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Flashcards in Abdominal Wall And Cavity Deck (52):
0

In a paramedial incision, which way would you displace the muscle and why?

Laterally, towards its nerve supply

1

What does a median incision go through?

Linea alba

2

Which incision would you use to access the gallbladder?

Subcostal

3

What would you use a pfannenstiel incision for?

C section

4

What happens to the rectus sheath at the arcuate line?

Above line, rectus abdominis covered anterior and posterior by aponeuroses of flat muscles of abdo wall
Below line, all 3 aponeuroses are anterior to muscle and so only fascia behind. This leaves region vulnerable to herniation

5

Which vessels are contained in rectus sheath?

Superior and inferior epigastric artery and veins

6

What are the 5 layers of the anterior abdominal wall?

Skin
Superficial fascia
Muscles and aponeuroses
Transversalis fascia
Parietal peritoneum

7

Where does the inguinal ligament run?

From ASIS to pubic tubercle

8

Which muscle runs from rib 5-12 to anterior iliac crest, linea alba and pubic tubercle?

External oblique

9

What is an aponeurosis?

Broad flat sheet of tendon

10

What is the linea alba?

Midline fibrous aponeuroses

11

Why can you safely inject a needle or cannula into linea alba?

Avascular

12

Where does lymph of the anterior abdominal wall drain to?

Above umbilicus - axillary nodes
Below umbilicus - inguinal nodes

13

What is a hernia?

Protrusion of tissue or organ through its retaining tissue

14

Name 3 sites for an anterior abdominal wall hernia

Umbilical
Inguinal
Femoral

15

What is hesselbachs triangle?

Area of bulging of direct hernia. Medial to inferior epigastric artery. Bordered by rectus abdominis and inguinal ligament

16

Which type of anterior abdo wall hernia are women and men most likely to get?

Men - indirect inguinal
Women - femoral

17

What are the differences in contents of inguinal canal in males and females?

Males - spermatic cord and contents
Females - round ligament of uterus and lymphatics from uterus

18

What are the boundaries of the abdomen?

Diaphragm to pelvic girdle

19

What vertebral level is the Subcostal plane on?

L3

20

What vertebral level is the supracristal plane on?

L4

21

What vertebral level is the transtubercular plane on?

L5

22

What planes divide the abdomen into the 9 regions?

Mid clavicular lines
Subcostal plane
Transtubercular plane

23

What does the external oblique aponeurosis lower free border form?

Inguinal ligament

24

Where does the internal oblique run from and to?

From iliac crest and inguinal ligament
To linea alba, pubic bone and ribs 9-12

25

What do the lower aponeurosis of the internal oblique form?

Part of the conjoint tendon

26

Which arteries are united by the epigastric arteries?

Subclavian artery and external iliac artery

27

What can the vascular supply of the abdominal wall provide a bypass for?

Descending aorta

28

What nerve is at risk from a gridiron incision?

Ilioinguinal

29

What serves as a reference point to differentiate between an inguinal and a femoral hernia?

Pubic tubercle
Above and medial - inguinal
Below and lateral - femoral

30

What are the borders of the lumbar (petit) triangle?

External oblique
Latissimus dorsi
Iliac crest

31

What is the deep inguinal ring?

Invagination of transversalis fascia
Lies between the midpoint of inguinal ligament and the midinguinal point (1cm above the inguinal ligament)

32

What is the superficial inguinal ring?

Lies supero-lateral to the pubic tubercle
Point of emergence of spermatic cord (male) or round ligament and coverings (female)

33

What forms the tunica vaginalis?

Testicle is retroperitoneal and descends through the anterior abdominal wall and pulls a fold of peritoneum with it that forms the tunica vaginalis

34

What forms the posterior wall of the inguinal canal?

Transversalis fascia

35

What level does the coeliac trunk, SMA and IMA branch from the aorta?

T12
L1
L3

36

What pain modalities are viscera not sensitive to?

Cutting or thermal stimuli

37

What are the 2 compartments of the greater sac?

Supracolic and infracolic

38

Why does the lesser sac become sectioned off?

Pancreas, liver, duodenum and gallbladder become secondarily retroperitoneal

39

How does the stomach rotate to reach its adult position?

Rotates to right about longitudinal axis & clockwise about sagittal axis

40

What does the ventral mesentery become?

Lesser omentum

41

What does the dorsal mesentery become?

Greater omentum

42

Describe the surface anatomy of the liver

Right costal margin
Follows upper limit of diaphragm
5th rib at mid clavicular line
Associated with costodiaphragmatic recess

43

What holds the liver in place?

Peritoneum

44

Which part of the liver is in contact with the diaphragm?

Bare area

45

What are the 4 lobes of the liver?

Left
Right
Caudate
Quadrate

46

What is the porta hepatis?

Entry and exit point for portal vein, bile duct, hepatic artery and autonomics from liver

47

What structures form a H shape on the posterior of the liver?

Ligamentum venosum
Ligamentum teres
Porta hepatis
IVC
Gallbladder

48

Which peritoneal recesses can accumulate fluid / be a focus for abscess formation?

Sub-phrenic space
Hepato-renal space - Morison's pouch

49

What are the functions of the peritoneum?

Facilitate movement between abdominal organs and between organs and the abdominal wall
Produce peritoneal fluid which contains leukocytes and antibodies

50

What is the difference between intraperitoneal and retroperitoneal organs?

Intraperitoneal organs are almost completely covered by peritoneum and suspended by a mesentery whereas retroperitoneal organs are only partially covered by peritoneum

51

What is the dermatome supply of the following regions – epigastric, umbilicus and suprapubic?

Epigastric: T7
Umbilicus: T10
Suprapubic: L1