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Advanced Anatomy > Lecture 14: Abdominal Wall + Inguinal Region > Flashcards

Lecture 14: Abdominal Wall + Inguinal Region Flashcards

1
Q

List the layers of the abdomen from superficial to deep

A

Skin
Superficial Fascia
Muscles covered by deep fascia
Transversalis fascia
Parietal Peritoneum
Abdominal cavity

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2
Q

What are the 4 Quadrants of he abdomen (going clockwise)

A
  1. LUQ
  2. LLQ
  3. RLQ
  4. RUQ
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3
Q

List the nine regions of the abdomen

A

image

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4
Q

What is the dividing line for the superficial lymphatic drainage of abdominal wall

A

Umbilicus

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5
Q

Describe lymph flow above the umbilicus

A

Axillary lymph nodes - specifically pectoral

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6
Q

Describe lymph flow below the umbilicus

A

Superficial inguinal lymph nodes

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7
Q

What is the dividing line for the superficial venous drainage of abdominal wall

A

Umbilicus

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8
Q

What drains the abdominal region above the umbilicus

A

Axillary V

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9
Q

What drains the abdominal region below the umbilicus

A

External Iliac + femoral veins

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10
Q

List the abdominal wall muscles superficial to deep

A

External oblique
Internal oblique
Transversus abdominis & Rectus abdominus

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11
Q

What are tendinous intersections

A

They subdivide the rectus abdominis into multiple segments

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12
Q

What forms the rectus sheath

A

Interlaced aponeuroses of abdominal muscles (ant/post rectus sheath)

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13
Q

What does the rectus sheath enclose

A

Rectus abdominis muscle
superior/inferior epigastric vessels
anterior rami T7-12

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14
Q

What is the linea alba

A

Fibrous vertical band connecting L/R sheaths

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15
Q

T/F: The rectus sheath is the same composition throughout all levels

A

False; it changes

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16
Q

What is the arcuate line?

A

Arched line where posterior sheath abruptly ends (approx b/t umbilicus and pubic symph.)

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17
Q

What is the rectus sheath composition like BELOW the ribs / ABOVE arcuate line. Also, describe the anterior/posterior rectus sheath at this level.

A

The internal oblique aponeurosis splits to enclose rectus abdominis muscles.
Ant rectus sheath: from external oblique and part of the internal oblique
Post rectus sheath: from transverse and part of internal oblique

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18
Q

What is the rectus sheath like below the arcuate line?

A

All 3 aponeuroses travel in front of muscle (no posterior rectus sheath)

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19
Q

Nerve supply ro rectus sheath/abdominal area

A

Anterior rami T7-11 [intercostal N]
T12 [subcostal nerve]
L1 [lumbar]

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20
Q

The L1 spinal nerve splits into two named nerves. What are they?

A

Iliohypogastric (sup)
Ilioinguinal (inf)

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21
Q

Does the ilioinguinal nerve travel through the inguinal canal?

A

yes

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22
Q

Where do nerves travel in relation to internal oblique and transversus abdominis muscles

A

Between

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23
Q

What is the plane called where nerves travel between int. oblique and transversus abdominis

A

Transversus abdominis plane

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24
Q

What is a transversus abdominis plane (TAP) block

A

Anesthetic technique to numb nerves of the abdominal wall. Done for laparoscopic surgeries, some hernia repairs, and hysterectomies.

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25
Q

Superior Epigastric Artery: continuation of _______ artery

A

Internal thoracic

26
Q

Inferior Epigastric Artery: branch of _________artery

A

External iliac

27
Q

Posterior Intercostal, Subcostal and Lumbar Arteries off of the _______

A

aorta

28
Q

Superficial Epigastric Artery : branch of _______ artery

A

Femoral

29
Q

What is the inguinal canal

A

Tunnel through inferior abdominal wall

30
Q

What does the inguinal canal connect

A

abdominal cavity w/ scrotum/labia

31
Q

What is a potential weak spit in the abdominal wall

A

Inguinal canal

32
Q

The deep inguinal ring

A

Tunnel entrance; lateral ‘ring’, entrance of “tunnel” from abdominal cavity

33
Q

Superficial inguinal ring

A

Medial ring, opening into scrotum/labia

34
Q

What are the borders of the inguinal canal

A

Anterior wall: external oblique aponeurosis
Posterior wall: transversalis fascia (lateral 2/3) and conjoint tendon (medial 1/3)
Floor: inguinal ligament (inferior attachment of external oblique)

35
Q

What are the contents of the inguinal canal

A

Ilioinguinal nerve
Spermatic cord or round ligament of the uterus
Genitofemoral nerve (quite small)

36
Q

What is the function of the genitofemoral nerve

A

Sensory to thigh, motor to muscle of spermatic cord

37
Q

a protrusion of abdominal contents through the abdominal wall is known as a

A

Hernia

38
Q

Do you think inguinal hernias are more common in males or in females? Why?

A

Inguinal hernias are more common in males (b/c spermatic cord keeps that tunnel ‘open’)

39
Q

What are the 2 types of inguinal hernias

A

indirect
direct

40
Q

Indirect (‘congenital’) Inguinal Hernia - describe it

A

takes an indirect path out of the abdomen (through the entire “tunnel”)
Hernial sac starts lateral to the inferior epigastric vessels
More common with testes

41
Q

Direct (Acquired) Inguinal Hernia

A

Hernia goes ‘directly’ through superficial ring (NOT through the canal)
Hernial sac leaves abdominal cavity medial to the inferior epigastric vessels
More common in older males (over age 40) with weak abdominal muscles

42
Q

Direct Inguinal Hernia

A

‘neck’ of the hernial sac tends to be wide, since it isn’t constricted by the inguinal canal

43
Q

Why does an inguinal hernia protude when coughing

A

B/c intra-abdominal pressure is increased, decreased abdominal space in abdomen

44
Q

What peritoneum lines the abdominal wall

A

Parietal peritoneum

45
Q

What peritoneum covers the abdominal/pelvic viscera

A

Visceral peritoneum

46
Q

What is the peritoneal cavity

A

Serous fluid secreted in this space

47
Q

Define mesentery

A

a double layer of peritoneum that connects some intestines to the posterior abdominal wall

48
Q

What is found between the layers of mesentery?

A

Blood vessels, nerves, lymphatics, fat between the layers of mesentery

49
Q

What is omentum?

A

A double layer (fold) of peritoneum that connects the stomach to another organ

50
Q

What is greater omentum?

A

stomach –> transverse colon

51
Q

What is lesser omentum?

A

Stomach (and part of duodenum) to liver

52
Q

Parietal Peritoneum innervation

A

T7-L1 (same innervation as abdominal wall)

53
Q

Where is pain felt in parietal peritoneum?

A

Tends to be precisely localized and severe

54
Q

What is rebound tenderness?

A

common clinical sign of inflamed parietal peritoneum

55
Q

Visceral peritoneum

A

Innervation via ANS

56
Q

Visceral peritoneum pain tends to be…

A

Dull and poorly localized (referred pain)

57
Q

What is the foregut supplied by?

A

Celiac trunk

58
Q

What is the midgut supplied by?

A

Superior mesenteric artery

59
Q

What is the hindgut supplied by?

A

Inferior mesenteric artery

60
Q

Lymphatic drainage of the GI tract - lymphatic drainage will eventually go

A

go to nodes that cluster around arteries of the same name
Celiac lymph nodes
Superior mesenteric lymph nodes
Inferior mesenteric lymph nodes

61
Q

Innervation of the GI tract

A

almost soley from ANS

Parasympathetics from Vagus (CN X) and pelvic splanchnic nerves (S2-S4)

Sympathetics from thoracic splanchnic nerves (T5-T12) and lumbar splanchnic nerves (L1, L2)

Advanced Anatomy (18 decks)

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