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Flashcards in Anterior Abdominal Wall Deck (75):
1

What are the 6 layers of the anterior abdominal wall?

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

2

Name the superficial fascial layers below the navel.

1. Fascia of Camper's (superficial fatty)

2. Fascia of Scarpa's (deep membranous)

3

Describe Fascia of Camper's.

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

4

Describe Fascia of Scarpa's.

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

5

What is the tunica dartos?

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

6

Where does the inguinal ligament form?

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

7

Which muscle contributes to the inguinal ligament?

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

8

What forms the floor of the inguinal canal?

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

9

Origin of the External Oblique?

External surface of ribs

10

Insertion of the External Oblique?

Linea alba, iliac crest, pubic tubercle

11

Innervation of the External Oblique?

Ventral rami of 6 inferior thoracic nerves

12

Action of the external and internal Obliques?

Compresses and supports abdominal viscera
Flexes and rotate trunk

13

Origin of the internal Oblique?

Inguinal ligament, iliac crest, and lumbar fascia

14

Insertion of the internal Oblique?

Ribs, linea alba, pubis

15

Innervation of the internal Oblique?

Ventral rami of 6 inferior thoracic and 1st lumbar nerves

16

Origin of the Transverse Abdominis?

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



17

Insertion of the Transverse Abdominis?

Linea alba, pubic crest, pubis

18

Innervation of the Transverse Abdominis?

Ventral rami of 6 inferior thoracic and 1st lumbar nerves

19

Action of the Transverse Abdominis?

Compresses and supports abdominal viscera

20

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

External oblique

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


21

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

Internal oblique

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

22

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

Transversus Abdominis

Direction: runs transverse (horizontal)

23

What muscle forms the cremaster muscle?

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

24

Where is the cremaster muscle?

The cremaster is formed next to the scrotum

25

What is the linea alba?

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

26

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

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

27

The rectus abdominis is transected by fine lines called _________.

tendinious intersections

28

Origin of the Rectus Abdominis?

Pubic symphis, pubic crest

29

Insertion of the Rectus Abdominis?

Xiphoid process, costal cartilages

30

Innervation of the Rectus Abdominis?

Ventral rami of 6 inferior thoracic nerves

31

Action of the Rectus Abdominis?

Compresses and supports abdominal viscera
Flexes trunk

32

What forms the rectus sheath?

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

33

What are the contents of the rectus sheath?

Rectus abdominis and Pyramidalis (2 muscles)

Superior and inferior epigastric vessels (2 vessels)

Lower 6 intercostal nerves

34

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

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

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

35

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

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

The rectus abdomonis is related to what 3 lines?

Linea alba - midline

Linea semilunaris - lateral border of rectus abdominis

Arcuate line - three aponeurosis in front of the rectus

37

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

Superiorepigastric artery (From internal thoracic/mammary artery)

Inferior epigastric artery (From external iliac artery)

38

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

Lower 6 intercostal nerves

39

What does the T10 dermatome refer to?

The umbilicus (navel)

40

Where does the inguinal canal form?

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

41

Direction of the inguinal canal?

It is directed downward and medially.

42

The inguinal canal is ________ in males than in females.

Larger

43

What is the gubernaculum?

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

44

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

The transversus abdominis

45

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

(Hint: 7 layers)

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

The continuation of the ___________ is the _____________.

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

47

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

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

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

The transversalis fascia:

Contains the deep inguinal ring

Forms the posterior wall of the inguinal canal

49

The Deep Inguinal Ring
is lateral to the _________________.

inferior epigastric vessels

50

The spermatic cord is called the _______________ in females.

Round ligament

51

Function of the spermatic cord?

The spermatic cord descends the testes

52

Location of the round ligament?

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

53

What are the boundaries of the inguinal triangle?

Medial border: linea semilunaris

Lateral border: lateral umbilical fold (inferior epigastric vessels)

Inferior border: inguinal ligament

54

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

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

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

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

The _____________ supports the superior inguinal ring.

The conjoint tendon

57

What passes through the superficial ring?

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

58

What is the route of the ilioinguinal nerve?

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

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

Forms the anterior wall of the inguinal canal

Contains the superficial inguinal ring

60

What are the boundaries of the inguinal canal?

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

Name the 3 coverings of the spermatic cord.

External spermatic fascia(from external oblique muscle)

Cremaster muscle and fascia (from the internal oblique)

Internal spermatic fascia (from transversalis fascia)




62

Name the 3 arteries of the spermatic cord.

Testicular Artery
Cremastric Artery
Artery of Vas

63

Name the 3 veins of the spermatic cord.

Vas deferens.
Venous plexus.
Vestige of Processus Vaginalis.

64

Name the 3 nerves of the spermatic cord.

Genital branch of genitofemoral

Sympathetic plexus around testicular Artery

Sympathetic plexus around artery of Vas Deferens

65

Inguinal hernias are 20X more common in _______.

Males - due to their larger canal

66

Indirect hernias lie ________ to the inferior epigastric artery.

LATERAL

67

Direct hernias lie ________ to the inferior epigastric artery.

MEDIAL

68

Which type of hernia is more common?

Indirect hernias

69

Which hernia is congenital? Why?

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

70

Location of an indirect hernia?

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

Which hernia is acquired? Why?

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

Location of a direct hernia?

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

73

What is formed from the Urachus in the embryological peritoneum?

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

74

What is formed from the umbilical artery in the peritoneum?

Medial umbilical ligament forms from the obliterated umbilical artery.

75

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

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