Anatomy Lecture 1 -- Abdomen 1

Question 1

List the 7 layers of the anterior abdominal wall

Answer 1

Question 2

List and identify the 5 parts of the external oblique muscle

Answer 2

Question 3

Describe the directionality of the external oblique muscle

Answer 3

Downwards medially

Question 4

Define the free lower edge of the external oblique muscle

Answer 4

Inguinal ligament

Question 5

List and identify the two parts of the internal oblique muscle

Answer 5

Question 6

Describe the directionality of the internal oblique muscle

Answer 6

Downwards laterally

Question 7

List and identify the parts of the transversus abdominis muscle

Answer 7

NOTE: hole in aponeurosis = arcuate line

Question 8

List and identify the attachments of the rectus abdominis muscle

Answer 8

Question 9

List and identify the 3 parts of the rectus abdominis muscle (disregarding the fleshy fibres)

Answer 9

Question 10

Define the order of the layers in the rectus sheath above the costal margin

Answer 10

Question 11

Define the order of the layers in the rectus sheath above the arcuate line

Answer 11

Question 12

Define the order of the layers of the rectus sheath below the arcuate line

Answer 12

Question 13

Define the arcuate line

Answer 13

Lower edge of the posterior sheath of the rectus abdominis so that the transversalis fascia is directly posterior to the rectus abdominis muscle below it

Question 14

From where does the superior epigastric artery originate?

Answer 14

Internal thoracic artery

Question 15

From where does the inferior epigastric artery originate?

Answer 15

External iliac artery

Question 16

What does the external iliac artery divide into?

Answer 16

Deep circumflex iliac artery and the inferior epigastric artery

Question 17

What is the relationship between the superior and inferior epigastric arteries?

Answer 17

They anastamose

Question 18

From a posterior view, what contains the inferior epigastric vessels?

Answer 18

Lateral umbilical fold

Question 19

From where does the superficial epigastric artery originate?

Answer 19

Femoral artery

Question 20

Give important inferiorly located vessels that supply the anterior abdominal wall

Answer 20

• Deep circumflex iliac artery
• Superficial epigastric artery
• Inferior epigastric artery

Question 21

Give 4 important deep veins of the anterior abdominal wall

Answer 21

• Superior epigastric vein
• Deep circumflex iliac vein
• Superficial circumflex iliac vein
• Inferior epigastric vein

Question 22

Give 3 important superficial veins for the drainage of the anterior abdominal wall

Answer 22

• Axillary vein
• Thoraco-epigastric vein
• Superficial epigastric vein

Question 23

Where does the superior epigastric vein drain to?

Answer 23

Internal thoracic vein

Question 24

Where does the deep circumflex iliac vein drain to?

Answer 24

External iliac vein

Question 25

Where does the superficial circumflex iliac vein drain to?

Answer 25

Femoral vein

Question 26

Where does the inferior epigastric vein drain to?

Answer 26

External iliac vein

Question 27

Where does the superficial epigastric vein drain to?

Answer 27

Femoral vein

Question 28

2 lymph nodes that superficially drain the anterior abdominal wall

Answer 28

Axillary lymph nodes Superficial inguinal lymph nodes

Question 29

What innervates the anterior abdominal wall?

Answer 29

* Anterior and lateral cutaneous branches of the lowest five inercostal nerves (T7 - T11) and the subcostal nerves (T12) * Iliohypogastric nerve * Ilioinguinal nerve

Question 30

Define "thoracoabdominal nerves"

Answer 30

The lowest five intercostal nerves, which supply portions of both the thoracic wall and abdominal wall

Question 31

Thoracoabdominal nerve coinciding with the belly button

Answer 31

T10

Question 32

Where do the iliohypogastric and ilioinguinal nerves originate from?

Answer 32

L1

Question 33

Which parts of the anterior abdominal wall are supplied the motor iliohypogastric nerve?

Answer 33

Muscles of the abdominal wall

Question 34

What does the sensory iliohypogastric nerve supply?

Answer 34

Suprapubic region Lateral aspect of the buttocks

Question 35

Which parts of the anterior abdominal wall are supplied by the motor inguinal nerve?

Answer 35

Muscles of the abdominal wall

Question 36

What does the sensory ilioinguinal nerve supply?

Answer 36

* Upper medial part of the thigh * Anterior part of scrotum * Mons pubis and labium majus

Question 37

Define the precise location of the iliohypogastric nerve

Answer 37

Pierces the aponeurosis of the external abdominal oblique muscle 3 - 5 cm above the superficial inguinal ring

Question 38

Define the precise location of the ilioinguinal nerve

Answer 38

Emerges from the superficial inguinal ring and passes on the surface of the spermatic cord (or round ligament)

Question 39

Define the inguinal canal

Answer 39

The space betwee nthe peritoneum and the external abdominal oblique muscle through which the testicle descended

Question 40

List the 7 layers involved in the formation of the spermatic cord

Answer 40

Question 41

Through which layer does the testes pass but it does not contribute to the formation of the spermatic cord?

Answer 41

Transversus abdominis muscle

Question 42

Define the precise location of the deep inguinal ring

Answer 42

½ way between the ASIS and pubic tubercle

Question 43

What layer becomes the external spermatic fascia in the spermatic cord?

Answer 43

External oblique aponeurosis

Question 44

What layer becomes the cremasteric fascia of the spermatic cord?

Answer 44

Internal oblique muscle fibers

Question 45

What becomes the internal spermatic fascia of the spermatic cord?

Answer 45

Transversalis fascia

Question 46

Define the spatial relationship of the spermatic cord and inguinal canal to the inferior epigastric vessels

Answer 46

Lateral to the inferior epigastric vessels

Question 47

What is the conjoint tendon derived from?

Answer 47

The fusion of the aponeuroses of the transversus abdominis and internal oblique muscles

Question 48

Role of the conjoint tendon

Answer 48

Insert into the pubic crest in continuity with the pectineal line and form the medial reinforcement to the posterior wall of the inguinal canal

Question 49

Define the lacunar ligament

Answer 49

A posterior projection of the inguinal ligament formed by the inguinal ligament's backward and lateralward reflection as it reaches the pubic tubercle and attaches to the pectineal line for about 1.25 cm

Question 50

Define Cooper's ligament

Answer 50

An extension of the lacunar ligament that runs on the pectineal line of the pubic bone

Question 51

What does the inguinal canal contain in females?

Answer 51

Round ligament

Question 52

2 types of inguinal hernias

Answer 52

Question 53

More common type of inguinal hernia and the percent incidence

Answer 53

75% = indirect inguinal hernia

Question 54

Differentiate between the age groups that more commonly experience direct vs. indirect inguinal hernias

Answer 54

Direct = men over 40 Indirect = male children

Question 55

Location of herniation of direct vs. indirect inguinal hernias

Answer 55

DIrect = medial to inferior epigastric artery (inferior part of inguinal triangle; **Hesselbach's triangle**) Indirect = path taken by testis through inguinal canal; deep inguinal ring and superficial ring (outside Hesselbach's triangle)

Question 56

Most probably cause of direct inguinal hernia

Answer 56

Weakening of the conjoint tendon and/or weakening of the transversalis fascia

Question 57

Most probable cause of indirect inguinal hernia

Answer 57

Patent processus vaginalis

Question 58

How to alleviate temporarily a direct inguinal hernia

Answer 58

Lie down

Question 59

Define the medial border of the inguinal/ Hesselbach's Triangle

Answer 59

Lateral margin of the rectus abdominis muscle/sheath

Question 60

Define the superolateral border of the inguinal triangle/ Hesselbach's Triangle

Answer 60

Inferior epigastric vessels

Question 61

Define the inferior border of the inguinal / hesselbach's triangle

Answer 61

Inguinal ligament (Poupart's ligament)

Question 62

Define the processus vaginalis

Answer 62

An invagination of the peritoneum as it is carried with the testes as it descends to create the spermatic cord. Usually is obliterated (i.e. closed)

Question 63

Define a femoral hernia

Answer 63

Hernia occuring just below the inguinal ligament, when abdominal contents pass through a naturally occurring wekaness called the femoral ring/canal

Question 64

Which group of people are most commonly affected by femoral hernias and why

Answer 64

Women due to wider bone structure of the female pelvis

Question 65

What vessel must one be careful of when operating on a femoral hernia

Answer 65

Aberrant obturator artery