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Flashcards in Abdominal Wall Anatomy Deck (39):

Abdominal communication with the thoracic and pecliv cavity

Thoracic connection to abdominal cavity- holes in the diaphragm

Communication to pelvis- open communication


Extent of the abdominal cavity superiorly and inferiorly and posterior

Superior- diaphragm, coastal margin, xiphoid

inferior- lilac crest, anterior superior iliac spine, inguinal ligament, pubic symphysis

posterior-lumbar vertebrae, muscle and fascia


Rectus abdominus is?

The msucle that connects the ribs to the pelvis (six pack)


Tendinous insertions?

Interruptions in the rectus abdominus that allows you to control each rectus abdominus muscle


What is the linea alba

white line in cadavers where the aponeurosis of the lateral muscles come over and meet. Nothing there expect muscle so makes a good point of incision because there are no blood vessels or nerves.

Right in line with the umbilicus


Linea semilunaris line

The lateral edge of the rectus abdominus. Good point of surgurical access and you avoid structures that you should incise through


Umblicus is

The entrance of the umbilical cord. Usually at the 10th thoracic level


What is in the right upper quadrant?

Most anteriorly- liver, small part of stomach, tranverse colon, small intestine

Middle- gallbladder,top portion of ascending colong, duodenum, pancrease

posteriorly- right kidney and suprarenal gland


What is in the right lower quadran

Anterior- small intestine

Middle Ascending colon and appendix

Posteriorly ureters and half of urinary bladder


What is in the left upper quad

Anterior- Stomach, transverse colon, and SI (jejunum and ileum)

Middle- Spleen, pancreas, top of descending colon, small bit of duodenum

Posterior- Left kidney, suprarenal and abdominal aorta


What is in the left lower quadrant

Anterior- jejunum and ileum

Middle- descending colon

Posterio- half of urinary bladder, left ureters


How to divide into the 9 quad system

Vertical- Line at the midclavicular line

Two horizontal lines- one under the costal margin and one extending between the iliac crest


Name the nine zones

1. Right hypochondrium, 2. epigastric,
3. left hypochondrium
4.right flank, umblical region, left flank, right groin, pubic (hypogastric) region, left groin


Match the three regions to foregut, midgut and hindgut pain

Foregut- epigastric
MId- umbilical
Hind- pubic (hypogastric) region

The pain associated with these areas can compartmentalize it so this one is useful


What structures are by the transpyloric plane and where is it?

Half way between the jugular notch and the pubic symphsis

Pylorus of the stomach, fundus of the gallbladder, neck and body of the pancreas, hila of the kidneys, 1st part of duodenum, and the origin of the superior mesenteric artery


Structures in the foregut

Artery- celiac

esophagus, stomach, duodenum, liver, pancrease, biliary appartus, gallbladder


Structures in the midgut (umblical region

Atery- superio mesenteric

Duodenum (2-4th part), jejunum, ileum, cecum, appendix, ascending colon, transverse colon


Structures in the hind gut (hypogastric/pubic region)

Artery- inferior mesenteric

transverse colon
Descending colon
sigmoid colon
anal canal


What thoracic nevce is the umblical associated with

T10- important neural landmark especially when determing spinal injury


What innervates the thoracic wall

The intercostal thoracic nerves from T7-T12


Explain blood supply to abdominal wall

Main the superior epigastric artery which is a continuation to the internal thoracic artery

The Superior epigastric anastomoses with the inferior epigastric which is a branch of the external iliac artery

Other blood supplies- lower posterior intercostal arteries
Lumbar arteries
Branches of the femoral artery

Veins follow the artery


Explain the layers of superficial fascia of the abdominal cavity

It's uniform in thickness around the umblicus

Camper- outer fatty
Scarpas- deeper fibrous (tough) layer- always there

The scarpas extends to the inguinal ligament and adheres to the fascia lata of the thigh


Layers of the deep fascia

Rectus muscle with its aponeurosis and below that is the transversalis fascia (can't be dissected out)


Scarpas fascia range

Stops at the inguinal ligament and in a male contiunes covers the scrotum over the penis and stops before the head of penis and

Female covers clit and covers the labia majora

So injecting bacteria under the scapas fascia can infiltrate the entire area

Urine would flow into the space contained by the scapas fascia if the pelvis is crushed and the ureter is cut, so swelling would begin


Muscles of the abdominal cavity

Outer Layer
Rectus abdomnius
External oblique
Internal oblique
Transversus abdominus


Rectus Sheath difference below the ___ line

Arcuate line

Anterior rectus above is the external and internal oblique

Posterio-- rectus sheath above the arcuate line is the internal and transversus

Below the line all three layers are anterior


Expalin how the layers work around the rectus abdominus

External is always superficial to the rectus abdominus

The deepest layer always stay deep to the rectus abdominus

The middle layer splits to enclose the rectus

At the arcuate line all three sheaths are anterior so that they don't miss the pubic smpyhsis


Inferior epigastric artery

Lie within the lateral umbliical folds and associated with the arcuiate line.


Structures inside the abdominal wall

3 folds and what lies in them?

Know this!

Median umbliical fold that relates to the urchus which is part of the developing urinary bladder

Medial umbilical fold contains obliterated umbilical artery

Laterl umblical fold- inferior epigastric artery


Inguinal region

male vs female

Where- Under the inguinal ligament; two creases between the abdomen and the thigh
Shaped like- oblique tubes

Two rings- the deep (opening to pelvic cavity) and superficial (proximal opening to scrotum or labia majora)


Contents of inguinal canal in males and femal

Females- through the canal is the round ligmanet exteds from uterus and inserts onto the labia majora and the illioinguinal nerve (off L1)

Males- through the inguinal canal is the spermatic cord that extend to the scrotum and the illioinguinal nerve

Illioinguinal nerve is lateral to the other parts


Content of the spermatic cord (5)

1. Testicular artery
2. Pampiniform venous plexus
3. Vas deferens and its artery
4. Autonomic nerves
5. Lymphatic


Parts of the inguinal ligament

Where does it extend from?

Lateral crus fibers
Medical Crus fibers
Intercrural fibers

Anterior superior iliac spine to the pubic tubercle


Fascia covering the spermatic cord and where do they come from?

External spermatic fascia from external oblique
Cremasteric fascia from internal oblique
Internal spermatic fascia from transversalis fascia


What layer of spermatic cord fascia is most important? Why

The cremasteric fascia (from the internal oblique) and it has skeletal muscle. So stroking the inside of the thigh will cause the testes to go up. Good assessment for neural activity.


Explain the descend of testis

They start in the abdominal cavitiy in utero and are guided down into the scrotum as you grow by the gubernaculum.

Important because of the path


key factor of direct and indirect inguinal hernias

Lateral is the deep inguinal ring (indirect-- often due to defect in descent of testis)

Medical is the anterior abdominal wall (direct)



abnormal accumulation of fluid in the cavity of the tunica vaginalis



Cutting the vas deferens so disconneting the testis from the penis