Anterior Abdominal Wall

Question 1

External Oblique

Answer 1

Attaches to linea alba, pubic tubercle, anterior half of iliac crest
Function: laterally flex and rotate trunk

Question 2

Internal Oblique

Answer 2

Attaches to inferior border of last 3 or 4 ribs, ilnea alba, pectineal line via conjoint tendon
Function: laterally flex and rotate trunk

Question 3

Transverse Abdominis

Answer 3

Attaches to aponeurosis of posterior and anterior rectus sheath, conjoint tendon to pubic crest and pectineal line
Function: supports viscera

Question 4

Rectus Abdominis

Answer 4

Attaches to cartilages of ribs 5-7, xiphoid process

Function: flex trunk

Question 5

What is inside the rectus sheath?

Answer 5

Rectus abdominis, superior epigastric vessels (internal thoracic), inferior epigastric vessels (external iliac), lymphatic vessels, nerves (ventral rami T7-T12)

Question 6

What are the boundaries of the rectus sheath?

Answer 6

Anterior: aponeurosis of internal and external obliques
Midline: linea alba
Posterior: aponeuroses of internal oblique and transversus abdominus —> ends at arcuate line

Question 7

Which umbilical ligament is the only one to function post-partum?

Answer 7

The 2 lateral ligaments contain the internal epigastric vessels, and thus function after the fetus state.

Question 8

Are the retroperitoneal organs within the peritoneal cavity? Where are they, specifically?

Answer 8

No, these organs lie outside the PC in the lesser sac or omental bursa, in a cavity behind the stomach.

Question 9

How do the greater and lesser sacs communicate?

Answer 9

They communicate via the Omental foramen = epiploic foramen = foramen of Winslow.

Question 10

What is the hepatoduodenal ligament?

Answer 10

It is a ligament between the liver and duodenum using the lesser omentum.

Question 11

Which ligament connects the less curvature of the stomach to the liver?

Answer 11

Gastrohepatic ligament.

Question 12

Why is the inguinal region clinically significant?

Answer 12

Because this is the site of hernias.

Question 13

What can palpation of the spermatic cord at the inguinal rings tell us?

Answer 13

This indicates hernia in this area, if one can feel bulging when palpating the spermatic cord and the patient coughs.

Question 14

What can weakening of the conjoint tendon do?

Answer 14

This can cause a direct inguinal hernia.

Question 15

What does the spermatic cord contain?

Answer 15

Inside there are 8 things:

1) Ductus (vas) deferens
2) Artery of vas deferens
3) Testicular artery
4) Pampiniform plexus
5) Cremasteric arter
6) Sympathetic nerve fibers
7) Lymphatic vessels
8) Genital branch of the genitofemeral nerve

Question 16

What does the spermatic cord do? And where is it located?

Answer 16

It suspends the testis in the scrotum and it is found in the inguinal canal.

Question 17

What is the thermoregulatory mechanism at work in the scrotum?

Answer 17

There are 3 main parts:

1) The dartos muscle contracts and wrinkles the skin so as not to lose heat. It also relaxes so heat can dissipate.
2) The testicular artery and pampiniform plexus work together. The blood from the outside the body is cooler and the blood from the testicular artery is warmer. The veins pull heat from the artery so the blood entering the scrotum is cooled.
3) The cremaster reflex involves a muscle derived from the internal oblique that contracts when it is cold, drawing the testes closer to the body. It also relaxes, descending the testes farther from the body, allowing heat to dissipate.

Question 18

What is the difference between a direct inguinal hernia and an indirection inguinal hernia?

Answer 18

A direct inguinal hernia has a protrusion that bypasses the deep inguinal ring and penetrates the posterior wall of the inguinal canal, medial to IEV. The indirect version traverses the deep inguinal ring lateral to the IEV, runs through the canal, and exits through the superficial ring into the scrotum; mostly congenital.