Class 1

Question 1

Explain what and where the pubic crest, tubercle, symphisis and sacroiliac joint are?

Answer 1

Symphisis = Fibrocartilaginous joint between two pubis'
Tubercle = Tubercle lateral to the pubic symphisis that attaches to the inguinal ligament
Crest = crest medial to the pubic tubercle extending to the medial end of the pubic bone (i.e. the symphisis)

Question 2

What lines divide the abdomen into its 4 and 6 quadrants?

Answer 2

4:

• Medial Sagittal line vertically
• Transumbilical line Horizontally

6:

• Right & left midclavicular vertically
• Transtuberculer horizontally (through iliac tubercles and body of L5)
• Transpyloric horizontally (midpoint of pubic symphisis and jugular notch)

Question 3

Name the 9 sections of the abdomen?

Answer 3

Right and left hypochondriac + Epigastric

Right & Left Lumbar + Umbilical

Right & Left Iliac + Hypogastric

Question 4

Whats the action and innervation of the external oblique muscle?

Answer 4

Anterior Rami T7-T11 & Subcostal Nerve (T12).

Flex/rotate the trunk
Compress & Support the abdominal organs

Question 5

Whats the action/innervation of the internal oblique

Answer 5

Anterior rami of T7-11 + subcostal nerve (T12) AND the L1.

Flexes & Rotates the trunk
Compress & Support the abdominal organs

Question 6

Whats the action and innervation of the transversus abdominus?

Answer 6

Compresses and supports the abdominal viscera

Innervated by the anterior rami T7-11, subcostal nerve (T12) and L1.

Question 7

Whats the function & innervation of the rectus abdominis?

Answer 7

Flexes trunk
Compresses the abdominal viscera
Stabilizes the pelvic tilt

Anterior rami of T7-L1

Question 8

What changes about the abdominal wall muscles around the level of the umbilicus?

Answer 8

Below the umbilicus the rectus abdominis is the deepest muscle layer

Above it the transversus thoracis runs behind the rectus abdomins instead of in front

Question 9

Whats the function of the rectus abdominis?

Answer 9

Flexion of the trunk

Question 10

Define the rectus sheath?

Answer 10

An aponeurosis of the transeversus abdominis and oblique muscles that sheaths the rectus abdominis so it can contract without sticking to the other perppendicular abdominal muscles.

Question 11

Define an aponeurosis?

Answer 11

Sheet of fibrous tissue substituting a tendon in flat muscles.

Question 12

What level is the umbilicus at?

Answer 12

Vertebral L4

Dermatome T10

Question 13

What thoracic spinal segments innervate the anterior abdominal wall?

Answer 13

Anterior rami of T7->T12:

• T7-11 are the thoraco-abdominal nerves
• T12 is the subcostal

Question 14

What is the inguinal ligament attached to?

Answer 14

Anterior superior iliac spine and the pubic tubercle

Question 15

What makes up the borders of the inguinal canal?

Answer 15

Anterior = Aponeurosis of ext. oblique

Posterior = Transversus Fascia

Roof = Muscular Aponeurotic arches of int. oblique & transversus abdominus

Floor = Inguinal ligament

Question 16

Where are the openings of the inguinal canal?

Answer 16

Deep inguinal ring 1/2 way from iliac spine to pubic tubercle

Superficial Inguinal Ring 1/3 way from tubercle to spine (1cm above and superolateral)

Question 17

How does the deep inguinal ring relate to the inferior epigastric vessels (and what are they)?

Answer 17

Ring is superior and lateral to the IEVs

Arises from external iliac and supplies abdominal wall

Question 18

What do the Inferior and Superior epigastric vessels arise from and where do they anastomose?

Answer 18

Superiorly = Internal thoracic
Inferiorly = External Iliac
Visibly just under the rectus abdominis above the umbilicus

Question 19

What are the contents of the inguinal canal?

Answer 19

Men - Spermatic cord
Women - Round ligament of uterus

Both - Blood, lymphatics, ilioinguinal nerve, genital branch of genitofemoral nerve.

Question 20

What are the two types of inguinal hernias?

Answer 20

Direct - Abdominal contents push through weak spot in muscles making up the posterior wall of the canal

Indirect - Abdominal contents push a congenital weakness in the deep inguinal ring into the inguinal canal

They can both pass through the canal and out the superfcial ring

Question 21

Where do femoral hernias occur?

Answer 21

Below the inguinal ligament, abdominal contents pass through a weak area in the posterior wall of the femoral canal

Question 22

Where do umbilical hernias occur?

Answer 22

Through a weakness at the site of passage of the umbilical cord through the abdominal wall.
Congenital abnormal fibres at the linea alba may also contribute to a weakness of the wall.

Question 23

What are the 4 functions of the GI mucosa?

Answer 23

Protective - Oral cavity, pharynx, oesophagus & anal canal
Secretory - Stomach
Absorptive - Entire small intestine
Absorptive/protective - Large intestine