Lecture 2 - Anterolateral Abdominal Walls Flashcards
What are the boundaries of anterolateral abdominal walls (5)
Xiphoid Costal margins Lateral: posterior axillary folds, roughly where back muscles begin Inguinal ligament Pelvic crest
What level do the abdominal contents protrude up into the diaphragm
Level of T8 in the median plane and 5th rib of mid-clavicular plane
What overlies the costodiaphragmatic recess?
Abdominal recess in dome
What are the four pairs of muscles in the anterior abdominal wall?
Anterolateral: External oblique, internal oblique, transversus abdominus
Median: Rectus abdominus
What does the external oblique connect (4)
Lower 8 ribs
Pubic tubercle
Iliac crest
Linea alba
What does the thickened lower border of the aponeurosis of the external oblique roll inwards to form
Inguinal ligament
What does the inguinal ligament connect
Anterosuperior iliac spine to pubic tubercle
What is the part of the inguinal ligament attached to the pecten pubis called?
Lacunar ligament
What direction is the external oblique
Downwards and forwards
What does the internal oblique join? (4)
Costal margin, lumbar fascia, iliac crest, linea alba
What is the transversus abdominus attached to? (4)
Lower costal cartilages (7-12)
Lumbar fascia
Iliac crest
Linea alba
Which of the anterior abdominal wall muscles does not have aponeurosis medially?
Transversus abdominus
What does the rectus abdominus connect to?
Xiphoid
Costal cartilages (5-7)
Pubic crest
Where are the 3-4 tendinous intersections
- Xiphoid process
- Halfway between 1 and 2
- Umbilicus
- Between umbilicus and pubis
What is the general function of the rectus abdominus
Support of abdominal contents, expiration, expulsion of abdominal content
What is the composition of the anterior rectus sheath
Aponeurosis of external oblique
Part of aponeurosis of internal oblique
What is the composition of the posterior rectus sheath
Part of aponeurosis of internal oblique and aponeurosis
What is the linea alba
The three fusion of three layers of the rectus sheath in between 2 parts of rectus abdominus
What is the linea semilunaris
The lateral edges of rectus abdominus where the rectus sheath arises from the aponeurosis of the abdominal muscle
Where does the transversalis fascia lie beneath
The deepest muscle (transversus abdominus
What lies beneath the transversalis fascia
A variable amount of fat then peritoneum
What vessels supply the rectus muscles
Deep epigastric vessels
What vessels supply the other non-rectus abdominal wall muscles
Mostly deep circumflex iliac branch of external iliac
Contribution from posterior intercostal vessels
What is the blood supply of the skin (3)
Posterior intercostals, epigastric and cutaneous branch of femorals
What nerves supply the anterior abdominal wall muscles
Lower intercostal nerves + 1st lumbar
L1 gives rise to ileohypogastric and ileoinguinal nerves
What nerve supplies the superficial fascia near umbilicus
T10
What is the inguinal canal
A passage through the aponeuroses and muscle of the lower abodominal wall
The inguinal canal is a real opening true or false
False, its filled with connective tissues
What does the inguinal canal carry in males
Spermatic cord
What does the inguinal canal carry in females
Round ligament
How long is the inguinal canal
4cm
What is the position of the inguinal canal compared to the inguinal ligamnet
Posterosuperior
What are the two rings of the inguinal canal
Superficial inguinal ring
Deep inguinal ring
What is the superficial inguinal ring
A slit in aponeurosis of external oblique
Superolateral to pubic tubercle
Where is the deep inguinal ring
1cm above mid inguinal point
Halfway along the inguinal ligament or between ASIS and pubic symphysis
What does the femoral canal contain? (3)
Lateral to medial: nerves, femoral artery and femoral vein
Where does the femoral canal sit?
Under spermatic cord and inguinal ligament at mid-inguinal ligament
What is the ‘six pack’
A surface landmark for the tendinous intersections
Where is the transpyloric plane
Halfway between xiphosternal joint and umbilicus
What are two landmarks marked by the transpyloric plane
Pyloric sphincter
First lumbar vertebra
Where is the mid-inguinal point
Halfway between ASIS and pubic tubercle
What does the mid-inguinal point overly (4)
Femoral artery, deep inguinal ring, site of junction of external iliac and femoral artery, site of femoral pulse
