Anterior Abdominal Wall

Question 1

organization of the abdomen from superficial to deep

Answer 1

• skin
• superficial fascia (camper’s fascia)\
• deep fascia (Scarpa’s fascia)
• external oblique m. (with investing layer of deep fascia)
• internal oblique m. (with investing layer of deep fascia)
• transversus abdominis m.
• transversalis fascia
• extraperitoneal fat
• parietal peritoneum

Question 2

aponeurotic (tendinous) sheath that consists of anterior and posterior layers

Answer 2

rectus sheath

Question 3

rectus sheath envelops _____ and _____ muscles

Answer 3

rectus abdominis; pyramidalis

Question 4

the structure of the rectus sheath is relative to the _____, which is midway between the umbilicus and pubic symphysis

Answer 4

arcuate line

Question 5

superior to the arcuate line, anterior layer:

Answer 5

formed by aponeuroses of external oblique m. and 1/2 of internal oblique m.

Question 6

superior to the arcuate line, posterior layer:

Answer 6

formed by aponeuroses of 1/2 internal oblique m. and transversus abdominis m. and transversalis fascia

Question 7

inferior to the arcuate line, anterior layer:

Answer 7

formed by aponeurosis of external oblique, internal oblique and transversus abdominis

Question 8

inferior to the arcuate line, posterior layer:

Answer 8

formed by transversalis fascia

Question 9

from urinary bladder to umbilicus; covers median umbilical ligament

Answer 9

median umbilical fold

Question 10

covers medial umbilical ligaments; occluded portions of umbilical arteries

Answer 10

medial umbilical folds (2)

Question 11

covers inferior epigastric vessels

Answer 11

lateral umbilical folds (2)

Question 12

branch of femoral artery; supplied region of inguinal ligament

Answer 12

circumflex iliac artery

Question 13

drains to femoral vein; drains region of inguinal ligament

Answer 13

circumflex iliac vein

Question 14

branch of femoral artery; supplies abdomen inferior to umbilicus

Answer 14

epigastric artery

Question 15

drains to femoral vein; drains abdomen inferior to the umbilicus

Answer 15

epigastric vein

Question 16

branch of external iliac; runs between internal oblique and transversus abdominis; supplies inferior lateral abdominal muscles

Answer 16

deep circumflex iliac vessels

Question 17

branch of external iliac; enters posterior rectus sheath at arcuate line; supplies lower rectus abdominis m.; anastomoses with superior epigastric vessels

Answer 17

inferior epigastric vessels

Question 18

branch of internal thoracic (mammary) vessels; enters posterior rectus sheath lateral to sternum; supplies upper rectus abdominis muscle; anastomoses with inferior epigastric vessels

Answer 18

superior epigastric vessels

Question 19

branch of internal thoracic (mammary) vessels; runs along costal cartilages; supplies upper abdominal muscles and diaphragm

Answer 19

musculophrenic vessels

Question 20

nerves of the abdominal wall are ____

Answer 20

ventral rami of T7-L1 spinal nerves

Question 21

_____ supply region above umbilicus

Answer 21

T7, T8, and T9

Question 22

____ supplies the umbilical region

Answer 22

T10

Question 23

_____ supply region below umbilicus

Answer 23

T11, T12, and L1

Question 24

nerves of the abdominal wall run between ____ and ____

Answer 24

internal oblique and transversus abdominis muscles

Question 25

injury to last 3 nerves weakens the muscles in the ____ and predisposes to developing _____

Answer 25

inguinal region; direct inguinal hernias

Question 26

inguinal region extends between the ____ and the ____

Answer 26

anterior superior iliac spine (ASIS); pubic tubercle

Question 27

inguinal ligament is ____ to the femoral artery and vein

Answer 27

superior

Question 28

femoral artery and vein are called _____ before they pass beneath the inguinal ligament

Answer 28

external iliac artery and vein

Question 29

folded inferior border of the external oblique aponeurosis; extends from ASIS to pubic tubercle

Answer 29

inguinal ligament

Question 30

obliquely set tunnel 3-5 cm long; traverses anterior abdominal wall; runs parallel and superior to inguinal ligament

Answer 30

inguinal canal

Question 31

the male inguinal canal contains ____ and its contents as well as the ____

Answer 31

spermatic cord; ilioinguinal nerve (L1)

Question 32

contents of spermatic cord

Answer 32

vas deferens, testicular nerves and vessels, cremasteric muscle and fascia

Question 33

the female inguinal canal contains _____ (corresponds to the spermatic cord in males) and the _____

Answer 33

round ligament of the uterus; ilioinguinal nerve (L1)

Question 34

round ligament of the uterus is a remnant of the _____

Answer 34

gubernaculum

Question 35

opening in external oblique aponeurosis; obvious triangular opening lateral to pubic tubercle

Answer 35

superficial ring of inguinal canal

Question 36

opening in transversalis fascia; subtle piercing just lateral to inferior epigastric vessels

Answer 36

deep ring of inguinal canal

Question 37

deep ring is more ___ and ____; superficial ring is more ____ and ____

Answer 37

lateral/internal; medial/external

Question 38

connective tissue support for the opening of the superficial ring; medial and lateral to the opening

Answer 38

crus

Question 39

the ____ is where structures enter/exit the inguinal canal from the pelvic cavity

Answer 39

deep inguinal ring

Question 40

anterior wall of inguinal canal

Answer 40

external oblique aponeurosis

Question 41

posterior wall of inguinal canal

Answer 41

transversalis fascia and conjoint tendon (fusion of internal oblique and transversus abdominis aponeuroses medially)

Question 42

roof of inguinal canal

Answer 42

internal oblique and transversus abdominis muscles (superior)

Question 43

floor of inguinal canal

Answer 43

inguinal ligament (inferior)

Question 44

outpouching of abdominal viscera within a sac

Answer 44

abdominal hernia

Question 45

hernial sac composed of 3 layers:

Answer 45

peritoneum, extraperitoneal fat, and transversalis fascia

Question 46

90% of hernias occur in ____ region

Answer 46

inguinal

Question 47

extends through entire inguinal canal; most common type of hernia, more common in males than females

Answer 47

indirect inguinal hernia

Question 48

indirect inguinal hernia extends through entire inguinal canal and is ____ to inferior epigastric vessels; commonly enters ____ or ____

Answer 48

lateral; scrotum; labia majora

Question 49

indirect inguinal hernia usually from persistent ____ in males; connects peritoneum with descended testis

Answer 49

processus vaginalis

Question 50

indirect inguinal hernia referred to as ____ in females

Answer 50

canal of Nuck

Question 51

direct inguinal hernia goes through _____ (hesselbach's)

Answer 51

inguinal triangle

Question 52

contents of inguinal triangle

Answer 52

inferior epigastric a., rectus abdominis m., and inguinal ligament

Question 53

direct inguinal hernia emerges through _____ by or at superficial ring

Answer 53

conjoint tendon

Question 54

direct inguinal hernias are ____ to inferior epigastric vessels, usually do not enter scrotum or labia majora, and are more common in ____

Answer 54

medial; males

Question 55

direct inguinal hernias usually associated with _____

Answer 55

weakened abdominal wall

Question 56

hernia through femoral ring and canal; medial compartment of sheath; more common in females than males because femoral ring is wider in the female

Answer 56

femoral hernia

Question 57

most common type of hernia in females

Answer 57

indirect inguinal

Question 58

hernia through umbilical ring; most common in newborns; more common in females and obese individuals

Answer 58

umbilical hernia

Question 59

hernia through linea alba; most common in over 40; usually associated with obesity

Answer 59

epigastric hernia