Anterior abdominal wall, inguinal canal and testis

Question 1

What are the semilunar lines of surface anatomy of anterior abdominal wall?

Answer 1

curved lines marking lateral limit of rectus abdominis

Question 2

What are tendinous intersections

Answer 2

segment rectus abdominus and connect to anterior wall of aponeurotic coverings

Question 3

What do the tendinous intersections prevent?

Answer 3

Bowstringing

Question 4

What is the linea alba?

Answer 4

Midline tendinous line from xiphoid of sternum to pubic symphysis
Where aponeuroses of abdominal muscles meet

Question 5

Why is the umbilicus important?

Answer 5

All layers of the wall fuse at this point (around L3-L4)

Question 6

What do the thoracoabdominal nerves innervate?

Answer 6

T7-T11

T12 is a subcostal nerve

Question 7

What nerves come from the lumbar plexus?

Answer 7

Iliohypogastric (L1)

Ilioinguinal (L1)

Question 8

What does the ilioinguinal nerve go down to?

Answer 8

Spermatic cord and ends up in scrotum and labia majora for females

Question 9

Describe the layers of the abdominal wall

Answer 9

Skin
Fattey layer of superficial fascia (Camper’s)
Membranous layer of superficial fascia (Scarpa’s)
External oblique muscle
external oblique muscle
transversus abdominis muscle
(fascia in between each muscle)

transversalias fascia
parietal peritoneum

Question 10

Rectus abdominis sheath above umbilicus

Answer 10

External abdominal oblique aponeurosis above rectus abdominus muscle
internal abdominal oblique aponeurosis both anterior and posterior to RA muscle
Transverse abdominal aponeurosis, transversalis fascia and posterior rectus sheath posterior to RA muscle

Question 11

What is the anterior rectus sheath above the umbilicus composed of?

Answer 11

External abdominal oblique aponeurosis

Internal abdominal oblique aponeurosis

Question 12

What is the posterior rectus sheath above the umbilicus composed of?

Answer 12

Internal abdominal oblique aponeurosis
Transverse abdominal aponeurosis
Transversalis fascia
parietal peritoneum

Question 13

What is the anterior rectus sheath below the umbilicus composed of?

Answer 13

External abdominal oblique aponeurosis
Internal abdominal oblique aponeurosis
Transverse abdominal aponeurosis

Question 14

What is the posterior rectus sheath below the umbilicus composed of?

Answer 14

Transverse abdominal aponeurosis

transversalis fascia

Question 15

Where are most of the direct inguinal hernias happen?

Answer 15

Inguinal triangle of Hesselbach

Question 16

What are the inguinal triangle of Hesselbach borders?

Answer 16

lateral border of rectus muscle
inguinal ligament
inferior epigastric vessels

Question 17

What does the lateral umbilical fold have with it?

Answer 17

Inferior epigastric artery and vein

Question 18

What does the medial umbilical fold have with it?

Answer 18

Medial umbilical ligament

Question 19

What does the median umbilical gold have with it?

Answer 19

Median umbilical ligament

Question 20

What is the course of the inguinal canal?

Answer 20

Goes through deep inguinal ring and through superficial inguinal ring (oblique route)

Question 21

Why is the inguinal canal important?

Answer 21

Allows the scrotum to move outside of the body without letting other structures to leave

Question 22

What is the transversalis fascia within the scrotum?

Answer 22

Internal spermatic fascia

Question 23

What is the cremaster muscle and fascia function?

Answer 23

elevate the testes

Question 24

What is the cremaster muscle and fascia formed by?

Answer 24

Internal abdominal oblique muscle

Question 25

What does the external abdominal oblique aponeurosis from once in the scrotum?

Answer 25

External spermatic fascia

Question 26

What dose the dartos muscle do?

Answer 26

Wrinkles skin of the scrotum

Question 27

What does the dartos muscle come from?

Answer 27

Scarpa's fascia

Question 28

Is the camper's fascia found in scrotum?

Answer 28

NO

Question 29

From outside to inside describe the testis

Answer 29

External spermatic fascia Cremaster muscle Internal spermatic fascia

Question 30

What is found inside the spermatic cord?

Answer 30

Pampiniform plexus of veins testicular artery ductus deferens

Question 31

Define a hernia

Answer 31

Protrusion of a structure outside the compartment of the anatomic location

Question 32

What is the herniated sac

Answer 32

outpouching of peritoneum

Question 33

What are inguinal hernias?

Answer 33

Protrusion of a portion of an abdominal structure through the superficial inguinal ring

Question 34

Indirect hernias are

Answer 34

oblique and travel through entire length of inguinal canal | from deep inguinal ring to superficial inguinal ring

Question 35

Direct hernias are

Answer 35

pushes structures directly though the wall and end up through superficial inguinal ring

Question 36

What is a reducible hernia

Answer 36

see the bulge and able to push it back into the abdomen

Question 37

What is a irreducible hernia

Answer 37

not able to be pushed back

Question 38

What is a incarcerated hernia

Answer 38

Affecting blood supply

Question 39

What are the types of incarcerated hernias?

Answer 39

Obstructed (trapped tissue) | Strangulated (resulting in gangrene)

Question 40

Which type of hernia is always within the internal spermatic fascia?

Answer 40

Indirect inguinal hernia

Question 41

Which type of hernia is always outside the internal spermatic fascia?

Answer 41

Direct inguinal hernia

Question 42

Are direct inguinal hernias medial or lateral to inferior epigastric vessels?

Answer 42

Medial

Question 43

Are indirect inguinal hernias medial or lateral to inferior epigastric vessels?

Answer 43

Lateral

Question 44

What type of inguinal hernia are most commonly present in infants, children, and young adults?

Answer 44

Indirect

Question 45

What type of inguinal hernia are most commonly present in older men?

Answer 45

Direct

Question 46

What type of hernia protrudes directly through the abdominal wall?

Answer 46

Direct

Question 47

What type of hernia exit through superficial inguinal ring?

Answer 47

BOTH direct and indirect

Question 48

What type of inguinal hernia is acquired as a result of a developed weakness of the transversalis fascia?

Answer 48

Direct

Question 49

Herniorrhaphy

Answer 49

surgical repair of hernia

Question 50

Tension free (mesh) repairs

Answer 50

use of synthetic sheets

Question 51

what is the capsule of the testes?

Answer 51

Tunica albuginea

Question 52

Where is the primary site where sperm begins to develop?

Answer 52

Seminiferous tubules

Question 53

Layers of tunica vaginalis

Answer 53

Parietal layer cavity Visceral layer (inner most right on testes)

Question 54

Explain hydrocele

Answer 54

Presence of fluid of cavity in the tunica vaginalis enlargement of testes able to hold a light behind scrotum and see clear fluid through testis

Question 55

Varicocele is what?

Answer 55

Enlarges veins around scrotum | worm like

Question 56

anechoic ultrasound

Answer 56

Show black in US image

Question 57

Hypoechoic ultrasound

Answer 57

Reflect back but doesnt reflect as much compared to surrounding tissues

Question 58

Hyperechoic ultrasound

Answer 58

More reflective -- shows up brighter