Lecture 14: Abdominal Wall Flashcards
Anterolateral abdominal wall muscles
-EO
-IO
-transversus abdominis
anterior abdonimal wall muscles
-rectus abdominis and sheath
where do the abdominal muscles converge
linea alba
EO origin
ribs 5-12
EO insertion
iliac crest and pubis
Eo action
Bilateral: flexion of trunk
Unilateral: contralateral rotation of trunk
IO origin
-inguinal ligament
-iliac crest
-lumbodorsal fascia
IO insertion
ribs 10-12
IO action
Bilateral: abdominal compression
Unilateral:ipsilateral rotation
TA Origin
-costal margin
-iliac crest
-inguinal ligament
-thoracolumbar fascia
TA insertion
-linea alba
-xiphoid process
-pubis symphysis
TA action
rotation and flexion of the trunk
RA origin
pubic bone
RA insertion
xiphoid process, ribs 5-7
RA action
trunk flexion, pelvic stability
Rectus sheath
surrounds RA anteriorly and posteriorly
what is the rectus sheath formed by
EO, IO, TA aponeurosis’
what is the arcuate line between
umbilicis and pubis
layers of rectus sheath depend on
locating according to arcuate line
Anterior Rectus Sheath above arcuate line
-EO aponeurosis
-1/2 IO aponeurosis
_surrounds RA muscle
Posterior Rectus sheath above arcuate line
-1/2 Io aponeurosis
-TA aponeurosis
transversalis fascia above arcuate line
deep to rectus sheath
anterior rectus sheath below the arcuate line
-EO aponeurosis
-IO aponeurosis
-TA aponeurosis
transversalis fascia below arcuate line
in direct contact with RA
Posterior abdominal wall muscles
psoas major, quadratus lumborum, psoas minor, illiacus
Iliacus origin
iliac fossa
Illiacus insertion
lesser trochanter
Illiacus Action
flexion & ER of hip
Psoas Major Origin
Transverse processes T12-L5
Psoas Major Insertion
Lesser trochanter
Psoas Major action
flexion of the hip
Psoas Minor Origin
Lateral aspect of T12&L1
Psoas Minor insertion
iliopectineal line
Psoas minor action
trunk flexion
Quadratus Lumborum origin
iliac crest
Quadratus Lumborum insertion
transverse processes of T1-L5, rib 12
Quadratus Lumborum Action
Bilateral: extention of trunk
Unilateral: lateral flexion of trunk
Inguinal Ligament
attaches ASIS to pubis
Inguinal Ligament Function
-Anchors abdominal muscle
-Supports soft tissues of the groin
Inguinal Canal location
-lower anterior abdominal wall
-extends from deep inguinal ring -> superficial inguinal ring
Superficial inguinal ring
opening in EO aponeurosis
*termination of inguinal canal
Deep inguinal ring
evagination in transveralis fascia
anterior border of inguinal canal
EO aponeurosis
Posterior border of inguinal canal
transversalis fascia
Floor of inguinal canal
inguinal ligament
roof of inguinal canal
fibers of transversus abdominis & IO
Inguinal canal contents in MALES
-spermatic cord
-gonadal vessels (testicular a&v)
-ilioinguinal nerve
-lymphatics
Inguinal canal contents in FEMALES
-round ligament of uterus
-ilioinguinal nerve
-lymphatics
Sensory innervation of abdominal wall
dermatomes
Motor innervation of the abdominal wall
-thorcoabdominal nerves
-subcostal nerve
-lumbar plexus
Dermatomes
-cutaneous innervation
-arranged in inferiorly sloping parallel rows around the abdomen
-clinically relevant dermatomes: T10, L1
T10 dermatome
umbilical
L1 dermatome
inguinal
Motor innervation to abdominal muscles
-Thoracoabdominal nerves (T7-T11)
-Subcostal nerve (T12)
-Lumbar plexus (L1)
Lumbar plexus nerves in motor innervation to abdominal muscles
-Iliohypogastric
-Ilioinguinal
Location of lumbar plexus
-posterir abdominal wall
-Lumbar spinal nerves L1-L4
-innervation mainly to lower limb
superficial lymphatic drainage
drains cutaneous and subcutaneous structures
what structure above umbilicus does superficual lymph drainage drain
axillary node
what structure below umbilicus does superficual lymph drainage drain
superficial inguinal nodes
Deep lymph drainage below the umbilicus
- superficial inguinal nodes
- deep inguinal nodes
- common iliac nodes
- lumbar nodes
all drains into Cisterna Chyli
Lymph drainage return to venous circulation of left and right abdomen BELOW umbilicus
Cisterna Chyli -> Axillary nodes (left) -> Thoracic duct which returns lymph to venous system
Lymph drainage return to venous circulation right abdomen ABOVE umbilicus
Axillary nodes (right) -> Right Lymphatic duct which returns lymph to venous system