Topography of the abdominal wall and inguinal region

Question 1

What is scarpa’s fascia?

Answer 1

deep layer of the superficial fascia

Question 2

What is Camper’s fascia?

Answer 2

superficial layer of the superficial fascia

Question 3

What does Camper’s fascia continue as in the penis?

Answer 3

superficial layer of penis

Question 4

What does Camper’s fascia continue as in the scrotum?

Answer 4

tunica dartos

Question 5

What does the deep fascia continue as over the spermatic cord?

Answer 5

External spermatic fascia

Question 6

What does the deep fascia continue as over the penis?

Answer 6

Deep fascia of the penis (buck’s fascia)

Question 7

Innervation of external and internal oblique, transverse abdominus (4)

Answer 7

• Intercostal nerves T8 to T11
• Subcostal nerve (T12)
• Ilioinguinal nerve
• Iliohypogastric nerve

Question 8

Innervation of rectus abdominus

Answer 8

Intercostal nerves T7-T12

Question 9

What is the semilunar line of spigelius?

Answer 9

Curved line along the lateral border of rectus abdominus, at the aponeurosis of the transverse abdominus

Question 10

What forms the linea alba?

Answer 10

The aponeurosis of the external oblique, internal oblique and tranverse abdominal muscles

Question 11

Where does the linea alba extend from and to?

Answer 11

From the xiphoid process to the pubic symphesis

Question 12

What happens below the arcuate line?

Answer 12

All the muscle layers are now in front of the rectus sheath

Question 13

Where do the intercostal nerves come from?

Answer 13

The anterior rami of the inferior 6 thoracic spinal nerves (T7-T11)
(T12 is subcostal)

Question 14

From which spinal nerves does the ioliohypogastric nerve come from?

Answer 14

Anterior rami of spinal nerves L1-L2

Question 15

What does the iliohypogastric nerve supply? (3)

Answer 15

• Upper buttock
• Transverse and internal oblique
• Skin of mons pubis

Question 16

Where does the ilioinguinal nerve pierce the internal oblique?

Answer 16

above the superior anterior iliac spine

Question 17

What does the ilioinguinal nerve supply? (4)

Answer 17

• Transverse and internal abdominal
• Conjoint tendon
• Upper medial thigh
• scrotum, root of penis

Question 18

What do the superior epigastric vessels supply?

Answer 18

Superior part of rectus abdominus

Question 19

What do inferior epigastric vessels form?

Answer 19

the lateral umbilical fold

Question 20

What forms the inguinal ligament of Poupart?

Answer 20

The thickened inferior border of the aponeurosis of the external oblique

Question 21

What does the ligament of Poupart form in the inguinal canal?

Answer 21

The floor

Question 22

What forms the iliopubic tract?

Answer 22

the thickened inferior margin of the transversalis fascia

Question 23

What does the iliopubic tract contribute to in the inguinal canal?

Answer 23

the posterior wall

Question 24

What marks the inferior edge of the deep inguinal ring?

Answer 24

the iliopubic tract

Question 25

What forms the medial margin of the femoral canal?

Answer 25

iliopubic tract

Question 26

What do the ilioinguinal ligament and iliopubic tract function as together?

Answer 26

As the flexor retinaculum of the hip

Question 27

What structures does the lacunar ligament contribute to? (2)

Answer 27

- medial boundary of the femoral ring | - subinguinal hiatus

Question 28

What does the reflected ligament of Colles form?

Answer 28

The inferior margin of the superficial inguinal ring

Question 29

What fibers make up the iliopectineal arch / ligament?

Answer 29

Fused iliac and psoas fascia (along with fibers from inguinal ligament)

Question 30

What does the iliopectineal arch / ligament divide?

Answer 30

It divides the space deep to the inguinal ligament into the lateral muscular lacuna and the medial vascular lacuna

Question 31

Which 2 tendons make up the inguinal falx / conjoint tendon?

Answer 31

transverse abdominus and internal oblique

Question 32

Which wall does the conjoint tendon contribute to?

Answer 32

To the posterior wall of inguinal canal

Question 33

In which fascia / aponeurosis is the opening for the deep inguinal ring?

Answer 33

in the transversalis fascia

Question 34

What enters through the deep inguinal ring?

Answer 34

ductus deferens or round ligament and gonadal vessels

Question 35

What are the medial and inferior borders of the deep inguinal ring?

Answer 35

medial : lateral umbilical fold (inferior epigastric vessels) inferior : iliopubic tract

Question 36

Through which inguinal ring do indirect inguinal hernias go through?

Answer 36

through the deep inguinal ring

Question 37

In which fascia / aponeurosis is the opening for the superficial inguinal ring?

Answer 37

in the aponeurosis of the external oblique muscle

Question 38

What forms the roof of the inguinal canal? (2)

Answer 38

- Internal oblique | - Transverse abdominus

Question 39

What forms the anterior wall of the inguinal canal? (2)

Answer 39

- Aponeurosis of external oblique | - Aponeurosis of internal oblique (laterally)

Question 40

What forms the floor of the inguinal canal?

Answer 40

The inguinal ligament

Question 41

What forms the posterior wall of the inguinal canal?

Answer 41

- Transversalis fascia | - Conjoint tendon

Question 42

What are the contents of the inguinal canal? (3)

Answer 42

- Spermatic cord / round ligament of uterus - Genital branch of genitofemoral nerve - Ilioinguinal nerve

Question 43

What are the 3 layers of the thoracolumbar fascia?

Answer 43

1. Anterior : quadratus lomborum fascia 2. Middle layer 3. Posterior (thickest) layer

Question 44

Between which layers is the quadratus lomborum space?

Answer 44

between anterior and middle layers of thoracolumbar fascia

Question 45

Between which layers is the erector spinae space?

Answer 45

Between middle and posterior layers of thoracolumbar fascia

Question 46

What are the inferior, superior, floor and lat borders of the Petit trangle (inferior lumbar)?

Answer 46

Floor : internal oblique muscle Superior : Latissimus dorsi Inferior : iliac crest Lat : external oblique

Question 47

What is special about the auscultory triangle?

Answer 47

No musculature so you can hear breathing sounds very well

Question 48

What are the superior, inferior and lateral borders of the auscultory triangle?

Answer 48

Inferior : latissimus dorsi Superior : trapezius lateral : scapula

Question 49

What does the peritoneum develop from?

Answer 49

from the lateral plates of the mesoderm

Question 50

What connects the peritoneal sac and the omental bursa?

Answer 50

The epiploic foramen

Question 51

Which part of the duodenum is intraperitoneal?

Answer 51

Superior horizontal part only

Question 52

Which parts of the colon are intraperitoneal?

Answer 52

Appendix, cecum (sometimes), transverse colon sigmoid colon

Question 53

Which part of the rectum is semi-intraperitoneal?

Answer 53

Upper 1/3

Question 54

Which part of the rectum is retroperitoneal?

Answer 54

Middle 1/3

Question 55

Which part of the rectum is infraperitoneal?

Answer 55

Lower 1/3

Question 56

Where is the preperitoneal space located?

Answer 56

Bw anterior parietal peritoneum and transversalis fascia

Question 57

What is the median umbilical ligament a remnant of, what used to be its role?

Answer 57

Remnant of the urachus, which connected the fetal bladder to the umbilicus

Question 58

What are the medial umbilical folds / ligaments a remnant of?

Answer 58

Of the umbilical arteries

Question 59

What do the lateral umbilical folds cover?

Answer 59

They cover the inferior epigastric vessels

Question 60

What are the 2 parts of the ventral mesentery?

Answer 60

- Ventral mesogastrium | - Ventral mesoduodenum

Question 61

What are the 4 remnants of the ventral mesogastrium?

Answer 61

1. Falciform ligament of the liver 2. Hepatogastric ligament 3. Coronary ligament of the liver 4. Left triangular ligament of the liver

Question 62

What does the ventral mesoduodenum give rise to?

Answer 62

To the hepatoduodenal ligament

Question 63

What is the peritoneal relation of the distal part of the duodenum?

Answer 63

Secondary retroperitoneal

Question 64

What are the 3 recesses of the omental bursa?

Answer 64

- Superior recess (behind liver) - Inferior recess (behind stomach), obliterated after fetal life - Splenic recess

Question 65

What is the gastrocolic ligament formed by?

Answer 65

greater omentum (4 layers) with transverse mesocolon (2 layers), making it 6 layers

Question 66

What 2 structures does the transverse mesocolon connect?

Answer 66

Transverse colon to the posterior abdominal wall

Question 67

What 2 structures does the mesosigmoidum connect?

Answer 67

Sigmoid colon to pelvic wall

Question 68

4 borders of the epiploic foramen

Answer 68

Anterior : hepatoduodenal ligament Posterior : hepatorenal ligament and IVC Superior : liver Inferior : duodenum and duedorenal ligament

Question 69

What forms the gastropancreatic fold?

Answer 69

left gastric artery and coronary vein of the stomach

Question 70

What is the highest point of the peritoneal cavity?

Answer 70

Subphrenic / suprahepatic / hepaticophrenic recess

Question 71

What is Morrison's pouch?

Answer 71

subhepatic recess / hepatorenal recess, between the liver and the right kidney

Question 72

What 2 ligaments "form" the lesser omentum?

Answer 72

hepatogastric and hepatoduodenal

Question 73

Which vessels go through the lesser omentum?

Answer 73

Left and right gastric vessels

Question 74

What is the greater omentu derived from?

Answer 74

From the embryonic dorsal mesentery

Question 75

Which vessels are transmitted through the greater omentum?

Answer 75

Left and right gastroepiploic vessels

Question 76

Which 4 ligaments "make up" the greater omentum

Answer 76

Splenorenal Gastrosplenic Gastrophrenic Gastrocolic

Question 77

What does the gastrosplenic ligament contain? (2)

Answer 77

- Short gastric vessels | - Left gastroepiploic vessels

Question 78

What is the Monro Richter line?

Answer 78

Line passing from the umbilicus to ASIS

Question 79

What is the McBurney point?

Answer 79

On the lateral 1/3 of the monro line, marks the location of the appendix for surgery

Question 80

Which type of hernia is congenital?

Answer 80

The indirect inguinal hernia

Question 81

What does the hernia go through in an indirect hernia?

Answer 81

Deep inguinal ring, inguinal canal AND superficial inguinal ring