Anatomy of O&G Incisions

Question 1

describe the orientation of the external obliques

Answer 1

“hand in pocket” appearance

Question 2

what is the linea alba?

Answer 2

midline blending of aponeurosis

Question 3

what abdominal muscle’s aponeuroses split into 2?

Answer 3

internal oblique

Question 4

name the layers of the abdo wall

Answer 4

skin
superficial fascia
deep fascia
ext oblique
int oblique
transversus abdominis

Question 5

name the 2 layers of the superficial fascia of the abdo wall and what they do

Answer 5

Camper’s fascia - fatty superficial layer. Scarpa’s fascia - deep fibrous laye

Question 6

linea alba runs vertically from… to…

Answer 6

xiphoid process

pubic symphysis

Question 7

what layer is immediately deep to superficial fascia

Answer 7

rectus sheath

Question 8

what is the rectus sheath?

Answer 8

combined aponeuroses of anterolateral abdo muscles

Question 9

vertical midline incision over the abdomen indicates what surgery?

Answer 9

laparotomy

Question 10

a suprapubic incision could indicate what surgery

Answer 10

lower segment C section

abdo hysterectomy

Question 11

what layer of fascia lies below the transversus abdominis?

Answer 11

transversalis fascia

Question 12

why dont you want to cut a nerve in the abdo wall?

Answer 12

paralyse muscle and will cause patient to lose support -> hernias

Question 13

nerves enter from a ___ direction in the abdo

Answer 13

lateral

Question 14

what intercostal nerves become the thoracoabdominal nerves

Answer 14

7-11

T12 becomes subcostal

Question 15

the abdo nerves are located between what abdo structures?

Answer 15

internal oblique

transversus abdominis

Question 16

what nerves come off L1?

Answer 16

iliohypogastric

ilioinguinal

Question 17

the superior and inferior epigastric arteries lie posterior to…

Answer 17

rectus abdominis

Question 18

superior epigastric arteries are a continuation of what?

Answer 18

internal thoracic arteries

Question 19

arterial supply to anterior abdo wall?

Answer 19

superior and inferior epigastric arteries

Question 20

arterial supply to lateral abdo wall?

Answer 20

intercostal

subcostal

Question 21

what epigastric artery plays the biggest role in blood supply to the abdomen

Answer 21

inferior

Question 22

intercostal and subcostal arteries are a continuation of…

Answer 22

posterior intercostal arteries

Question 23

what plane do the internal obliques run in?

Answer 23

mostly “hands on chest” but do flatten out as they descend

Question 24

the rectus muscles are cut in LSCS T or F

Answer 24

F, just moved laterally

Question 25

describe the layers cut in an LSCS

Answer 25

``` skin superficial and deep fascia rectus sheath rectus abdominus (not cut) transversalis fascia peritoneum ```

Question 26

what is stiched close in an LSCS

Answer 26

uterine wall with visceral peritoneum rectus sheath skin

Question 27

what layers are opened in a laparotomy?

Answer 27

skin deep and superficial fascia linea alba peritoneum

Question 28

where is a laparoscopy done?

Answer 28

subumbilically | lateral ports eg just next to ASIS

Question 29

the inferior epigastric artery is a branch of...

Answer 29

the external iliac artery

Question 30

where does the inferior epigastric artery emerge from?

Answer 30

medial to the deep inguinal ring

Question 31

where is the deep inguinal ring located?

Answer 31

half way between ASIS and pubic tubercle

Question 32

inferior epigastric artery travels in a _____ direction posterior to __ ___

Answer 32

superomedial | rectus abdominus

Question 33

an abdo hysterectomy uses what incision?

Answer 33

same as LSCS

Question 34

how can you tell the difference between the ureter and uterine artery?

Answer 34

"water under the bridge" | ureter passes inferior, has peristaltic action