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Gross Anatomy Block 2 > Anterior Abdominal Wall And Inguinal Canal > Flashcards

Anterior Abdominal Wall And Inguinal Canal Flashcards

1
Q

4 quadrants of the anterior abdominal wall?

What planes separate them?

A

RUQ, RLQ, LUQ, LLQ

Vertical plane and horizontal plane

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2
Q

Subcostal plane is a horizontal plane that lies at which vertebrae?

A

L3 (upper border)(lower margin of 10th costal cartilages)

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3
Q

Intertubercular plane is horizontal and lies where?

A

Right and left iliac crest - body of L5

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4
Q

Vertical planes are located where

A

Midclavicular planes

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5
Q

9 regions of anterior abdominal wall?

A

Epigastric region-right and left hypochondriac
Umbilicial region- right and left lumbar
Hypogastric region- right and left inguinal

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6
Q

Layers of the ant abdominal wall from superficial to deep (6)

A

Skin, superficial fascia, muscles with their deep fascia, transversalis fascia, extraperitoneal fascia, parietal peritoneum

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7
Q

Superficial fascia divides into two layers. What are they and explain

A

Campers- more superficial, can be thick, continuous with superficial fat

Scarpas- more deep, fuses with fascia lata of thigh, right below the inguinal ligament

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8
Q

Where would blood accumulate if there was damage to your urethra

A

Scarpas fascia (continuous with superficial fascia of the penis) (would not affect the thigh, because potential space is closed when scarpas fuses with fascia lata)

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9
Q

Inguinal ligament separates __ and __?

What forms the inguinal ligament?

A

Abdomen and thigh

Lower border of external oblique aponeurosis folding back on itself

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10
Q

What forms the conjoint tendon

A

Lowest tendinous fibers of internal oblique and transversus abdominis

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11
Q

How to the upper fibers of the internal oblique run in relation to the fibers of the external oblique

A

Perpendicular

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12
Q

Name contents of rectus sheath (muscles, nerves, and vessels)

A

Rectus abdominis, pyramidalis, superior and inferior epigastric vessels, and 7-11 intercostal and subcostal nerves

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13
Q
  1. What forms the anterior wall of the rectus sheath?

2. Posterior wall?

A

Both walls are formed when the internal oblique aponeurosis splits into two lamina then:

  1. Anterior lamina joins aponeurosis of ext oblique
  2. Posterior lamina joins aponeurosis of transversus abdominis
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14
Q

Arcuate line divides what?

What level is it located ?

A

Marks lower end of posterior aponeurotic wall of rectus sheath

Level of ASIS

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15
Q

Difference in rectus abdominis below and above arcuate line?

A

Above the line- rectus abdominis is in contact with anterior and posterior layer of rectus sheath

Below the line- just in contract with anterior layer of rectus sheath

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16
Q

4 nerves of the anterior abdominal wall?

Where do these nerves run for a large part of their course?

What do these nerves supply (sensory and motor)

A

7-11 intercostal nerves, subcostal nerve, iliohypogastric and ilioinguinal nerves

Forward between int oblique and transversus abdominis

Sensory: skin, parietal peritoneum, and ant abdominal wall. Motor: muscles of ant abdominal wall

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17
Q

Course of 7-11 intercostal and subcostal nerve and what they innervate

A

Enter rectus sheath and supply rectus abdominis and pyramidialis (subcostal only) -> terminate by piercing ant wall of rectus sheath to supply skin of ant abdominal wall

18
Q
  1. Course of iliohypogastric and ilioinguinal nerves
  2. Iliohypogastric supplies?
  3. Ilioinguinal supplies?
A
  1. Do not enter rectus sheath; pierce int oblique anteriorly and run between this muscle and ext oblique aponeurosis
  2. Pierces ext oblique aponeurosis above superficial inguinal ring to supply suprapubic skin
  3. Emerges through superficial inguinal ring to supply skin of superomedial thigh and ext genitalia
19
Q

3 dermatomes of the ant abdominal wall

A

T7- inferior to the tip of the xiphoid process
T10- level of umbilicus
L1- pubic symphysis and area immediately superior to it

20
Q

Superior epigastric artery

  1. Terminal branch of?
  2. Where does it enter abdominal wall?
  3. What does it supply?
  4. What does it anastomose with?
A
  1. Internal thoracic artery (splits at ~6th intercostal space)
  2. Between sternal and costal origins of the diaphragm
  3. Upper central part of anterior abdominal wall
  4. Inferior epigastric artery
21
Q

Inferior epigastric artery

  1. Originates from?
  2. Supplies?
A
  1. Distal part of external iliac artery (just above inguinal ligament
  2. Lower central part of anterior abdominal wall
22
Q

Deep circumflex iliac artery

  1. Originates from
  2. Runs?
  3. Supplies?
A
  1. Distal part of external iliac artery (same place as inferior epigastric)
  2. Superior/laterally toward ASIS
  3. Lower lateral part of anterior abdominal wall
23
Q

10th and 11th posterior intercostal arteries, subcostal and lumbar arteries supply?

A

Upper lateral part of anterior abdominal wall

24
Q

Superficial epigastric and superficial circumflex iliac arteries (branches of femoral arteries) supply?

A

Superficial fascia/skin of lower part of anterior abdominal wall

25
Q

Musculophrenic artery supplies?

A

Anterior abdominal wall, just inferior to costal margin

26
Q

External iliac artery gives off what two branches?

When does it change its name to femoral artery?

A

Inferior epigastric artery and deep circumflex iliac artery

When it leaves inguinal ligament to enter the thigh

27
Q

Superficial veins of anterior abdominal wall drain superiorly into?

Inferiorly?

A

Superiorly into axillary vein via lateral thoracic vein

Inferiorly into femoral vein via superficial epigastric vein

28
Q

Clinical significance of superficial veins of anterior abdominal wall

A

May provide collateral circulation during blockage of either vena cava

29
Q

Where do the following deep veins drain into:

  1. Superior epigastric vein
  2. Inferior epigastric and deep circumflex iliac veins
  3. Lower posterior intercostal and subcostal veins
  4. Lumbar veins
A
  1. Internal thoracic vein
  2. External iliac vein
  3. Right side- azygos; left side- hemiazygos
  4. IVC
30
Q

Occlusion of the IVC would cause what

A

Superficial veins of anterior abdominal wall to become dilated

31
Q

Lymphatic drainage of:

  1. Superficial lymph vessels above umbilicus
  2. Below level of umbilicus
A
  1. Drains upward toward anterior axillary lymph nodes

2. Drains downward toward superficial inguinal lymph nodes

32
Q

Deep lymph vessels drain into

A

Internal thoracic (parasternal), external iliac, posterior mediastinal and lumbar (para-aortic) lymph nodes

33
Q

Location of the inguinal canal

A

Lies parallel and immediately above medial part of inguinal ligament

34
Q

Contents of inguinal canal in:

  1. Males
  2. Females
A
  1. Spermatic cord and ilioinguinal nerve (genitofemoral nerve is part of the spermatic cord)
  2. Round ligament of uterus, genitofemoral and ilioinguinal nerve
35
Q

Location of deep inguinal ring?

Location of superficial inguinal ring?

A

Opening in transversalis fascia; Between ASIS and pubic tubercle

Opening in aponeurosis of external oblique; immediately superior to pubic tubercle

36
Q

Borders of inguinal canal:

  1. Posterior
  2. Anterior
  3. Inferior
  4. Superior
A
  1. Transversalis fascia
  2. Aponeurosis of ext oblique
  3. Inguinal and lacunar ligaments
  4. Lower borders of internal oblique and transversus abdominis
37
Q

3 parts of an abdominal hernia

A
  1. Sac- pouch of parietal peritoneum
  2. Contents- can be any structure found within abdominal cavity
  3. Coverings- formed by layers of abdominal wall
38
Q

Most common type of abdominal hernia

A

Inguinal (more in males than females)

39
Q

Comparatively, what are the differences between indirect and direct hernias

A

Indirect is more common, considered congenital in origin (tunica vaginialis not closing up), and more common in children/young adults, runs a longer course

Direct more common in older men with weak abdominal muscles, acquired in origin, runs a shorter course

40
Q

How can you tell the difference between an indirect and direct inguinal hernia?

A

Indirect- leaves abdominal cavity lateral to inferior epigastric vessels

Direct- leaves abdominal cavity medial to inferior epigastric vessels

~both go through deep inguinal ring

41
Q

What is Hesselbachs triangle?

Boundaries?

A

Area where direct hernias protrude

Laterally- inferior epigastric vessels
Medially- rectus abdominis
Inferiorly- inguinal ligament

Gross Anatomy Block 2 (8 decks)

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