Regional Anatomy of Abdominal Wall and Inguinal canal

Question 1

Where does the aponeurotic sheath attach to?

Answer 1

• xiphisternal joint and iliac crest

- holds it in place and helps with flexion

Question 2

What are the tendinous intersections?

Answer 2

• are part of thre rectus sheath that extend to midline

Question 3

What happens when the tendinous intersections are strong?

Answer 3

• can cause loosening of inguinal ligament and cause herniation especially in men

Question 4

What are the 4 main supportive structures of the abdominal wall?

Answer 4

1. inguinal ligament
2. transversalis fascia
3. extraperitoneal fat
4. parietal peritoneum

Question 5

Why does the spermartic cord runs on a oblique plane through the inguinal canal?

Answer 5

Because the deep inguinal canal is more lateral compared to the external inguinal ring which is more medial

Question 6

What are the features of the male inguinal canal?

Answer 6

1. 4-5cm long (wider and longer due to the spermatic cord)

2. extends through anterolateral muscles of abdominal wall

Question 7

What is the superficial inguinal ring?

Answer 7

• inferomedial opening in aponeurosis of external obliquus abdominus

Question 8

Describe the structures that the spermatic cord pass through in the inguinal canal? (internal to external)

Answer 8

1. parietal peritoneum
2. extra peritoneal connective tissue
3. transveralis fascia (opening of deep inginual ring)
4. tranversalis abdmoninis
5. aponeurosis of transversalis abdominsi
6. internal obliquus abdominis
7. aponeurosis of the external obliquus abdominis (superficial inguinal ring)

Question 9

What is the contents of the male inguinal canal?

Answer 9

• spermatic cord

Question 10

What is the contents of the female inguinal canal?

Answer 10

• round ligament of uterus
• fat pad
• blood vessels and nerves

Question 11

What is the inguinal hernia?

Answer 11

• protrusion of a peritoneal sac with or without abdominal content (usually small intestine) through a weakened part of abdominal wall of inguinal region

Question 12

What are the two types of inguinal hernias?

Answer 12

1. direct

2. indirect

Question 13

What is an indirect hernia?

Answer 13

passes through the deep inguinal ring into the inguinal ring

Question 14

What is a direct hernia?

Answer 14

passes through the posterior wall of inguinal canal

Question 15

Why are direct hernias more common in males compared to females?

Answer 15

• because the diameter of the deep inguinal ring is much larger in males due to the spermatic cord

Question 16

Why are direct hernias less common then direct hernias?

Answer 16

• because the peritoneum will push it back

Question 17

What are the 4 major muscles of the posterior abdominal wall?

Answer 17

1. psoas major
2. iliacus
3. iliopsoas
4. quadratus lumborum

Question 18

What is the surface anatomy of the abdomen?

Answer 18

1. epigastric fossa
2. umbilicus
3. linea alba
4. inguinal groove
5. linea semilunaris
6. tendinous intersection of rectus abdominis
7. anterior superior iliac spine

Question 19

What is the epigastric fossa?

Answer 19

a depression inferior to the xiphisternal joint

Question 20

What is the linea alba?

Answer 20

Is the depression down the mid-line of the body between the xiphersternal joint and to the pubic symphysis

Question 21

What is the inguinal groove?

Answer 21

the depression coursing the inguinal ligament

Question 22

What is the linea semilunaris?

Answer 22

bilateral vertical curved line in the anterior abdominal wall where the layers of the rectus sheath fuse lateral to the rectus abdominis muscle and medial to the oblique muscles

Question 23

What and where are the tendinous intersections of the rectus abdominis?

Answer 23

The rectus abdominis is crossed by three fibrous bands called the tendinous intersections

• umbilicus
• xiphoid process
• mid way between the umbilicus and xiphoid process

Question 24

What are the four anatomical planes of the abdominal cavity?

Answer 24

1. midclavicular x2
2. transtubercular
3. transpyloric
4. subcostal

Question 25

What are the landmarks through which the transtubecular plane passes?

Answer 25

Transverse plane coursing through the left and right iliac tubercle of the iliac crest

Question 26

What are the landmarks through which the transpyloric plane passes?

Answer 26

Transverse plane passing between the midpoint of the superior manubrium and the pubic symphysis

Question 27

What are the landmarks through which the midclavicular plane passes?

Answer 27

Vertical plane passing between the midpoint of the medial and lateral points of the clavicle

Question 28

What are the landmarks through which the subcostal plane passes?

Answer 28

Transverse plane passing to the most inferior costal cartilages

Question 29

What are the 3 regions superior to the transpyloric plane?

Answer 29

1. right hypochondriac region
2. epigastric region
3. left hypochondriac region

Question 30

What are the 3 regions inferior to the transpyloric plane and superior to the transtubercular plane?

Answer 30

1. right lumbar region
2. umbilical region
3. left lumbar region

Question 31

What are the 3 regions inferior to the transtubercular plane?

Answer 31

1. right iliac (inguinal) region
2. hypogastric (pubic) region
3. left iliac (inguinal) region