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Anatomy hilary > Anterior Abdominal wall > Flashcards

Anterior Abdominal wall Flashcards

1
Q

What are the boundaries of the abdominal wall?

A

Superior - 5th intercostal space, xiphoid process: diaphragm
Inferior - Pubic bone and iliac crest L4
Anterior - Umbilicus L3-4
Posterior - Lumbar vertebrae and lateral muscles.

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2
Q

Posterior boundary of abdominal wall muscles x 3

A
  • Iliacus
  • Psoas major
  • Quadratus lumborum
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3
Q

What are the horizontal planes of region division?

A
  • Transpyloric plane

- Intertubercular plane

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4
Q

Where is the transpyloric plane?

A

Midway between the plendar gap and pubic symphysis (between xiphoid and umbilicus) L1.

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5
Q

Where is the intertubercular plane?

A

Through tubercles of iliac crests. 5cm posterior to ASIS – body of L5.

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6
Q

What are the upper 3 regions of the abdomen?

A
  • Right hypochondriac region
  • Epigastric region
  • Left hypochondriac region
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7
Q

What are the 3 middle regions in the abdomen?

A
  • Right lumbar region
  • Umbilical region
  • Left lumbar region
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8
Q

What are the 3 lower regions in the abdomen?

A
  • Right iliac region
  • Hypogastric region
  • Left iliac region
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9
Q

What is present in the right upper quadrant? x8

A
  • Right lobe of the liver
  • Gallbladder
  • Duodenum
  • Head of pancreas
  • Right adrenal gland
  • Upper lobe right kidney
  • Hepatic flexure of colon
  • Section of ascending and transverse colon
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10
Q

What is present in the left upper quadrant? x8

A
  • Left lower part of liver
  • Upper lobe of left kidney
  • Splenic flexure of colon
  • Section of transverse and descending colon
  • Stomach
  • Spleen
  • Pancreas
  • Left adrenal gland
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11
Q

What is present in the right lower quadrant? x9

A
  • Lower lobe of right kidney
  • Section of ascending colon
  • Right fallopian tube
  • Right ovary
  • Part of uterus (if enlarged)
  • Right spermatic cord
  • Cecum
  • Appendix
  • Right ureter
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12
Q

What is present in the left lower quadrant?

A
  • Lower lobe of left kidney
  • Section of descending colon
  • Left spermatic cord
  • Part of uterus (if enlarged)
  • Sigmoid colon
  • Left ureter
  • Left ovary
  • Left fallopian tube
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13
Q

What is present in the right hypochondria region?

A
  • Right lobe of liver
  • Gallbladder
  • Part of duodenum
  • Hepatic flexure of colon
  • Part of right kidney
  • Suprarenal gland
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14
Q

What is present in the epigastric region?

A
  • Pyloric end of stomach
  • Duodenum
  • Pancreas
  • Aorta
  • Portion of liver
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15
Q

What is present in the left hypochondriac region?

A
  • Stomach
  • Spleen
  • Tail of pancreas
  • Splenic flexure of colon
  • Upper pole of left kidney
  • Suprarenal gland
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16
Q

What is present in the lumbar region?

A
  • Ascending colon
  • Lower half of right kidney
  • Part of duodenum and jejunum
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17
Q

What is present in umbilical region?

A
  • Omentum
  • Mesentery
  • Transverse colon
  • Lower part of duodenum
  • Jejunum and ileum
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18
Q

What is present in left lumbar region?

A
  • Descending colon
  • Lower half of left kidney
  • Part of jejunum and ileum
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19
Q

What is present in the right iliac region?

A
  • Cecum
  • Appendix
  • Lower end of ileum
  • Right ureter
  • Right ovary in female
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20
Q

What is present in the hypogastric region? x2

A
  • Ileum

- Bladder

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21
Q

What is present in the left iliac region?

A
  • Sigmoid colon
  • Left ureter
  • Left ovary in female
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22
Q

What is Camper’s fascia continuous with?

A

Fascia over thorax and thigh

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23
Q

What does Scarpa’s fascia continue into perineum as?

A

As superficial perineal fascia = Colle’s fascia

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24
Q

What are the 7 functions of the abdominal wall?

A 
✓protect the abdominal viscera
✓move the vertebral column,
✓assist in forced expiration (e.g. coughing sneezing)
✓defecation
✓vomiting (also known as emesis)
✓urination
✓childbirth (parturition)
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25
Q

What does contraction of abdominal wall muscles and relaxation of diaphragm cause?

A

Pushes the dome of the diaphragm further up into the thoracic cavity, compressing the lungs deep / rapid / forced expiration

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26
Q

What does contraction of abdominal wall muscles and contraction of diaphragm cause?

A

Increases the intraabdominal pressure - expulsion of the contents

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27
Q

External oblique innervation

A

Thoraco-abdominal

Subcostal nerves

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28
Q

Insertion of external oblique

A
  • Aponeurotic insertion in midline at the linea alba
  • Iliac crest
  • Pubic tubercle
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29
Q

Origin of external oblique

A

External posterior surface of ribs 5-12

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30
Q

Function of external oblique

A

LATERAL ROTATOR and LATERAL FLEXOR

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31
Q

Origin of internal oblique

A
  • Thoracolumbar fascia
  • Anterior 2/3 of the iliac crest
  • Lateral 1/3 of the inguinal ligament
32
Q

Insertion of internal oblique

A

Inferior borders of 10th -12th ribs and the linea alba

33
Q

Innervation of internal oblique

A
  • Thoraco-abdominal

- Subcostal nerves T6-T12

34
Q

Function of internal oblique

A

Lateral rotator and flexor

35
Q

Origin of transversus abdominus

A
  • Inner aspect of the costal margin - ribs 7-12
  • Thoraco-lumbar fascia
  • Anterior 2/3 of the iliac crest
  • Lateral third of the inguinal ligament
36
Q

Insertion of transversus abdominus

A
  • Linea alba,
  • Pubic crest and the pectineal line (pelvic
    floor)
  • Inferior part of the internal oblique muscle
37
Q

What is the conjoint tendon?

A

The blending of the transversus abdominus and internal oblique at the superficial inguinal ring

38
Q

Innervation of transversus abdominus

A
  • Thoraco-abdominal

- Subcostal nerves T6-T12

39
Q

Where do the thoraco-abdominal and subcostal nerves travel between?

A

Between internal oblique and transversus abdominus

40
Q

Function of rectus abdominus

A

Most powerful flexor

41
Q

What are the 3 transverse fibrous bands of tissue in the rectus abdominus?

A

Transverse tendinous

intersections and linea alba

42
Q

Where is linea alba located

A

Located along the midline = connective tissue raphe.

43
Q

Where is linea semilunaris located?

A

Along each lateral border of rectus abdominis.

44
Q

Where is linea transversa located?

A

Tendinous bands of rectus abdominis.

45
Q

Where does the linea alba extend from?

A

Xiphoid process to pubic symphysis

46
Q

What do teh semilunaris and linea alba fuse oto foorm and where?

A

At the lateral margin of the rectus abdominus, the aponeuroses fuse to form the linea semilunaris

47
Q

What are the 4 roles of abdominal muscles?

A
  • Move the trunk
  • Depress the ribs in expiration
  • Compress the abdomen
  • Support the intestines
48
Q

What does the rectus sheath enclose?

A

Rectus abdominus

49
Q

What is the rectus sheath formed by?

A

Fusion of fascia of other three layers of abdominal

muscles

50
Q

What is the arcuate line?

A

The lower free edge of the posterior lamina.

51
Q

Where does the arcuate line of Douglas lie?

A

1/3rd the way between the umbilicus + pubic symphysis

52
Q

Blood supply of rectus sheath

A

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

53
Q

What is the nerve supply to abdominal muscles?

A

From T6-L1 (at L1 the ilioinguinal nerve – originates from ventral ramus of L1 spinal nerve – continues through inguinal canal)

54
Q

Where does the inguinal region extend between?

A

The ASIS and pubic tubercle

55
Q

Why is the inguinal region clinically important?

A

For hernia

56
Q

Where does the inguinal ligament run from?

A

The anterior superior iliac spine to pubic tubercle

57
Q

Why are herniated surgical interventions controversial in the inguinal canal?

A

Due to variations

58
Q

NB what is present in the spermatic cord?

A
  • Artery to Vas deferens.
  • Vas deferens
  • Genital branch of genitofemoral nerve – skin of scrotum / mons pubis.
  • Testicular arteries.
  • Pampiniform plexus of testicular veins – venous return, temp regulation
  • Lymph vessels.
  • Cremaster artery and vein and muscle -involuntary smooth muscle, raise and lower testes – raise in response to fear etc.
  • Processus vaginalis – embryonic out pouching of parietal peritoneum / embryonic structure
  • Autonomic nerves
  • Ilioinguinal nerve.
59
Q

Female inguinal canal contents

A
  • Round ligament of uterus
  • Ilioinguinal nerve
  • Lymph vessels
60
Q

Where is the inguinal canal present?

A

Between superficial and deep inguinal rings

61
Q

Where does the superficial inguinal ring lie?

A

Above and lateral to pubic tubercle

62
Q

What muscle layer is the superficial inguinal ring in?

A

External oblique

63
Q

What is the deep inguinal ring and opening of?

A

Of the evagination of the transversalis fascia

64
Q

Boundaries of inguinal canal

A

Anterior - ant apon of external oblique + lil internal oblique laterally
Posterior - transversalis fascia + medial by conjoint tendon
Roof - arching fibres of int oblique and transverse ab
Floor - sup surfaces of inguinal and lacunar ligaments

65
Q

What is an inguinal hernia?

A

A rupture or separation of a portion of the inguinal area of the anterior abdominal wall resulting in the protrusion of part of the small intestine

66
Q

When do direct hernias normally occur and why?

A

In older men (rarely women) due to weakness in abdominal wall behind or lateral to superficial inguinal ring.

67
Q

Where do direct inguinal hernias pass through?

A

Through abdominal wall to Hesselbecks triangle

68
Q

Do direct inguinal hernias extend into scrotum?

A

NO

69
Q

Location of direct inguinal hernia in relation to epigastric vessels.

A

Medial to the epigastric vessels

70
Q

What is the sac in direct inguinal hernias formed by?

A

Peritoneum

71
Q

What do indirect inguinal hernias tranverse?

A

Transverses deep and superficial inguinal rings and inguinal canal.

72
Q

Where do indirect inguinal hernias lie within?

A

Coverings of spermatic cord

73
Q

Do indirect inguinal hernias descend into scrotum?

A

Yes they can

74
Q

What is more common, direct or indirect inguinal hernias?

A

Indirect

75
Q

Where are indirect inguinal hernias in relation to epigastric vessels?

A

Lateral to epigastric vessels

76
Q

Borders of Hesselbach’s triangle

A

Laterally: Inferior epigastric vessels
Medially: Lateral border of the rectus muscle
Inferiorly: Inguinal ligament

77
Q

Where do direct hernias leave the abdomen through?

A

Through Hasselbach’s Triangle

Anatomy hilary (9 decks)

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