incisions are most commonly carried out in obs & gynae?
a) Lower segment caesarean section
b) Laparotomy incision
At what level are Caesarean sections carried out?
2cm above pubic symphysis
measured as two finger breadths
On which line is a Caesarean incision made?
What are the three layers of abdominal fascia called?
Where are they found relative to the abdominal muscles?
Superficial - Camper's fascia, Scarpa's fascia; found superficial to external obliques
Deep - transversalis fascia; found deep to rectus abdominis and transversus abdominis
What are the four groups of abdominal wall muscles?
Rectus abdominis medially
Transversus abdominis laterally
What are the three layers of intercostal muscles?
Which direction do the external oblique muscles run in?
Hands in pockets
The external oblique muscles run in an (anterior / posterior) direction.
Which ribs do the external obliques attach to superiorly?
Ribs 5 - 11
Which structures do the external obliques attach to inferiorly?
What structure is a flattened aponeurosis found in the midline?
What structures are flattened aponeuroses found laterally?
What is an aponeurosis?
The external obliques run in the same direction as which respiratory muscles?
Which direction do the internal obliques run in?
i.e the opposite of external intercostals, remember hands in pockets
What fascia is found posteriorly?
Which abdominal muscles attach to the thoracolumbar fascia?
Which bony feature of the pelvis do all of the abdominal muscles attach to?
Which flattened tendons make up the borders of rectus abdominis?
Linea alba in the midline
Linea semilunaris laterally
Tendinous intersections between the groups of muscles
What structures does the linea alba attach to superiorly and inferiorly?
Xiphoid process of the sternum superiorly
Pubic symphysis inferiorly
Which structure is made up of the combined aponeuroses of transversus abdominis, external oblique and internal oblique?
Is rectus abdominis part of the rectus sheathe?
As in it doesn't have an aponeurosis to contribute, it's just surrounded by the rectus sheathe
Transversus abdominis is described as a corset muscle - why?
Keeps the abdominal organs contained within the abdominal cavity
Force of gravity pushes all these muscles downwards, creating a need for support
What is the advantage of tendinous intersections between the muscle groups of rectus abdominis?
If rectus abdominis was one long muscle it would contract in a weird way
What horizontal line marks a change in the structure of the rectus sheathe?
Where exactly is the arcurate line?
Halfway between umbilicus and pubic crest
Describe the structure of the rectus sheathe above and below the arcurate line.
Above acurate line:
external oblique anterior to rectus, internal oblique split into two leaflets, one anterior and one posterior to rectus, transversalis fascia posterior to rectus
Below arcurate line:
everything is anterior to rectus apart from transversalis fascia
This gets asked about in exams
Which muscle is always superficial to rectus abdominis in the rectus sheathe?
Which muscle splits into anterior and posterior leaflets in the rectus sheathe above the acurate line?
Anterior leaflet is superficial to rectus, posterior leaflet is deep to rectus
Describe the structure of the rectus sheathe above the arcurate line.
External oblique superficial to rectus
Internal oblique split into two leaflet - anterior leaflet superficial to rectus, posterior leaflet deep
Transversalis fascia deep to rectus