Unit Two Abdominal Wall Flashcards
The rectus sheath is formed by
Aponeuroses of three lateral abdominal muscles
Rectus sheath completely encloses
The upper 3/4s of the rectus abdominis muscles
The rectus sheath covers the anterior surface of what part of the abdominal muscle
Lower 1/4 of the muscle
The anterior wall aponeurosis of the upper 3/4 covers what
External oblique and internal oblique
The rectus sheath posterior wall aponeurosis of upper 3/4 covers what
Internal oblique and transversus abdominis
In the upper 3/4 of the rectus sheath internal oblique splits to enclose what muscle
Rectus abdominis
Rectus sheath of lower 1/4 anterior wall aponeurosis covers what
External oblique, internal oblique and transversus abdominis
Rectus sheath lower 1/4 posterior wall aponeurosis
No posterior wall but contains transversalis fascia and arcuate line
The posterior layer of the rectus sheath ends inferiorly at what
Arcuate line
What are the contents of the rectus sheath
Rectus abdominis, pyramidalis, lower 6 thoracic nerves, superior epigastric vessels, inferior epigastric vessels, posterior intercostal vessels, lymphatics
The inguinal canal is the oblique passage through
The lower part of the anterior abdominal wall
The inguinal canal extends from
The deep to superficial inguinal ring
The inguinal canal is found above
Medial 1/2 of inguinal ligament
Inguinal canal begins where
Deep inguinal ring
Inguinal canal ends where
Superficial inguinal ring
What are the four boundaries in the inguinal canal
Floor, anterior wall, roof and posterior wall
What is the floor boundary of the inguinal canal
Rolled edge of inguinal ligament supported by lacunae ligament
Anterior wall of of inguinal canal
Aponeurosis of external oblique and lateral internal oblique
What is the roof boundary of the inguinal canal
Lower edges of internal oblique and transversus (conjoint tendon medially)
Posterior wall boundary of inguinal canal
Transversalis fascia laterally and conjoint tendon medially
Contents of inguinal canal in female
Round ligament and ilioinguinal nerve (L1)
Contents in male inguinal canal
Spermatic cord and ilioinguinal nerve (L1)
What is the inguinal ligament
Dense band of inferior most part of external abdominal oblique
Inguinal ligament acts as a
Flexor retinaculum of hip joint along with iliopubic tract
What is the iliopubic tract
Thickening of transverse abdomen posteriorly
Inguinal ligament forms the roof of what
Subinguinal space
What are the two types of inguinal hernias
Indirect and direct
Indirect hernia is what compared to inferior epigastric vessels
Lateral
Indirect hernia goes through
Canal and pushes out
Which inguinal hernia most likely to happen
Indirect
Direct hernia goes through what
Wall
Direct hernia is where compared to inferior epigastric vessels
Medial
Indirect hernia congenital or acquired
Congenital
Direct hernia congenital or acquired
Acquired
What is the spermatic cord
The collection of structures that traverse the inguinal canal and pass to and from the testis
What makes up the spermatic fasciae
Internal spermatic, cremasteric, external spermatic fascia
Peritoneum forms what in spermatic cord
Tunica vaginalis
Transversalis fascia turns into what of spermatic cord
Internal spermatic fascia
Internal abdominal oblique muscle becomes what in spermatic cord
Cremaster muscle and fascia
External abdominal oblique muscle becomes what in the spermatic cord
External spermatic fascia
Function of cremaster muscle
Contracts testes
What are the contents in the spermatic cord
Vas deferens, testicular artery, cremasteric artery, artery to vas deferens, pampiniform plexus, testicular vein, genital branch of genitofemoral nerve, autonomic nerves (pain), lymphatics and processes vaginalis
Function of pampiniform plexus
Cools blood by pulling heat out for testes
In the upper 3/4 of the rectus sheath, what splits the abdominal wall to enclose the rectus abdominis
Internal oblique
The lower 1/4 of the rectus sheath begins where
Near a point midway between umbilicus and pubic symphysis. Present at the level of the ASIS
What is present at the junction of the upper 3/4 and lower 1/4 of the rectus sheath
Arcuate line
What is the cutaneous nerve supply of of the anterior abdominal wall
Anterior rami of lower six thoracic nerves (T7-T12) and lumbar nerves (L1)
What are the branches of the anterior rami of the lower six thoracic nerves
Lateral and anterior cutaneous branches
What are the branches of the lumbar nerves that innervate the cutaneous anterior abdominal wall
Iliohypogastric and ilioinguinal nerve
What are the vertical lines of division of the abdomen
Mid clavicular lines (x2)
The mid clavicular lines pass through
The midpoint between the ASIS and the symphysis pubis
The horizontal lines of division in the abdomen are
Subcostal plane, intertubercular plane, trans pyloric plane
Subcostal plane at what vertebrae level
L3
Intertubercular plane at what vertebrae level
L5
Transpyloric plane at what vertebrae level
L1
The transpyloric place crosses through what
Pylorus, neck of pancreas, fundus of gallbladder, end of spinal cord, colic flexures, cisterna chyli
The subcostal plane joins
The owner point of the costal margin on each side (R10)
The intertubercular place joins what
Tubercles on the iliac crest
Transpyloric place is where
Halfway between the jugular notch and the pubic bone
Belly button is where compared to vertebrae
T10
What are the abdominopelvic regions
Upper, middle and lower
The upper regions of the abdominopelvic are
Right and left hypochondrium, epigastric
The middle regions of the abdominopelvic regions consists of what regions
Right and left lumbar, and umbilical
The lower abdominopelvic regions consist of what regions
Right and left iliac, hypogastrium
What is fascia
Masses of connective tissue large enough to be visible to the unaided eye
What is the superficial fascia that is a fatty layer of the abdomen
Campers fascia
What is the membranous layer of the superficial fascia of the abdomen
Scarpa’s fascia, colle’s fascia
Camper’s fascia is continuous with
The superficial fat over the rest of the body
Scarpas fascia is present where
Present in the lower 1/3 of the anterior abdominal wall
Colles fascia inferiorly extends into what
The perineum
Name the layers of fascia starting from superficial to deep
Camper, scarpa, investing fascia (3 layers of superficial, intermediate, and deep)
Origin of external abdominal oblique
Lower 8 ribs
Insertion of external abdominal oblique
Xiphoid process, linea alba, pubic symphysis, pubic crest, pubic tubercle and iliac crest
Innervation of external abdominal oblique
T7-L1
The inferior margin of the aponeurosis of the external oblique forms what
Inguinal ligament
What forms the superficial inguinal ring
A triangular shaped defect in the aponeurosis of the external abdominal oblique
How is the linea alba formed
Fusion of the external oblique aponeurosis
Is the linea alba vascular or avascular
Avascular
Origin of the internal abdominal oblique
Lumbar fascia, iliac crest, lateral 2/3 of inguinal ligament
Insertion of internal abdominal oblique
Lower 3 ribs, xiphoid process, linea alba, pubic symphysis, pubic crest, pectineal line
Innervation of internal abdominal oblique
T7 - L1
Internal abdominal oblique aponeurosis splits to enclose what
Rectus abdominis
Origin of transversus abdominis
Lower six costal cartilages, lumbar fascia, iliac crest, lateral 1/3rd of inguinal ligament
Insertion of transversus abdominis
Xiphoid process, linea alba, symphysis pubis, pubic crest, pectineal line
Innervation of transversus abdominis
T6-L1
What forms the conjoint tendon
Lower most fibers of internal oblique and transversus abdominis
The conjoint tendon attaches where
Pubic crest
AKA of conjoint tendon
Inguinal flax
The transversalis fascia is deep to what muscle
Transversus abdominis
The transversalis fascia contains what
Deep inguinal ring
Origin of rectus abdominis
Pubic symphysis and pubic crest
Insertion of rectus abdominis
5th to 7th costal cartilage and xiphoid process
Innervation of rectus abdominis
T7 - T11
What is present in the rectus abdominis
Three to four tendinous intersections
The lateral margin of the rectus abdominis is called what
Linea semilunaris
The linea semilunaris crosses the costal margin at what number costal cartilage
9th
Origin of pyramidalis
Anterior surface of pubis and pubic symphysis
Insertion of pyramidalis
Linea alba
Nerve supply of pyramidalis
T12
Action of pyramidalis
Tenses the linea alba
Actions of abdominal wall muscles
Rotate/move trunk, depresses the ribs, compress the abdomen, support the viscera
How does the abdominal wall muscles assist in breathing
Relax during inspiration and contract during forced expiration
What occurs when abdominal wall muscles cause diaphragm to be fixed by holding inspired air and closing laryngeal openings
Micturation, defecation and parturition
When the right external oblique is rotating to the left what muscle is synergistic with that muscle
Left internal oblique and will assist
What is the motor pathway nerve supply
Supplies motor to muscles along the way and end up in skin for sensory
Where is the neurovascular plane
Located between the transverse abdominis and internal abdominal oblique
The nerve supply in the abdomen is similar to what was observed with ???
Intercostal nerves in thorax
What supplies the anterior abdominal muscles with blood
Superior and inferior epigastric arteries
The superior and inferior epigastric arteries run where compared to rectal sheath
Posterior
What is another blood supply to the abdominal wall
Deep circumflex iliac artery
