Lect 3 Anterior Abdomen, Inguinal Region, Peritoneum

Question 0

What is the cremasteric reflex in males?

Answer 0

• Stimulation of the inner thigh results in elevation of the corresponding testis into the inguinal canal - through contraction of cremasteric muscle.

Question 1

What does the external oblique muscle layer give rise to in testes?

Answer 1

external spermatic fascia

Question 2

What does the superficial fascia give rise to in the testes?

Answer 2

Dartos fascia and muscle

Question 3

Which abdominal layer is not represented in the scrotum?

Answer 3

transversus abdominis

Question 4

What does the transversalis fascia give rise to in testes?

Answer 4

internal spermatic fascia

Question 5

What does the peritoneum give rise to in testes?

Answer 5

the Processus Vaginalis, which will pinch off and form the parietal and visceral layers of the Tunica Vaginalis

Question 7

List the contents of the inguinal canal in males.

Answer 7

SC-I-G-L spermatic cord (everything within external spermatic fascia) ilioinguinal nerve genitofemoral nerve (genital branch) lymphatics from testes (goes to deep iliac nodes instead of superficial inguinal nodes)– important in testicular cancer

Question 7

Which organs are intraperitoneal?

Answer 7

sigmoid colon, stomach, D1, jejunum, ileum, cecum, transverse colon

Question 8

Which organs are retroperitoneal?

Answer 8

SAD-PUCKER Suprarenal glands Aorta/IVC Duodenum Pancreas Ureters Colon (ascending and descending) Kidneys Esophagus Rectum

Question 10

retroperitoneal organs

Answer 10

• Retroperitoneal organs are behind the parietal layer of peritoneum and are attached to the posterior abdominal wall - only partially covered by visceral peritoneum -much less mobile than intraperitoneal organs

Question 11

intraperitoneal organs

Answer 11

• Organs are completely surrounded by visceral peritoneum. - not attached to posterior abdominal wall, so these organs are much more mobile.

Question 12

Define “greater sac”

Answer 12

• area of the abdomen posterior+ inferior to the greater omentum, and contains the small intestines.

Question 13

Define “lesser sac”

Answer 13

• AKA omental bursa. Defined by the lesser momentum. - A blind-ended tube extending horizontally across the abdomen at T12: starting with omental foramen on right, ending with the dead end on left.

Question 13

rectovesicular pouch

Answer 13

In males, fluid accumulates here between the rectum and the bladder. It’s more difficult to get to the pouch in males but you would access it through the anterior wall of the rectum.

Question 14

Pouch of Douglas

Answer 14

• In females, fluid accumulates in the rectouterine pouch (between the rectum and the uterus) or the Pouch of Douglas. - Drain fluid by inserting a needle into the vagina and through the posterior fornix of the uterus.

Question 15

Layers of abdomen from skin to entering abdominal cavity:

Answer 15

skin Camper’s fascia Scarpas fascia (below umbilicus) external oblique muscle internal oblique muscle anterior rectus sheath rectus abdominis posterior rectus sheath transversus abdominis muscle fascia transversalis extraperitoneal fat peritoneum

Question 16

Lesser omentum

Answer 16

Double layer of peritoneum extending from porta hepatis of liver to lesser curvature of stomach and beginning of duodenum o Consists of hepatogastric and hepatoduodenal ligaments and forms anterior wall of lessersac o Contains the right and left gastric vessels o Its right free margin contains the proper hepatic artery, bile duct and portal vein

Question 18

inguinal ligament

Answer 18

Formed by lower border of external oblique aponeurosis. Passes between anterior superior iliac spine laterally and the pubic tubercle medially.

Question 18

Greater omentum

Answer 18

Hangs from the greater curvature of the stomach o Covers the transverse colon o Right and left gastroepiploic (omental) vessels are contained within it o Referred to as the “abdominal policeman” o Adheres to areas of inflammation

Question 19

Lacunar ligament

Answer 19

AKA Gimbernat’s ligament. - Crescent-shaped extension of fibers at the medial end of the inguinal ligament - Forms medial border of femoral ring and the floor of the inguinal canal.

Question 21

Scarpa’s fascia

Answer 21

• Deep membranous layer of superficial fascia inferior to umbilicus. Thin and membranous, no fat. - deep to Camper’s fascia.

Question 22

Dartos fascia

Answer 22

Specialized layer made of fused Camper’s and Scarpa’s fascia in the scrotum, contains smooth muscle fibers.

Question 23

Camper’s fascia

Answer 23

• fatty layer of superficial fascia, continuous over inguinal ligament and superficial fascia of the thigh. - Superficial veins, arteries and nerves reside in it. - In men, continuous with penis, then fuses with Scarpa’s, form dartos fascia in scrotum. - In women, component of labia majora.

Question 24

Pectineal ligament

Answer 24

AKA Cooper’s ligament. Formed by fibers extended from medial end of the lacunar ligament

Question 25

Describe the innervation of the anterior abdominal wall.

Answer 25

anterior rami of T7-L1. Somatic nerves, follow dermatomes. These nerves are also sensory to the parietal peritoneum.

Question 26

What does the internal oblique muscle layer give rise to in testes?

Answer 26

cremasteric muscle and fascia of spermatic cord

Question 27

List the contents of the inguinal canal in Female:

Answer 27

round ligament of the uterus ilioinguinal nerve genitofemoral nerve (genital branch) lymphatics** **allow some lymph from the vulva to drain up to the deep iliac nodes, instead of superficial inguinal nodes. Clinically important in external genitalia tumors.