abdominal wall 1 Flashcards
(37 cards)
what are the quadrants of the abdomen?
- trans umbilical plane (L3/4)
- midline
- this creates 4 quadrants (right and left upper and lower)
how are the surface regions split for neonates?
- midclavicular lines
- subcostal plane (L3)
- intertubercular line (iliac crest tubercles) -L5
This creates:
- the right and left hypochindrium, flank and groin
- midline- epigastric, umbilical and pubic region.
what are the layers of the abdomen from superficial to deep?
- skin
- superficial fascia: (camper’s fascia (fatty) and scarpa’s fascia (membranous)
- muscular layers: (with investing fascia) (external oblique, internal oblique, transversus abdominis)
- transversalis fascia
- extraperitoneal fascia
- parietal peritoneum
what will Camper’s and Scarpa’as fascia be continous with?
it continous into the perineum
how would you describe the structure of the skin?
why do we cut parralel to these lines?
the skin has Langers lines on it:
- we ideally cut parallel to the lines otherwise tension will occur across the incision and lead to a larger scar
what are the 3 flat muscles of the abdominal wall?
- external oblique
- internal oblique
- transversus abdominalis
what is the one straight muscle?
rectus abdominis
what is the small inconsistent muscle of the abdomen?
pyramidalis
what is the function of the abdominla wall muscles?
- supports anterolateral abdominal wall
- supports and protects the abdominal viscera
- maintains and raises the intraabdominal structures (antagonise diaphragmatic action, forced expiration)
- flexes and roated the trunk
- aids posture
describe the innervation of the abdominal wall muscles?
supplied by 3 different nerves:
- thoracoabdominal nerves (anterior rami of T6-11)
- subcostal nerve (T12)
- iliohypogastric (L1)
rectus abdominis:
- attachments
- innervation?
- function?
attachments:
- from pubic crest, symphyis, tubercle to costal cartillages of rivs 5,6,7 and xiphoid process
innervation:
- anterior rami of T6-T12
function:
- flexes the trunk, compresses viscera, stabilises the pelvis (resists anterior tilt)
Has 6 tendinous intersections (6 pack)
within the rectus sheath
pyramidalis:
- attachments?
- function?
- innervation?
this muscle is only found in 70% of people
attachments:
- pubic crest to linea alba
function:
- tenses linea alba
innervation:
- anterior rami of T12
what forms the abdominal wall rectus sheath?
what do they all unite to form?
formed from aponeuroses of:
- external oblique
- internal oblique
- tranversus abdominis
- tranversalis fascia
- They unite centrally to form linea alba from pubic sympysis to xiphoid process
what happens to the abdominal wall rectus sheath above the arcuate line?
and below the arcuate line?
- above the arcuate line, internal oblique aponeurosis splits to cover rectus abdominis anteriorly and posterirly.
- below the arcuate line, aponeuroses are anterior to rectus abdominis
what is contained within the rectus sheath?
- abdominis
- pyramidalis
- superior and inferior epigastric vessels.
inguinal ligament:
- where is it?
- attachments?
- where does its fibres insert?
- what does these insertions create?
- it is at the lower border of the external oblique aponeurosis
- attaches to the ASIS to the pubi tubercle
- some fibres insert on pecten pubis, forming the lacunar ligament
Lacunar Ligament?
- what are its posterior extension called?
this is the medial border of the femoral triangle
- it has a posterior extension along pectineal line termed pectineal ligament
describe the thoraco- lumbar fascia?
where is the weak spot?
- this is tough strong fascia in the lumbar region
- there is a weak spot between lat dorsi and external oblique, this is called the Triangle of Petit (inferior lumbar triangle)… a lumbar hernia can occur here.
where does the thoracolumbar fascia insert onto?
inserts onto the iliac crest, lumbar vertebra and ribs.
what 2 muscles will insert into the thoraco lumbar fascia?
internal oblique and transversus abdominalis.
internal oblique:
- innervation?
Innervation:
- T6-L1 anterior rami
transversus abdominis:
innervation?
innervation:
- T6-L1 anterior rami
what 2 thing will the conjoint tendon connect?
what is anterior to it?
AKA - inguinal Flax
the internal oblique and transversus abdominis share an insertion on the pubic crest and pectineal line via the conjoint tendon.
- the superficial inguinal ligament ring opens anteriorly
what will pass through the inguinal canal fro males and females?
what is the inguinal canal?
This is a passage within the inferior aspect of the anterior abdominal wall and it allows structures to pass from the abdominal cavity externally.
male = spermatic cord
female = round ligament of the uterus
both= genital branch of genitofemoral nerve L1, 2 and ilioinguinal nerve L1.
has a deep and superficial ring
