Lecture 9 RH Flashcards

1
Q

What structures surround the abdominal cavity?

A

Thorax superiorly

Pelvis inferiorly

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2
Q

What are the layers of the subcutaneous fascial compartment?

A

superficial fascia of anterior abdominal wall has an outer layer of superficial fascia and an inner layer of superficial fascia.

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3
Q

What are the names of the layers of the superficial fascial compartment?

A

Fatty layer is called the camper’s fascia.

membranous layer is called the scarpa’s fascia.

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4
Q

What is the parietal peritoneum?

A

6th layer of the abdominal wall is the serous membrane; the parietal peritoneum.

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5
Q

What is the visceral peritoneum?

A

visceral peritoneum surrounds abdominal viscera .

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6
Q

What are the boundaries of the abdominal cavity?

A

Costal margin above.

Iliac crest below.

ASIS
Forms inguinal ligament
Pubic tubercle

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7
Q

What features do all 3 abdominal wall muscles share?

A

all 3 abdominal wall muscles are fleshy laterally and aponeurotic medially.

There is a relationship between muscle layers and spermatic cord.

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8
Q

How are the external oblique muscles arranged?

A

External obliques run downward and anteriorly.

Superiorly it overlaps the costal margin and extends onto the anterior surface of lower thoracic cage and merges with pec major and serratus anterior.

Posteriorly it goes as far as the thoracolumbar fascia.

anteriorly they meet at the aponeurosis in the middle at the raphe known as the linea alba..

Inferiorly the edge is free and forms the inguinal ligament. (Triangular opening before the rest attaches to pubic crest).

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9
Q

How are the internal oblique muscles arranged?

A

posteroinferomedially arranged
Meets with the other abdominal muscles from both sides at the linea alba.

Internal oblique muscles arise from the anterior half of the iliac crest and the ASIS.
Internal oblique muscles continue to arise from the lateral and lowermost 2/3rds of the inguinal ligament. The superior part of it arises from the thoracolumbar fascia.

They attach to the pubic crest. Lower most fibers arise arch then attach.

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10
Q

What is the deepest layer of oblique abdominal muscles?

A

Transverse abominus

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11
Q

What is the difference between external and internal oblique muscles in regards to their attachment to the costal margin?

A

internal oblique muscles attach directly to the costal margin. External oblique muscles lie anteriorly to it and merge with the pectorals and the serratus anterior.

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12
Q

How are transversus abdominus arranged?

A

Horizontally in arrangement.

Transverse abdominus is continuous with the diaphragm and underlies the costal margin.

Arise posteriorly from the thoracolumbar fascia.

anteriorly the transversus abdominus meet halfway accross the abdomen at the linea alba.

lowermost fibers arise from lateral 1/3 of inguinal ligament. These fibers arch and attach to the pubic crest via a conjoined tendon with the internal oblique fibers.

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13
Q

Where is the rectus abdominus muscle orientated?

A

rectus abdominus muscle is known as a divergent muscle. it originates at the pubic crest and diverges to go above the costal margin and attach to costal cartilages 5, 6, and 7.

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14
Q

At what levels are the tendinous divisions on the rectus abdominus muscles typically located?

A

umbilicus

xiphoid sternal joint

halfway between umbilicus and the xiphosternal joint

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15
Q

How are abdominal muscles arranged relative to the rectus abdominus?

A

all oblique muscles interact with linea alba posteriorly and anteriorly to the rectus abdominus with fibers running anteriorly and posteriorly to form the rectus sheath.

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16
Q

What is the difference between the upper rectus sheath and the lower rectus sheath?

A

The upper rectus sheath surrounds the rectus abdominis completely.

The lower rectus sheath only passes anteriorly to the rectus abdominis. Fascia transversalis lies behind the rectus abdominis.

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17
Q

Where do the upper and lower rectus sheath separate?

A

halfway between the umbilicus and the pubic crest (the same point where a tendinous separation of the rectus abdominis is)

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18
Q

What is the name of the fascia that lines the abdominal cavity? What layer lies deep to this fascia?

A

transverse fascia superficial to the parietal peritoneum.

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19
Q

What line lies at the point between the superior and inferior rectus sheath?

A

the arcuate line.

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20
Q

What does the posterior rectus sheath contain?

A

Vascular supply to the anterior abdominal wall.

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21
Q

Where does the neurovascular plane lie? Between what layers?

A

Between Internal Oblique muscles and transversus abdominus.

22
Q

Which rami innervate the anterior abdominal wall muscles?

A

innervation by ventral rami

23
Q

What spinal nerves innervate the abdominal region?

A

T7, 8, 9 above umbilicus

T10: umbilicus (remember this)

T11, 12: below umbilicus and above groin

L1: Groin (remember this)

24
Q

Where does the internal thoracic artery run?

A

Internal thoracic nerve runs slightly right of the sternum

25
Q

What structures does the superior epigastric artery supply?

A

The anterior abdominal wall muscles via the rectus sheath posteriorly.

26
Q

What structures does the inferior epigastric artery supply?

A

anterior abdominal wall muscles inferior to the umbilicus.

27
Q

What structures does the superficial epigastric artery supply?

A

Arises from femoral artery and runs through the femoral sheath about 1cm below inguinal ligament then goes up superficial to the inguinal ligament between the 2 layers of superficial fascia. It anastomoses with inferior epigastric artery and with the other superficial epigastric artery.

28
Q

Where does the superior epigastric artery run?

A

through the posterior rectus sheath anastomosing within the rectus sheath. and supplying the anterior abdominal wall muscles.

29
Q

Where does the superficial epigastric artery run?

A

runs in superficial fascia towards the umbilicus.

30
Q

What blood vessel gives rise to the superior epigastric artery and where does this branching occur?

A

The internal thoracic artery.

This branching occurs near the inferior border of the sternum.

31
Q

What are the branches of the internal thoracic artery?

A

Musculophrenic artery.

Superior epigastric artery.

32
Q

What does the musculophrenic artery supply?

A

continues along costal margin feeding off into costal vessels entering into costal spaces.

33
Q

Where do veins in the abdominal area run relative to the arteries?

A

veins run alongside the arteries. Typically superficial to them.

34
Q

What is the venous drainage of the anterior abdominal wall like?

A

venous drainage of abdominal wall drains into the systemic veins and partly into the hepatic portal venous system through paraumbilical veins.

35
Q

What is the point of the slit found in the inguinal ligament between the pubic tubercle and pubic crest?

A

Slit found in external oblique between pubic tubercle and pubic crest. This is known as the superficial inguinal ring. During development the testes pass through this ring.

36
Q

What is the inguinal ligament?

A

The free inferior edge of external oblique that is thickened and attaches from ASIS and connects to the pubic tubercle.

37
Q

What is the lacunar ligament?

A

crescent shaped ligament that connects to the pectineal line of the pubic bone.

38
Q

What is the pectineal ligament?

A

The ligament that arises from the lacunar ligament and is linear in shape.

39
Q

Where do the testes and ovaries originally develop?

A

they develop from extraperitoneal fat (right before the peritoneum. Not superficial subcutaneous fat).

40
Q

How did the testes end up in the scrotum during development?

A

They initially descend posteriorly in the extraperitoneal fat of the posterior abdominal wall and then descend through anterior abdominal wall right above the pelvis and take with them the anterior abdominal wall muscles.

41
Q

What exactly happens to the testes during development?

A

During the 12th week of development the testes are in the pelvis.

During the 28th week they start to move through the anterior abdominal wall through the inguinal canal and enter the scrotum soon after.

42
Q

What happens to the ovaries during development?

A

ovaries descend as well but stop at the pelvis.

43
Q

Where do the skin and the superficial fascia of the scrotum come from?

A

skin and superficial fascia of the scrotum is continuous with the anterior abdominal wall.

44
Q

What is the name of the path that the testes goes through to enter the scrotum?

A

The inguinal canal.

45
Q

What is the deep inguinal ring?

A

deep inguinal ring is a small deficiency in the fascia transversalis?

46
Q

What is the last deficiency that the testes traverse before reaching the scrotum?

A

The last deficiency that the testes go through before entering the scrotum is the superficial inguinal ring and is the exit into the inguinal canal.

47
Q

What happens to internal oblique and transversus abdominus during development?

A

they arch above the passage of the testes.

48
Q

What are the boundaries of the superficial inguinal ring?

A

Medial opening in external oblique aponeurosis between pubic tubercle and pubic crest.

49
Q

What do the testes take with them when they descend into the scrotum?

A

It’s neurovascular supply

The vas deferans

lymphatics

*These structures constitute the spermatic cord and they connect the testes to the body.

50
Q

Where does the spermatic cord gain its layers of fascia?

A

As it goes through fascia transversalis it gains the deep spermatic fascia.

As it goes beneath the arching fibers of transversus abdominus and internal oblique it gains the premasteric fascia which contains some muscle fibers.

At the superficial inguinal ring it gains the external spermatic fascia.

51
Q

What are the boundaries of the inguinal canal?

A

Floor: Inguinal ligament

Roof: Arching fibers of transversus abdominus and internal oblique

Anterior wall: External oblique aponeurosis, internal oblique muscle

Posterior wall: Transversalis fascia, conjoint tendon (Medially)