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Gross III > Part II. Anterolateral abdominal wall pg 33-39 > Flashcards

Part II. Anterolateral abdominal wall pg 33-39 Flashcards

1
Q

The abdominal cavity is located between what two anatomical landmarks?

A

Thoracic diaphragm and pelvic inlet/superior pelvic aperture

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2
Q

The abdominopelvic cavity is located between what two anatomical landmarks?

A

Thoracic diaphragm and Pelvic diaphragm

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3
Q

Are the abdominal and pelvic cavities continuous with each other?

A

Yes

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4
Q

What landmark denotes the transition between the abdominal and pelvic cavity

A

Superior pelvic aperture/pelvic inlet

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5
Q

What lines the abdominal cavity and viscera?

A

Peritoneum

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6
Q

The potential space between the peritoneal layers of the abdominal cavity is called what?

A

Peritoneal cavity

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7
Q

What are the planes that delineate the abdomen into 9 regions, as clinicians often do?

A
  • subcostal plane
  • transtubercular plane
  • midclavicular plane (x2)
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8
Q

Where is the subcostal plane?

A

It is the horizontal plane between and inferior to the 10th costal cartilages

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9
Q

Where is the transtubercular plane?

A

Horizontal plane through iliac tubercles and L5 vertebrae.

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10
Q

Where are the midclavicular planes?

A

Vertical planes through the midpoint of each clavicle to ipsilateral midinquinal region.

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11
Q

What re the 9 regions of the abdominal cavity?

A
  • Epigastric region bordered on either side by R/L hypochondriac region
  • Umbilical region bordered on either side by R/L lateral region
  • Pubic region bordered on either side by R/L inguinal region
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12
Q

More general divisions of the abdominal cavity are delineated by only 2 planes. What are they?

A

Transumbilical plane

Median plane

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13
Q

Where is the transumbilical plane?

A

Horizontal plane through umbilicus and L3-L4 IVD

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14
Q

Where is the median plane?

A

Vertical plane through the midpoint (midsagittal) of the body

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15
Q

Using the more general divisions of the abdomen (using 2 lines), what are the 4 regions of the abdomen?

A
  • R/L Upper Quadrants

- R/L Lower Quadrants

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16
Q

Contents in RIGHT upper quadrant of the abdomen:

A
  • Liver (right lobe)
  • Gall bladder
  • Stomach (pylorus)
  • Duodenum
  • Pancreas (head)
  • R Suprarenal gland
  • R Kidney
  • R Colic (hepatic) flexure
  • Ascending colon (superior part)
  • Transverse colon (right half)
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17
Q

Contents in LEFT upper quadrant of the abdomen:

A
  • Liver (left lobe)
  • Spleen
  • Stomach
  • Jejunum and proximal Ileum
  • Pancreas (body and tail)
  • L Suprarenal gland
  • L Kidney
  • L Colic (splenic) flexure
  • Transverse colon (left half)
  • Descending colon (superior part)
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18
Q

Contents in RIGHT lower quadrant of the abdomen:

A
  • Cecum
  • Appendix
  • Ascending colon (inferior part)
  • Ileum (most of it)
  • R Ovary
  • R Uterine tube
  • R Ureter
  • R Spermatic Cord
  • Uterus (if enlarged)
  • Urinary bladder (if very full)
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19
Q

Contents in LEFT lower quadrant of the abdomen:

A
  • Descending colon (inferior part)
  • Sigmoid colon
  • L Ovary
  • L Uterine tube
  • L Ureter
  • L Spermatic cord
  • Uterus (if enlarged)
  • Urinary bladder (if very full)
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20
Q

Where is the anterolateral abdominal wall located?

A
  • Inferior to ribs 7-10 costal cartilages and xiphoid process
  • superior to inguinal ligament and pelvic bones
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21
Q

What are the two superficial fascia layers of the anterolateral abdominal wall?

A
  • Camper’s fascia (superficial fatty layer)

- scarpa’s fascia (deep membranous layer

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22
Q

What is Camper’s fascia equivalent to histologically?

A

Hypodermis

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23
Q

Describe Scarpa’s fascia histologically.

A

It is a thin layer of Dense irregular CT with a thin layer of loose CT separating it from the deep fascia

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24
Q

What is the functional significance of the thin layers of loose CT that separates Scarpa’s fascia from the deep fascia?

A

It allows for independent movement of superficial and deep fascia

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25
Q

What is the dense irregular CT they surround the abdominal muscles and their anoneuroses?

A

Deep fascia (investing fascia)

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26
Q

What is the loose CT located between muscles/aponeuroses and parietal peritoneum?

A

Endoabdominal fascia

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27
Q

Endoabdominal fascia is analogous to ____________ in the thorax and continuous with _________ in the pelvis.

A

Endothoracic fascia: endopelvic fascia

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28
Q

What fascia provides a potential surgical dissection plane for extraperitoneal and/or retroperitoneal organs

A

Endoabdominal fascia

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29
Q

What are the 5 muscles of the anterolateral abdominal wall?

A
  • external oblique m.
  • internal oblique m.
  • transversus abdominis m.
  • rectus abdominis m.
  • pyramidalis m.
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30
Q

Orientation of the muscle fibers of external oblique muscles?

A

Inferioanteriorly (like external intercostal)

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31
Q

Origin of external oblique

A

Ribs 5-12

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32
Q

Insertion of external oblique muscle

A
  • linea alba
  • pubic tubercle
  • anterior 1-2 of iliac crest
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33
Q

The aponeurosis that begins approximately at the midclavicular line

A

Linea semilunaris

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34
Q

The inferior margin of the linea alba thickens and rolls to form what?

A

Inguinal ligament

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35
Q

The inguinal ligament extends from where to where?

A

ASIS to pubic tubercle

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36
Q

The inguinal ligament is the anterosuperior attachment point for what?

A

Fascia lata

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37
Q

What innervates the external obliques and rectus abdominis muscle?

A
  • T7-11 thoracoabdominal nerves
  • subcostal nerve (T12)

Note: internal oblique and transversus are innervated by those nerves as well as iliohypogastric nerve and ilioinguinal nerve.

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38
Q

Orientation of the muscle fibers of the internal oblique

A

Fan out anteromedially from ASIS

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39
Q

What is the origin of internal oblique muscles?

A
  • Thoracolumbar fascia

- anterior 2/3 of iliac crest - inguinal ligament

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40
Q

What is the insertion of the internal oblique muscles?

A
  • Ribs 10-12
  • linea alba
  • pectin pubis via conjoint tendon
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41
Q

What muscle arches over the spermatic cord while it is in the inguinal canal?

A

Internal oblique m.

42
Q

Is the rectus abdominis muscles wider superiorly or inferiority?

A

Superiorly

43
Q

Is the rectus abdominis muscles thicker superiorly or inferiorly?

A

Inferiorly

44
Q

The aponeurosis associated with external oblique m., internal oblique m., and transversus abdominus is _________ and it contributes to _________.

A
  • linea semilunaris

- anterior rectus sheath

45
Q

Inferomedial aponeurosis fibers of the internal oblique deccusate and join with aponeurotic fibers of the transversus abdominis muscle to form what structure?

A

Conjoint tendon

46
Q

Where does the conjoint tendon attach?

A

Pubic crest and pectin pubis

47
Q

What are the actions of both the internal and external oblique?

A
  • Compress abdominal viscera

- flex and rotate trunk

48
Q

What is the orientation of the muscle fibers of transversus abdominis muscle?

A

Mostly transverse and medically

49
Q

What is the origin of the transversus abdominis muscle?

A
  • Thoracolumbar fascia
  • costal cartilages 7-12
  • iliac crest
  • inguinal ligament
50
Q

What is the insertion of transversus abdominis muscle?

A
  • Linea alba
  • pubic crest via conjoint tendon
  • pectin pubis via conjoint tendon
51
Q

What innervates internal obliques and transversus abdominis muscles?

A

T7-11 thoracoabdominal nerves, subcostal nerve, ilihypogastric nerve, ilioinguinal nerve

52
Q

What is the action of the transversus abdominis muscle?

A

Compress and support the abdominal viscera and trunk

53
Q

How is rectus abdominis muscle attached to the anterior rectus sheath?

A

By 3 semitendinous rings

54
Q

_________ is located midline between 2 rectus abdominis muscles and ________ is located at the lateral margins of each rectus abdominis muscle.

A

Linea alba: linea semilunaris

55
Q

What is the origin of rectus abdominis muscle?

A

Pubic symphysis and pubic crest

56
Q

What is the insertion of rectus abdominis muscle?

A

Xiphoid process and costal cartilages

57
Q

What is the action of the rectus abdominis muscles?

A

Flex trunk and compress abdominal viscera

58
Q

What is the small triangular muscle that overlaps inferior portion of rectus abdominis but is absent in 20% of people?

A

Pyrimidalis muscle

59
Q

Where does the pyramidalis muscles span from, if present?

A

Pubis and linea alba

60
Q

Fibrous envelope surrounding Rectus Abdominis M (and Pyramidalis M if present)

A

Rectus Sheath

61
Q

What forms the rectus sheath?

A

decussation/interweaving of aponeuroses of lateral abdominal wall Ms

62
Q

Defect in Linea Alba through which fetal Umbilical AV passed and where all lateral abdominal wall aponeuroses fuse

A

Umbilical ring

63
Q

The landmark for a structural change in the rectus sheath, located on posterior rectus sheath about 1/4 way up from pubic crest

A

Arcuate line

64
Q

What is the composition of the anterior rectus sheath superior to the arcuate line?

A
  • Aponeurosis of External Oblique M

- Anterior lamina of aponeurosis of Internal Oblique M

65
Q

What is the composition of the posterior rectus sheath superior to the arcuate line?

A
  • Posterior lamina of aponeurosis of Internal Oblique M
  • Aponeurosis of Transversus Abdominis M
  • Endoabdominal (Transversalis) fascia
66
Q

What is the composition of the anterior rectus sheath inferior to the arcuate line?

A
  • Aponeurosis of External Oblique M
  • Aponeurosis of Internal Oblique M
  • Aponeurosis of Transversus Abdominis M
67
Q

What is the composition of the posterior rectus sheath inferior to the arcuate line?

A
  • Endoabdominal (Transversalis) fascia
68
Q

Combined Function of Anterolateral Wall Muscles

A
  • Move trunk and maintain posture (both standing and sitting)
  • Protect abdominal viscera from injury
  • Compress abdominal viscera (increasing intra-abdominal pressure) which assists in defecation, urination, coughing, sneezing, forced expiration and childbirth
69
Q

Which Anterior abdominal branch of ventral primary rami innervates the dermatome at the level of the umbilicus?

70
Q

Thoracoabdominal nerves come from what VPRs?

71
Q

Thoracoabdominal nerves run in plane between ______ and ______ muscles.

A

Internal oblique and transversus abdominis

72
Q

What do the thoracoabdominal nerves innervate?

A

Lateral abdominal wall muscles (internal oblique, external oblique, transversus abdominis, rectus abdominis) and skin in the corresponding dermatomes

73
Q

What nerve is the anterior continuation of T12 VPR?

A

Subcostal nerve

74
Q

What does the subcostal nerve innervate?>

A

abdominal wall muscles and skin above ASIS and below umbilicus

75
Q

Superior terminal branch of ventral primary ramus of L1

A

Iliohypogastric Nerve

76
Q

Anterior cutaneous component of iliohypogastric nerve pierces _________.

A

External Oblique aponeurosis

77
Q

What does ilihypogastric nerve innervate?

A
  • Internal Oblique M
  • Transversus Abdominis M
  • hypogastric skin and skin over iliac crest (superior to inguinal canal)
78
Q

Inferior terminal branch of ventral primary ramus of L1

A

Ilioinguinal N

79
Q

What does Ilioinguinal nerve innervate?

A
  • Internal Oblique M
  • Transversus Abdominis M
  • Innervates skin of anterior scrotum/labia majora, mons pubis and medial thigh
80
Q

What nerve passes through the Inguinal Canal with round ligament/spermatic cord?

A

Ilioinguinal nerve

81
Q

What are the segmental branches from descending aorta that supply lateral flank and lumbar regions?

A

Posterior Intercostal As, Subcostal A and Lumbar As

82
Q

What is the branch from internal thoracic artery in the 6th intercostal space that descend along the costal margin of the thoracic cage?

A

Musculophrenic artery

83
Q

What is the branch from internal thoracic artery in the 6th intercostal space that descends between posterior rectus sheath and rectus abdominis muscle?

A

Superior epigastric artery

84
Q

What is the branch from external iliac artery just superior to inguinal ligament that ascend in transversalis fascia and enters rectus sheath inferior to arcuate line?

A

inferior epigastric a

85
Q

Superior and inferior epigastric arteries anastomoses to supply what?

A

rectus abdominis muscle and lower umbilical region

86
Q

What does musculophrenic artery supply?

A

hypochondriac region and anterolateral thoracic diaphragm

87
Q

What is the branch from external iliac artery that starts superior to and parallels the inguinal ligament to pass toward ASIS?

A

Deep circumflex artery

88
Q

What does the deep circumflex artery supply?

A

Deep inguinal region

89
Q

What branches from the femoral artery inferior to the inguinal ligament and then parallels it to pass toward the ASIS?

A

Superficial circumflex iliac artery

90
Q

What does the superficial circumflex iliac artery supply?

A

Skin in inguinal region

91
Q

What branch from the femoral artery, inferior to inguinal ligament, and ascend in superficial fascia towards the umbilicus?

A

Superficial epigastric artery

92
Q

What does the superficial epigastric artery supply?

A

Skin in pubic and lower umbilical region

93
Q

Venous drainage of anterolateral abdominal wall superior to umbilicus via:

A
  • Lateral Thoracic V to Axillary V to Subclavian V - Internal Thoracic V to Subclavian V
94
Q

Venous drainage of anterolateral abdominal wall inferior to umbilicus via:

A
  • Inferior Epigastric V to External Iliac V

- Superficial Epigastric V to Great Saphenous V to Femoral V to External Iliac V

95
Q

Small superficial tributaries of Hepatic Portal V associated with Caput Medusa

A

Parumbilical Vs

96
Q

What vein sometimes develops between Lateral Thoracic V and Superficial Epigastric V and may indicate underlying problems with venous return: i.e. IVC blockage?

A

Thoracoepigastric V

97
Q

Superficial lymphatics of the anterolateral abdominal wall above transumbilical plane drain primarily to where? A small percentage drain to where?

A
  • axillary nodes

- parasternal nodes

98
Q

Superficial lymphatics of the anterolateral abdominal wall below transumbilical plane drain to where?

A

superficial inguinal nodes

99
Q

Deep lymphatics of the anterolateral abdominal wall drain to where?

A

nodes along the External Iliac A

100
Q

Two artery branches that supply the lesser curvature of the stomach

A

Right and left gastric

101
Q

Two artery branches that supply the greater curvature of the stomach

A

Right and left gastro-omental/ gastroepiploic arteries

102
Q

Artery branches that supply the fundus

A

Short gastric

Gross III (20 decks)

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