Lecture 2 - Anterior Abdominal Wall Flashcards
The ___ spans from just under the diaphragm superiorly to the pelvic inlet inferiorly.
abdominal cavity
organization of the abdomen wall
skin
camper’s Fascia (superficial fatty layer)
Scarpa’s fascia (membranous layer)
layers of the muscular layer of abdomen wall
external oblique
internal oblique
transversus oblique
what is deep to transvesus oblique muscle
transversalis fascia (endo-abdominal fascia)
what is deep to transversalis fascia
extraperitoneal fat
deepest later of abdomen wall
parietal peritoneum
a tendious like sheet
aponeurosis
in the midline of the anterior abdomen wall we have __ which is the median plane attachment point of all these connective tissues
linea alba
what muscle is on the midline or in between the obliques
rectus abdominis m.
all connective tissues anterior and posterior to the abdominis rectus m
rectus sheath
the rectus abdominis sheet separates into superior and inferior by ___, found between the umbilicus and pubic symphysis
arcuate line
what give the “6 pack” look on the rectus abdominis
tendinous intersection
Anterolaterally- 3 muscles with medial aponeurosis inserting onto linea alba (tendinous
external oblique
internal oblique
transversus abdominis
Medially- Rectus abdominis muscle surrounded by the 3 layers of ___, called Rectus Sheath
aponeurosis
what is superficial and deep to rectus abdominis SUPERIOR to arcuate line
superior (anterior) =external oblique and 1/2 of internal oblique
Deep (posterior)= 1/2 of internal oblique and transversus abdominins, as well as transversalis fascia and parietal peritoneum
what is superficial and deep to rectus abdominis when you are INFERIOR of arcuate line
superficial (anterior) = external oblique, internal oblique, and transversus abdominis
deep (posterior) = transversalsis fascia and parietal peritoneum
Infraumbilical peritoneal folds:
from urinary bladder to umbilicus
covers median umbilical ligament
median umbilical fold
Infraumbilical peritoneal folds: covers medial umbilical ligaments
occluded portions of umbilical aa.
medial umbilical folds (2)
Infraumbilical peritoneal folds: covers inferior epigastric vessels
lateral umbilical folds (2)
All vessels run in ___ fat & fascia
superficial
br. of femoral a.
supplies region of inguinal ligament
Circumflex Iliac a.
br. of femoral a.
supplies abdomen inf. to umbilicus
Epigastric a.
drains to femoral v.
drains region of inguinal ligament
Circumflex Iliac v.
drains to femoral v.
drains abdomen inf. to umbilicus
Epigastric v.
Br. of External Iliac
Runs between IO & TA
Supplies inferior lateral abdominal mm.
deep circumflex iliac a.
Br. of External Iliac
Enters posterior rectus sheath at arcuate line
Supplies lower rectus abdominus mm.
anastomoses with Sup. Epigastric
Inferior Epigastric a.
Br. of Internal Thoracic (Mammary)
Enters posterior rectus sheath lat. to sternum
Supplies upper rectus abdominus mm.
Anastomoses with Inf. Epigastric
superior epigastric a.
Br. of Internal Thoracic (Mammary)
Runs along costal cartilages
Supplies upper abdominal mm. & diaphragm
musculophrenic a.
nerves of the abdominal wall
Ventral rami of T7-L1 spinal nn.
supply region above umbilicus
T7,T8,T9
nerves supplies umbilical region
T10
nerves supply region below umbilicus
T11, T12 & L1
all nerves of the abdominal wall run between
Run between IO and TA mm.
Injury to which nerves weakens the muscles in inguinal region
last 3 nn (T11 T12 and L1
Inferior lateral abdominal region
Superior to thigh
Medial to ilium
Lateral to pubic bone
inguinal region
Area extends between the anterior superior iliac spine (ASIS) and the pubic tubercle.}
inguinal region
Inguinal ligament, canal (male & female), superficial and deep rings of the inguinal canal, walls of the canal
inguinal region
Folded inferior border of the EO aponeurosis
Extends from ASIS to pubic tubercle
inguinal ligament
Obliquely set tunnel 3 to 5 cm long
Traverses ant. abdominal wall
Runs parallel & superior to inguinal ligament.
inguinal canal
Contains spermatic cord & its contents
vas deferens, testicular nn & vessels, cremasteric m & fascia) & Ilioinguinal n. (L1
male inguinal canal
Contains round ligament of uterus
Ilioinguinal n. (L1)
female inguinal canal
opening in EO aponeurosis
obvious triangular opening lateral to pubic tubercle
superficial inguinal canal ring
opening in transversalis fascia
subtle piercing just lateral to inferior epigastric vessels
deep inguinal canal ring
Inguinal Canal Walls:
___ = EO aponeurosis
____ = transversalis fascia & conjoint tendon
fusion of IO, TA aponeuroses medially
___= IO & TA muscles (superior)
___ = inguinal ligament (inferior)
Anterior wall = EO aponeurosis
Posterior wall = transversalis fascia & conjoint tendon
fusion of IO, TA aponeuroses medially
Roof = IO & TA muscles (superior)
Floor = inguinal ligament (inferior)
Outpouching of abdominal viscera within a sac
hernia
Hernial sac composed of 3 layers
peritoneum, extraperitoneal fat & transversalis fascia
90% of hernias occur in
inguinal region
extends thru entire inguinal canal
lateral to inferior epigastric vessels
commonly enters scrotum or labia majora
most common type of hernia (more in ♂ than ♀)
usually from persistent processus vaginalis in ♂
(connects peritoneum with descended testis)
referred to as canal of Nuck in ♀
Indirect Inguinal Hernia
thru inguinal triangle (Hesselbach’s)
inferior epigastric a., rectus abdominus m. & inguinal ligament
emerges thru conjoint tendon by or at superficial ring
medial to inferior epigastric vessels
usually does not enter scrotum or labia majora
more common in ♂ than ♀
usually associated with weakened abdominal wall
Direct Inguinal Hernia
thru femoral ring & canal
= medial compartment of sheath
more common in ♀than ♂ (femoral ring is wider in♀)
femoral hernia
thru umbilical ring
most common in newborns
more common in ♀ & obese individuals
umbilical hernia
thru linea alba
most common in over 40
usually assoc. with obesity
epigastric hernia
