EXAM3_G20_Anterolateral_Abdominal_Wall Flashcards

1
Q

The horizontal cuts of the abs making a 6 pack is called?

A

Tendinous intersections

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2
Q

What vert level is the umbilicus at?

A

L4

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3
Q

What are lines lateral to midaxillary line and crescent shape?

A

Semilunar lines

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4
Q

What is the defined line of the costal cartilage at the anatomical thoracic outlet on the anterior side?

A

Costal margin

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5
Q

What are the superior boundaries of the anterolateral abdominal wall?

A

Costal margin and xiphoid process

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6
Q

What are the 3 inferior boundaries of the anterolateral abdominal wall?

A
  1. Iliac crest (l4 vert level)
  2. Inguinal ligament (ASIS to Pubic tubercle)
  3. Pubic crest and tubercle
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7
Q

What is the lateral bump on the pubic bone called

A

pubic tubercle

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8
Q

What is medial to the pubic tubercle but lateral to the pubic symphysis?

A

Pubic crest

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9
Q

What is the lateral line of the hip pointing down towards the pubic tubercle?

A

Pectineal line

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10
Q

what is the continuous serous membrane called in the abdominal cavity?

A

Peritoneum

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11
Q

What are the lines that divide the abdomen into RU.RL LU LL quadrants?

A
Transumbilical plane (horizontal line)
Median plane (vertical line)
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12
Q

The lines that divide the body into 9 regions

A
Subcostal plane (rib 10, L2 vert level) - horizontal 
Transtubercular plane (iliac tubercle, L5 vert level)- hz
Midclavicular planes (left and right)
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13
Q

What are the two horizontal lines that make up the 9 regions of abdominal wall?

A

Subcostal plane

Transtubercular Plane

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14
Q

What are the 9 regions of the ab wall?

A

R. Hypochondraic Epigastric L. Hypochondraic
R. Lateral Umbilical L. Lateral
R. Inguinal Pubic L. Inguinal

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15
Q

7 Layers of the anterolateral abdominal wall

SCSDTEP

A

skin campers scarpas deep transversalis extraperitoneal parietal peritoneum

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16
Q

Superficial fascia consists of 2 layers?

A

Camper’s fascia (thick/fatty)

Scarpa’s fascia (thin/membranous)

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17
Q

Deep fascia consists of ?

A

Epimysium of each of the muscle layers

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18
Q

Endo-abdominal fascia cosists of

A

Transversalis fascia (anterolateral part)

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19
Q

fainting after urinating is called

A

Micurition

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20
Q

Parturition

A

Giving birth

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21
Q

What two muscles flex and rotate the trunk?

A

External and internal oblique

Transversus abdominis DOES NOT flex or rotate trunk

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22
Q

What muscle tenses the linea alba?

A

Pyramidalis muscles

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23
Q

the external oblique is homologous to

A

external intercostal muscles

ends anteriorly forming part of the rectus sheath

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24
Q

The inguinal ligament is formed by the inferior margins of the

A

rectus sheath

undercurving fibrous band formed by the external oblique

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25
Q

what is the function of the inguinal ligament?

A

Retaining band for deep structures of lower limb

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26
Q

Torsional movements come from contralateral internal and external obliques working together. The internal obliques end in an _____ _____ that forms part of the rectus sheath

A

anterior aponeurosis forms part of the rectus sheath

27
Q

Transversus abdominis function?

A

increases ab pressure- anterior aponeurosis forms part of the rectus sheath
- arches over inguinal ligament and contributes to the area of weakness

28
Q

Rectus abdominis attaches to xiphoid process and ribs 5,6,7 tapers inferior and separated by the ___ ___ and packs are created by ___ ____.

A

Linea alba

Tendinous intersections

29
Q

What are the surgical landmark for cut on median plane?

A

Pyramidalis - tenses linea alba

30
Q

What is the strong fibrous covering enclosing the rectus abdominis which is formed by aponeurosis of all 3 flat abdominal muscles?

A

Rectus sheath (anterior and posterior portions)

31
Q

What sheath does NOT extend all the way down to the pubic crest? What happens 3/4 of the way toward pubic crest?

A

Posterior rectus sheath

Passes anterior and fuses with anterior rectus sheath causing the ARCUATE LINE

32
Q

What is the Arcuate line?

A

Posterior rectus sheath passing anterior and fusing with the anterior rectus sheath

33
Q

what is the wall inferior to the Arcuate line prone to herniation?

A

b/c this part is only reinforced by the transversalis fascia

34
Q

Edge of the rectus abdominis and the inguinal ligament is the area of weakness where herniation of abdominal wall occurs is called ?

A

Inguinal (Hesselbach’s) triangle

35
Q

What passes through the inguinal triangle (hesselbach’s triangle)

A

Inferior epigastric artery and vein

36
Q

Innervation of the anterolateral abdominal wall is mainly by these four nerves:

A
  1. thoraco-abdominal nn
    (continuation of T7-T11 intercostal nn.)
  2. Subcostal nn (anterior ramus of T12)
  3. Iliohypogastric nn
    (terminal branches of L1 Anterior ramus)
  4. Ilioinguinal nn
    (terminal branches of L1 anterior ramus)
37
Q

Continuation of intercostal nerves of T7-T11 are called?

A

Thoracoabdominal nerves

38
Q

Terminal branches of L1 anterior ramus makes what two nerves?

A

Iliohypogastric nn

ilioinguinal nn

39
Q

What nerve pierces the Lateral ab wall and enters the lateral superficial fascia?

A

Lateral Cutaneous branches of the t10 abdominal nerve

40
Q

What nerves pierce the rectus abdominis (anterior) and enter anterior superficial fascia?

A

Anterior cutaneous branches of the t10 abdominal nerve

41
Q

what incision is used for appendectomy?

A

Gridiron incision (right iliac crest area in direction of groin to pubic)

transverse abdominal incision would be same spot just opposite direction

42
Q

three incisions of the abdominal wall

A

Median incision
Left paramedian incision
Subcostal incision

43
Q

what innervates cutaneous nerves over rectus abdominis? and lateral abdominal wall?

A

T7-T10 thoracoabdominal nerve & subcostal nerve

44
Q

What superficial cutaneous nerves innervates the DIP’s area?

A

Iliohypogastric nerve L1

45
Q

What superficial cutaneous nerves innervate the groin area?

A

Ilioinguinal nerve L1

46
Q

What supplies blood to the lateral region of the abdominal wall?

A

10th & 11th posterior intercostal & Subcostal arteries

47
Q

What supplies the superficial pubic & umbilical regions with blood? what is it a branch from?

A

Superficial epigastric artery (branch from femoral artery)

48
Q

What supplies medial part of anterolateral wall with blood? What is it a branch from?

A

Inferior epigastric (branch of external iliac artery)

49
Q

Inferior epigastric can anastomose with ?

A

superior epigastric that branches off internal thoracic

don’t mix up superficial epigastric and superior epigastric!

50
Q

External iliac artery branches into?

A

inferior epigastric artery

51
Q

where does superficial epigastric artery come from?

A

branch of femoral artery

52
Q

Venous drainage of anterolateral abdominal wall

A

Most drain directly into tributaries of SVC and IVC

Some drain into liver (mixes w/ gut blood) hepatic portal vein

53
Q

What happens if there is a blockage in the portal system?

A

diverts Gut blood into caval system which dilates to accommodate flow

54
Q

What drains deep wall superior to the transumbilical plane?

A

Superior epigastric vein>internal thoracic>SVC

55
Q

What drains deep lateral wall superior to transumbilical plane?

A

Subcostal 10th & 11th posterior intercostal veins

into azygous system>SVC

56
Q

What drains deep wall inferior to transumbilical plane?

A

Inferior epigastric vein>

into external iliac vein>IVC

57
Q

Cavo-Caval anastomosis is the

A

communication of blood between deep and superficial veins

58
Q

What two veins drain the wall superior to transumbilical plane? where do they drain?

A
  1. Thoraco-epigastric vein
  2. Lateral Thoracic vein
    - drain into AXILLARY Vein then into SVC
59
Q

What drains superficial wall inferior to transumbilical plane?

A

Superficial epigastric vein into femoral vein into IVC

60
Q

What vein can drain into the porta-caval (porto-systemic) anastomosis? from abdominal wall to liver via this system?

A

Paraumbilical veins

61
Q

Obstruction of hepatic portal v due to cirrhosis or liver fibrosis makes gut blood divert into paraumbilical veins. Where does the blood drain?

A

Portal-caval anastomosis between paraumbilical and caval veins (thoraco-epigastric) passes portal blood to IVC and SVC

62
Q

What is the classic clinical sign of obstructed hepatic portal system? what veins distended?

A

Caput Medusa-

Paraumbilical ,lateral thoracic, thoraco-epigastric

63
Q

superficial Lymph drainage- superior and inferior to umbilicus?

A

sup- drains to axillary nodes

inf- drain to inguinal nodes

64
Q

deep lymph drainage -

A

iliac and lumbar nodes