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HS Exam 2 > Abdominal Wall- Real > Flashcards

Abdominal Wall- Real Flashcards

(111 cards)

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1
Q

what layers are reconstructed when closing paramedian incision above arcuate line

A

peritoneum, transversalis fascia, rectus muscle, rectus sheath, superficial fascia, skin

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2
Q

what layers are reconstructed when closing paramedian below the arcuate line

A

peritoneum, transversalis fascia, posteiror rectus sheath, rectus muscle, anterior rectus sheath, superficial fascia, skin

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3
Q

what lymph nodes are affected by melanoma on th left lateral region of the abdominal wall

A

parasternal nodes

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4
Q

what lymph nodes are affected by testicular carcninoma

A

external iliac nodes

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5
Q

what is the advantage of a paramedian and midline incision compared to a pararectus incision

A

paramedian- don’t compromise the nerve and blood supply to the rectus muscle as is done with pararectus

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6
Q

what complications go with severing/compressing a nerve on the anterior abdominal wall? (iliohypogastric or ilioinguinal)

A

muscle weakens which could lead to a hernia

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7
Q

what is the abdominal wall

A

skin to transversals fascia

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8
Q

what is the abdominal cavity

A

trasversali fascia down

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9
Q

what is the transversals fascia

A

deep fascia of transversalus abdomens, psoas, diaphragm, iliac us, and pelvic musculature

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10
Q

what layers are in the abdominal wall

A

skin
2 layers of superficial fascia (campers and scarpas)
3 muscle layers (internal and external oblique, transversalus abdomins)

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11
Q

what are the areas in the abdominal cavity

A

subserous fascia
retroperitoneal space
peritoneum
periotoneal cavity

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12
Q

where does the skin over the scrotum and labia major come from

A

abdominal wall skin

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13
Q

describe camper’s fascia

A

superficial layer of superficial layer of the anteriolateral abdominal wall
fat layer

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14
Q

where is liposuction done

A

camper’s fascia

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15
Q

describe the scarpa’s fascia

A

deep layer of superficial layer of the anteirolateral abdominal wall
no fat
tough fibrous layer that attaches to the fascia kata, ishiopubic rami, and ishial tuberosity

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16
Q

what layer are subcutaneous sutures put into

A

scarpa’s fascia

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17
Q

what is collie’s fascia

A

scarpa’s fascia in the perineum

defines the area of blood/urine extravasation after penial bulb injury

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18
Q

what is darts fascia

A

fusion of camper’s and scarpa’s fascia in the scrotum

fat of camper’s is lost, but stays in labia

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19
Q

what is the purpose of the scrotum and how is it accomplished

A

decrease the temperature of the testis by smooth muscle controlling its position relative to the body

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20
Q

what are the abdominal muscles

A

external oblique
internal oblique
transversus abdominis

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21
Q

where is the deep fascia

A

both sides of each of the abdominal muscles

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22
Q

what are the functions of the abdominal muscles

A

support and protect abdominal viscera
increase intraabdominal pressure for things
trunk motor control

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23
Q

what special structures are formed by the abdominal muscles

A

rectus sheath
inguinal canal
spermatic cord

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24
Q

what is formed by the external oblique aponeurosis

A 
inguinal ligament
anterior layer of rectus sheath
superficial inguinal ring
pectinate ligament
lacunar ligament
external spermatic fascia
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25
what and where is the inguinal ligament
thickening of the inferior edge of the external oblique muscle, spanning between the ischium spine and pubic tubercle forms the floor of the inguinal canal
26
what and where is the superficial inguinal ring
V shaped opening in this aponeurosis of the external oblique muscle spermatic cord passes through it superior and lateral to the pubic tubercle
27
what and where is the pectineal ligament
extension of the lacunar ligament, lateral to the pubis (formed by external oblique aponeurosis)
28
what and where is the lacunar ligament
triangular ligament between the pubis and inguinal ligament that forms the medial floor of the inguinal canal extension- pectineal ligament
29
what forms the superior and posterior wall of inguinal canal
internal oblique
30
what is the origin of the cremaster muscle
internal oblique muscle
31
what is the purpose and innervation of the cremaster muscle
covers testis and elevates | innervated by femoral nerve
32
what structures are formed from the aponeurosis of the internal oblique muscle
rectus sheath | conjoint tendon
33
how does the internal oblique aponeurosis form the rectus sheath
above arcuate line- splints into anterior and posterior layers below arcuate line- all anteiror
34
what is the conjoint tendon
internal oblique and transversus abdominis aponeuroses merge to form the posterior wall of the inguinal canal
35
what happens if the conjoint tendon is weakened?
direct inguinal hernia
36
what part of the inguinal canal does the transverses abdomins form
superior and posterior walls
37
what structures does the transversus abdominis aponeurosis form
``` conjoint tendon rectus sheath trasversali fascia deep inguinal ring internal spermatic fascia ```
38
how does the transversus abdominis form the rectus sheath
above arcuate line- posterior | below arcuate line- anterior
39
what and where is the deep inguinal ring
internal opening of inguinal canal, medial to the inferior epigastric vessels
40
where are the superior and inferior epigastric arteries
posterior to the rectus abdominis
41
where is the arcuate line
midway between the umbilicus and the pubic symphysis
42
what forms the rectus sheath above the arcuate line
anterior- external oblique and anterior internal oblique | posterior- posterior internal oblique and transversus abdominis
43
what forms the rectus sheath below the arcuate line
anterior- all 3 muscle aponeuroses | posterior- transversalis fascia
44
why are there more layers below the arcuate line than above
support the abdomen
45
what levels supply the abdomen
T7-L1
46
where is the iliohypogastric nerve
L1, lowest nerve on the abdominal wall
47
where is the ilioinguinal nerve
L1, travels through inguinal canal and innervates the scrotum/labia majora
48
what happens when abdominal nerves are compressed
muscle weakess which can lead to hernia
49
what is the basis for referred pain
distribution of fibers- structures on the same level are innervated the same ex: T10 gets umbilicus and appendix, appendicitis starts as umbilicus pain
50
what are the deep muscular arteries that supply the abdomen
``` superior epigastric musculophrenic intercostal 10, 11 subcostal inferior epigastric deep iliac circumflex ```
51
what are the branches from the external iliac artery that supply the abdomen
inferior epigastric | deep iliac circumflex
52
what are the superficial arterial branches that supply the abdomen
superficial epigastric | superficial iliac circumflex
53
where do the superficial arterial branches supplying the abdomen come from and what layer are they in
femoral artery | camper's fascia
54
what arteries can easily be injured in laproscopic surgery
superficial and inferior epigastric artteries
55
what is the superficial lymphatic drainage above the umbilicus
parasternal nodes--> superior epigastric nodes-> axillary nodes via path of thoracoepigastric veins
56
what is the superficial lymphatic drainage below the umbilicus
superficial and deep inguinal nodes via path of superficial epigastric v
57
what is the deep lymphatic drainage above the umbilicus
internal thoracic nodes-> supericar epigastric and lumbar nodes via path of T9-T11 arteries
58
what is the deep lymphatic drainage below the umbilicus
external iliac nodes via path of deep iliac circumflex and inferior epigastric vessels
59
what are the 5 folds of the internal surface of anterior abdominal wall
median umbilical fold 2 medial umbilical folds 2 lateral umbilical folds
60
what is the median umbilical fold a remnant of
urachus
61
what is the medial umbilical folds remnants of
umbilical artery
62
what is near the lateral umbilical folds
inferior epigastric vessels
63
what are the 5 fossa of the internal surface of the anterior abdominal wall
supravesicular fossa medial inguinal fossa (2) lateral inguinal fossa
64
where is the supra vesicle fossa
between the 2 medial umbilical folds, including line of median umbilical fold
65
where is the medial inguinal fossa
between the medial and lateral folds
66
where is the inguinal triangle
in the medial inguinal fossa
67
what forms the inguinal triangle
edge of rectus inguinal ligament inferior epigastric vessels
68
where is a direct inguinal hernia
inguinal triangle
69
where is the lateral inguinal fossa
lateral to the lateral umbilicus fold
70
where is an indirect inguinal hernia
lateral inguinal fossa
71
what are the advantages of a median incision
good access for exploratory surgery | minimal bleeding
72
where is a paramedian incision
lateral to midline
73
where is a gridiron incision
aka McBurney anterior to ilium wing used for appendectamy
74
where is a transverse incision
horizontally over the iliac crest
75
where is a suprapubic incision
above pubic symphysis
76
what is a disadvantage of a paramedian incision
limited access
77
what is an advantage of a suprapubic incision
avoids peritoneal cavity
78
where is a subcostal incision
under ribs | used for gallbladder or spleen access
79
where is a pararectus incision
lateral edge of rectus sheath
80
why are pararectus incisions bad
cuts off nerve and blood supply to rectus sheath
81
how should muscle be reflected
towards the nerve bundle to avoid stretching issues
82
where is the superficial epigastric artery and vein and where do they come from
lateral to the line alba in the campers fascia | originate from the femoral vessels
83
fiber direction of the external oblique
superiolateral to inferiomedial
84
fiber direction of the internal oblique
superiomedial to inferiolateral
85
where is the lateral crus and what does it attach to
lateral portion of the superficial inguinal ligament and attaches to the pubic tubercle
86
where is the medial crus and what does it attach to
medial portion of superficial inguinal ligament and attaches to the pubic crest
87
where are the intercrural fibers
fibers going across the top of the inguinal canal and hold the cruses together
88
where is the external spermatic fascia
external oblique aponeurosis that extends into the spermatic cord
89
where is the ilioinguinal nerve
comes out of the superficial inguinal ring anterior to spermatic cord/round ligament of the uterus
90
what does the ilioinguinal nerve innervate
anterior genital surface and the medial thigh
91
where is the lacunar ligament
triangular looking ligament behind the spermatic cord
92
where is the pectineal ligament
line near lacunar ligament, behind the spermatic cord
93
where is the conjoint tendon
behind the lacunar ligament, forms the posterior inguinal wall
94
where is the cremaster muscle
muscle extension from the internal oblique muscle that originates medially and laterally to join with the spermatic cord
95
what plane are the ilioinguinal and iliohypogastric nerves found
intermuscular plane between the external and internal obliques
96
what is the fiber direction of the transversus abdominis
same as internal oblique- inferolateral to superiomedial
97
where is the transversalis fascia
below the transversus abdominis
98
how is the deep inguinal ring identified
lateral to the inferior epigastric vessels and the ductus deferens passes through it
99
what structures are in the rectus sheath
rectus abdominis pyramidalis muscle superior and inferior epigastric vessels
100
where is the semilunar line
line lateral to rectus abdominis
101
where are tendinous intersections
connections between the anterior rectus sheath and anterior rectus muscle
102
where is the pyramidal is muscle
between the anterior surface of the pubis and linea alba
103
where are the inferior epigastric artery and vein
inferior posterior rectus abdomens and superficial to the posterior rectus sheath above the arcuate line and then enter the rectus sheath at the arcuate line and pass in the transveralis fascia behind the inguinal canal
104
where are the superior epigastric artery and vein
superior posterior rectus abdominis and superficial to the posterior rectus sheath above the arcuate line
105
where do inferior epigastric vessels enter the rectus sheath
arcuate line
106
where is the ductus deferens
center of spermatic cord
107
where is the pampiniform plexus of veins
inside the internal spermatic fascia surrounding the testicular artery anteriorly to ductus deferencs
108
where is the tunica vaginalis
covering of the testis (2 layers- parietal and visceral)
109
parts of the epididymis
head- superior to testis body- behind testis tail- infeiror to testis appendix- little bump on the head
110
what is the tunica albuginea
fibrous capsule of the testis- very thick inferiorly
111
where is the genitofemoral nerve
passes anteiror to inguinal canal from medial to lateral and extends into the thigh area

HS Exam 2 (24 decks)

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