Skin And Superfical Fascia Flashcards
Ascites
Accumulation of fluid in the skin of anterior abdominal wall
Linear ablicantes
Undue stretching results in the formation of whitish streaks in the skin of the lower part of the anterior abdominal wall
What is umblicus
Remnant of the root of umblical cord
Level of umbilicus
Disc between L3 and L4
Anterior median line
Why is umblical level referred to as a WATERSHED
Lymph and venous blood flows upwards the plane of umblicus and downwards below this plane.
These do not cross the umblical plane
Portocaval anstomoses site
Name the veins at umblicus forming this anastomoses
In portal hypertension these anastomoses open up to form dilated veins radiating from the umblicus caput medusae
Ans2- paraumblical Vein Above SuperiorEpigastric
Lateral thoracic
Below
Superficial epigastric
Inferior epigastric
Sides Posterior intercostal and lumbar
In Superior vena caval obstruction blood flow
⬇️
Inferior vena cava obstruction
⬆️
Four folds of embryonic plate meet at
Umblicus
2 lateral folds
1 head
1 tail
Umblicus is the meeting point of 3 systems
Digestive VITELLOINTESTINAL DUCT
Excretory. Urachus
Vascular Umblical Veins
What is fistula
Abnormal passage between a hollow tubular organ and the body surface, or between two hollow or tubular organs.
Raspberry red Timor or cherry red Timor is caused by
Remnants of the vitellointestinal duct at umblicus
Faecal fistula cause
Persistence of a patent vitellointestinal duct
Persistence of proximal and middle part of VI DUCT
Meckels Diverticulum PROCIMAL
MIDDLE PART. ENTEROCOELE
What is a diverticulum
Diverticula are small, bulging pouches that can form in the lining of your digestive system.
What is another name for MECKELS DIVERTICULUM
Diverticulum Ilei
In which week should a normal MECKELS DIVERTICULUM disappear
6th week of IUL
Length of MECKELS DIVERTICULUM
2 inches or 5 cm
Location of MECKELS DIVERTICULUM
Situated 2 FEET or 60 cm from the ileocaecal valve
ALONG ANTIMESENTRIC BORDER OF ILEUM
What do you mean by antimesentric border
the convex margin of a small bowel loop, that lies opposite the mesenteric attachment.
Caliber of meckels Diverticulum
Equal to ileum
Is the apex of Meckels Diverticulum always free
No it can be free Attached to 1. Umblicus 2. Mesentry 3. Abdominal structure via a fibrous band
Two types of tissues that may be present in the Diverticulum
Gastric
Pancreatic
Inflammation of the Diverticulum results in
Symptoms resembling appendicitis pain in LOWER RIGHT ABDOMEN
Meckels Diverticulum may cause
Intestinal obstruction
Persistence of urachus
Urinary fistula at umblicus
Name umblical vessels
2 umblical arteries and a vein only visible at birth
Name the 2 layers of superficial fascia of anterior abdominal wall
Superficial FATTY LAYER ➡️ FASCIA OF CAMPER
DEEP MEMBRANOUS LAYER▶️ FASCIA PF SCARPA
Modifications of the superficial fatty layer
In the Penis it’s devoid of fat
In the Scrotum it’s REPLACED by Dartos Muscle
How is passage of extravasated urine prevented
The deep membranous layer of abdomen is continuous with the deep membranous layer of perineum known as COLLE’S FASCIA.
Attachments is such that they prevent it
Holden’s line ♟ Pubic tubercle Body of pubis Margins of pubic arch Posterior border of perineal membrane Above umblicus merges with fatty layer
What is Holden’s line and it’s significance
It’s a line of firm attachment between the membranous layer of front of thigh and deep fascia except near the inguinal ligament .
Begins little lateral to the pubic tubercle extends up to 8 cm
Significance: the firm attachment along Holden’s line prevents passage of extravasated urine into the thigh beyond this line in case urethra is ruptured in the perineum.
Modification of fascia of scarpa
Suspensory ligament and fundiform ligament of the penis and clitoris
Extravasated urine into superficial perineal pouch
Fascia of scarpa is cont with superficial perineal pouch via scrotum and penis. At times urethra ruptures and urine extravastes
Contents of superficial fascia
Cut Nerves vessels and lymphatic
Name the anterior cutaneous nerves supplying anterior abdominal wal
Lower 5 intercostal nerves Subcostal nerve supplies pyramidalis Iliohypogastric nerve (L1)
Iliohypogastric and Ilioinguinal do not enter the rectus sheath
Ilioinguinal nerve supplies
Pierces the external spermatic fascia
Skin of external genitalia
Upper medial side of the thigh
Lateral cutaneous branch of any abdominal wall
T10 T11 as intercostal nerves
Each of them pierces the external oblique muscle dicving into LARGE ANTERIOR and SMALLER POST branch
Subcostal and Iliohypogastric (T12,L1) anterosuperior part of gluteal region
Where does iliohypogastric nerve become cutaneous
2.5 cm above the superficial inguinal ring
CUTANEOUS ARTERIES OF ANTERIOR ABDOMINAL WALL
Anterior - superior epigastric(B: Internal Thoracic Artery B: SUBCLAVIAN ARTERY)
Inferior Epigastric(B: External Iliac artery
COMMON ILIAC ARTERY
BIFURCATION of abd aorta at L4
Lateral Cutaneous - Posterior Intercostal Arteries
Lower- Superficial Epigastric- Skin up to umblicus
Superficial Circumflex iliac- Abdomen skin and thigh
BOTH ARE BRANCHES OF COMMON FEMORAL ARTERY B: External Iliac
Superficial external pudendal - B: femoral artery
SVC OBSTRUCTION pathway
Backflow in descending order
Brachiocephalic
Subclavian
Axillary
Lateral thoracic vein
Thoracoepigastric vein
Superficial epigastric
Great saphenous
Femoral vein
IVC TO ❤️
IVC OBSTRUCTION
Common iliac External iliac Femoral Great saphenous Superficial epigastric Thoracoepigastric Lateral thoracic Axillary Subclavian Brachiocephalic SVC to ♥️
