Anatomy of Obs and Gynae Surgical Incisions Flashcards Preview

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Flashcards in Anatomy of Obs and Gynae Surgical Incisions Deck (40)
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1

List the two most common surgical incisions in O+G and their anatomical locations

Lower segment C-section (suprapubic, 'bikini line')
Laparoscopy (vertical midline incision)

2

Which anatomical lines are used to determine location of incision and layers incised?

Langer's lines

3

List the layers of the anterolateral abdominal wall from superficial to deep

Skin
Superficial fascia
External oblique
Internal oblique
Transverse abdominus
Rectus sheath
Rectus abdominus

4

What is the linea alba?

Midline blending of aponeuroses

5

What is an aponeurosis?

Flat sheet or ribbon of tendon-like material that anchors a muscle or connects it with the part that the muscle moves

6

List the attachments of external oblique

Lower ribs (5-11)
Iliac crest
Pubic tubercle
Linea alba

7

Describe the orientation of fibres of external oblique

'Hands in pockets'
Same direction as external intercostals - inferomedial

8

List the attachments of internal oblique

Lower ribs (912)
Thoracolumbar fascia (posterior)
Iliac crest
Linea alba

9

Describe the orientation of fibres of internal oblique

'Hands in chest'
Same direction as internal intercostals - inferolateral

10

List the attachments of transverse abdominus

Lower ribs
Thoracolumbar fascia
Iliac crest
Linea alba

11

Describe the orientation of fibres of transverse abdominus

'Corset muscle'
Transverse!

12

What structures divide each rectus abdominus into 3 or 4 smaller muscles?

Tendinous intersections

13

What is the function of tendinous intersections?

Improve mechanical efficiency

14

List the attachments of rectus abdominus

Xiphoid process and costal cartilages
Pubic bones and pubic symphysis

15

What is the rectus sheath?

Deep to superficial fascia, strong fibrous layer surrounding rectus abdominus muscles

16

What is the clinical relevance of the rectus sheath?

Combined aponeuroses of anterolateral abdominal wall muscles

17

What is the arcuate line?

Horizontal line that demarcates the lower limit of the posterior layer of the rectus sheath

18

When undertaking a suprapubic incision, both layers of rectus sheath will be present. True/ False?

False
Only anterior rectus sheath below the arcuate line

19

List the layers of the internal surface of the abdominal wall, up to the anterolateral abdominal wall muscles

Transversalis fascia
Extraperitoneal fat
Parietal peritoneum

20

List the spinal nerves that supply the abdominal wall from superior to inferior, and give their nerve roots

7th - 11th intercostal nerves
Subcostal (T12)
Iliohypogastric (L1)
Ilioinguinal (L1)

21

What do the intercostal nerves become when they leave the thorax and enter the abdomen?

Thoracoabdominal nerves

22

State the course of the nerves that supply the abdominal wall

Travel in plane between internal oblique and transverse abdominus

23

Describe the blood supply to the anterior abdominal wall

Internal thoracic artery --> Superior epigastric arteries
External iliac artery --> Inferior epigastric arteries

24

Describe the blood supply to the lateral abdominal wall

Posterior intercostal arteries --> Intercostal and subcostal arteries

25

The blood supply to the anterior abdominal wall passes posterior to what muscle?

Rectus abdominus

26

How does a surgeon minimise trauma to muscle fibres?

Incise in same direction as muscle fibre

27

During a LSCS incision, muscles are cut. True/ False?

False
Rectus muscles are seperated in lateral direction, moving them towards nerve supply

28

List the layers when opening, from superficial to deep, in a LSCS incision

Skin + fascia
Anterior rectus sheath
Rectus abdominus
Transverse fascia + peritoneum
Retract bladder
Uterine wall
Amniotic sac

29

List the layers to stitch closed, from deep to superficial, in a LSCS incision

Uterine wall with visceral peritoneum
Rectus sheath
Fascial layer if increased BMI
Skin

30

List the layers when opening, from superficial to deep, in a laparotomy

Skin + fascia
Linea alba
Peritoneum