Sievert Anatomy Abdominal Wall

Question 1

What are the superior surface boundaries of the anterior abdominal wall?

Answer 1

right and left costal margins of the 7-10th ribs and xiphoid process

Question 2

What are the inferior surface boundaries of the anterior abdominal wall?

Answer 2

inginal ligament and the superior margins of pelvic girdle

Question 3

What are the lateral boundaries of the anterior abdominal wall?

Answer 3

lateral abdominal wall

Question 4

Although boundaries are rigid or bony structures, the soft tissues of the anterior abdominal wall are not restricted to these boundaries. For example, many of the anterior wall muscles have much more extensive origins and insertions.
True or False?

Answer 4

True

Question 5

How do you create four quadrants in the abdominal wall? What do these quadrants result in?

Answer 5

a horizontal line through the umbilicus and a vertical line through the midline
RU, LU, RL, LL

Question 6

What are the 5 layers of the abdominal wall?

Answer 6

skin
superficial fascia
muscle with investing fascia
trasversalis fascia
parietal periotoneum

Question 7

The superficial fascia of the anterior abdominal wall is composed of 2 layers; a more superifical fatty layer called (blank) and a deeper membranous layer called (blank).

Answer 7

Campers

Scarpas

Question 8

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

Answer 8

external oblique muscle

Question 9

(blank) are especially prone to laying down excess fat in Camper’s layer

Answer 9

men

Question 10

Scarpa’s layer is continuous with the superificial perineal fascia so it has relevance for (blank)

Answer 10

extravasation of urine

Question 11

The potential space deep to scarpa;s fascia does not communicate with the thigh because it fuses with the (blank) at the inguinal ligamet

Answer 11

fascia lata

Question 12

What four muscles form the anterior abdominal wall?

Answer 12

external oblique
internal oblique
transversus abdominus
rectus abdominus

Question 13

The external abdominal oblique muscles arises from the surface of ribs (blank-(blank)) and inserts into the (blank X 3).

Answer 13

5-12

linea alba,anterior iliac crest, pubic tubercle

Question 14

The inferior border of the external oblique reflects slightly on (blank) to create the inguinal ligament and the anterior border of the inguinal canal.

Answer 14

itself

Question 15

What does the external oblique make by reflecting onto itself?

Answer 15

inguinal ligament and anterior border of inguinal canal

Question 16

Where does the innervation to the external obliques come from?

Answer 16

T7-T12 (intercostals and subcostals)

Question 17

What is the action of the external obliques?

Answer 17

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

Question 18

The internal abdominal oblique arises posteriorly from the lateral part of the (blank) and ineriorly from the (blank and (blank).

Answer 18

thoraco-lumbar fascia

iliac crest and inguinal ligament

Question 19

The internal abdominal oblique courses supero-medially to insert into the (blank) and lower (blank) with its fibers running perpendicular to the external oblique muscle.

Answer 19

linea alba and lower ribs

Question 20

the internal obliques also insert into the (blank) and *blank) via the conjoint tendon along with the transversus

Answer 20

pecten pubis and pubic crest

Question 21

The internal abdominal obliques insert into the pecten pubis and pubic crest via the (blank)

Answer 21

conjoint tendon

Question 22

What nerves innervate the internal abominal obliques?

Answer 22

T6-T11 intercostal nerves and subcostal and LI spinal

Question 23

What is the main action of the internal abdominal obliques?

Answer 23

to rotate the trunk to the same size, compress the abdominal viscera and assist with flexion of the trunk against resistance. Also supports back muscles due to origin at thoracolumbar fascia

Question 24

Two of the anterior abdominal wall muscles play an important role in supporting and strengthening the back by virtue of their attachment to the thoracolumbar fascia.
What are they?

Answer 24

transversus abdominus

internal oblique muscle

Question 25

Where does the rectus abdominis arise from?

Answer 25

the pubic symphysis and crest.

Question 26

The Rectus abdominis courses superiorly to insert into the (blank) and the (blank-blank) costal cartilages

Answer 26

xiphoid process | 5th through 7th

Question 27

What nerves innervate the rectus abdominis?

Answer 27

T6-T11 intercostal and subcostal nerves.

Question 28

what is the action of the rectus abdominis?

Answer 28

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

Question 29

What is the rectus abdominis sheathed by?

Answer 29

the rectus sheath, a connective tissue sleeve formed by the aponeurotic tendons of the lateral three abdominal wall muscles.

Question 30

What makes up the rectus sheath?

Answer 30

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

Question 31

The two paired rectus muscles are separated by the (blank) and are divided into approx. four bellies each by tendinous intersections with the anterior wall of the sheath.

Answer 31

linea alba

Question 32

Where is the arcuate line?

Answer 32

halfway between the umbilicus and the pubic symphysis.

Question 33

Above the arcuate line, aponeurotic fibers of the transversus and some from the internal, pass (blank) to the rectus abdominis muscle.

Answer 33

posterior

Question 34

Below the arcuate line, all aponeurotic fibers pass (blank) to the rectus muscle.

Answer 34

anterior

Question 35

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

Answer 35

linea alba

Question 36

Blood supply to the abdominal wall comes from where?

Answer 36

T10, T11 intercostal arteries, the musculophrenics, the subcostal artery, the first lumbar artery, the superior epigastric, the deep inferior epigastric as a branch off the external iliac and the deep circumflex iliac.

Question 37

There significant anastomotic connections between the arteries of the abdominal wall, especially the superior and deep inferior epigastrics. True or False

Answer 37

True

Question 38

Which 2 arteries run within the sheath?

Answer 38

the superior and inferior epigastric arteries

Question 39

Where is the superior epigastric artery located?

Answer 39

end of internal thoracic artery | ie. subclavian branch turns into internal thoracic which turns into superior epigastric

Question 40

Where will you find the inferior epigastric artery?

Answer 40

branched off the external iliac artery

Question 41

These vessels provide collateral circulation to the rectus muscle and abdominal wall. Remember a surgeon can use the internal thoracic artery for bypass because of two collateral flow situations. What vessels am I talking about?

Answer 41

superior and inferior epigastric arteries

Question 42

How is the venous drainage of the abdominal wall accomplished?

Answer 42

by anastomotic connections between the veins and accompanying arteries.

Question 43

What is the unpredictable vessel in the abdominal wall that has numerous small paraumbilical vein tributaries that connect with other vessels in the skin?

Answer 43

the obliterated umbilical vein

Question 44

Where is the transversalis fascia located?

Answer 44

deep to the transversus abdominis muscle

Question 45

What is a transparent fascia that lines the entire abdominal wall and has a name that changes depending on its position.. ie diaphramatic fascia, pelvic fascia etc.

Answer 45

transversalis fascia

Question 46

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

Answer 46

peritoneum

Question 47

What may be between the peritoneum and the transversalis fascia?

Answer 47

fat!

Question 48

What is the skin and muscle of the anterior abdominal wall innervated by?

Answer 48

T6-T11 intercostal nerves and subcostal nerve T12

Question 49

What innervates the inferior aspect of the abdominal wall?

Answer 49

L1 nerve via the iliohypogastric and ilioinguinal nerves

Question 50

All nerves run between the two deepest layers of the wall giving off (blank) and (blank) cutaneous branches on the way

Answer 50

lateral and anterior

Question 51

Which cutaneous nerve provides sensation to the subxiphoid area?

Answer 51

T6

Question 52

Which cutaneous nerve provides sensation to the umbilical area?

Answer 52

T10

Question 53

Which cutaneous nerve provides sensation to the suprapubic area?

Answer 53

T12 and L1

Question 54

What should you use as reference to find T10?

Answer 54

the umbilicus

Question 55

What is the suprapubic area innervated by?

Answer 55

the iliohypogastric nerve and ilioinguinal nerve

Question 56

What do the iliohypogastric nerve and the ilioinguinal nerve run through? What do they supply?

Answer 56

the inguinal canal | the anterior wall of the scrotum in males and anterior aspect of labia majora in females

Question 57

Where does a dorsal ramus go?

Answer 57

to true back muscles

Question 58

If you have a body wall structure that is below the diaphragm, will you have a pre or post ganglionic to it?

Answer 58

a post, all body wall structures no matter where are post

Question 59

Muscles of the (blank) contribute to the inguinal canal

Answer 59

anterior abdominal wall

Question 60

The inguinal canal is formed by (blank) in the male and the (blank) in the females

Answer 60

descent of the testis | round ligament of the uterus

Question 61

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

Answer 61

posterior abdominal wall

Question 62

the (blank) is thought to control the descent of the testis and ovary.

Answer 62

gubernaculum

Question 63

What make up the coverings and contents of the spermatic cord?

Answer 63

the periotoneum, transversalis fascia, internal oblique, and external oblique

Question 64

As the testis descends it drags (blank X 4) along with it.

Answer 64

peritoneum, transversalis fascia, internal oblique, external oblique, scarpas fascia and the skin

Question 65

The peritoneum surrounds the testis forming a (blank) for the testis which was originally part of, and connected to, the periotoneal sac in the abdominal cavity by the processus vaginalis.

Answer 65

celomic sac

Question 66

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

Answer 66

tunical vaginalis

Question 67

Where are all the layers including the cremaster muscle at the deep or superfical rings?

Answer 67

superficial ring

Question 68

What will come down into the center of the spermatic cord?

Answer 68

the vas deferens

Question 69

The testis drag some (blank) oblique muscles with it as it enters the deep ring to form the (blank).

Answer 69

internal oblique muscle | cremaster muscle

Question 70

Where is the conjoint tendon

Answer 70

next to the spermatic cord

Question 71

What two muscles combine as they pass medially through the rectus sheath to form a conjoint tendon (fossa terminalis).

Answer 71

the transversus and internal oblique

Question 72

The point where the transversus and internal oblique combine creates what?

Answer 72

a weak spot below them with only the aponeurosis of the external abdominal oblique there for support

Question 73

As the testis drags the peritoneum with it during descent, the cord picks up additional (blank) during the course.

Answer 73

layers

Question 74

The internal wall of the abdominal cavity is marked by (blank) folds

Answer 74

three

Question 75

The most lateral fold of the internal wall is called the (Blank) and is formed by the (blank).

Answer 75

lateral umbilical fold | deep inferior epigastric vessels

Question 76

The medial umbilicial fold is formed by the (blank)

Answer 76

obliterated umbilical arteries

Question 77

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

Answer 77

the obliterated urachus (the former connection of the primitive bladder to the umbilicus)

Question 78

What are the borders of the inguinal triangle?

Answer 78

medial-rectus abdominus lateral- deep inf. epigastric inferior- inguinal ligament

Question 79

The (blank) tendon arches across the inguinal triangle. A high arch can create a weak area in the triangle because the superficial ring is (blank) to the triangle.

Answer 79

conjoint | anterior

Question 80

The weak area of the triangle is (blank) to the deep ring.

Answer 80

medial

Question 81

(blank) is a protrusion of organ or tissue through muscle wall.

Answer 81

hernia

Question 82

(blank) hernia is a hernia though the medial portion of the inguinal canal, medial to inferior epigastric artery. This is through Hesselbach's triangle.

Answer 82

direct

Question 83

(blank) hernia is a hernia through lateral portions of the inguinal canal- usually through patent processus vaginalis. Follows the course of descent of the testis.

Answer 83

Indirect

Question 84

(blank) hernias follow the course of the testis and are inside the processus vaginalis, whereas (blank) hernias pass through the triangle and are not in the processus vaginalus.

Answer 84

indirect | direct

Question 85

(blank) hernias have all layers of the spermatic cord. (blank) hernias may not have all layers of the spermatic cord because they pass under the conjoint tendon and do not pass through the processus vaginalis.

Answer 85

indirect | direct

Question 86

What ligament goes from the ant. sup. iliac spine to the pubic tubercle?

Answer 86

the inguinal ligament

Question 87

What is the lacunar ligament?

Answer 87

it is the ligament between the inguinal ligament and the pectineal ligament

Question 88

(blank) hernias occur inferior to the inguinal ligament.

Answer 88

femoral

Question 89

What are all the borders of a femoral hernia?

Answer 89

anterosuperiorly->inguinal ligament medially->lacunar ligament Posteriorly Inferiorly-> pectineal ligament And occurs in the fermoral canal borderd laterally by the femoral vein and artery

Question 90

What canal does a femoral hernia occur in and what artery and vein border it laterally?

Answer 90

femoral canal borderd laterally by the femoral vein and artery

Question 91

The femoral sheath is trasversalis fascia surrounding what three things.

Answer 91

the artery, vein and lymphatics (most medial) | NO NERVES!

Question 92

Where are the femoral lymphatics and why are they important?

Answer 92

They are in the femoral canal, because stuff (like hernias) can be pushed in here

Question 93

Is the femoral canal long? | Why?

Answer 93

no | because the femoral sheath blends with the fascia of the thigh

Question 94

The opening of the femoral canal is called (Blank)

Answer 94

the femoral ring