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Anatomy Exam 2 Blue Boxes > Abdominal Wall/ Inguinal Region > Flashcards

Abdominal Wall/ Inguinal Region Flashcards

1
Q

liposuction

A

surgical method for removing unwanted subcutaneous fat

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2
Q

where can fluid accumulate in abdominal fascia?

A

between membranous layer of subQ (scarpa’s fascia) and deep fascial covering of rectus abdominus & external obliques (potential space)

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3
Q

what’s important about the fascia lata of the thigh that parallels the inguinal ligament?

A

accumulated fluid in abdominal wall can’t move inferiorly because of the fusal of the deep fascia of the thigh with scarpa’s fascia

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4
Q

what layer reduces risk of infection during abdominal surgery?

A

transveralis fascia

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5
Q

what is space of Bogros? why is it important?

A

-anterolateral part of potential space between transversalis fascia and parietal peritoneum -used for placing prosthetics when repairing inguinal hernias (typically in men)

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6
Q

what causes abdominal protrusion?

A

food, fluid, fat, feces, flatus, & fetus (six F’s)

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7
Q

what is ascites?

A

abnormal accumulation of serous fluid in peritoneal cavity

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8
Q

what can cause lordosis with respect to the abdominal region?

A

tumors or excess fat can cause the pelvis to tilt anteriorly at hip joints

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9
Q

where do abdominal hernias typically occur?

A

inguinal, umbilical, & epigastric regions

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10
Q

which type of hernia is common in neonates?

A

umbilical hernia because of weak abdominal wall in umbilical ring or incomplete closure of abdominal wall after umbilical cord ligation

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11
Q

acquired umbilical hernias occur most commonly in?

A

women and obese people

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12
Q

what is an epigastric hernia?

A

hernia in the epigastric region through the linea alba (midline between xiphoid process and umbilicus)

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13
Q

what is a spigelian hernia?

A

-hernia that occurs along semilunar lines -common in people older than 40 -associated with obesity

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14
Q

what is guarding of muscles?

A

involuntary spasms due to cold hands during palpitation

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15
Q

what is important about the superficial abdominal reflex?

A

-contraction of abdominal muscles when strokes lateral to medial towards umbilicus -diseased organ or injury will cause rapid reflex -obese people unlikely to produce reflex

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16
Q

an inguinal hernia and abdominal wall muscle weakness is indicative of?

A

injury to the nerves of anterolateral abdominal wall -inferior thoracic spinal nerves T7-T12 -ilio-inguinal & iliohypogastric nerves (L1)

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17
Q

what muscle is an exception to the use of langer’s lines in surgery?

A

rectus abdominus can be transected because its fibers run short distances between tendinous intersections & segmental nerves are lateral in rectus sheath (can be preserved)

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18
Q

what is an important complication of a median or midline incision?

A

linea alba has small vessels and nerves, but may undergo necrosis if edges are not sewn together properly

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19
Q

what kind of incisions are used for an appendectomy?

A

gridiron (muscle splitting)

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20
Q

what and where is McBurney’s incision?

A

oblique incision made at McBurney’s point, 2.5 cm superomedial to anterior superior iliac spine, to umbilicus

21
Q

what are Pfannenstiel (suprapubic) incisions & what are they used for?

A
  • horizontal incisions at pubic line
  • used for gynecological & obstetrical operations (C-sections)
22
Q

what incisions provide access to the gallbladder and bilary ducts (right side) & spleen (left side)?

A

subcostal incision: parallel & 2.5 cm inferior to costal margin to avoid 7th/8th thoracic spinal nerves

23
Q

which incisions are considered to be high risk?

A
  • pararectus: along lateral border of rectus abdominus, can cut off nerve supply
  • inguinal: repairing hernias, can injure ilio-inguinal nerve
24
Q

what can result if the muscular & aponeurotic layers of abdomen do not heal properly from a surgery?

A

incisional hernia; protrusion of omentum or organ

25
Q

what’s important about endoscopic surgery?

A
  • allows for minimally invasive surgery; small incisions using remotely operated instruments
  • reduces risk for infection, cut nerves, incisional hernias
26
Q

what clinical problem does this picture indicate?

A
  • obstructed flow to inferior or superior vena cava
  • anastomoses with thoraco-epigastric vein allows for venous blood return to heart
27
Q

what is cryptorchism?

A

undescended or unretractable testis (usually unilaterally and in inguinal canal)

28
Q

why is an undescended testis clinically relevant?

A

greatly increased risk for malignancy because its unpalpable and cancer goes undetected

29
Q

what is an external supravesical hernia and which nerve can be damaged in its repair?

A
  • goes through supravesical fossa & medial to an inguinal hernia
  • can damage iliohypogastric nerve during the repair
30
Q

what structure is clinically relevant in infants with erythroblastosis fetalis or hemolytic disease?

A

postnatal patent umbilical vein (when occluded, forms round ligament of liver)

31
Q

where can tumors near the round ligament of the uterus spread?

A

from uterus to labium majus (homolog of scrotum & distal attachment of round ligament) & then to superficial inguinal nodes

32
Q

what is a direct inguinal hernia?

A

acquired inguinal hernia that rarely passes through scrotum

33
Q

what is an indirect inguinal hernia?

A

congenital inguinal hernia that usually passes into scrotum (labium majus in females)

34
Q

how and where do you palpate the superficial inguinal ring?

A
  • superolateral to pubic tuberacle by invaginating skin of upper scrotom with index finger
  • important for finding inguinal hernias
35
Q

what nerve is the cremasteric reflex testing and why is it important?

A
  • rapid elevation of testes
  • tests ilio-inguinal nerve
  • hyperactive reflex may indicate undescended testes
36
Q

if the processus vaginalis persists in females, what forms?

A

small peritoneal pouch called canal of Nuck in inguinal canal, which may extend into labium majus and cause indirect inguinal hernia

37
Q

what is a hydrocele?

A
  • excess fluid in persistant processus vaginalis
  • can cause indirect inguinal hernia
  • may be located in testis or spermatic cord (see pic)
38
Q

how is a hydrocele detected?

A

transillumination: shining light on scrotal enlargement (serous fluid glows red)

39
Q

what is a hematocele & how does it occur?

A
  • blood in tunica vaginalis
  • results from rupture of branches of testicular artery from trauma
  • can cause hematoma
  • transillumination: blood does not glow
40
Q

what is torsion of spermatic cord & how is it fixed?

A
  • twisting of cord which can lead to necrosis of testes
  • venous/arterial obstruction, edema, hemorrhage
  • testes are surgically fixed to scrotal septum
41
Q

describe the innervation of the scrotum and why its important?

A
  • anterolateral surface of scrotum supplied by L1 (ilio-inguinal nerve)
  • posteroinferior surface supplied by S3 (pudendal nerve)
  • to anesthetize, spinal agent must be injected in different locations
42
Q

what is the difference between a spermatocele and an epididymal cyst?

A
  • spermatocele: cyst in epididymis near the head, milky, usually asymptomatic
  • epididymal cyst: cyst anywhere on epididymis
  • see pic
43
Q

what is the appendix of the testes?

A

-vesicular remnant of cranial end of paramesonephric (müllerian) duct, which forms half of uterus in female

44
Q

what are the appendices of the epididymis?

A
  • remnants of cranial end of mesonephric (wolffian) duct, forms part of ductus deferens
  • attached to head of epididymus
45
Q

what is a varicocele and why does it occur?

A
  • dilation of pampiniform plexus of veins
  • result from defective venous valves in testicular vein, & kidney/renal vein problems
  • occurs mostly on left side because right side drains into IVC easier
46
Q

where does cancer of the testis metastastize to?

A

initially to retroperitoneal lumbar lymph nodes (inferior to renal veins) & then to mediastinal & supraclavicular nodes

47
Q

where does cancer of the scrotum metastastize to?

A

superficial inguinal lymph nodes (in subQ inferior to inguinal ligament and along terminal part of great saphenous vein)

48
Q

why do cancers of testis and scrotum metastastize to different places?

A

because testes come from posterior abdominal wall to scrotum during development

49
Q

how else can testicular cancer metastastize?

A

by hematogenous spread of cancer cells via blood to lungs, liver, brain, & bone

Anatomy Exam 2 Blue Boxes (11 decks)

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