Anterior Abdominal Wall

Question 1

What is in the right upper quadrant of the anterior abdomen?

Answer 1

• liver & galbladder
• stomach
• duodenum
• pancreas
• right kidney & suprarenal gland
• right colic
• ascending + transverse colon

Question 2

What is in the right lower quadrant of the anterior abdomen?

Answer 2

• cecum
• ileum
• vermiform appendix
• ascending colon
• right ovary, uterine tube, ureter, spermatic cord
• uterus bladder

Question 3

What is in the left upper quadrant of the anterior abdomen?

Answer 3

• liver
• stomach
• jejunum + prox. ileum
• pancreas
• left kidney + suprarenal gland
• left colic
• descending + transverse colon

Question 4

What is in the left lower quadrant of the anterior abdomen?

Answer 4

• sigmoid colon
• descending colon
• left ovary, ureter, spermatic cord
• uterus
• urinary bladder

Question 5

What does the paraumbilical vein drain the abdomen into?

Answer 5

portal vein of liver

Question 6

What is the cause and symptom of Caput Medusae?

Answer 6

• cause -> portal hypertension + blockage of IVC
• symptom -> swelling of paraumbilical veins

Question 7

What are the layers of the anterior abdominal wall?

Answer 7

skin -> superficial fascia -> deep fascia-> flat muscles -> transversalis fascia -> fat -> peritoneum

Question 8

What are the layers of the superificial fascia of the anterior abdomen?

Answer 8

• camper’s (fatty layer): superficial
• scarpa’s (membranous layer): deep

Question 9

What are the flat muscles of the anterior abdomen?

Answer 9

• external & internal oblique
• transversus abdominis

Question 9

What gives the 6 pack appearance?

Answer 9

tendinous intersections

Question 10

What divides the anterior and posterior rectus sheath?

Answer 10

rectus abdominis

Question 11

What are the insertions of the external oblique?

Answer 11

• linea alba
• pubic tubercle
• ant. iliac crest

Question 12

What direction do the external oblique fibers run in?

Answer 12

infero-medially

Question 13

What is the origin of the external oblique?

Answer 13

ribs 6-12

Question 14

What does the external oblique contribute to?

Answer 14

inguinal lig. & spermatic fascia

Question 15

What are the origins of the internal oblique?

Answer 15

• thoracoumbar fascia
• ant. iliac crest
• lat. linguinal lig

Question 16

What are the insertions of the internal oblique?

Answer 16

• linea alba
• ribs 10-12
• pubis

Question 17

What direction do the fibers of the internal oblique run in?

Answer 17

supero-medially

Question 18

What contributes to the cremaster muscle?

Answer 18

internal oblique

Question 19

What are the origins of the transversus abdominis?

Answer 19

• ribs 7-12
• thoracolumbar fascia
• iliac crest
• lat. 1/3 inguinal lig

Question 20

What are the actions of the anterior abdominal wall muscles?

Answer 20

assist in vomiting, sneezing, & defecation

Question 21

How is the rectus sheath formed?

Answer 21

by aponeuroses of ant. abdominal wall muscles

Question 22

What is the main difference between above & below the arcuate line?

Answer 22

fibers

Question 23

What is included in the anterior sheath ABOVE the arcuate line?

Answer 23

ext. & 1/2 int. oblique

Question 24

What is included in the posterior sheath ABOVE the arcuate line?

Answer 24

* int. oblique * transversus abdominis * transversalis fascia * peritoneum

Question 25

What is included in the anetrior sheath BELOW the arcuate line?

Answer 25

* ext. & int. oblique * transversus abdominis

Question 26

What is included in the posterior sheath BELOW the arcuate line?

Answer 26

* transversalis fascia * peritoneum

Question 27

Where is the transversalis fascia located?

Answer 27

deep to flat muscles

Question 28

What gives rise to the posterior rectus sheath?

Answer 28

transversalis fascia

Question 29

What continues as the internal spermatic fascia?

Answer 29

transversalis fascia

Question 30

Aneterior abdominal wall layers are dragged down with the testes when they descend into what?

Answer 30

scrotum

Question 31

What are the trends with the ant. abdominal muscles in the spermatic cord?

Answer 31

* ext. oblique -> ext. spermatic fascia= outer spermatic cord * int. oblique -> cremaster muscle= middle spermatic cord * trans. fascia -> int. spermatic fascia= inner spermatic cord

Question 32

What runs from the deep inguinal ring?

Answer 32

testis

Question 33

What is contained in the spermatic cord?

Answer 33

vas deferens & testicular art. + vein

Question 34

What do the superficial and deep inguinal ring come from?

Answer 34

* super -> ext. oblique aponeurosis * deep -> trans. fascia

Question 35

What are the borders of the inguinal canal?

Answer 35

* roof: int. oblqiue + trans. abdominis * ant. wall: ext. + int. oblique apon. * floor: inguinal + lacunar lig. * post. wall: conjoint tendon + trans. fascia

Question 36

What are the contents of the inguinal canal?

Answer 36

* ilioinguinal nerve * genital branch off genitofemoral nerve * spermatic cord (male) or round lig. of uterus (female)

Question 37

What is the origin & insertion of the inguinal ligament?

Answer 37

* origin -> ASIS * insertion -> pubic tubercle

Question 38

What does the inguinal ligament contribute to?

Answer 38

lacunar lig.

Question 39

What are the 5 peritoneal folds?

Answer 39

* median umbilical (1) -> over remnant of urachus * medial umbilical (2) -> over fetak umbilical art. * lat umbilical (2) -> over inf. epigastric vessels

Question 40

What is the site of direct hernias?

Answer 40

inguinal triangle

Question 41

What are the borders fo the inguinal triangle?

Answer 41

* lat= lat. umbilical * medial= med. umbilical * base= inguinal lig.

Question 42

Where is a direct hernia?

Answer 42

through weak spot on post. wall of inguinal canal

Question 43

Where is an indirect hernia?

Answer 43

through deep inguinal ring of inguinal canal

Question 44

What are the characteristics of a direct hernia?

Answer 44

* LESS common * LESS prone to strangulation * covered by peritoneum * originates from inguinal canal

Question 45

What are the characteristics of an indirect hernia?

Answer 45

* MOST common * MORE prone to strangulation * covered by peritoneum + spermatic cord * originates from lat. inf. epigastric vessels

Question 46

Where would direct inguinal hernias typically occur?

Answer 46

med. to lat. umbilical lig.