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Flashcards in Blue Boxes 2: Abdominal Wall Deck (23)
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How do you elicit the superficial abdominal reflex?

Quickly stroking horizontally, lateral to medial, toward the umbilicus


What nerves are succeptible to injury in surgical incisions or trauma at any level of the abdominal wall?

Inferior thoracic spinal nerves (T7 - T12) and the iliohypogastric and ilio-inguinal nerves (L1)


Why is the rectus abdominis a surgical procedural exception?

Because surgeons transect it directly across its muscle bellies. Its muscle fibers run short distances between tendinous intersections, and the segmental nerves supplying it enter the lateral part of the rectus sheath where they can be located and preserved


Surgically, are muscles and viscera retracted toward, or away from their neurovascular supply?



Why can medial abdominal incisions preferably be made along the linea alba?

Because it only transmits small vessels and nerves to the skin, a midline incision is relatively bloodless and avoids major nerves. However, because of its poor blood supply, the linea alba may undergo necrosis if its edges are not aligned properly during closure


The direction of oblique and transverse incisions is decided by what factors?

Muscle fiber orientation, nearby hard tissue, minimizing potential nerve damage.


What is a Gridiron Incision?



Where is McBurney point?

2.5cm superomedial to the ASIS on the spino-umbilical line


What type of incision is often used for an appendectomy? Where is this incision made?

Gridiron incision at McBurney point


During an appendectomy at McBurney point, what nerve runs deep to the internal oblique and must be identified and preserved?



What are Suprapubic (Pfannenstiel) incisions?

"bikini" incisions made at the pubic hairline


What are suprapubic incisions used for?

Most gynecological and obstetrical operations, ex cesarean section


What nerves are identified and preserved during suprapubic incisions?

iliohypogastric and ilio-inguinal


Why are transverse incisions not made through the tendionous intersections of the rectus abdominus and instead are made through the muscle body

Cutaneous nerves and branches of the superior epigastric vessels pierce these fibrous regoins of the muscle


What type of incision would you use for an expoloratory procedure of the abdomen?

Median or midline incision, because it can be extended superiorly and inferiorly without created much more damage


What type of incisions provide access to the gallbladder and biliary ducts on the right side and the spleen on the left?

Subcostal incisions


What are two examples of high-risk incisions in the abdomen?

Pararectus (along lateral border of the rectus sheath - may cut of nerve supply to rectus abdominis)
Inguinal (may injure the ilio-inguinal nerve, used to repair inguinal hernias)


What is an incisional hernia?

A protrusion of an omentum or an organ through a surgical incision


What new technology is used to minimize the invasiveness of abdominal surguries?



When flow in the superior or inferior vc is obstructed, anastomoses between the tributaries of what major superficial abdominal veins may provide collateral pathways for bloodflow?

Thoraco-epigastric and superficial epigastric


What are Cryptorchid Testes?



What is the primary health concern of cryptorchidism (undescended testicle)?

Greatly increased risk for developing malignancy in the undescended testis, it is not palpable and is usually not detected until cancer has progressed


Where do undescended testes usually end up?

inguinal canal