The Abdomen (2) Flashcards
State the boundaries of the abdomen.
Superior: 5th intercostal space, xiphoid process, diaphragm
Inferior: pubic bone, iliac crest at the level of L4
Umbilicus at the level of L3-4
Posterior: lumbar vertebrae, psoas, iliacus, quadratus lumborum
The abdomen may be split into 4 quadrants, name them.
RUQ, LUF, RLQ, LLQ
The abdomen may be split into 9 parts, name them, from left to right, and then from up to down.
Right hypochondrium, epigastric, left hypochondrium, right flank, umbilical, left flank, right inguinal, pubic, left inguinal
State the layers of the abdominal wall from superficial to deep.
Skin, Camper fascia (adipose), Scarpa fascia (membrane), investing fascia (separating muscle), rectus fascia, rectus abdominis, external oblique, internal oblique, transversus abdominis, transversalis fascia, parietal peritoneum
What separates the right and left rectus abdominis?
Linea alba
State some functions of the abdominal wall.
Protection of organs, movement of vertebrae, coughing, emesis, urination, childbirth
Where do the rectal sheaths connect?
At the linea alba
At what point do the aponeuroses stop having a posterior and anterior division around abdominal muscles and run solely anteriorly?
The arcuate line, about midway between the pubic symphysis and the umbilicus. Hence, the rectus abdominis is in direct association with transversalis fascia
State the major fossae of the abdomen which are potential sites for herniation.
Medial inguinal fossa, lateral inguinal fossa
What is a hernia?
A hernia is the protrusion of tissue through the wall of the cavity that contains it.
What are the most common abdominal wall hernias?
Inguinal, femoral and incisional hernias
State the nerve supply of the muscles of the abdominal wall.
T6-L1 spinal nerves
Where do nerves pierce the abdomen?
They pierce the abdomen at the anterior ends of the intercostal spaces
Between what layers do the nerves run?
Between the internal oblique and the transversus abdominis layers
State the continuation of the ilionguinal nerve.
The ilioinguinal nerve originates from ventral ramus of L1 spinal nerve and continues through the inguinal canal.
What are the major sources of blood supply to the abdomen?
The superior and inferior epigastric arteries
What is McBurney’s point?
McBurney’s point approximates the location of the appendix. It is located 1/3rd of the way along the imaginary line from the right ASIS of the pelvis to the umbilicus. A gridiron incision is made here. Tenderness at this spot is a sign of acute apendicitis.
State the attachments of the inguinal ligament.
ASIS and pubic tubercle
What is the neurovascular significance of the inguinal ligament?
The femoral nerve, artery and vein enter the thigh by passing deep to the inguinal ligament.
State the biological sex differences of the inguinal canal.
The superficial inguinal ring is larger in males. Far more contents in males than in females.
State the location of the openings of the inguinal canal.
The deep inguinal ring is the opening of the invagination of the transversalis fascia. It lies above the inguinal canal, midway between the ASIS and the pubic tubercle.
The superior inguinal ring is a triangular defect in the aponeurosis of the external oblique muscle layer. Lies superolateral to the pubic tubercle.
State the contents of the inguinal canal that are common to both sexes.
Ilioinguinal nerve and lymph vessels
State the contents of the inguinal canal in males (spermatic cord).
A. to vas deferens, vas deferens, genital branch of genitofemoral nerve, testicular arteries, pampiniform plexus of testicular veins, cremaster artery, vein and muscle, processus vaginalis, autonomic nerves.
State the superior and inferior borders of the ilioinguinal canal.
Superior: arching fibers of the internal oblique and TA muscles
Inferior: superior surfaces of inguinal and lacunar ligaments
State the cause and location of a direct inguinal hernia.
Typically occurring in older men due to weakness in abdominal wall behind or lateral to superficial inguinal ring. It occurs medial to the epigastric vessels.
State the cause and location of an indirect inguinal hernia.
It traverses deep and superficial inguinal rings and inguinal canal. It lies within coverings of spermatic cord. It may descend into scrotum. More common in young males. It lies lateral to the epigastric vessels.
State the boundaries of Hessebach’s triangle.
Lateral: inferior epigastric vessel
Medial: lateral border of RA
Inferior: inguinal ligament
State the relation of in/direct hernias to Hesselbach’s triangle.
Direct hernia’s leave the abdomen through Hesselbach’s triangle. Indirect hernias protrude lateral to Hesselbach’s triangle
