the invagination of the peritoneum into tranversalis fascia

A

Deep Inguinal Ring

54
Q

What structures pass through the deep inguinal ring in males vs females

A

Males - Vas deferens and gonadal vessels/nerves

Females - Round ligament

55
Q

Where does the femoral canal/ring lie

A

Immediately lateral to the lacunar ligament

56
Q

Where do gonads originally form

A

Near T10 axial level

57
Q

What connects gonads to the future scrotal swellings and helps them to descend

A

Gubernaculum

58
Q

What is the outpocketing of the parietal peritoneum that descends with the gonads

A

Process vaginalis

59
Q

What represents the remains of processus vaginalis around the testes when the connection to the peritoneum is closed

A

Tunica Vaginalis

60
Q

What layers of the abdominal wall are carried along as the male gonad descends and help form the spermatic cord. What are they called in the spermatic cord?

A

Transversalis fascia - Internal spermatic fascia

Internal oblique m. - Cremasteric m.

External oblique m. - External spermatic fascia

61
Q

What are the contents of the spermatic cord

A
  • Vas deferens (ductus deferens)
  • Testicular artery
  • Testicular veins
    • Pampiniform plexus
  • Gonadal nerves
  • Gonadal lymphatics
62
Q

What is Cryptorchid testis

A

Undescended testis (increases risk of developing cancer)

63
Q

What is it called when there’s an open connection between tunica vaginalis and the abdomen

A

Persistent processus vaginalis

64
Q

What is hydrocele

A

Peritoneal fluid accumulation within tunica vaginalis. More common in babies.

(When illuminated will see light glow through it)

65
Q

What is an Hematocele

A

Accumulation of blood in the tunica vaginalis

(Opaque when illuminated)

66
Q

What does the guberculum become as ovaries descenend

A

It becomes attached to the developing uterus and forms the ovarian ligament and round ligament of the uterus.

67
Q

What is the course of the round ligament of the uterus

A

Enters deep ring and exists superficial ring attaching to labial swellings

68
Q

What are the contents of the female inguinal canal

A

Round ligament of the uterus

Iliolingual nerve

Genitofemoral nerve

69
Q

What lymph nodes do the scrotum drain into

A

Superficial inguinal nodes and eventually travel into iliac and lumbar lymph nodes

70
Q

What lymph nodes do the testes drain into

A

Lumbar and pre-aortic lymph nodes

71
Q

What results in the median umbilical fold?

A

Fold due to obliterated urachus

72
Q

What results in the medial umbilical fold?

A

Fold due to obliterated umbilical arteries

73
Q

What results in the lateral umbilical fold?

A

Fold due to inferior epigastric artery

74
Q

What are the boundaries of Inguinal (Hesselbach’s) Triangle?

A

Medial: lateral border of the rectus abdominis muscle (linea semilunaris)

Lateral: inferior epigastric vessels

Inferior: inguinal ligament

75
Q

Describe a direct hernia.

A
  • Bulges through weakness in tranversalis fascia in Hesselbach’s triangles and pushes directly through the fascia and bulges out due to weak abdomincal structures next to the spermatic cord (in males)
  • Medial to epigastric artery
76
Q

Describe an indirect hernia.

A
  • Through deep inguinal ring and out superficial inguinal ring
  • Lateral to inferior epigastric vessels
77
Q

Describe a femoral hernia.

A
  • Hernia below inguinal ligament
  • more common in women

GIGU Exam 1 (25 decks)

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