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Block 3 Week 1 Meg > Sievert 1 > Flashcards

Sievert 1 Flashcards

1
Q

List the layers of the abdominal wall

A
  1. skin
  2. superficial fascia
  3. muscle with investing fascia
  4. transversalis fascia
  5. parietal peritoneum
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2
Q

The superficial fascia of the anterior abdominal wall is composed of two layers, a more superficial fatty layer called (blank)’s and a deeper membranous layer called (blank)’s

A

Camper’s; Scarpa’s

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3
Q

In which layer are men especially prone to laying down excess fat?

A

Camper’s layer

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4
Q

There is a potential space between Scarpa’s fascia and the investing fascia of the (blank)

A

external oblique muscle

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5
Q

Scarpa’s layer is continuous with the (blank) so it has relevance for extravasation of urine

A

superficial perineal fascia

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6
Q

Four muscles form the anterior abdominal wall

A

External oblique
Internal oblique
Transversus abdominis
Rectus abdominis

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7
Q

Where does the external abdominal oblique muscle arise from?

A

Ribs 5-12

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8
Q

What are the three sites of attachment of the external abdominal oblique?

A
  1. linea alba
  2. anterior iliac crest
  3. pubic tubercle
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9
Q

The inferior border of this muscle reflects slightly on itself to create the (blank) and the anterior border of the (blank)

A

external abdominal oblique; inguinal ligament; inguinal canal

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10
Q

Where does innervation to the external abdominal oblique come from?

A

T7-T12

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11
Q

What is the action of the external abdominal oblique?

A

Action is to rotate the trunk to the opposite side, raise intra-abdominal pressure, and assist with flexion against resistance.

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12
Q

Where does the internal abdominal oblique arise posteriorly?

A

The lateral part of the thoraco-lumbar fascia

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13
Q

Where does the internal abdominal oblique arise inferiorly?

A

From the iliac crest and the lateral half of the inguinal ligament

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14
Q

The internal abdominal oblique also inserts into the pecten pubis and pubic crest via the (blank) along with the transversus

A

conjoint tendon

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15
Q

Where does innervation to the internal abdominal oblique come from?

A

Ventral ramus of T6-T11 intercostal nerves, subcostal and L1 spinal

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16
Q

What is the action of the internal abdominal obliques?

A

To rotate the trunk to the same side, compress the abdominal viscera and assist with flexion of the trunk against resistance.

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17
Q

The internal abdominal obliques also play a role in support of the intrinsic back muscles by virtue of their origin from (blank)

A

the thoraco-lumbar fascia

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18
Q

Where does the transversus abdominis muscle arise from?

A

From the lateral part of the thoraco-lumbar fascia posteriorly, the 7th-12th costal cartilages, and inferiorly from the iliac crest and lateral third of the inguinal ligament

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19
Q

The transversus abdominis muscle courses anteromedially to insert into the (blank) with its fibers running parallel to what plane?

A

linea alba; transverse plane

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20
Q

The transversus abdominis muscle also inserts into the pecten pubis and pubic crest via the (blank) tendon, like the internal oblique.

A

Conjoint

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21
Q

Where does innervation to the transversus abdominis come from?

A

T6-T11 intercostal nerves, subcostal, and L1 spinal

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22
Q

What is the action of the transversus abdominis muscle?

A

Compresses the abdominal viscera, and plays a role in support of the back muscles due to its connection to the thoraco-lumbar fascia

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23
Q

The two anterior abdominal wall muscles that play an important role in supporting and strengthening the back by virtue of their attachment to the thoracolumbar fascia

A

Internal abdominal oblique; transversus abdominus

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24
Q

The Rectus Abdominis arises inferiorly from the (blank). It courses superiory to insert into the (blank) and (blank)

A

pubic symphysis and crest
xiphoid process
5-7th costal cartilages

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25
Q

Where does innervation to the rectus abdominis come from?

A

T6-T11 intercostal nerves and the subcostal

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26
Q

What is the action of the rectus abdominis?

A

To flex the trunk against resistance, compress the abdominal viscera and stabilize the tilt of the pelvis

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27
Q

A connective tissue sleeve formed by the aponeurotic tendons of the lateral three abdominal wall muscles

A

Rectus sheath

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28
Q

What are the two paired rectus muscles separated by?

A

linea alba

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29
Q

How many “bellies” is the rectus abdominis divided into? What divides them?

A

four; tendinous intersections with the anterior wall of the rectus sheath

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30
Q

The arcuate line is about halfway between the (blank) and the (blank)

A

umbilicus; pubic symphysis

31
Q

Describe what happens to the layers of the abdominal wall above the arcuate line vs below the arcuate line.

A

Above the arcuate line, aponeurotic fibers of the transversus and some from the internal pass posterior to the rectus abdominis muscle. However, below the arcuate line, all three layers pass ANTERIOR to the rectus muscle.

32
Q

The (blank) is an interdigitation of all aponeurotic fibers in the midline

A

linea alba

33
Q

Where does the blood supply from the abdominal wall come from?

A

T10, T11 intercostal arteries
the subcostal artery
the superior epigastic as a branch of the external iliac
the deep circumflex iliac

34
Q

T/F: there are significant anastomotic connections between the arteries supplying the abdominal wall, especially the superior and deep inferior epigastrics.

A

True

35
Q

Which two arteries run within the sheath?

A

Superior and inferior epigastric arteries

36
Q

end of internal thoracic artery, branch of subclavian artery

A

Superior epigastric artery

37
Q

branch of external iliac artery

A

Inferior epigastric artery

38
Q

Which artery can a surgeon use for bypass because of two collateral flow situations?

A

Internal thoracic artery

39
Q

The venous drainage is accomplished by rich anastomotic connections between the veins accompanying the arteries. The only unpredictable vessel is the obliterated (blank) with numerous small paraumbilical vein tributaries

A

umbilical vein

40
Q

Transparent fascia that lines the entire abdominal wall

A

Transversalis fascia

41
Q

The transversalis fascia is (blank) to the transversus abdominis muscle

A

Deep

42
Q

Parietal layer fused to all surfaces of abdominal wall except where it covers certain organs which are retroperitoneal

A

Peritoneum

43
Q

What innervates the skin and muscle of the anterior abdominal wall?

A

T6-T11 intercostal nerves and the subcostal nerve (T12)

44
Q

What innervates the inferior aspect of the abdominal wall?

A

L1 nerve via the iliohypogastric and ilioinguinal nerves

45
Q

Cutaneous nerves provide sensation
Subxiphoid area
Umbilical area
Suprapubic area

A

T6
T10
T12/L1

46
Q

Which two nerves supply the anterior wall of the scrotum in males and the anterior aspect of the labia majora in females?

A

iliohypogastric and ilioinguinal nerves

47
Q

Between which two layers do all anterior rami of spinal nerves travel?

A

The two deepest layers: inntermost and internal

48
Q

The inguinal canal is formed by the descent of the (blank) in the male and the (blank) in the female

A

testis; round ligament of the uterus

49
Q

The testis and ovary both develop in the (blank) abdominal wall and migrate during development

A

posterior

50
Q

The (blank) is thought to control the

descent of the testis and ovary

A

gubernaculum

51
Q

As the testis descends, what does it drag with it? These layers make up the coverings and contents of the (blank).

A

peritoneium, transversalis fascia, internal oblique, and external oblique; spermatic cord

52
Q

The peritoneum surrounds the testis forming a celomic sac for the testis which was originally part of and connected to the peritoneal sac in the abdominal cavity by the (blank)

A

processus vaginalis

53
Q

The processus vaginalis normally closes off leaving the (blank) isolated from its origin in the abdomen.

A

tunical vaginalis

54
Q

As the testis enters the deep ring, it drags some of what muscle with it? What muscle does it pierce to form the superficial ring?

A

internal oblique; external oblique

55
Q

The lateral umbilical fold is formed by what vessels?

A

deep inferior epigastric vessels

56
Q

The medial umbilical fold is formed by what arteries?

A

Obliterated umbilical arteries

57
Q

The midline fold is the median umbilical fold and is formed by the obliterated (blank)

A

urachus

58
Q

Borders of the inguinal triangle
Medial?
Lateral?
Inferior?

A

Medial: rectus abdominis
Lateral: deep inferior epigastric
Inferior: inguinal ligament

59
Q

What is the name of the tendon that arches across the triangle, and may reveal a weak area if its arch is too high?

A

Conjoint tendon

60
Q

The weak area is (blank) to the deep ring and is found in the inguinal triangle.

A

Medial

61
Q

A hernia through the medial portion of the inguinal canal - medial to inferior epigastric artery. This is through Hesselbach’s Triangle

A

Direct

62
Q

A hernia through lateral portion of inguinal canal - usually through patent processus vaginalis. Follows the course of descent of the testis.

A

Indirect

63
Q

Which type of hernia will be surrounded by all layers of the spermatic cord, because it passes through the processus vaginalis?

A

Indirect

64
Q

Where do femoral hernias occur?

A

Inferior to the inguinal ligament

65
Q

What is a femoral hernia bordered by? Medially? Anterosuperiorly? Posteroinferiorly?

A

lacunar ligament; inguinal ligament; pectineal ligament

66
Q

The femoral sheath is transversalis fascia surrounding what three things? Which thing is most medial?!

A

femoral artery, femoral vein, and lymphatics which are found in the canal. The lymphatics are the most medial.

67
Q

Four boundaries of the femoral canal?

A

Inguinal ligament anterosuperiorly; lacunar ligament medially; pectineal ligament posteroinferiorly; and femoral vein laterally

68
Q

Define fibrous adhesions.

A

Fibrous adhesion: strong fibrous bands often encountered after previous operative procedures

69
Q

Stage 1 appendicitis causes inflammation, which creates what kind of pain?

A

visceral pain, poorly localized

70
Q

Stage 2 appendicitis causes the whole organ to become enlarged, thickened and red, and causes what two types of pain?

A

visceral and localized pain due to involvement of the parietal peritoneum

71
Q

Stage 3 appendicitis causes perforation, allowing inflammatory material to pour into the greater sac. What kind of pain does this cause?

A

diffuse parietal irritation

72
Q

(blank) hernias will not necessarily have all the layers because they pass under the conjoint tendon and do not pass through the (blank)

A

Direct; processus vaginalis

73
Q

Is the femoral nerve within the femoral sheath?

A

No; only the artery, vein, and lymphatics

74
Q

The femoral sheath blends with the fascia of the (blank).

A

Thigh

Block 3 Week 1 Meg (17 decks)

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