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Flashcards in Abdominal Wall Deck (50):
1

Superior Boundary

R and L costal margins

2

Inferior Boundary

Line connecting ASIS to pubic symphysis

3

Lateral Boundary

Vertical line through ASIS

4

Umbilicus

Lies at level of L3 and L4 vertebrae

5

Linea Alba

Site where aponeruosis of three flat abdominal muscles interact

6

Vasalva Maneuver

Coordinated increase of abdominal pressure, partially due to contraction of wall

7

Linea Semilunaris

Lateral border of rectus abdominis
9th costal cartilage to pubic tubercle

8

Quadrant Pattern

Median and Transumbilical Plane at L3/L4 level
R Upper and Lower
L Upper and Lower

9

9 Region Pattern

Horizontal Subcostal (L3) and Transtubercular Plane (L5) Vertical right and left midclavicular lines
R and L Hypochondrium (epigastric in middle)
R and L Lumbar (umbilical in middle)
R and L Iliac (hypogastric in middle)

10

Superficial Fascial Layers

Campers Fascia = more superficial - fat
Scarpas Fascia = Membranous portion

11

Campers Fascia

Contains superficial epigastric A and V
Continuous with superficial fascia of lower limb and labia majora

12

Scarpas Fascia

Fuses medially with linea alba and with fascia lata below inguinal ligament
Continuous with superficial fascia of perineum, dartos fascia of scrotum, and superficial penile fascia

13

Innervation - ventral rami of...

T7 to T11 = intercostal nerves (thoracoabdominal nerves)
T12 = subcostal
L1 = ilioinguinal and iliohypogastric

14

Nerves run between

Transversus abdominis and internal oblique

15

Dermatomes

T7 to L1 again

16

Herpes Zoster

Shingles - often follows dermatomes on anterior-lateral thoracic and/or abdominal walls

17

All nerves provide ___ branches

Lateral cutaneous and anterior cutaneous branches

18

Arterial Supply - Superior anterior wall

Internal thoracic Branches
Posterior/Thoracic Aorta Branches

19

Arterial Supply - Inferior anterior wall

External Iliac Branches
Femoral Artery Branches

20

Superior anterior wall

Internal Thoracic
- Superior Epigastric
- Musculophrenic
Thoracic Aorta
- Posterior intercostal and subcostal arteries

21

Inferior anterior wall

Femoral Artery
- Superficial circumflex iliac
- Superfcial Epigastric
External Iliac
- Deep circumflex iliac
- Inferior Epigastric

22

Venous drainage...

Follows arteries

23

Venous Drainage of Superior Wall

Posterior intercostal veins and subcostal drain into azygos system
Superior epigastric and musculophrenic drain into internal thoracic vein

24

Venous Drainage of Inferior Wall

Inferior epigastric and deep circumplex drain to external iliac
Superficial epigastric and superficial circumflex drain into great saphenous and then to femoral vein

25

Muscular Basket

Muscle and collagen fibers within and btw abdominal area
Distensible but rigid

26

Benefits to muscular basket
Benefits to corset training

Function in protection, posture
Protect organs
Skinny - acts like external gastric bypass
Helps with posture

27

Risks

Abdominal muscles will atrophy because the corset is doing the work for them

28

Abdominal Guarding

Patients with internal abdominal problems often present with abdominal guarding - tense and twitchy muscles

29

External Abdominal Oblique - O

Ribs 5 to 12

30

External Abdominal Oblique - I

Linea alba, pubic tubercle, and iliac crest
Hands in pockets

31

External Abdominal Oblique - Innervation

Ventral Rami of T7-T12

32

External Abdominal Oblique - Action

Compress and support abdominal viscera
Laterally flex to the same side
Rotate to the opposite side

33

Internal Abdominal Oblique - O

Thoracolumbar Fascia
Iliac Crest

34

Internal Abdominal Oblique - I

Rubs 10-12
Linea alba
Pecten Pubis via conjoint tendon (aponeurosis of transvers abdominis and internal oblique)

35

Internal Abdominal Oblique - Innervation

Central Rami of T7-T12

36

Internal Abdominal Oblique Action

Compress and support abdominal viscera
Laterally flex to same side
Rotate to same side

37

Transversus Abdominis Origin

Costal cartilages of ribs 7-12
Thoracolumbar fascia
Iliac Crest

38

Transversus Abdominis Insertion

Linea Alba
Pubic Crest
Pecten pubis via conjoint tendon

39

Transversus Abdominis Innervation

L1 - ilioinguinal and iliohypogastric

40

Transverus Abdominis Action

Compress and support abdominal viscera

41

Rectus Abdominis Origin

Pubic symphysis and pubic crest

42

Rectus Abdominis Inerstion

Xiphoid process and costal cartilages of ribs 5-7

43

Rectus Abdominis Innervation

Ventral Rami of T7-T12

44

Rectus Abdominis Action

Compres and suport abdominal viscera
Flexion of trunk

45

Rotate to left you are using...

Left internal obluqie
Right external oblique

46

Rectus Sheath

Aponeurosis of the three flat abdomnal muscles (EO, IO, TA)
Completely encloses the rectus abdominis muscle above the arcuate line

47

Arcuate Line

Located midway between the umblicus and pubic crest
Inferior to arcuate line, all aponeurotic fibers run anterior to rectus abdominis
So rectus sheath is absent here

48

Conjoint Tendon

Internal Oblique and Transversus abdominis tendons
At point ant to rectus abdominis muscle

49

Patient with swelling in epigastric region - What is it?

Epigastric Hernia (or ventral)
Coming through linea alba

50

Diastasis Recti

Separation of rectus abdominis at linea alba
Occasionally occurs in older patients and those with weakened abdominal muscles
Normal in pregnant women - muscles move with pregnancy
Bulge when raise head - vasalva
Avoid crunches!!! - just stand there and squeeze abdominal muscles