GI 4 - Abdominal Wall + Hernias Flashcards Preview

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Flashcards in GI 4 - Abdominal Wall + Hernias Deck (30):
1

Name the 5 muscles which form the anterolateral abdominal wall:

1) External obliques
2) Internal obliques
3) Transverse abdominis
4) Rectus abdominis
5) Pyramidalis

2

What is the function of the anterolateral abdominal wall?

- Forms firm flexible wall
- Protects abdominal viscera
- Assists forced expiration
- Allows increased abdominal pressure for coughing/vomiting etc

3

Name the straight line down the middle of the rectus abdominis:

Linea alba

4

Where is the arcuate line? What is its significance?

1/3rd between the umbilicus and pubic symphysis

- Above this line = anterior and posterior shealth surrounding rectus abdominis
- Below this line = only anterior sheath

5

Why are most abdominal incisions performed through tendond/aponeurosis, not muscle?

- Tendons can be stitched back together to provide strength
- Muscles cannot be stitched - they shred

6

Where is the incision for an appendicetomy performed? What type of incision is it?

- McBurney's point = 2/3rds from umbilicus to ASIS
- Grid-iron incision

7

Why is a C- section performed below the arcuate line?

No posterior sheath behind the rectus abdominus
= Better recovery

8

What is Ectopia cordis?

- Congenital
- Heart either partially or completely outside thorax

9

What is the presentation of a patent urachus?

Urine from umbilicus

10

What is the presentation of a patent vitelline duct?

Faeces from the umbilicus

11

What is exomphalos?

- Congenital
- Failure of abdominal contents to move into abdomen after development
- Viscera covered by peritoneum

12

What is gastroschisis?

Abdominal content's do not move into abdomen after development
- Viscera not covered by peritoneum

13

What is the difference between exomphalos and gastroschisis?

Exomphalos - abdominal contents covered by peritoneum
Gastroschisis - abdominal contents not covered by peritoneum

14

What can cause visceral pain?

- Inflammation
- Ischaemia
- Stretch

15

Explain somatic referred pain:

Pain caused to proximal part of somatic nerve may be percieved in the distal dermatome of the nerve

16

What structures divide the peritoneal cavity into the greater and lesser sacs?

Greater omentum
Lesser omentum

17

What structure divides the greater omentum into the supra- and infra-colic compartments?

Transverse mesocolon

18

What GI structures are present in the supracolic compartment?

- Abdominal oesophagus
- Stomach
- Liver
- Spleen
- Upper part of duodenum

19

What GI structures are present in the infracolic compartments?

- Small intestine
- Ascending colon
- Descending colon

20

Name the structures which connect the supra- and infracolic compartments:

Left and right paracolic gutter's

21

Name the structures in the free edge of the lesser omentum:

- Hepatic artery
- Hepatic portal vein
- Common bile duct

22

Name the extensions of the peritoneal membrane, in which fluid can collect:

- Rectouterine pouch (women)
- Vesicouterine pouch (women)
- Rectovesicle pouch (men)
- Paracolic gutters
- Hepatorenal pouch

23

Where are the main sites of potential weakness in the abdominal wall?

- Umbilical area
- Femoral cana
- Inguinal canal
- Site of previous abdominal surgery

24

What are the anterior and posterior walls of the inguinal canal?

Anterior = External obliques
Posterior = Transversalis fascia + Conjoint tendon (medially)

25

What structures form the roof and floor of the inguinal canal?

Roof = Muscular arches + aponeuroses of internal oblique + transverse abdominus
Floor = Inguinal ligament + lacunar ligament (medially)

26

Which structure lies at the midpoint of the inguinal ligament?

Deep inguinal ring

27

What structure lies at the mid-inguinal point?

Femoral artery

28

What is the length of the inguinal canal?

~ 4 cm

29

Define hernia:

Protrusion of organ through a cavity wall of which it is normally contained

30

What is the difference between direct and indirect hernias, in regards to their origin?

Direct = originate medial to inferior epigastric vessels
Indirect = originate lateral to inferior epigastric vessels