L3 - Anterior Abdominal Wall Flashcards by Rawan Alkhateeb

Name the organs in the Right Upper Quadrant

Liver (Right Lobe)

- Gallbladder

- Stomach (Pylorus)

- Duodenum

- Right Kidney

- Pancreas (Head)

- Ascending Colon: Superior Part

- Transverse Colon: Right Half

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Name the organs in the Right Lower Quadrant

- Cecum

- Vermiform Appendix

- Most of Ileum

- Ascending Colon: Inferior Part

- Uterus (If enlarged)

- Urinary Bladder (If very full)

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Name the organs in the Left Upper Quadrant

- Liver: Left Lobe

- Spleen

- Stomach

- Jejunum and Proximal Ileum

- Pancreas: Body and Tail

- Transverse Colon: Left Half

- Descending Colon: Superior Part

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Name the organs in the Left Lower Quadrant

- Sigmoid Colon

- Descending Colon: Inferior Part

- Uterus (If enlarged)

- Urinary Bladder (If very full)

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Which of these are in the RLQ?

A. Liver

B. Transverse Colon

C. Cecum

D. Stomach

E. Sigmoid Colon

Cecum

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What are the layers of the Anterior Abdominal Wall?

Skin →

Camper’s Fascia →

Scarpa’s Fascia →

External Oblique →

Internal Oblique →

Transversus Abdominus Muscle →

Transversalis Fascia →

Parietal Peritoneum

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In the lower abdomen, there are two distinct layers

What are they?

Superficial fatty

Camper’s fascia
contains superficial veins

Membranous

Scarpa’s fascia
Gives rise to fundiform ligament of penis
Can be sutured

**Superficial Fascia contains both Camper’s and S_carpa’s Fascia_

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Scarpa’s Fascia turns into all the following EXCEPT:

Fundiform Ligament of the Penis

Superficial penile Fascia

Tunica Dartos of the Scrotum

None of the above

None of the above

Scarpa’s Fascia turns into:

Fundiform Ligament of the Penis
Superficial penile Fascia
Tunica Dartos of the Scrotum

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True or False

You CANNOT suture Camper’s Fascia, you CAN suture Scarpa’s Fascia

True

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A lot of anastomose is in the:

umbilical cord
esophagus
rectum

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What can Portal Hypertension lead to?

Caput Medusae

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Membranous Layer of Superficial Fascia aka Scarpas Fascia is continuous with the

Tunica Dartos of the scrotum

and

Superficial penile fascia

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What is the Deep Inguinal Ring made by?

Transversalis Fascia

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What structure is this?

Inguinal Ligament

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What structure is this?

Lacunar Ligament

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What structure is this?

Anterior Inguinal ligament

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What structure is this?

Conjoint tendon

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What structure is this?

Superficial inguinal ring

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The superior and inferior crus are also known as

medial crus

lateral crus

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External Oblique Muscle

Name its origin and insertion

Origin

Outer surface of ribs 6-12

Insertion

Linea alba

Pubic tubercle

Anterior ½ of iliac crest

*Aponeurotic fibers form external spermatic fascia

Same direction as the external intercostals

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when it goes into the scrotum, External Oblique →

External Spermatic Fascia

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Internal Oblique Muscle

Name its origin and insertion

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Origin

Thoracolumbar fascia

Anterior 2/3 of iliac crest

Lateral ½ of inguinal ligament

Insertion

Inferior borders 10-12th ribs

Linea alba

Pubis via conjoint tendon

Gives rise to the cremaster muscle

when it goes into the scrotum, Internal Oblique →

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Cremaster Muscle

Transversus Abdominis Muscle

Name its origin

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Origin

Inner surfaces of 7th-12th costal cartilages

Thoracolumbar fascia

Iliac crest

Lateral 1/3rd of inguinal ligament

**Transversalis Fascia**

- Helps form posterior wall of rectus sheath above arcuate line - Forms posterior wall of rectus sheath below arcuate line - Continues over spermatic cord as internal spermatic fascia **ALWAYS on the posterior wall of the rectus sheath**

when it goes into the scrotum, Transveralis Fascia →

**Internal Spermatic Fascia**

**Inner View of Anterolateral Abdominal Wall** What are the five folds of the peritoneum?

**Median umbilical fold (1)** **(down the midline)** - over remnant of urachus **Medial umbilical fold or ligaments (2)** - over obliterated fetal - umbilical arteries **Lateral umbilical folds (2)** - over inferior epigastric - vessels only fold functioning in our body right now

What is the site of the direct inguinal hernia and where does it occur?

**Inguinal triangle** occur **medial** to the **inferior epigastric vessels**

Direct vs. Indirect Hernias

_Direct_: - MEDIAL to the Inferior Epigastric Vessels Inside the Inguinal Triangle _Indirect_: LATERAL to the Inferior Epigastric Vessels

True or False The rectus sheath only surrounds the anterior rectus abdominal muscle

**False** rectus sheath surrounds both the anterior and posterior rectus abdominal muscle

Above Arcuate Line What is found on the Anterior and Posterior to Rectus Abdominus?

**Anterior to Rectus Abdominus:** - External Oblique - Internal Oblique (1/2) **Posterior to Rectus Abdominus:** - Internal Oblique (1/2) - Transversus Abdominus - Transversalis Fascia - Parietal Peritoneum

Below Arcuate Line What is found on the Anterior and Posterior to Rectus Abdominus?

**Anterior to Rectus Abdominus:** - External Oblique - Internal Oblique - Transversus Abdominus **Posterior to Rectus Abdominus:** - Transversalis Fascia - Parietal Peritoneum

The lateral folds on the anterior abdominal wall contain which structure(s)? A. Inferior Epigastric Vessels B. Remnant of the Urachus C. Remnant of the Obliterated Umbilical Arteries D. Superior Epigastric Vessels

**A. Inferior Epigastric Vessels**

**Inguinal Ligament** What does it represent where does it run, and what does it form?

Represents --\> inferior border of the abdomen Runs --\> from the anterior superior iliac spine to the pubic tubercle Forms --\> the major part of the floor of the inguinal canal

What is the External/Superficial Ring made by? What is the Internal/Deep Ring made by?

Made by **External Oblique Aponeurosis** Made by the **Transversalis Fascia**

What is the Conjoint Tendon: made by?

Made by **Internal Oblique and Transversus Abdominus**

The external spermatic fascia, cremaster muscle, and the internal spermatic fascia the spermatic cord

**SURROUND**

Testicular artery & vein + Vas deferns = Transversus Abdominus + Internal Oblique =

**Spermatic Cord** **Conjoint Tendon**

Which structure helps form the deep/internal inguinal ring? A. Transversalis Fascia B. External Oblique C. Internal Oblique Aponeurosis D. Transversus Abdominus Muscle

**A. Transversalis Fascia**

For Females: The only thing that runs through the inguinal canal (that we need to know) is

**- round ligament of the uterus** **- the ilioinguinal nerve** **- the genital branch of the genitofemoral nerve**

True or False The ilioinguinal nerve runs through the inguinal canal but is not inside the spermatic cord.

True These rings of inguinal canal allow for protection of the peritoneum during increased abdominal pressure

Arterial, venous, and lymphatic supply to the testes originates from where?

the **abdominal area**

Female Inguinal Canal

What are the Floor, Roof, and Walls of the Inguinal Canal?

**Roof** fibers of internal oblique and transversus **Anterior Wall** aponeurosis of external oblique and internal oblique **Floor** lower edge of inguinal ligament and lacunar ligaments **Posterior wall** conjoint tendon and transversalis fascia

MALT stands for what?

**M: Muscles** **Roof:** Internal Oblique and Transversus Abdominus Muscles **A: Aponeuroses** **Anterior Wall:** Aponeuroses of External and Internal Oblique **L: Ligaments** **Floor:** Inguinal and Lacunar Ligaments **T: Tendons** **Posterior Wall:** Conjoint Tendon and Transversalis Fascia

When does the Processus Vaginalis fuse together?

**once the testes has descended**

True or False Rectus Abdominus and Transversus Abdominus contribute to the surrounding of the testes

**False** Rectus Abdominus and Transversus Abdominus **do NOT** contribute to the surrounding of the testes

What is the covering of the indirect Hernia? What is the covering for the Direct Hernia?

Indirect Hernia = **Peritoneum** AND **Spermatic Cord** Direct Hernia = ONLY **Peritoneum**

Indirect Hernia Pathway:

Deep inguinal ring → Superficial inguinal ring → Into the scrotum

Direct Hernia associated with: Indirect hernia associated with:

- side of finger - tip of finger

L3 - Anterior Abdominal Wall Flashcards

(53 cards)