3 Abdominal Wall

Question 1

abdomen

Answer 1

region of trunk btwn diaphragm + pelvic inlet/brim

Question 2

posterior border of abdomen

Answer 2

lumbar vertebrae/discs
12th ribs
upper body pelvis w/ psoas y quadratus lumborum muscles

Question 3

anterior border of abdomen

Answer 3

lower thoracic wall
external abdominal oblique
internal abdominal oblique
transversus abdominis

Question 4

subdivisions of abdominal wall

Answer 4

anterior
posterior
anterolateral
left lateral (flank)

Question 5

anteroleateral abdominal wall bounded by

Answer 5

7th - 10th costal cartilages
xiphoid process
inguinal ligament
pelvic girdle

Question 6

anteroleateral abdominal wall contains

Answer 6

skin
superficial fascia (hypodermis)
muscles/aponeuorsis (deep fascia)
extraperitoneal fat
parietal peritoneum

**Smiles Stay Fake Mainly to Entertain Foreign Pricks Passing by

Question 7

fascial linings

Answer 7

superficial fascia
deep fascia
endoabdominal (transversalis) fasic

Question 8

superficial fascia

Answer 8

subcutaneous tissue (hypodermis)
- fatty and membranous layers

Question 9

deep fascia

Answer 9

dense connective tissue that covers the abdomen

- separates the 3 muscles layers

Question 10

endoabdominal (transversalis) fascia found between

Answer 10

(1) extraperitineal fat
(2) parietal peritneum
(3) transversalus abdominis muscle

Question 11

endoabdominal (transversalis) fascia facts

Answer 11

• name changes according to structures it overlies (diaphragmatic, pelvic, etc)
• loose areolar tissue

Question 12

endoabdominal (transversalis) fascia contains

Answer 12

(1) blood vessels
(2) lymphatic structures

**no nerves

Question 13

anterior abdominal wall muscles

Answer 13

external abdominal oblique
internal abdominal oblique
transversus abdominis
rectus abdominis
pyramidalis

Question 14

external abdominal oblique

Answer 14

**anterior abdominal wall muscle

O: external surface of ribs 5 – 12
I: linea alba +pubic tubercle + anterior iliac crest
A: compress y support abdominal viscera + flex y rotate trunk
N: thoracoabdominal nerves
subcostal nerve

\ //

Question 15

internal abdominal oblique

Answer 15

**anterior abdominal wall muscle

O: thoracolumbar fascia + anterior iliac crest + inguinal ligament
I: inferior border of lower ribs 10 – 12 + linea alba
A: compress y support abdominal viscera + flex/rotate trunk
N: thoracoabdominal nerves + L1 – L2

// \

Question 16

transversus abdominis

Answer 16

**anterior abdominal wall muscle

O: inferior surface of costal cartilages 7 – 12
iliac rest
inguinal ligament
I: aponeurosis of internal abdominal oblique
lina alba
A: compress & support abdominal viscera
N: thoracoabdominal nerves + L1 – L2

= =

Question 17

rectus abdominis

Answer 17

**anterior abdominal wall muscle

O: pubic crest + symphysis
I: xiphoid process + costal cartilages 5 – 7
A: flex trunk compress + abdominal viscera + stabilize tilt of the pelvis
N: thoracoabdominal nerves

only muscle that flex/rotates trunk b/c it runs obliquely

(aka) antilordosis muscle

Question 18

clinical application of abdominal muscles

Answer 18

(infants) abdominal muscles not as developed, therefore they have round, pudgy bellies

(preggo) abdominal muscles separate
- lordosis causes back problems

Question 19

pyramidalis

Answer 19

**anterior abdominal wall muscle

O: pubic crest
I: linea alba
A: draw down on linea alba (aid in expiration)
N: thoracoabdominal nerves

absent in 20% of population
located inside rectus sheath

Question 20

joint action EAO + IAO + TA + RA

Answer 20

antagonizes diaphragm
- helps w/ forced expiration

left rotation uses right EAO + left IAO

Question 21

clinical application of pyramidalis

Answer 21

pyramidalis = surgical landmark to determine midline and linea alba
- esp. in C-sections

Question 22

rectus sheath

Answer 22

woven aponeuroses from EAO, IAO, TA

• contains V.A.N.
• relations differ depending upon if above or below arcuate line

Question 23

arcuate line

Answer 23

collection of fascia that is very strong and thick where fascia is suddenly in front of the abdominal muscles

Question 24

innervation of anterolateral walls

Answer 24

I: ventral rami (T7 - L1)

travels between IAO + TA
supplies skin, abdominal wall, and peritoneum

Question 25

L1 nerves

Answer 25

illiohypogastric nerve | ilioinguinal nerve

Question 26

inguinal region

Answer 26

region that extends from anterior superior iliac spine (ASIS) to the pubic tubercle - includes inguinal ligament y inguinal canal

Question 27

inguinal ligament

Answer 27

inferiormost part of external abdominal oblique aponeurosis | - equivalent of retinacula

Question 28

retinacula

Answer 28

band of connective tissue that covers tendon

Question 29

inguinal canal

Answer 29

parallel and superior to medial 1/2 inguinal ligament | - pathway = oblique (rings do not overlap)

Question 30

inguinal canal contains

Answer 30

spermatic cord (males) round ligament (females) - only connective tissue for filter blood y lymph vessels ilioinguinal nerve

Question 31

development of inguinal canal

Answer 31

when testes descend, they pass between EAO and IAO into scrotum where cremaster muscle is formed - cremaster muscle derived from IAO - grabs muscles from IAO to make cremaster muscle of scrotum

Question 32

rings found in inguinal canal

Answer 32

deep (internal) inguinal ring | superficial (external) inguinal ring

Question 33

deep (internal) inguinal ring

Answer 33

ENTRANCE to canal | - outpocketing of transversalis fascia

Question 34

superficial (external) inguinal ring

Answer 34

EXIT to canal | - split in aponeurosis of EAO

Question 35

structural weakness of inguinal area

Answer 35

increased intra-abdominal pressure forces deep (internal) wall of inguinal canal against superficial (external) wall of inguinal canal - contractions strengthen wall - muscle weakness leads to inguinal hernia

Question 36

inguinal hernia

Answer 36

abdominal viscera protrudes through abdominal wall 90% = protrusion of parietal peritoneum and abdominal viscera thru a normal or abnormal opening

Question 37

types of inguinal hernias

Answer 37

acquired (direct) inguinal hernia | congenital (indirect) inguinal hernia

Question 38

acquired (direct) inguinal hernia

Answer 38

enters directly thru abdominal wall (medial to inferior epigastric vessels) - cause: deep (internal) abdominal wall weakness - enters canal mid-path and runs PARALLEL to spermatic cord **more common in males NEXT TO CANAL

Question 39

congenital (indirect) inguinal hernia

Answer 39

enters deep ring (lateral to inferior epigastric vessels) and exits superficial ring - crosses whole canal within spermatic cord - affects males and females equally **most common (2/3) DIRECTLY THROUGH CANAL

Question 40

parts of the posterior abdominal wall

Answer 40

``` L1-L5 vertebrae Muscles: psoas, iliacus, quadratus lumborum diaphragm (superior part of wall) thoracolumbar fascia` fat, nerves, vessels ```

Question 41

quadratus lumorum

Answer 41

**posterior abdominal wall muscle SA: 12th rib lumbar transverse processes IA: internal iliac crest A: flex trunk + laterally fix 12th rib during respiration N: T12 + L1 – L4 arcuate ligaments of diaphragm cross in front of anterior surface of quadratus lumborum

Question 42

abdominal dermatome T7

Answer 42

tip of xiphoid process

Question 43

abdominal dermatome T10

Answer 43

umbilicus

Question 44

abdominal dermatome L1

Answer 44

inguinal ligaments + pubic symphysis