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SHB Exam 3 > Anterior Abdominal Wall > Flashcards

Anterior Abdominal Wall Flashcards

1
Q

What are the 6 layers of the anterior abdominal wall?

A
  1. Skin
  2. Superficial Fascia (No deep fascia in the abdomen to allow for distention during pregnancy in women and stretching during eating)
  3. Anterior abdominal wall muscles
  4. Transversalis Fascia (Very fine fascia)
  5. Extraperitoneal Fascia
  6. Peritoneum
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2
Q

Name the superficial fascial layers below the navel.

A
  1. Fascia of Camper’s (superficial fatty)

2. Fascia of Scarpa’s (deep membranous)

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3
Q

Describe Fascia of Camper’s.

A

Fascia of Camper’s (superficial fatty): continues into the pelvis to form a very thin dartos fascia

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4
Q

Describe Fascia of Scarpa’s.

A

Fascia of Scarpa’s (deep membranous): continues into the scrotum to form the tunica dartos and Colles’ Fascia (fascia of the perineum)

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5
Q

What is the tunica dartos?

A

Dartos (tunica dartos) is a thin layer of muscle fibers around the scrotum formed from the Fascia of Scarpa’s.

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6
Q

Where does the inguinal ligament form?

A

The gap between the anterior superior iliac spine (ASIS) and the pubic tubercle will be filled by the inguinal ligament.

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7
Q

Which muscle contributes to the inguinal ligament?

A

The inguinal ligament is formed from the aponeurotic fibers of the external oblique muscle

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8
Q

What forms the floor of the inguinal canal?

A

The inguinal ligament folds under to form the floor of the inguinal canal

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9
Q

Origin of the External Oblique?

A

External surface of ribs

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10
Q

Insertion of the External Oblique?

A

Linea alba, iliac crest, pubic tubercle

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11
Q

Innervation of the External Oblique?

A

Ventral rami of 6 inferior thoracic nerves

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12
Q

Action of the external and internal Obliques?

A

Compresses and supports abdominal viscera

Flexes and rotate trunk

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13
Q

Origin of the internal Oblique?

A

Inguinal ligament, iliac crest, and lumbar fascia

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14
Q

Insertion of the internal Oblique?

A

Ribs, linea alba, pubis

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15
Q

Innervation of the internal Oblique?

A

Ventral rami of 6 inferior thoracic and 1st lumbar nerves

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16
Q

Origin of the Transverse Abdominis?

A

Internal surface of ribs, lumbar fascia, inguinal ligament, iliac crest

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17
Q

Insertion of the Transverse Abdominis?

A

Linea alba, pubic crest, pubis

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18
Q

Innervation of the Transverse Abdominis?

A

Ventral rami of 6 inferior thoracic and 1st lumbar nerves

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19
Q

Action of the Transverse Abdominis?

A

Compresses and supports abdominal viscera

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20
Q

What is the direction of the muscle fibers of the external oblique?

A

External oblique

Direction: “Hands in your pockets”; downward, forward, and medially

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21
Q

What is the direction of the muscle fibers of the internal oblique?

A

Internal oblique

Direction: “Raise your hands to the sky”; upward, forward, medially

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22
Q

What is the direction of the muscle fibers of the Transverus oblique?

A

Transversus Abdominis

Direction: runs transverse (horizontal)

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23
Q

What muscle forms the cremaster muscle?

A

Muscle fibers and fascia for the cremaster muscle are derived from the internal oblique

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24
Q

Where is the cremaster muscle?

A

The cremaster is formed next to the scrotum

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25
Q

What is the linea alba?

A

The aponeuroses of the abdominal muscles meet in the midline at the linea alba

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26
Q

If making an incision for surgery, where should you cut?

A

Cut at the region of the linea alba because it is the least vascular plane

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27
Q

The rectus abdominis is transected by fine lines called _________.

A

tendinious intersections

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28
Q

Origin of the Rectus Abdominis?

A

Pubic symphis, pubic crest

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29
Q

Insertion of the Rectus Abdominis?

A

Xiphoid process, costal cartilages

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30
Q

Innervation of the Rectus Abdominis?

A

Ventral rami of 6 inferior thoracic nerves

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31
Q

Action of the Rectus Abdominis?

A

Compresses and supports abdominal viscera

Flexes trunk

32
Q

What forms the rectus sheath?

A

The aponeuroses of the external oblique, internal oblique , and transverse muscles of the abdomen

33
Q

What are the contents of the rectus sheath?

A

Rectus abdominis and Pyramidalis (2 muscles)

Superior and inferior epigastric vessels (2 vessels)

Lower 6 intercostal nerves

34
Q

What are the posterior and anterior walls of the rectus sheath above the arcuate line?

A

Anteriorly: Aponeuroses of the external and internal oblique (anterior layer) muscles

Posteriorly: Aponeuroses of the internal oblique (posterior layer) and transverse abdominis muscles

35
Q

What are the posterior and anterior walls of the rectus sheath below the arcuate line (lower Zone)?

A

Anterior: Aponeuroses of the external, internal, and transversus muscles provide extra support for the rectus abdominis anteriorly

Posterior; Rectus abdominis is in contact with the transversalis fascia

36
Q

The rectus abdomonis is related to what 3 lines?

A

Linea alba - midline

Linea semilunaris - lateral border of rectus abdominis

Arcuate line - three aponeurosis in front of the rectus

37
Q

Name the blood supply of the anterior abdominal wall/muscles.

A

Superiorepigastric artery (From internal thoracic/mammary artery)

Inferior epigastric artery (From external iliac artery)

38
Q

Name the general innervation of the anterior abdominal wall/muscles.

A

Lower 6 intercostal nerves

39
Q

What does the T10 dermatome refer to?

A

The umbilicus (navel)

40
Q

Where does the inguinal canal form?

A

The canal forms an oblique passage just above the center of the inguinal ligament.

41
Q

Direction of the inguinal canal?

A

It is directed downward and medially.

42
Q

The inguinal canal is ________ in males than in females.

A

Larger

43
Q

What is the gubernaculum?

A

Gubernaculum: fibrous band that extends from the caudal part of the testes forming a path as it descends into the pelvis.

44
Q

Which muscle does not participate in the descent of the testes?

A

The transversus abdominis

45
Q

Describe the sheath and derivatives (external to internal) formed around the testes at it descends.

(Hint: 7 layers)

A
  1. Skin
  2. Scarpa’s - dartos muscle
  3. External oblique - external spermatic fascia
  4. Internal oblique - cremaster muscle
  5. Transversus abdominis - NO CONTRIBUTION
  6. Transversalis fascia - internal spermatic fascia
  7. Peritoneum - tunica vaginalis (parietal/visceral layers)
46
Q

The continuation of the ___________ is the _____________.

A

The continuation of the epididymis is the vas deferens (or ductus deferens).

47
Q

What is the difference between the tunica vaginalis and tunica albuginea?

A

Tunica vaginalis - derived from the peritoneum and forms a visceral and parietal layer around the testis

Tunica albuginea - forms a tight cover around the testes

48
Q

What is the relationship of the transversalis fascia to the inguinal canal? (2 things)

A

The transversalis fascia:

Contains the deep inguinal ring

Forms the posterior wall of the inguinal canal

49
Q

The Deep Inguinal Ring

is lateral to the _________________.

A

inferior epigastric vessels

50
Q

The spermatic cord is called the _______________ in females.

A

Round ligament

51
Q

Function of the spermatic cord?

A

The spermatic cord descends the testes

52
Q

Location of the round ligament?

A

The round ligament runs from the uterus down to the labia majora

53
Q

What are the boundaries of the inguinal triangle?

A

Medial border: linea semilunaris

Lateral border: lateral umbilical fold (inferior epigastric vessels)

Inferior border: inguinal ligament

54
Q

What is the relationship of the transversus abdominis to the inguinal canal? (2 things)

A

Forms the roof of the canal

The high arching fibers from the inguinal ligament join together with the internal oblique to form the conjoint tendon

55
Q

What is the relationship of the internal oblique to the inguinal canal? (2 things)

A

Forms roof of the canal with the transversus abdominis

The low arching fibers from the inguinal ligament join with the transversus abdominis to form the conjoint tendon

56
Q

The _____________ supports the superior inguinal ring.

A

The conjoint tendon

57
Q

What passes through the superficial ring?

A

The spermatic cord in males/round ligament in females and the ilioinguinal nerve pass through the superficial ring

58
Q

What is the route of the ilioinguinal nerve?

A

The ilioinguinal nerve pierces the transversus abdominis, runs between the TA and the internal oblique, and pierces the lower part of the internal oblique to enter the canal and exit through the superficial inguinal ring

59
Q

What is the relationship of the external oblique to the inguinal canal? (2 things)

A

Forms the anterior wall of the inguinal canal

Contains the superficial inguinal ring

60
Q

What are the boundaries of the inguinal canal?

A

Anterior Wall
External oblique aponeurosis

Posterior Wall
Transversalis fascia and Conjoint tendon

Roof
Arched fibers of internal oblique (low arched) and transversus abdominis (high arched)

Floor
Inguinal Ligament

61
Q

Name the 3 coverings of the spermatic cord.

A

External spermatic fascia(from external oblique muscle)

Cremaster muscle and fascia (from the internal oblique)

Internal spermatic fascia (from transversalis fascia)

62
Q

Name the 3 arteries of the spermatic cord.

A

Testicular Artery
Cremastric Artery
Artery of Vas

63
Q

Name the 3 veins of the spermatic cord.

A

Vas deferens.
Venous plexus.
Vestige of Processus Vaginalis.

64
Q

Name the 3 nerves of the spermatic cord.

A

Genital branch of genitofemoral

Sympathetic plexus around testicular Artery

Sympathetic plexus around artery of Vas Deferens

65
Q

Inguinal hernias are 20X more common in _______.

A

Males - due to their larger canal

66
Q

Indirect hernias lie ________ to the inferior epigastric artery.

A

LATERAL

67
Q

Direct hernias lie ________ to the inferior epigastric artery.

A

MEDIAL

68
Q

Which type of hernia is more common?

A

Indirect hernias

69
Q

Which hernia is congenital? Why?

A

Indirect hernias are congenital and associated with the persistence of the processus vaginalis

70
Q

Location of an indirect hernia?

A

Indirect hernias will traverses the inguinal canal by passing through the deep ring, inguinal canal and superficial ring.

The hernial sac is within the spermatic cord so it passes into the scrotum.

71
Q

Which hernia is acquired? Why?

A

Direct hernias because they push through a weakened area of the abdominal wall muscles and through the posterior wall of the inguinal canal (i.e. through the inguinal triangle)

72
Q

Location of a direct hernia?

A

The direct hernial sac passes through the superficial inguinal ring and is external and parallel to the spermatic cord.

73
Q

What is formed from the Urachus in the embryological peritoneum?

A

Median umbilical ligament forms the obliterated Urachus that connects bladder to navel

74
Q

What is formed from the umbilical artery in the peritoneum?

A

Medial umbilical ligament forms from the obliterated umbilical artery.

75
Q

What is formed from the inferior epigastric arteries in the peritoneum?

A

Lateral umbilical ligaments are formed by the inferior epigastric arteries on their way to rectus sheath.

SHB Exam 3 (14 decks)

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