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(1) Organ Anatomy > S2_L1: Abdominal Wall > Flashcards

S2_L1: Abdominal Wall Flashcards

1
Q

What are the 5 Ps that can be absent in the body when the individual is born?

A
  1. pyramidalis
  2. palmaris longus
  3. plantaris
  4. psoas minor
  5. pectoralis major

Additional: Congenital absence of the pectoralis major is Poland syndrome

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2
Q

Determine the corresponding contents of the quadrants of the abdomen

  1. Spleen
  2. Sigmoid colon
  3. Cecum
  4. Gallbladder
  5. Jejunum and proximal ileum
  6. The first three parts of the duodenum

A. Right Upper Quadrant
B. Left Upper Quadrant
C. Right Lower Quadrant
D. Left Lower Quadrant

A
  1. B
  2. D
  3. C
  4. A
  5. B
  6. A
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3
Q

Determine the corresponding contents of the quadrants of the abdomen

  1. Left Colic (splenic) flexure
  2. Inferior part of descending colon
  3. Pylorus
  4. Appendix
  5. Superior part of ascending colon
  6. Body and tail of pancreas

A. Right Upper Quadrant
B. Left Upper Quadrant
C. Right Lower Quadrant
D. Left Lower Quadrant

A
  1. B
  2. D
  3. A
  4. C
  5. A
  6. B
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4
Q

Determine the corresponding contents of the quadrants of the abdomen

  1. Most of ileum
  2. Right lobe of liver
  3. Left Suprarenal (adrenal) gland
  4. Inferior part of ascending colon
  5. Left Spermatic cord
  6. Head of the pancreas

A. Right Upper Quadrant
B. Left Upper Quadrant
C. Right Lower Quadrant
D. Left Lower Quadrant

A
  1. C
  2. A
  3. B
  4. C
  5. D
  6. A
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5
Q

Determine the corresponding contents of the quadrants of the abdomen

  1. Left Ovary
  2. Right Colic (hepatic) flexure
  3. Left Half of transverse colon
  4. Most of stomach
  5. Right Uterine tube
  6. Right Kidney

A. Right Upper Quadrant
B. Left Upper Quadrant
C. Right Lower Quadrant
D. Left Lower Quadrant

A
  1. D
  2. A
  3. B
  4. B
  5. C
  6. A
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6
Q

The prominent hair bearing folds of skin formed by the enlargement of genital swellings of the fetus. This contains adipose and terminals strands of the round ligaments of the uterus.

A

Labia majora

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7
Q

Determine the corresponding underlying structures of the regions of the abdomen

  1. Spleen
  2. Appendix
  3. Rectum, bladder
  4. Adrenal glands (R&L)
  5. Cecum
  6. Esophagus

A. Right Hypochondriac Region
B. Epigastric Region
C. Left Hypochondriac Region
D. Right Lumbar Region
E. Umbilical Region
F. Left Lumbar Region
G. Right Iliac Region
H. Hypogastric Region
I. Left Iliac Region

A
  1. C
  2. G
  3. H
  4. B
  5. G
  6. B
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8
Q

Determine the corresponding descriptions of the types of hernia

  1. Hernial sac lies below and lateral to pubic tubercle
  2. Hernia of linea semilunaris usually below the umbilicus
  3. As it emerges the superficial inguinal ring, it lies above and medial to the pubic tubercle
  4. May be congenital or acquired
  5. Common in females, the protrusion of abdominal parietal peritoneum down through the femoral canal
  6. Occurs through the lumbar triangle (Petit’s triangle), a weak area in the posterior abdomen

A. Lumbar hernia
B. Umbilical hernia
C. Spigelian hernia
D. Inguinal hernia
E. Femoral hernia

A
  1. E
  2. C
  3. D
  4. B
  5. E
  6. A
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9
Q

Determine the corresponding descriptions of the types of inguinal hernia

  1. Neck of hernial sac is wide
  2. Common in old men due to weak abdominal muscles
  3. Most common, congenital
  4. Sac enters inguinal canal lateral to inferior epigastric vessels
  5. Usually unilateral with the R side more affected
  6. Sac lies medial to the inferior epigastric vessel

A. Direct inguinal hernia
B. Indirect inguinal hernia

A
  1. A
  2. A
  3. B
  4. B
  5. B
  6. A
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10
Q

Determine the corresponding layers involved in an abdominal stab wound to the ff locations

  1. Posterior wall of rectus sheath
  2. Transversus abdominis muscle or aponeurosis
  3. Fascia transversalis
  4. Linea alba
  5. External oblique muscle or aponeurosis
  6. Extraperitoneal connective tissue

A. Lateral to the rectus sheath
B. At the anterior rectus sheath
C. At the midline
D. All of the above

A
  1. B
  2. A
  3. D
  4. C
  5. A
  6. C
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11
Q

Determine the corresponding descriptions of the common incisions done in the anterior abdominal wall

  1. Anterior wall of rectus sheath is incised medially and parallel to the lateral of the rectus muscle
  2. Used for cecostomy or appendectomy
  3. Made through the linea alba
  4. Incision through the rectus abdominis muscle longitudinally
  5. Done supraumbilical (to expose upper abdominal cavity) or infraumbilical (for lower exposure of lower abdomen and pelvis)
  6. Above or below the umbilicus that can extend from flank to flank

A. Paramedian incision
B. Midline incision
C. Pararectus incision
D. Transrectus incision
E. Transverse incision
F. McBurney’s incision

A
  1. C
  2. F
  3. B
  4. D
  5. A
  6. E
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12
Q

Determine the corresponding descriptions of the common incisions done in the anterior abdominal wall

  1. Has a disadvantage of sectioning the nerve supply to the part of the muscle
  2. Is rare to damage more than one segmental nerve thus post op weakness of the muscle in minimal
  3. Anterior wall of rectus sheath exposed and incised 1 inch from midline
  4. Oblique incision made in the right iliac region 2 inches above and medial to the ASIS (or ⅔ from umbilicus)
  5. Rapid method in gaining entrance to the abdomen and does not damage the muscles, its nerve and blood supply
  6. Its disadvantage is the opening is small and any longitudinal extension require one or more segmental nerves of the rectus abdominis to be divided

A. Paramedian incision
B. Midline incision
C. Pararectus incision
D. Transrectus incision
E. Transverse incision
F. McBurney’s incision

A
  1. D
  2. E
  3. A
  4. F
  5. B
  6. C
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13
Q

It is the separation of the rectus abdominis due to excessive stretching of rectus sheath aggravated by coughing or straining. It occurs in the elderly and multiparous women.

A

Diastasis recti

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14
Q

Determine the corresponding descriptions of the types of umbilical hernia

  1. Small hernia caused by weakness of the scar of the umbilicus at linea alba
  2. Aka Omphalocele
  3. Sac protrudes through the linea alba in the region of the umbilicus
  4. Aka paraumbilical hernia
  5. Caused by failure of the midgut to return to abdominal cavity
  6. Common in women

A. Congenital umbilical hernia
B. Acquired adult umbilical hernia
C. Acquired infantile umbilical hernia

A
  1. C
  2. A
  3. B
  4. B
  5. A
  6. B
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15
Q

Determine the corresponding descriptions of the muscles in the posterior abdominal wall

  1. Joins lateral side of the psoas tendon
  2. Anterior surface is covered by lumbar fascia
  3. Fan shaped muscle
  4. Medial arcuate ligament is a thickened part of this muscle
  5. Flat quadrilateral shaped muscle alongside the vertebral column
  6. Is thickened above to form the lateral arcuate ligament, and below to form the iliolumbar ligament

A. Iliacus
B. Transversus abdominis
C. Quadratus lumborum
D. Psoas major
E. Posterior part of the diaphragm

A
  1. A
  2. C
  3. A
  4. D
  5. C
  6. C
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16
Q

Determine the corresponding descriptions of the ligaments associated with the anterior abdominal wall

  1. Becomes continuous with the thickening of the periosteum insertion
  2. Lower border of external oblique aponeurosis between anterior superior iliac spine and pubic tubercle
  3. Crescent shape extension of fiber at the medial end of the inguinal ligament
  4. Fiber that extends from lacunar ligament along the pectineal line of the pubis
  5. Forms medial margin of femoral ring
  6. Extends back and upward to pectineal line of the superior ramus of pubis

A. Pectineal (Cooper’s) ligament
B. Lacunar ligament
C. Inguinal ligament

A
  1. A
  2. C
  3. B
  4. A
  5. B
  6. B
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17
Q

Determine the corresponding descriptions of the openings in the anterior abdominal wall

  1. Oblique passage through the lower part of the anterior abdominal wall and is present in both sexes
  2. Gives passage to the spermatic cord and ilioinguinal nerve in the male and to the round ligament of the uterus and ilioinguinal nerve in the female
  3. Oval opening in fascia transversalis above the inguinal ligament
  4. Crescentic edge forms the medial margin of this opening
  5. Margin of the ring gives attachment to the internal spermatic fascia (or internal covering of round ligament of uterus)
  6. Triangular in shape from external oblique muscle, medial and above to pubic tubercle

A. Femoral ring
B. Superficial inguinal ring
C. Deep inguinal ring
D. Inguinal canal

A
  1. D
  2. B
  3. C
  4. A
  5. C
  6. B
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18
Q

Determine the corresponding descriptions of the flat transverse muscles in the anterolateral abdominal wall

  1. The deepest of the flat muscles
  2. Has a lower free border that arches over the spermatic cord and then descends behind it to be attached to the pubic crest and pectineal line
  3. Its fibers run superomedially or up medial perpendicular to the fibers of external oblique
  4. Largest and most superficial flat muscle in the abdominal wall
  5. Fibers run inferomedially
  6. Deep to this muscle is the transversalis fascia

A. External oblique
B. Internal oblique
C. Transversus abdominis

A
  1. C
  2. B
  3. B
  4. A
  5. A
  6. C
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19
Q

Determine the corresponding descriptions of the vertical muscles in the anterior abdominal wall

  1. Extends along the whole length of the anterior abdominal wall
  2. Often absent
  3. Long strap muscle, broad above and close to midline
  4. Small muscle in front of lower part of rectus abdominis
  5. Divided into 3 transverse tendinous intersections

A. Rectus abdominis
B. Pyramidalis

A
  1. A
  2. B
  3. A
  4. B
  5. A
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20
Q

Determine the corresponding descriptions of the ff planes

  1. Pass through tips of 9th costal cartilage
  2. Line joining the tubercles of iliac crest (or upper part of body of L5)
  3. Plane passing the highest points of iliac crest
  4. Lowest point of costal cartilage, 10th costal cartilage, or body of L3
  5. Crosses the inferior of left hilum of the kidney and superior part of right hilum of the kidney
  6. Crosses opening of stomach into duodenum (pyloric orifice) on right

A. Subcostal plane
B. Transpyloric plane
C. Intertubercular plane
D. Intercristal plane

A
  1. B
  2. C
  3. D
  4. A
  5. B
  6. B
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21
Q

Determine the corresponding descriptions of the types of inguinal hernia

  1. Hernial sac neck is narrow
  2. Sac is the remains of the processus vaginalis (outpouching of the peritoneum)
  3. More common in males: common in children and young adults
  4. Sac bulges directly anteriorly through the posterior wall of the inguinal canal
  5. Hernial sac may extend down to scrotum or labia majora

A. Direct inguinal hernia
B. Indirect inguinal hernia

A
  1. B
  2. B
  3. B
  4. A
  5. B
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22
Q

TRUE OR FALSE: The bigger the hernia, the less the strangulation of the viscera.

A

True

23
Q

Determine the corresponding boundaries of the lumbar triangle / Petit’s triangle

  1. anterior border of latissimus dorsi
  2. iliac crest
  3. posterior margin of external oblique muscle

A. Anteriorly
B. Posteriorly
C. Inferiorly

A
  1. B
  2. C
  3. A
24
Q

TRUE OR FALSE: In cases of a lumbar hernia, the neck of the hernia is large and incidence of strangulation is high.

A

False, incidence of strangulation is low

25
Q

It develops when the outer layers of the abdominal wall are weak, allowing the inner lining of the abdomen to push through. Some of the intestine or abdominal tissue slips into the newly formed sac, causing it to bulge out or protrude beneath the skin. It may strangulate the segment and it can die (necrose).

A

Hernia (Luslos)

26
Q

Enumerate the 3 transverse tendinous intersections of the rectus abdominis

A
  1. Xiphoid
  2. Umbilicus
  3. Between the 2
27
Q

The lateral margin of the rectus abdominis

A

Linea semilunaris

28
Q

Separates the 2 rectus abdominis

A

Linea alba

29
Q

The collection of structures that pass through inguinal canal to and from testes. It is composed of the vas deferens, testicular artery and vein, testicular lymph vessels, autonomic nerves, processus vaginalis, cremasteric artery, artery of vas deferens, and genital branch of genitofemoral nerve.

A

Spermatic cord

30
Q

Determine the corresponding descriptions of the contents of the spermatic cord

  1. Branch from the abdominal aorta at the level of L2
  2. Lymph ascends to the inguinal canal to reach the lumbar nodes (para-aortic nodes) located at the level of L1
  3. Transports spermatozoa from epididymis to urethra
  4. Blood supply of the testes and epididymis
  5. Drains to left renal vein on the left and into the inferior vena cava on the right
  6. From the pampiniform plexus

A. Vas deferens / Ductus deferens
B. Testicular artery
C. Testicular vein
D. Testicular lymph vessels

A
  1. B
  2. D
  3. A
  4. B
  5. C
  6. C
31
Q

Determine the corresponding descriptions of the ff structures

  1. Posterior to the testis
  2. Contains substance added to the seminal fluid to provide nourishment for the maturing sperm; For absorption of fluid
  3. Tough, thick fibrous capsule of testes
  4. Firm mobile organ within the scrotum
  5. Provides storage for maturation of spermatozoa

A. Testes
B. Tunica albuginea
C. Epididymis
D. Lower ends of spermatic cord

A
  1. C
  2. C
  3. B
  4. A
  5. C
32
Q

TRUE OR FALSE: The left testis is usually lower than right.

A

True

33
Q

The quadrants of the abdomen are formed by a transumbilical horizontal plane passing through umbilicus and intervertebral disc between ___ and vertical median plane.

A

L3-L4

34
Q

TRUE OR FALSE: A smaller or lesser scar is the result of cutting in the lines of cleavage (Langer’s lines) during a surgical procedure.

A

True

35
Q

TRUE OR FALSE: The superficial inguinal ring is much larger in women than in men.

A

False

36
Q

It starts from the deep inguinal ring (fascia transversalis) to superficial inguinal ring (external oblique muscle). In males, it allows structures to pass to and from the testes to abdomen. In females, it allows passage of round ligament from uterus to labium majus.

A

Inguinal canal

37
Q

Determine the corresponding boundaries of the inguinal canal

  1. formed by rolled inferior edge of aponeurosis of the external oblique
  2. aponeurosis of external oblique muscle, reinforced by internal oblique from inguinal ligament
  3. formed by arching lowest fibers of the internal oblique and transversus abdominis
  4. conjoint tendon

A. Anterior wall
B. Posterior wall
C. Inferior wall (floor of ligament)
D. Superior wall (roof)

A
  1. C
  2. A
  3. D
  4. B
38
Q

A fibrous structure that extends from the xiphoid process of the sternum to the pubic symphysis. It is a result of the aponeuroses of the flat muscles entwining in the midline.

A

Linea alba

39
Q

In the anteromedial aspect of the abdominal wall, each flat lateral abdominal muscle forms a/an ___, which covers the rectus abdominis muscle. The rectus sheath is formed by this.

A

Aponeurosis
- a broad, flat tendon

40
Q

What nerve does the inguinal canal transmit?

A

ilioinguinal nerve

41
Q

Determine the corresponding descriptions of the abdominal arteries

  1. Supply lower lateral part of abdomen
  2. Supply lateral part of abdomen
  3. Supply lower central part of anterior abdominal wall
  4. Terminal branch of internal thoracic artery
  5. Supply upper central part of anterior abdominal wall

A. Superior epigastric artery
B. Inferior epigastric artery
C. Deep circumflex iliac artery
D. Lower 2 posterior intercostal arteries and 4 lumbar arteries

A
  1. C
  2. D
  3. B
  4. A
  5. A
42
Q

Determine the corresponding dermatomes of the ff levels

  1. Above the inguinal ligament and symphysis pubis
  2. Epigastrium at the xiphoid process
  3. Umbilicus

A. T7
B. T10
C. L1

A
  1. C
  2. A
  3. B
43
Q

Determine the corresponding descriptions of the areas of the rectus sheath

  1. Posterior wall is formed by the 5th to 7th costal cartilages and intercostal spaces
  2. Aponeuroses of all three muscles form the anterior wall, the posterior wall is absent and rectus muscle lies in contact with fascia transversalis
  3. Anterior wall is formed by the aponeurosis of external oblique
  4. Aponeurosis of internal oblique splits to enclose the rectus muscle; external oblique aponeurosis is directed in front of the muscle and transversus aponeurosis is directed behind the muscle

A. Above the costal margin
B. Between the costal margin and arcuate line (ASIS)
C. Between the level of the arcuate line (ASIS) and pubis

A
  1. A
  2. C
  3. A
  4. B
44
Q

Determine the corresponding descriptions of the ff structures

  1. Downward prolongation of the transversalis and iliac fascial linings around the femoral vessels and lymphatics
  2. Continuous below with fascial lining the pelvic wall and its name is according to the structure it overlies
  3. Long fibrous sheath that encloses the rectus abdominis muscle and pyramidalis muscle
  4. Found between the transversalis and parietal peritoneum
  5. Thin layer of fascia that lies between muscle layer and abdominal wall and the parietal peritoneum
  6. Serous membrane that forms the wall of the abdomen

A. Rectus sheath
B. Fascia transversalis
C. Femoral sheath
D. Parietal peritoneum
E. Extraperitoneal fat

A
  1. C
  2. B
  3. A
  4. E
  5. B
  6. D
45
Q

It is the scar representing the site of attachment of the umbilical cord at the level of L3-L4

A

Umbilicus

46
Q

The natural lines of skin that run down and forward (horizontal around the trunk). These can be very vascular or very sensitive.

A

Lines of cleavage (Langer’s lines)

47
Q

Determine the corresponding descriptions of the ff structures

  1. The muscle fibers carried by the spermatic cord as it passes under the lower border of internal oblique
  2. Attaches medially to linea alba, lateral is a free border
  3. Raising or lowering of the testes
  4. Cremasteric muscle with fascia
  5. The lower fibers of internal oblique join with the tendon of transversus abdominis
  6. It exerts tension on spermatic cord and raise or lowers testes

A. Cremasteric reflex
B. Cremasteric muscle
C. Cremasteric fascia
D. Conjoint tendon

A
  1. B
  2. D
  3. A
  4. C
  5. D
  6. D
48
Q

This line demarcates the true and false pelvis

A

Iliopectineal line

49
Q

Determine the laterality of the internal and external oblique muscles working when an individual rotates the trunk to the Right.

A

(L) external oblique and (R) internal oblique

50
Q

Determine the corresponding descriptions of the ff structures

  1. Thin and fades out laterally and above where it becomes continuous with superficial fascia of back and thorax
  2. Forms internal spermatic fascia from the margins of the deep inguinal ring
  3. Is loosely attached to underlying structures except at the umbilicus
  4. Becomes the Colle’s fascia in the scrotum (labia majora) and posteriorly it gets fused to perineal body and becomes the posterior margin of the perineal membrane
  5. Continuous with superficial fat of the rest of the body

A. Skin
B. Femoral sheath
C. Fatty layer / Camper’s fascia
D. Membranous layer / Scarpa’s fascia

A
  1. D
  2. B
  3. A
  4. D
  5. C
51
Q

Determine the corresponding descriptions of the ff structures

  1. In scrotum, represents the thin layer of smooth muscle the Dartos muscle
  2. Its nerve supply is derived from anterior rami of lower 6 thoracic and L1
  3. Found 1 inch below the inguinal ligament
  4. Inferiorly, fuses with the deep fascia of the thigh (1 fingerbreadth below the inguinal ligament)
  5. Contains the femoral artery, vein and lymph vessels
  6. Is usually thick and thicker in obese patients

A. Skin
B. Femoral sheath
C. Fatty layer / Camper’s fascia
D. Membranous layer / Scarpa’s fascia

A
  1. C
  2. A
  3. B
  4. D
  5. B
  6. C
52
Q

It regulates the temperature of testicles and increase / reduce the surface area

A

Dartos muscle

53
Q

Determine the corresponding descriptions of the composition of the superficial fascia of the anterior abdominal wall

  1. Divided into two distinct layers
  2. A single sheet of connective tissue
  3. Contains the fatty superficial layer (Camper’s fascia) and the membranous deep layer (Scarpa’s fascia)
  4. Continuous with the superficial fascia in other regions of the body

A. Above the umbilicus
B. Below the umbilicus

A
  1. B
  2. A
  3. B
  4. A
54
Q

Determine the corresponding descriptions of the functions of the femoral sheath

  1. Is the posterior wall of rectus sheath
  2. The spermatic fascia pierces the transversalis fascia to form the deep inguinal ring

A. At midpoint
B. At inferior to the arcuate line

A
  1. B
  2. A

(1) Organ Anatomy (11 decks)

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