Lecture 10 - Anterior Abdominal wall and inguinal region Flashcards

1
Q

The muscle layers in the abdo are important for what role?

A

rewspiration - increasing intra abdominal pressure - urination, defecation and child birth

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2
Q

Once inside the muscles we have a ______ layer which is continuous with pelvic cavity below

A

Once inside the muscles we have a peritoneum layer which is continuous with pelvic cavity below

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3
Q

So there is skin, _______ fascia and then _layers for abdominal (flat) muscle - very similar to thorax

A

So there is skin, superifical fascia and then 3 layers for abdominal (flat) muscle - very similar to thorax

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4
Q

Lining the internal surface of rectus abdominus is _______ fascia and then extra peritoneal ___ before the peritoneum.

A

Lining the internal surface of rectus abdominus is transversalis fascia and then extra peritoneal fat before the peritoneum.

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5
Q

The 3 muscles attach to what superiorly?

A

Costal margin - but 3 layers wold get too crowded

Superficial -over top
middle - to the border
inferior - innerside

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6
Q

The 3 muscles are fleshy lateral (very clear msucle fibres) but in the midline they are replaced by _______ membrane

A

The 3 muscles are fleshy lateral (very clear msucle fibres) but in the midline they are replaced by aponeurotic membrane

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7
Q

The relationship of the abdominal wall to the spermatic cord and teses is important, why?

A

The spermatic cotrd traverses these abdomial wall muscles

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8
Q

External oblique is homologous with whihc other msucle

A

external intercostals

“Front pocket” msucles - medially and inferiorly orientated

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9
Q

The most superior fiberes of EO overlap what?

A

the costal margin - touches pec major and serratus anterior

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10
Q

EO attaches to what inferiorly?

A

anterior half of iliac crest and the ASIS

Then jumps down and attaches to pubic tubercle/crest (free inf. edge between - thickened, called the inguinal ligament)

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11
Q

Internal Oblique (IO) is on what direction

A

back pockets - posterior and inferior

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12
Q

How does IO insert superiorly?

A

perfectly ont he costal margin

thoracolumbar fascia posteriorly

linear alba medially

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13
Q

How does IO insert inferiorly?

A

Anterior half of the iliac crest and the ASIS

Lateral 2/3 of the inguinal ligament

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14
Q

True or False

The fibres of IO arise from the inguinal ligament

A

True

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15
Q

True or False

the lowest most fibres of IO don’t go to the linear alba

A

True

they arise from the inguinal ligament, arch over and attach to the pubic tbercle

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16
Q

Transversus Abdominus (TA) goes ____ the costal margin

A

Transversus Abdominus (TA) goes inside the costal margin

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17
Q

The lowermost fibres of TA arise from ______ of inginal lig.

A

lateral 1/3

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18
Q

True or False

Superiorly, TA is continuous in origin with the diaphragm

A

True

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19
Q

Posteriorly, Ta goes as far as …

A

the thoracolumbar fascia

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20
Q

Anteriorly, TA meets at the ..

A

linear alba

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21
Q

The Lowermost fibres of TA also arise from the inguinal ligament, but the ________ - fibres then arch over and insert into the _____ _______ (join with __in a conjoined tendon)

A

The Lowermost fibres of TA also arise from the inguinal ligament, but the lateral 1/3 - fibres then arch over and insert into the pubic tubercle (join with IO in a conjoined tendon)

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22
Q

Rectus Abdominis (RA) is a pair of ______ oriented muscles in the midline

A

Rectus Abdominis (RA) is a pair of longitudinal oriented muscles in the midline

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23
Q

RA is anchored inferiorly at the ___ ____, as they ascend - they get ___ overlapping the front of the ____

A

RA is anchored inferiorly at the pubic crest, as they ascend - they get wider overlapping the front of the ribcage

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24
Q

RA inserts on costal cartilages ….

A

5,6,7

25
Q

Three tendonous intersections of RA interrupt the vertical fibres - divides the muscle in _ compartments that makes the muscle fibres more ______

A

Threee tendonous intersections interrupt the vertical fibbres - divides the muscle in 4 compartments that makes the muscle fibres more powerful

26
Q

Where are the 3 tendonous interuptions of RA?

A

2 in between sternum and umbilicus

  1. at the umbilics
27
Q

Aponeurosis of the 3 lateral muscles creates what…

A

a sheath for RA

28
Q

The nerves and vessels also relate to the ____ _____

A

The nerves and vessels also relate to the rectus sheath

they are within

29
Q

How do the abdominal wall muscles arrange themselves around RA?

A

TA goes behind,

Internal splits into 2

external is in front

30
Q

aponeurosis of EO is synonymous with what?

A

the Rectus sheath (fibrous envelope)

31
Q

At a point halfway between the umbilicus and the pubic bone all 3 aponeuroses pass above the __

A

At a point halfway between the umbilicus and the pubic bone all 3 aponeuroses pass above the RA

Happens all of a sudden - only have an anterior rectus sheath

32
Q

The posterior rectus sheath is lost at a distinct point - where is this?

A

halfway between the umbilicus and pubic bone

33
Q

What is the nerve supply to the anterior abdominal wall?

A

Lower six intercostal nerves - T7-12

skin and muscles

34
Q

What is the artery supply to the anterior abdominal wall?

A

The superior epigastric a. (branch of the internal thoracic) meets the inferior epigastric (from external iliac) to supply the the anterior abdominal wall

The superficial epigastric (from femoral a.) is also in the superficial fascia

35
Q

Where does the arterial supply run?

A

in the posterior rectus sheath.

36
Q

There is dual venous drainage of ant. abdominal wall what are they?

A

Cava system
and
Portal vein

it is a site overlap for the two systems

37
Q

Which veins follow the arteries in the ant. abdominal wal?

A

super and inferior epigastric veins (+superificial and deep) veins follow the arteries

38
Q

From the medial side of the inguinal ligament there is a slight extension - some fibres reflect onto the pectineal line of the pubic bone, what is this called?

A

lacunar ligament

39
Q

What is the pectineal ligament?

A

small linear attachment that follows along the pectineal line

40
Q

What is the triangle opening created by the free inferior edge of EO - extending between the ASIS and pubic tubercle

A

The superficial inguinal ring

41
Q

Where to the testes develop?

A

on the posterior abdominal wall in the extraperitoneal fat (quite deep in the abdominal)

42
Q

WHen do they descend into the scrotum?

A

28th week

43
Q

The scrotum has ___and ________ ______ continuous with the anterior wall

A

The scrotum has skin and superficial fascia continuous with the anterior wall

44
Q

What do the testes have to traverse through?

A

the 3 muscles of abdo wall
transversus fascia
traverse through the inguinal canal

45
Q

From the deep inguinal ring the inguinal canal continues 5 cm and the exit point is where?

A

The superficial (external) ring which is a triangular deficiency in the external oblique aponeurosis

46
Q

What creates the roof of the inguinal canal?

A

the arches of TA and IO

47
Q

What is the order of strucutres that the testes passes through on its way to the scrotum

A

Transversalis facia
TA
IO
EO

48
Q

What is the deep inguinal ring?

A

a hole in fascia transversalis

a fingerbreadth above the inguinal ligament halfway between the ASIS and pubic tubercle

49
Q

As the testes descending they bring the vas deferens and associated vessels - can see them clearly before the enter the canal - but not after because…

A

they bcome encolsed in sheaths:

internal spermatic fascia (through fascia transversalis)

cremaster beneath the arching fibres of EO

External fascia from the ring

50
Q

What is the superficial ring

A

medial opening the EO aponeurosis

51
Q

What is the Deep ring

A

deficiency “outpouching” of fascia transversalis

52
Q

What is the floor of the Inguinal canal?

A

Inguinal ligament

53
Q

What is the anterior wall of the inguinal canal?

A

EO aponeurosis

IO muscle (lat)

54
Q

What is the posterior wall of the inguinal canal?

A

Transversalis fascia, conjoint tendon (med)

55
Q

The external spermatic fascia is derived from…

A

external inguinal ring

56
Q

The protrusoin of abdomial contents through the abdominal wall is called a..

A

Hermia - usually at a site of weakness at linea alba, umbilical

Scars may allow it to happen

57
Q

What wil cause inguinal hernias?

A

Raised intra abdominal pressure 0 abdominal contents leave through the inguinal.

58
Q

Indirect hernias mean..

A

Arise from incompltee closure of the processus vaginalis

Contents are going through the canal - is possible to push contents back up

59
Q

What are DIRECT hermia’s?

A

Protrusion through a weakness in its posterior wall