Uren's notes 1 Flashcards
Inguinal ligament
Runs from anterior superior iliac spine to the pubic tubercle
4 regions of anterior abdominal wall
Horizontal line drawn at L4 - transumbilical plane RUQ, LUQ, RLQ, LLQ Liver is in the RUQ, stomach in the LUQ
9 regions of anterior abdominal wall
Two vertical lines from right and left mid-clavicular point Horizontal lines drawn at the subcostal and transtubercle points of the iliac crest
Transpyloric plane (TPP)
Vertebral level L1, level at which the spinal cord ends
Subcostal plane
Approximate location of inferior mesenteric plane
Supracristal plane
Approximate location where abdominal aorta bifurcates
Intertubercular plane
Approximate location where R and L common iliac veins join to form IVC
Superficial fascia
Camper’s fascia and scarpa’s fascia
Camper’s fascia
Outer layer composed predominantly of fat Superficial veins, arteries, and nerves reside in it
Scarpa’s fascia
Deep to camper’s fascia Attaches to fascia lata of the thigh, prevents fluid located deep to Scarpa’s fascia from entering into the thigh
Nerves of anterior abdominal wall
T7 - xiphoid T10- umbilicus T12 - inguinal
Blood supply to anterior abdominal wall superiorly
Musculophrenic and superior epigastric arteries (terminal branches of the internal thoracic artery)
Blood supply to anterior abdominal wall laterally
10th-12th intercostal arteries
Blood supply to anterior abdominal wall inferiorly
Inferior epigastric and deep circumflex iliac arteries (branches of external iliac arteries)
Lymphatics above the umbilicus
Drain into axillary lymph nodes
Lymphatics below umbilicus
Drain to superficial inguinal nodes
Lateral group muscles of anterior abdominal wall
External oblique, internal oblique, transversus abdominis
Anterior group muscles of anterior abdominal wall
Two rectus abdominis
Rectus sheath
Encases the two rectus abdominis muscles
Anterior rectus sheath
Comprised of aponeuroses of the external and internal obliques
Posterior rectus sheath
Comprised of the aponeuroses of the internal obliques and transverse abdominis
Arcuate line
Where the posterior rectus sheath ends. Inferior epigastric artery enters the posterior rectus sheath
External oblique
Innervated by intercostal nerve T7-T11 Subcostal nerve T12
Internal oblique
Innervated by intercostal nerve T7-T11, subcostal nerve T12 Iliohypogastric and ilioinguinal nerves L1
Transversus abdominis
Innervated by intercostal nerve T7-T11, subcostal nerve T12, iliohypogastric and ilioinguinal nerves L1
Rectus abdominis
Innervated by intercostal nerve T7-T11, subcostal nerve T12
Deep layers of anterior abdominal wall
Fascia transversalis Extraperitoneal fat Parietal peritoneum
Exit of the testes from the main body cavity into the scrotum occurs via the
Inguinal canal
Inguinal canal
Has two openings: superficial ring and deep ring
Inguinal canal in females
Round ligament of the uterus
Inguinal canal in males
Spermatic cord
Deep ring
Transversalis fascia
Superficial ring
External oblique aponeurosis
Anterior wall of inguinal canal
External oblique aponeurosis, internal oblique muscle
Posterior wall of inguinal canal
Transversalis fascia
Indirect inguinal hernias
Neck of the hernia lies lateral to the inferior epigastric vessels, and passes through the deep inguinal ring Congenital, common in infants
Direct inguinal hernias
Neck of the hernia lies medial to the inferior epigastric vessels Head of the hernia moves into Hesselbach’s triangle
