Topography of the abdominal wall and inguinal region Flashcards
What is scarpa’s fascia?
deep layer of the superficial fascia
What is Camper’s fascia?
superficial layer of the superficial fascia
What does Camper’s fascia continue as in the penis?
superficial layer of penis
What does Camper’s fascia continue as in the scrotum?
tunica dartos
What does the deep fascia continue as over the spermatic cord?
External spermatic fascia
What does the deep fascia continue as over the penis?
Deep fascia of the penis (buck’s fascia)
Innervation of external and internal oblique, transverse abdominus (4)
- Intercostal nerves T8 to T11
- Subcostal nerve (T12)
- Ilioinguinal nerve
- Iliohypogastric nerve
Innervation of rectus abdominus
Intercostal nerves T7-T12
What is the semilunar line of spigelius?
Curved line along the lateral border of rectus abdominus, at the aponeurosis of the transverse abdominus
What forms the linea alba?
The aponeurosis of the external oblique, internal oblique and tranverse abdominal muscles
Where does the linea alba extend from and to?
From the xiphoid process to the pubic symphesis
What happens below the arcuate line?
All the muscle layers are now in front of the rectus sheath
Where do the intercostal nerves come from?
The anterior rami of the inferior 6 thoracic spinal nerves (T7-T11)
(T12 is subcostal)
From which spinal nerves does the ioliohypogastric nerve come from?
Anterior rami of spinal nerves L1-L2
What does the iliohypogastric nerve supply? (3)
- Upper buttock
- Transverse and internal oblique
- Skin of mons pubis
Where does the ilioinguinal nerve pierce the internal oblique?
above the superior anterior iliac spine
What does the ilioinguinal nerve supply? (4)
- Transverse and internal abdominal
- Conjoint tendon
- Upper medial thigh
- scrotum, root of penis
What do the superior epigastric vessels supply?
Superior part of rectus abdominus
What do inferior epigastric vessels form?
the lateral umbilical fold
What forms the inguinal ligament of Poupart?
The thickened inferior border of the aponeurosis of the external oblique
What does the ligament of Poupart form in the inguinal canal?
The floor
What forms the iliopubic tract?
the thickened inferior margin of the transversalis fascia
What does the iliopubic tract contribute to in the inguinal canal?
the posterior wall
What marks the inferior edge of the deep inguinal ring?
the iliopubic tract
What forms the medial margin of the femoral canal?
iliopubic tract
What do the ilioinguinal ligament and iliopubic tract function as together?
As the flexor retinaculum of the hip
What structures does the lacunar ligament contribute to? (2)
- medial boundary of the femoral ring
- subinguinal hiatus
What does the reflected ligament of Colles form?
The inferior margin of the superficial inguinal ring
What fibers make up the iliopectineal arch / ligament?
Fused iliac and psoas fascia (along with fibers from inguinal ligament)
What does the iliopectineal arch / ligament divide?
It divides the space deep to the inguinal ligament into the lateral muscular lacuna and the medial vascular lacuna
Which 2 tendons make up the inguinal falx / conjoint tendon?
transverse abdominus and internal oblique
Which wall does the conjoint tendon contribute to?
To the posterior wall of inguinal canal
In which fascia / aponeurosis is the opening for the deep inguinal ring?
in the transversalis fascia
What enters through the deep inguinal ring?
ductus deferens or round ligament and gonadal vessels
What are the medial and inferior borders of the deep inguinal ring?
medial : lateral umbilical fold (inferior epigastric vessels)
inferior : iliopubic tract
Through which inguinal ring do indirect inguinal hernias go through?
through the deep inguinal ring
In which fascia / aponeurosis is the opening for the superficial inguinal ring?
in the aponeurosis of the external oblique muscle
What forms the roof of the inguinal canal? (2)
- Internal oblique
- Transverse abdominus
What forms the anterior wall of the inguinal canal? (2)
- Aponeurosis of external oblique
- Aponeurosis of internal oblique (laterally)
What forms the floor of the inguinal canal?
The inguinal ligament
What forms the posterior wall of the inguinal canal?
- Transversalis fascia
- Conjoint tendon
What are the contents of the inguinal canal? (3)
- Spermatic cord / round ligament of uterus
- Genital branch of genitofemoral nerve
- Ilioinguinal nerve
What are the 3 layers of the thoracolumbar fascia?
- Anterior : quadratus lomborum fascia
- Middle layer
- Posterior (thickest) layer
Between which layers is the quadratus lomborum space?
between anterior and middle layers of thoracolumbar fascia
Between which layers is the erector spinae space?
Between middle and posterior layers of thoracolumbar fascia
What are the inferior, superior, floor and lat borders of the Petit trangle (inferior lumbar)?
Floor : internal oblique muscle
Superior : Latissimus dorsi
Inferior : iliac crest
Lat : external oblique
What is special about the auscultory triangle?
No musculature so you can hear breathing sounds very well
What are the superior, inferior and lateral borders of the auscultory triangle?
Inferior : latissimus dorsi
Superior : trapezius
lateral : scapula
What does the peritoneum develop from?
from the lateral plates of the mesoderm
What connects the peritoneal sac and the omental bursa?
The epiploic foramen
Which part of the duodenum is intraperitoneal?
Superior horizontal part only
Which parts of the colon are intraperitoneal?
Appendix, cecum (sometimes), transverse colon sigmoid colon
Which part of the rectum is semi-intraperitoneal?
Upper 1/3
Which part of the rectum is retroperitoneal?
Middle 1/3
Which part of the rectum is infraperitoneal?
Lower 1/3
Where is the preperitoneal space located?
Bw anterior parietal peritoneum and transversalis fascia
What is the median umbilical ligament a remnant of, what used to be its role?
Remnant of the urachus, which connected the fetal bladder to the umbilicus
What are the medial umbilical folds / ligaments a remnant of?
Of the umbilical arteries
What do the lateral umbilical folds cover?
They cover the inferior epigastric vessels
What are the 2 parts of the ventral mesentery?
- Ventral mesogastrium
- Ventral mesoduodenum
What are the 4 remnants of the ventral mesogastrium?
- Falciform ligament of the liver
- Hepatogastric ligament
- Coronary ligament of the liver
- Left triangular ligament of the liver
What does the ventral mesoduodenum give rise to?
To the hepatoduodenal ligament
What is the peritoneal relation of the distal part of the duodenum?
Secondary retroperitoneal
What are the 3 recesses of the omental bursa?
- Superior recess (behind liver)
- Inferior recess (behind stomach), obliterated after fetal life
- Splenic recess
What is the gastrocolic ligament formed by?
greater omentum (4 layers) with transverse mesocolon (2 layers), making it 6 layers
What 2 structures does the transverse mesocolon connect?
Transverse colon to the posterior abdominal wall
What 2 structures does the mesosigmoidum connect?
Sigmoid colon to pelvic wall
4 borders of the epiploic foramen
Anterior : hepatoduodenal ligament
Posterior : hepatorenal ligament and IVC
Superior : liver
Inferior : duodenum and duedorenal ligament
What forms the gastropancreatic fold?
left gastric artery and coronary vein of the stomach
What is the highest point of the peritoneal cavity?
Subphrenic / suprahepatic / hepaticophrenic recess
What is Morrison’s pouch?
subhepatic recess / hepatorenal recess, between the liver and the right kidney
What 2 ligaments “form” the lesser omentum?
hepatogastric and hepatoduodenal
Which vessels go through the lesser omentum?
Left and right gastric vessels
What is the greater omentu derived from?
From the embryonic dorsal mesentery
Which vessels are transmitted through the greater omentum?
Left and right gastroepiploic vessels
Which 4 ligaments “make up” the greater omentum
Splenorenal
Gastrosplenic
Gastrophrenic
Gastrocolic
What does the gastrosplenic ligament contain? (2)
- Short gastric vessels
- Left gastroepiploic vessels
What is the Monro Richter line?
Line passing from the umbilicus to ASIS
What is the McBurney point?
On the lateral 1/3 of the monro line, marks the location of the appendix for surgery
Which type of hernia is congenital?
The indirect inguinal hernia
What does the hernia go through in an indirect hernia?
Deep inguinal ring, inguinal canal AND superficial inguinal ring