Surgical Antomy Of The Abdomen

Question 1

Describe some of the functions of the abdominal wall.

Answer 1

Provides a firm, flexible wall which keeps the abdominal viscera in the abdominal cavity, protects the abdominal viscera. Matins the anatomical position of the viscera against gravity, assists in forceful expiration, and is involved in any action that increases the abdominal pressure

Question 2

What are the layers of the abdominal wall?

Answer 2

Skin, superficial fascia, muscles and associated fascia, parietal periotoneum,

Question 3

What are some of the features of the superfical fascia/

Answer 3

Consists of fatty connective tissue, above the umbilicus is a single sheet of connective tissue, and below the umbilicus is divided into two layers, a fatty superifical layer (the compers fascia) and a membranous deep layer (scapers fascia) superficial vessels run between these two layers of fascia

Question 4

What are the three flat muscles of the abdominal wall?

Answer 4

The external oblique, the internal oblique and the transversus abdominsus.

Question 5

What are some of the features of the external oblque muscle?

Answer 5

Largest and most superficial muscle, the fibres run inferiomedially, and apporach the midline where they form an aponeurosis.

Question 6

What is the linea alba?

Answer 6

In the midline all the aponeurosis comes together to form a fibrous sheath, the linea alba that runs from the xiphoid process of the sternum to the pubic symphysis

Question 7

What are some of the features of the internal oblique muscle?

Answer 7

Lies deep to the external oblique, is smaller and thinnner in structure and the fibres run superiomedially, and also contributes towards the linea alba

Question 8

What are some of the features of the tranversus abdominus muscle?

Answer 8

Deepest of the flat muscles with transversely running fibres, contributes aponeurotic fibres towards the linea alba, and deep to this there is a layer of fascia called the transveraslis fascia

Question 9

What are some of the features of the rectus abdominus muscle?

Answer 9

Is a vertical muscle, split in two by the linea alba, muscle is intersected by fibrous strips kknonw as tendinous intersections, and helps to stabilise the pelvis during walking,

Question 10

What is the pyramiddis?

Answer 10

A small triangle shaped muscle found in the rectus abdominius, located inferiorly with its base on the pubis, the apex attached to the linea alba and walls to surround the linea alba

Question 11

What is the rectus sheath?

Answer 11

Is formed by the aponeurosises of all the external oblique muscles and has an anterior and posterior wall for most of its length,

Question 12

When do the aponeurosis move the the anterior wall as part of the rectus sheat?

Answer 12

About half way between the umbilicus and the pubic symphisis

Question 13

What is the median incision?

Answer 13

An incision which is made through the linea alba, and can be extended down the whole length of the abdomen by curving round the umbilicus,- the linea alba is poorly vascularised by the blood losses are minimal and the major nerves are avoided

Question 14

What is a paramedian incison?

Answer 14

Is performed laterally to the linea alba, and provides access to some of the more lateral structures.

Question 15

What is a tranverse incision?

Answer 15

Made inferiorly and just lateral to the umbilicus, causes the least damage to the nerve supply and also heals well

Question 16

What is a suprapubic incision?

Answer 16

5 cm superior to the pubic symphsis, used when access to the pelvic organs is needed and care must be taken not to perforate the bladder

Question 17

What is a subcostal incision?

Answer 17

The incision is inferior to the xiphoid proccess.

Question 18

What is a Mc Burney incision ?

Answer 18

Grid iron incision, consists of two lines which split the fibres of the muscles, and mc burneys point is 1/3 of the distance between the ASIS and the umbilicus

Question 19

What is ectopia cardis?

Answer 19

Is an emboryoigcal defect whereby the lateral body folds fail to close in the thoaric region, and this causes the heart to lie outside the body cavity,

Question 20

What is a meckels diverticulum?

Answer 20

Where a small portion of the vitelline duct persist and and this forms a out pocket of ileum, the meckeys divertuculum, and this does not usually cause symptoms in adults

Question 21

When may a meckels divertuculum be symptomatic?

Answer 21

When it contains hetertopic pancreatic tissue or gastic mucosa or and it may cause bleeding

Question 22

What is explhos/ omphaolcele?

Answer 22

A herniation of the amboimnal viserca through an enlarged amboimal ring, covered by amnion, and is caused by a failure of the bowel to return to the body after physiological herniation

Question 23

What is gastrochisis?

Answer 23

A protustion of the abdominal contents in the body into the amniotic cavit, is lateral to the umbilicus in this region, and they is abnormal closure of the body wall against the contecting stalk, Is not voered by viserca and may be damaged by the amniotic fluid, and is more likley in babies that are born to younger mothers

Question 24

What is reffered pain?

Answer 24

Pain percieved at a site distant from what is causing the pain.

Question 25

Describe the features of somatic reffered pain?

Answer 25

Pain that is cause by a noxious stimula to the proximal part of a soft tic nerve that is perceived in the distal dermatome of that nerve

Question 26

What is visceral reffered pain?

Answer 26

There are visceral pain fibres running through the body, along with somatic fibres that enter the spinal cord at the same location, and therefore the cns perceives the pain as coming from the somatic portion of the body as opposed to the visceral portion of the body

Question 27

What are some of the things that can cause visceral pain?

Answer 27

ischameia, abnomrally strong muscle contractions, inflmation adn strecth.

Question 28

Where would pain in the foregut be reffered to?

Answer 28

The epigastric region

Question 29

Where would pain in the midgut be reffered to?

Answer 29

The periumbilical region

Question 30

Where would pain in the hindgut be referred to?

Answer 30

The suprapubic region