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Anatomy 701 > Abdominal Wall > Flashcards

Abdominal Wall Flashcards

1
Q

What nerves innervate the abdominal wall

A

Dorsal rami of spinal nerves and ventral rami of spinal nerves

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2
Q

What ventral rami of spinal nerves innervate the anterolateral wall?

A

Lateral cutaneous branch, anterior cutaneous branch, muscular/collateral branch

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3
Q

Where is the T4 segmental distribution?

A

T4 - nipple line

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4
Q

Where is the xiphoid process

A

T6

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5
Q

Where is the umbilicus?

A

T10

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6
Q

Which side of the body do spinal nerves run lower?

A

anteriorly
T9 runs posteriorly at T9 disc level and anteriorly at L3 level

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7
Q

Caval opening is at which vertebral level?

A

T8

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8
Q

What is abdominal aorta malfunction?

A

Lower extremity gets blood supply from superior epigastric artery

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9
Q

What is the inferior vena cava malfunction?

A

Lower extremity blood can drain back to superior vena cava

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10
Q

What vessels supply the lateral abdominal wall?

A

Posterior intercostal/subcostal/lumbar arteries

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11
Q

What vessels supply the anterior abdominal wall?

A

Superior and inferior epigastric arteries, deep and superficial circumflex iliac artery

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12
Q

How many layers of the abdominal wall are there?

A

9

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13
Q

What order do the layers of the abdominal wall go from superficial to deep?

A

skin
superficial fascia
fatty layer (camper’s fascia)
membranous layer (scarpa’s)
external oblique
internal oblique
transversus abdominis
transversalis fascia
extraperitoneal fascia
parietal peritoneum

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14
Q

What happens during herniation?

A

abdominal contents will push through the different layers of the structures which make up the abdominal wall

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15
Q

Where are the external oblique muscles?

A

the external surface of the 5th through 12th ribs, deeper to the costal head of pectoralis major to the linea alba, iliac crest, pubic tubercle. It folds to form the inguinal ligament

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16
Q

What innervates the external oblique muscles?

A

intercostal nerves T7-T11 and subcostal nerve T12

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17
Q

What is the muscle fiber direction of the external oblique muscles?

A

Same as external intercostals, “hands into pockets”

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18
Q

What is the blood supply to the external oblique muscles?

A

Intercostal arteries

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19
Q

What actions do the external oblique perform?

A

B contraction: trunk flx
unilateral contraction: ipsilateral SB and contralateral RT to the left and right

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20
Q

What happens during closed chain motions?

A

Axial skeleton approaches the appendicular skeleton

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21
Q

Internal oblique muscles origin and insertion

A

Inferior border of 10th through 12th ribs, thoracolumbar fascia

linea alba, anterior 2/3 of iliac crest, continuous as part of the cremaster muscle

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22
Q

what innervates the internal oblique muscles?

A

Intercostal nerves T7-T11/ subcostal nerve T12, iliohypogastric, genital branch of genitofemoral nerve

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23
Q

What supplies blood to the internal oblique muscles?

A

Intercostal arteries

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24
Q

What is the function of the internal oblique muscles?

A

Support abdominal contents and stabilize pelvis

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25
Q

What does the internal oblique do?

A

Bilateral contraction - trunk flexion
Unilateral contraction - ipsilateral SB and RT, elevate testes

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26
Q

What are the attachments of the transversus abdominis?

A

Thoracolumbar fascia and inner surface of ribs 7-12

Linea Alba, iliac crest, pubic tubercle, folds to form inguinal ligament

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27
Q

What is the direction of the muscles fibers in transversus abdominis?

A

Horizontal muscle fibers interdigit with diaphragm

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28
Q

What is the innervation of the transversus abdominis?

A

Intercostal nerves T7-T11 and subcostal nerve T12, branches of L1

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29
Q

Where do intercostal nerves run?

A

Between transversus abdominis and internal oblique muscles

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30
Q

What is the function of the transversus abdominis?

A

Increase intrabdominal pressure (compression) and ipsilateral rotation, stabilize the spine

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31
Q

What is the rectus abdominis also known as?

A

6 pack

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32
Q

Distal attachment of which muscle narrows down and forms a weak point on the anterior abdominal wall ?

A

Rectus abdominis

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33
Q

small triangular muscle in the distal anterior rectus abdominis, not exist in all the people, nor exist in both sides

A

Pyramidalis

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34
Q

Rectus abdominis: Innervation?

A

Intercostal nerves T7-T11 and subcostal nerve T12

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35
Q

Rectus abdominis function

A

compression, stabalizes the abdomen, trunk flexion

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36
Q

Superior epigastric artery is a continuous branch of which artery?

A

Internal thoracic mammary artery (branch of subclavian artery)

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37
Q

Aponeruosis fiber crossing does what?

A

improving the strength and functions, superficial to deep
- Between 2 same layer oblique: intramuscular exchange
- Between opposite external and internal oblique: intermuscular exchange

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38
Q

Linea alba: the midline of the aponeurosis fiber exchange. True or False?

A

True

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39
Q

Rectus abdominis is wrapped by what?

A

A Aponeurosis of the 3 abdominal muscles

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40
Q

Arcuate line is where?

A

1/3 distance of umbilicus to pubic symphysis of posterior rectus abdominis

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41
Q

Where is there a weakness of the abdominal wall?

A

deep to rectus below the arcuate line

42
Q

Where are all aponeuosis of 3 layers of muscles

A

Superficial to rectus below arcuate line

43
Q

Where is the aponeurosis of the external oblique?

A

Superficial to rectus above arcuate line

44
Q

Where is the aponeurosis of transversus abdominis?

A

Above arcuate line deep to rectus

45
Q

Half of which muscle’s aponeurosis is superficial to rectus and half is deep to rectus?

A

Internal oblique

46
Q

When is the placenta completed?

A

3rd week of gestation

47
Q

There is no direct exchange of mother and baby’s blood. true or false?

A

True

48
Q

How is the embryo/fetus connected to the placenta?

A

Umbilical cord

49
Q

Umbilical arteries become what after birth?

A

Umbilical ligaments/folds

50
Q

Umbilical vein becomes what after birth?

A

ligament teres and ligamentum venosum

51
Q

Allantois becomes what after birth?

A

Medial umbilical ligament/fold

52
Q

Foramen ovale becomes what after birth?

A

Fossa Ovalis

53
Q

What structure may not fully close after birth and cause no harm?

A

Fossa ovalis

54
Q

Ductus arteriosus becomes what after birth?

A

Ligamentum arteriosum

55
Q

A patient tore the right internal oblique muscle fully during MVA. Which motion will be compromised?

A

Side bend and rotation

56
Q

Hesselbach’s triangle (inguinal triangle) boundaries:

A

Lateral: medial of lateral umbilical fold
Inferior: inguinal ligament
Medial: lateral rectus abdominis

57
Q

What is portal hypertension?

A

Liver pathology blocks portal vein flow through
- Anastomosis with rectal vein to IVC: internal hemorrhoids (1/6 but with severe bleeding)
- Anastomosis of portal vein branches to esophageal veins: esophageal varices
- Anastomosis with superficial epigastric veins to IVC: caput medusa

58
Q

What veins close after birth and reopen in portal hypertension?

A

Paraumbilical veins

59
Q

Whats the difference between portal hypertension and IVC obstruction?

A

superficial abdominal veins to SVC, not around umbilicus exactly

60
Q

inguinal ligament is:

A

External oblique aponeurosis spanning ASIS and pubic tubercle

61
Q

Inguinal canal is made up of?

A

Layers of abdominal muscle

external oblique - forms superficial/external inguinal ring

internal oblique - forms cremaster muscle to form spermatic cord in the males

Transversus abdominis - forms deep/internal inguinal ring

62
Q

Innervation of the inguinal canal?

A

Genital branch of genitofemoral nerve (motor) and the ilioinguinal nerve (sensory)

63
Q

How many degrees less than the internal temperature do the testes need for sperm development?

A

2-3 degrees Celcius

64
Q

Testes not descending is called what?

A

Cryptorchidism

65
Q

What the reflex called that causes the testes to elevate in the scrotum?

A

Cremasteric reflex

66
Q

Which muscles contribute their aponeurosis/tendon to form the rectus sheath above arcuate line?

A

external and internal oblique and transverse abdominis

67
Q

Indirect inguinal hernia happens at the:

A

Deep inguinal ring

68
Q

Indirect inguinal hernias are common in which gender?

A

Males

69
Q

What is the most common type of abdominal hernia?

A

Indirect inguinal hernia

70
Q

What is a direct or acquired inguinal hernia?

A

Happens at superficial inguinal ring due to weakness of abdominal wall (Hesselbach’s triangle)

71
Q

Abdominal contents never enter the scrotum in which type of hernia?

A

Direct

72
Q

Umbilical hernias cause:

A

Urine drainage 2/2 allantois not close to form urachus

73
Q

Umbilical hernias are due to:

A

Abnormal closure of umbilicus after birth

74
Q

Post surgical hernias happen mainly after what kind of surgery?

A

Laparotomy/laproscopy

75
Q

Do all hernias increase risk of bowel obstruction?

A

Yes

76
Q

Diastasis recti is a seperation of what?

A

linea alba

77
Q

Does diastasis recti happen more in males or females?

A

Equally in both

78
Q

Hernia and diastasis recti worsen with what?

A

Increasing intra-abdominal pressure

79
Q

Which structure forms the medial umbilical fold?

A

remnant umbilical artery

80
Q

Layers of the thoracolumbar fascia

A
  • Anterior layer: internal oblique, transversus abdominis
  • Between anterior and middle layer: quadratus lumborum
  • Between middle and posterior layer: erector spinae
  • Posterior layer: extrinsic back muscles
81
Q

Quadratus lumborum is located where?

A

origin - Inferior border of 12th rib and lateral transverse process of L1~L4
insertion - Posterior iliac crest and iliolumbar ligament

82
Q

Quadratus lumborum is innervated by”

A

Subcostal T12 and L1-L4 lumbar spinal nerves (ventral rami)

83
Q

What are the functions of quadratus lumborum?

A

(B) Depress 12th rib to facilitate respiration
(Uni) ipsilateral lumbar SB and Hip lift

84
Q

Psoas Major innervation

A

Femoral nerve (L2-L4), lumbar plexus

85
Q

Psoas major proximal and distal attachments

A

TP, bodies, and discs of T12-L5

lesser trochanter

86
Q

Motions of the Psoas Major?

A

Open chain: hip FLX/ER/ADD; Closed chain: trunk flexion (B)/ ipsilateral SB

87
Q

Psoas minor exists in everyone. T/F?

A

False. Does not exist in all people not in both sides of the same person. VARIATION

88
Q

A patient has been diagnosed direct inguinal hernia. Where does the herniation happen?

A

Superficial inguinal ring

89
Q

What happens to someone with median arcuate ligament syndrome?

A

compression of aorta/celiac trunk, pain around stomach, afraid of eating

90
Q

Arcuate ligaments are what?

A

Tendinous structures of diaphragm, wrapping muscles and aorta

91
Q

Lumbar Plexus: Ventral rami of T12/L1~L4 exit between which two muscles?

A

Quadratus lumborum and psoas major

92
Q

Does quadratus lumborum belong to an intrinsic back muscle? Ventral or dorsal rami of spinal nerves innervate this muscle?

A

No.

Ventral rami of spinal nerves

93
Q

What plane of is at L1

A

transpyloric plnane

94
Q

What plane is at L3?

A

Subcostal plane

95
Q

What plane is at L5?

A

Intertubercular plane

96
Q

What plane is at L4?

A

Supracristal/transumbilical plane

97
Q

What is in the right upper quadrant?

A

Liver and duodenum

98
Q

What is in the left upper quadrant?

A

Stomach and sleen

99
Q

What is in the right lower quadrant?

A

Cecum and descending colon

100
Q

What in in the left lower quadrant?

A

Descending and sigmoid colon

101
Q

What is McBurney’s point?

A

Appendix referral pain

Anatomy 701 (8 decks)

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