Anterior Abdominal Wall & Inguinal Region Flashcards Preview

Jeff A&P Module II > Anterior Abdominal Wall & Inguinal Region > Flashcards

Flashcards in Anterior Abdominal Wall & Inguinal Region Deck (52)
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1
Q

What is the superior border of the anterolateral abdominal wall?

A

xiphoid process

costal margins

2
Q

What is the inferior border of the anterolateral abdominal wall?

A

inguinal ligaments

pelvic girdle

3
Q

What are the 9 anterior abdominal regions?

A

right hypochondriac, epigastric, left hypochondriac, right lateral, umbilical, left lateral, right inguinal, hypogastric (pubic), left inguinal

4
Q

What are the 4 planes that divide the 9 abdominal regions?

A
2 horizontal:
-subcostal
-transtubercular
2 vertical
-2 midclavicular planes, running inferiorly to midinguinal points
5
Q

Describe the layers of the abdominal wall from superficial to deep.

A
  • Skin
  • Camper’s fascia (subcutaneous fat)
  • Scarpa’s fascia (deep membranous layer)
  • Investing (deep) fascia surrounding muscles
  • External oblique muscle
  • Internal oblique muscle
  • Transverse abdominis
  • Transversalis fascia
  • Extraperitoneal fat
  • Parietal peritoneum
6
Q

What is the origin of the external obliques?

A

external surfaces of ribs 5-12

7
Q

What is the insertion of the external obliques?

A
  • linea alba
  • pubic tubercle
  • anterior half of iliac crest
8
Q

What is the innervation of the external obliques?

A
  • thoracoabdominal nerves (ventral rami T7-T11)

- subcostal nerve (T12)

9
Q

What is the origin of the internal obliques?

A
  • thoracolumbar fascia
  • anterior 2/3 iliac crest
  • CT deep to lateral 1/3 of inguinal ligament
10
Q

What is the insertion of the internal obliques?

A
  • inferior borders of ribs 10-12
  • linea alba
  • pecten pubis via conjoint tendon
11
Q

What is the innervation of the internal obliques?

A
  • thoracoabdominal nerves (ventral rami T6-T11)
  • subcostal nerve (T12)
  • L1
12
Q

What is the origin of the transversus abdominis?

A
  • internal surfaces of costal cartilages 7-12
  • thoracolumbar fascia
  • iliac crest
  • CT deep to lateral 1/3 of inguinal ligament
13
Q

What is the insertion of the transversus abdominis?

A
  • linea alba
  • pubic crest
  • pecten pubis via conjoint tendon
14
Q

What is the innervation of the transversus abdominis?

A
  • thoracoabdominal nerves (ventral rami T6-T11)
  • subcostal nerve (T12)
  • L1
15
Q

Where is the pyramidalis in relation to other abdominal muscles?

A

anterior to inferior part of rectus abdominus muscle;

attaches to anterior surface of pubis and anterior pubic ligament and ends in linea alba

16
Q

What is the action of the pyramidalis?

A

tenses linea alba;

only present in 80% of people

17
Q

What is the rectus sheath?

A

-incomplete fibrous sheath;
-compartment for rectus abdominis and pyramidalis;
formed by interweaving of apopneuroses of the flat muscles;
-creates linea alba

18
Q

What forms the anterior layer of the rectus sheath?

A

interweaving of apopneurosis of external oblique and anterior laminae of internal oblique’s apopneurosis

19
Q

What forms the posterior layer of the rectus sheath?

A

interweaving of posterior laminae of internal oblique’s apopneurosis and apopneurosis of transverse abdominal

20
Q

Where does the rectus abdominis sit in relation to the rectus sheath?

A

in between anterior and posterior layers

21
Q

What is the arcuate line?

A

demarcation of lower limit of posterior layer of rectus sheath;
inferior to umbilicus, all the muscle apopneuroses pass superficial to rectus abdominus muscle: all 3 apopneuroses now form anterior layer;
visible on posterior internal wall of rectus sheath

22
Q

Describe the median fold of the interior abdominal wall.

A

runs from apex of bladder to umbilicus;

remnant of fetal urachus, which previously joined the bladder to the umbilicus

23
Q

Describe the 2 medial folds of the interior abdominal wall.

A

remnants of fetal medial umbilical arteries, now occluded

24
Q

Describe the 2 lateral folds of the interior abdominal wall.

A

protrude because of inferior epigastric vessels

25
Q

What is the abdominal wall arterial supply?

A
  • superior epigastric aa
  • inferior epigastric aa
  • intercostal and subcostal aa
  • circumflex iliac aa
  • superficial epigastric aa
26
Q

Explain collateral venous return.

A

if either IVC is blocked, superficial and/or deep vein anastomoses are able to compensate

27
Q

What is the system of collateral venous return specifically in the abdomen.

A
SVC
-deep: superior epigastric vein
-superficial: lateral thoracic vein
IVC
-deep: inferior epigastric vein
-superficial: superficial epigastric vein
28
Q

What are the thoracoabdominal nerves? Where are they in relation to the anterior abdominal muscles?

A

ventral rami of T7-T11;
anterior cutaneous and lateral cutaneous branches;
travel between internal obliques and transversus abdominis

29
Q

Describe the branching of the L1 nerve.

A

L1 branches into:

  • iliohypogastric nerve
  • ilioinguinal nerve
30
Q

What nerve innervates the umbilicus?

A

T10- serves as a good reference point

31
Q

What 2 passages exist in the inguinal region?

A
  • inguinal canal = passage to perineum

- subinguinal space = passage to lower limb

32
Q

What forms the inguinal ligament? What is its location?

A

inferior edge of the external oblique muscle apopneurosis- curls up on itself;
forms a portion of inguinal canal;
runs from ASIS to pubic tubercle

33
Q

Where is the subinguinal space? What passes thru it?

A
inferior to inguinal ligament;
passing thru: 
-hip flexor muscles
-femoral nerve
-femoral sheath (femoral artery, femoral vein, femoral canal)
34
Q

How is the inguinal canal formed?

A

by descent of gonads during development;

led by processus vaginalis

35
Q

What forms the deep inguinal ring? Describe its location.

A

transversalis fascia;

superior to middle of inguinal ligament, lateral to inferior epigastric vessels

36
Q

What forms the superficial inguinal ring? Describe its location.

A

apopneurosis of external obliques;

superolateral to pubic tubercle

37
Q

What keeps the superficial inguinal ring from splitting apart?

A

intercrural fibers provide extra support when intra-abdominal pressure increases

38
Q

What forms the anterior wall of the inguinal canal?

A

external oblique apopneurosis;

reinforced laterally by internal oblique apopneurosis

39
Q

What forms the posterior wall of the inguinal canal?

A
transversalis fascia;
conjoint tendon (formed by internal obliques and transversus abdominis)
40
Q

What forms the roof of the inguinal canal?

A

arcing fibers of internal obliques and transversus abdominis

41
Q

What forms the floor of the inguinal canal?

A
  • iliopubic tract (thickened inferior margin of transversalis fascia)
  • inguinal ligament
  • lacunar ligament (inferior aspect of external oblique apopneurosis)
42
Q

What are the contents of the inguinal canal in males vs. females?

A

both sexes:

  • blood vessels, lymphatic ducts, ilioinguinal nerve
    males: spermatic cord
    females: round ligament of uterus
43
Q

What aspect of the inguinal canal is palpable in both sexes?

A

superficial ring;

superior to pubic tubercle

44
Q

Explain the formation of the inguinal canal in females.

A

1) ovaries attached to:
- posterior abdominal wall
- perineum via gubernaculum (path of descent)
2) descent is restricted by uterus and upper gubernaculum

45
Q

In females, what does the gubernaculum become during formation of the inguinal canal?

A

upper gubernaculum: ovarian ligament

lower gubernaculum: round ligament of uterus

46
Q

Explain the formation of the inguinal canal in males.

A

1) testes descend along path of gubernaculum and processus vaginalis
2) pulls peritoneum, abdominal muscles, and fascia along with it (EXCEPT transversus abdominis muscle, which splits at gubernaculum)

47
Q

Describe the spermatic cord coverings and fascia from superficial to deep.

A
  • skin
  • external spermatic fascia from external oblique
  • Cremaster muscle & fascia from internal oblique
  • internal spermatic fascia from transversalis fascia
  • tunica vaginalis from peritoneum (doesn’t descend into scrotum like other coverings)
48
Q

What causes retraction of testicles?

A

contraction of Cremasteric muscle

49
Q

Define: inguinal hernia.

A

protrusion of abdominal contents (peritoneum and small intestine) through abdominal wall;
more common in men

50
Q

Define: indirect (congenital) inguinal herniation.

A

inguinal herniation thru inguinal canal;
pushes thru deep ring, LATERAL to inferior epigastric vessels;
can descend into scrotum along path of spermatic cord

51
Q

Define: direct inguinal herniation.

A

inguinal hernation thru Hesselbach’s (inguinal) triangle;
pushes thru MEDIAL to inferior epigastric vessels;
can involve superficial ring if severe enough

52
Q

What structures form Hesselbach’s (inguinal) triangle?

A
  • lateral border of rectus abdominis medially
  • inguinal ligament inferiorly
  • inferior epigastric vessels laterally