Abdominal Wall

Question 1

Layers of the abdominal wall

Answer 1

skin
Camper’s fascia (fatty)
Scarpa’s fascia (membranous)
muscles/associate fascia (ext/int/TA)
transversalis/extraperitonal fascia
parietal peritoneum

Question 2

Significance of the umbilicus

Answer 2

scar along linea alba, site of attachment for umbilical cord

Question 3

superficial fascia of the abdomen

Answer 3

layer of fatty connective tissue continuous with other bodily fasica
splits into two layers at the umbilicus level
fatty Camper’s and membranous Scarpa’s, Camper’s most superficial

Question 4

Abdominal fascia in men vs women

Answer 4

men: continues to penis, layers fuse and lose fat going into the scrotum to form a fascia layer with smooth muscle fibers (dartos fascia)
women: layers retain some fat and go into labia majora

Question 5

Scarpa’s fascia: properties and attachments

Answer 5

thin/membranous
no fat
deep to Camper’s
continues into thigh and fuses with fascia lata
attaches to linea alba and pubic symphysis

Question 6

anterolateral muscles of the abdomen (5)

Answer 6

internal oblique
external oblique
transverse abdominus
rectus abdominus
pyramidalis
all form aponeurosis medially and attach at linea alba

Question 7

transversalis fascia

Answer 7

deepest layer of abdominal wall before extraperitoneal fascia

Question 8

extraperitoneal fascia

Answer 8

deepest layer of abdominal wall
deep to transversalis fascia

Question 9

Where are the thoracoabdominal nerves found? What levels are they?

Answer 9

Below Ext and int obliques and above TA
T7-T11

Question 10

external oblique

Answer 10

origin: outer surface 5th-12th ribs
insertion: linea alba, pubic crest, ASIS, iliac crest
innervation: anterior rami T7-12 and L1
action: rotate trunk contralaterally, compress abdominal contents

Question 11

internal oblique

Answer 11

origin:thoracolumbar fascia, iliac crest, inguinal ligament
insertion: lower margins 9-12th ribs, pubic crest, linea alba
innervation: anterior rami T7-T12
action: ipsilateral trunk rotation, compress abdominal contents

Question 12

transversus abdominus

Answer 12

origin: thoracolumnbar fascia, iliac crest, inguinal ligament, costal cartilage lower ribs
insertion: linea alba, pubic crest, pectineal line
innervation: anterior rami T7-12, L1
action: compress abdominal contents

Question 13

rectus abdominus

Answer 13

origin: pubic crest, tubercle, and symphysis
insertion: costal cartilages of ribs 5-7 and xiphoid process
innervation: anterior rami T7-12
action: flex vertebral column, compress abdominal wall

Question 14

pyramidalis

Answer 14

origin: front of pubis and pubic symphysis
insertion: linea alba
innervation: anterior ramus T12
action: tenses linea alba

Question 15

What forms the rectus sheath?

Answer 15

aponeuroses of ext/int oblique and TA muscles
tendons of flat muscles

Question 16

What does the rectus sheath encompass?

Answer 16

rectus abdominus and pyramidalis

Question 17

significance of the arcuate line

Answer 17

above arcuate line: aponeuroses of ext oblique over rectus, int oblique surrounds, TA below
below arcuate line: all aponeuroses go above rectus abdominus

Question 18

What forms the inguinal ligament?

Answer 18

aponeurosis of external oblique, most superficial layer

Question 19

lacunar and pectineal ligaments

Answer 19

lacunar ligament connects the inguinal ligament to the pectineal ligament which attaches to the pectineal line of the pubis

Question 20

inguinal ligament path

Answer 20

formed by ext oblique aponeurosis
pass between ASIS and pubic tubercle

Question 21

lacunar ligament

Answer 21

extension of fibers at the medial end of the inguinal ligament
attach to pectin pubis on superior ramus of pubic bone

Question 22

pectineal ligament

Answer 22

extension of lacunar ligament along pectineal pubic line

Question 23

inguinal canal

Answer 23

above and parallel to inguinal ligament
deep inguinal ring to superficial inguinal ring
present in both sexes
not equivalent to femoral triangle

Question 24

deep inguinal ring formed by what fascia?

Answer 24

transversalis fascia

Question 25

contents of inguinal canal

Answer 25

men: spermatic cord
women: round ligament of the uterus

Question 26

spermatic cord structures include:

Answer 26

ductus deferens artery
testicular artery/veins
sympathetic/afferent nerves
lymphatics

Question 27

round ligament of the uterus

Answer 27

cord structure passing through inguinal canal
passes from uterus to deep inguinal ring, superficial ring, then attaches to connective tissue of labia majora
functions to maintain anteflexion position of uterus, turning fundus of the uterus towards cervix junction

Question 28

direct inguinal herbia

Answer 28

peritoneum passes through abdominal wall/posterior wall of the inguinal canal due to weak muscle/aponeurosis and presses through superficial ring

Question 29

indirect inguinal hernia

Answer 29

peritoneum passes through the deep ring to the inguinal canal

Question 30

Vessels present in the anterolateral abdominal wall

Answer 30

internal thoracic artery branches: intercostal, musculophrenic, and superior epigastric aa.
femoral artery branch: superficial circumflex iliac a.
external iliac branches: inferior epigastric and deep circumflex iliac aa.