Surgical Incisions

Question 1

when making an incision surgeons will generally try to follow what lines?

Answer 1

Langer Lines

Question 2

what are the attachments of the external obliques?

Answer 2

rib 5-11 and anterior iliac crest ti linea alba

Question 3

what are the attachments of the internal obliques?

Answer 3

iliac crest to thoracolumbar fascia: ribs 12,11,10

Question 4

what allows for twisting movement and rotation of body i.e. axe chopping?

Answer 4

transversus abdominus

Question 5

what alows for bending of body?

Answer 5

rectus abdominus split into sections rather than straight plank of muscle

Question 6

what is an LSCS?

Answer 6

lower segment ceaserian section

Question 7

when undertaking a suprapubic incision i.e. LSCS what is the only layer of tissue that will be cut?

Answer 7

anterior rectus sheath

Question 8

nerves enter from lateral direction T/F?

Answer 8

true

Question 9

iliohypogastric and ilioinguinal arise from which spinal root?

Answer 9

L1

Question 10

what is the blood supply of the anterior abdominal wall?

Answer 10

superior epigastric arteries

inferior epigastric arteries

Question 11

what is teh nerve supply to the anterolateral abdominal wall?

Answer 11

7th-11th intercostal nerves become thoracoabdominal nerves

subcostal (T12)

iliohypogastric (L1)

ilioinguinal (L1)

Question 12

during LSCS why are the rectus muscles not cut?

Answer 12

they are seperated in a lateral direction pulling them towards their nerve supply

Question 13

the superior and inferior epigastric arteries are continuations of which other arteries?

Answer 13

internal thoracic artery → sup epigastric

external iliac artery → inf epigastric

Question 14

after seperating rectus muscles what lies underneath?

Answer 14

onyl fascia and peritnoneum covering uterus so any further cuts need to be taken with care

Question 15

why must care be taken w lateral ports when performing laparoscopy?

Answer 15

avoid damage to inferior gastric arteries

Question 16

what is hesselbechs triangle?

Answer 16

inguinal triangle- importance w hernias

Question 17

what are the boundaries of the inguinal triangle?

Answer 17

lateral- rectus sheath

superolateral- inferior epigastric arteries

inferior- inguinal canal

Question 18

describe indirect and direct hernia?

Answer 18

indirect → passes through inguinal canal at deep inguinal ring

direct → bulges through weakened abdo wall and lies behind superficail inguinal ring

Question 19

of indirect and direct hernias which is medial and which lateral to the inferior epigastric arteries?

Answer 19

indirect - lateral

direct - medial

Question 20

what are the two options for hysterectomy?

Answer 20

abdominal

vaginal

Question 21

if abdominal hysterectomy what incision is made?

Answer 21

same as LSCS

Question 22

what is extremely important to differentiate between when performing hysterectomy?

Answer 22

uterine artery and ureter

Question 23

where is the ureter in relation to the uterine artery?

Answer 23

inferior

‘water under the bridge’

Question 24

if unsure how could you tell the differnce bettwen ureter and uterine artery?

Answer 24

ureter will vermiculate when touched