90 - Anterior Abdominal Wall

Question 1

Layers encountered if cutting into anterior abdominal wall 1 2 3 4 5 6 7

Answer 1

1) Skin 2) Superficial fascia (fatty layer) 3) Superficial fascia (membranous layer) 4) External oblique muscle 5) Internal oblique muscle 6) Transversus abdominus 7) Extraperitoneal fascia

Question 2

Tissue layout of obliques and transversalis abdominis

Answer 2

Fleshy laterally, aponeurotic medially

Question 3

Muscle with a free inferior edge

Answer 3

External oblique

Question 4

Inguinal ligament

Answer 4

Free inferior edge of the external oblique. Is thickened, curls inwards.

Question 5

Attachments of inguinal ligament

Answer 5

Lateral border attaches to iliac crest. Attachment at anterior superior iliac spine, public tubercule, with a free edge between.

Question 6

Attachments of the internal oblique

Answer 6

1) Attaches to costal margin superiorly 2) Attaches to lateral 2/3 inguinal ligament, anterior iliac crest laterally. 3) Upper fibres join at linea alba. 4) Lower fibres arch upwards, over, downwards, join public crest.

Question 7

Attachments of the internal oblique 1 2 3 4

Answer 7

1) Attaches to costal margin superiorly 2) Attaches to lateral 2/3 inguinal ligament, anterior iliac crest laterally. 3) Upper fibres join at linea alba. 4) Lower fibres arch upwards, over, downwards, join public crest.

Question 8

Where on the posterior abdominal wall do the obliques and transversalis abdominis join?

Answer 8

Thoracolumbar fascia

Question 9

Where do the lowermost fibres of the internal obliques arise from?

Answer 9

Lateral 1/3 of inguinal ligament

Question 10

Muscles sharing a conjoined tendon inserting into the pubic crest

Answer 10

Internal and external oblique

Question 11

*Configuration of rectus abdominis sheath above umbilicus

Answer 11

Question 12

*Configuration of rectus abdominis sheath below umbilicus

Answer 12

Question 13

Where does rectus abdominis arise from?

Answer 13

Pubic crest

Question 14

What does rectus abdominis attach to?

Answer 14

Costal cartilages 5, 6, 7

Question 15

What creates the ‘six pack’ shape?

Answer 15

Tendinous disruptions to vertical ascent of muscle fibres (3x).

Question 16

What forms the rectus abdominis sheath?

Answer 16

Aponeuroses from three muscles (internal, external obliques, transversus abdominis)

Question 17

Muscle whose aponeurosis encloses rectus abdominis from both anterior and posterior

Answer 17

Internal oblique

Question 18

Level at which all aponeuroses of internal, external obliques and transversus abdominis travel superficial to rectus abdominis?

Answer 18

Inferior to umbilicus

Question 19

Name for where the posterior rectus abdominis sheath ends

Answer 19

Arcurate line

Question 20

Where does the abdominal neurovascular plane lie?

Answer 20

Between the internal obliques and transverse abdominis

Question 21

Main arterial supplies of anterior abdominal wall 1 2

Answer 21

1) Superior epigastric artery (branches from internal thoracic) 2) Inferior epigastric artery (branches from external iliac artery)

Question 22

Venous drainage of anterior abdominal wall

Answer 22

Dual drainage. Portal and systemic drainage.

Question 23

Between which two points does the inguinal ligament stretch?

Answer 23

BEtween iliac spine and public tubercle

Question 24

What marks the pelvic inlet?

Answer 24

Pectineal line of pelvic bone

Question 25

What is the lacunar ligament?

Answer 25

Extension of inguinal ligament to the pectineal line

Question 26

Layers through which developing testes needed to descend. 1 2 3 4 5

Answer 26

1) Peritoneum 2) Extraperitoneal fat 3) Transversalis fascia 4) Transversus abdominis 5) Internal, external obliques

Question 27

How do the testes get past the transversalis fascia in development?

Answer 27

Deficiency in fascia transversalis through which testes descned is halfway between anterior superior iliac spine (ASIS) and public tubercle. A finger's breadth above the inguinal ligament.

Question 28

ASIS

Answer 28

Anterior superior iliac spine

Question 29

Where do the testes descend, relative to the inguinal ligament?

Answer 29

Descend underneath inguinal ligament

Question 30

How do the testes get past the internal obliques in development?

Answer 30

Internal oblique, transversus abdominis form a tunnel at the inguinal ligament. They then arch upwards, around, downwards to join the pubic tubercle.

Question 31

How do the testes get past the internal obliques in development?

Answer 31

Internal oblique, transversus abdominis form a tunnel at the inguinal ligament. They then arch upwards, around, downwards to join the pubic tubercle. Testes don't have to penetrate. Travel through the tunnel, go through triangular deficiency between public tubercle and public crest

Question 32

What forms the fascia surrounding the testes?

Answer 32

Each layer the testes pass through in development gives the testes another layer of fascia

Question 33

Layers of fascia around testes 1 2 3

Answer 33

1) Internal spermatic fascia 2) Cremasteric fascia 3) External spermatic fascia

Question 34

Where does the internal spermatic fascia come from?

Answer 34

Fascia transversalis

Question 35

Where does the cremastic fascia come from?

Answer 35

From transversus abdominis and internal oblique

Question 36

Fascia responsible for the contraction of the scrotum

Answer 36

Cremastic fascia

Question 37

Where does the external spermatic fascia come from?

Answer 37

External oblique

Question 38

Abdominal hernia

Answer 38

Unusual protrusion of abdominal contents through the abdominal wall

Question 39

Inguinal hernia

Answer 39

Herniation through the inguinal canal

Question 40

\*How do the femoral artery and vein pass from the abdomen to the lower limb?

Answer 40

Question 41

Superficial ring

Answer 41

Medial opening in external oblique aponeurosis (in the inguinal canal)

Question 42

Deep ring

Answer 42

Deficiency (“outpouching”) in fascia transversalis (in the inguinal canal)

Question 43

Inguinal canal

Answer 43

Slit-like passage extending downwards and medially above and parallel to medial half of inguinal ligament

Question 44

Floor of inguinal canal

Answer 44

Inguinal ligament

Question 45

Roof of inguinal canal

Answer 45

Arching fibres of internal oblique and transversus abdominus

Question 46

Anterior wall of inguinal canal

Answer 46

External oblique aponeurosis, internal oblique muscle(lat)

Question 47

Posterior wall of inguinal canal

Answer 47

Transversalis fascia, Conjoined tendon (medially)

Question 48

Indirect inguinal hernia

Answer 48

A protrusion through the deep ring into the inguinal canal

Question 49

Superficial ring

Answer 49

Medial opening in external oblique aponeurosis (into the inguinal canal)

Question 50

Deep ring

Answer 50

Deficiency (“outpouching”) in fascia transversalis (into the inguinal canal)

Question 51

Indirect inguinal hernia

Answer 51

A protrusion through the deep ring into the inguinal canal

Question 52

Indirect herniae

Answer 52

Herniae that arise from incomplete closure of the processus vaginalis, hence the herniated peritoneal contents extend into the scrotum (or labia)

Question 53

Direct herniae

Answer 53

A protrusion forwards into the inguinal canal through an area of weakness in its posterior wall

Question 54

Answer 54

Question 55

Answer 55

Question 56

Answer 56