WEEK 6

Question 1

Thoracic Wall Layers

Answer 1

• Skin
• superficial fascia
• external intercostals
• intermediate intercostals
• VAN
• Innermost intercostals
  
  • lateral innermost
  • anterior transverse thoracis
  • posterior subcostals
• Endothoracic fascia
• parietal pleura
• pleural cavity
• visceral cavity
• lung

Question 2

Abdominal Wall Layers

Answer 2

• Skin
• Superficial fascia
• External Abdominal Oblique
• Internal Abdominal oblique
• VAN
• Transverse abdominus
• transversalis fascia
• parietal peritoneum
• peritoneal cavity
• viceral peritoneum
• gut tube

Question 3

Spermatic Chord Layers + Abdominal Wall structures

Answer 3

• Ductus Deferens/ Testicular Arteries and Nerves Tunica vaginalis = Parietal Peritoneum
• Internal spermatic fascia = Transversalis fascia
• SKIPS THE TRANSVERSE ABDOMINUS
• Cremastor muscle = Internal abdominal oblique
• External spermatic fascia = External abdominal oblique

Question 4

What is the nervous innovation and embryology of the Diaphgram?

Answer 4

Innovated by the phrenic nerve C3,4,5

Embryology: Myotome in the cervical hypomere, hypaxial muscle, ventral medial lip, ventral primary ramus

Question 5

Thoracic Hypomeres: Thoracic Body wall Overview

Answer 5

Outer: External intercostals

Intermediate: Internal intercostals

(N.V.PLANE)

Inner: innermost intercostals , Transverse thoracis, Subcostals

Question 6

Thoracic Hypomere: Abdominal Body wall overview

Answer 6

Outer longitudinal layer - Linear Alba - Midclavicular line - Rectus abdominus - Pyramidalis Outer - External oblique Intermediate - internal oblique (N.V.PLANE) Inner - Transverse abdominis

Question 7

Name the 5 peritoneal folds

Answer 7

• x 1 Median umbilical fold
• x 2 Medial umbilical folds
• x 2 Lateral umbilical folds

Question 8

Inguinal Ligament

Answer 8

Not a true ligament but a fold in the aponeurosis of the external abdominal oblique Subinguinal space contains muscles and nerovasuclar structures Males: Spermatic chord layers Females: round ligament ilioingual nerve in both sexes

Question 9

Lumbar Hypomeres - Lumbar prevertebal muscles

Answer 9

Quadratus lumborum psoas major

Question 10

Sacral Hypomeres: Pelvic Wall Muscles + perineum

Answer 10

Pelvic Wall muscles:

• Obturator internus
• Piriformis

Perineum

• Urogenital
• Anal

Question 11

Sacral Hypomeres: Pelvic floor muscles

Answer 11

Pelvic flood muscles: - Levator ani puborectalis - levator ani pubococcygeus - levator ani illiococcygeus - ischiococcygeus

Question 12

Pelvic flood muscles

Answer 12

Question 13

Thoracic apetures of the diaphram

Answer 13

Vena caval appature (T8)

Oesophageal hiatus (T10)

Aortic hiatus (T12)

Question 14

Thoracic appature attachements of the diaphragm

Answer 14

Anterior: Xiphoid process

Posterior: medial and lateral acruate ligaments

Inferior: lumbar vertebral bodies via medial acrute ligmanents

Lateral: Inferior 6 costal cartilages

Question 15

Attachments of the Centeral tendon of the Diaphragm

Answer 15

Superior attachement: parietal pericardium

Inferior attachement: ligaments of the liver/ coranary ligament

Question 16

What are the Ligaments of the Diaphragm?

Answer 16

Median arcuate ligament: Arches over aorta and unites the left and right crus

Medial arcuate ligament: Arches over psoas major, L1,L2 VB and L1 TVP

Lateral arcuate ligament: Arches over quadratus lumborum. Tip of 12th rib

Question 17

Functions of the Diaphragm

Answer 17

Containment

Changes pressure within the thoracic and abdominal cavities

Respiration

Circulation

Sneezing, coughing, crying, urinating, defacating.

Question 18

Outer Thoracic Body Wall: External intercostals

Answer 18

Origin: Inferior border of the 1-11th rib

Insertion: Superior border of the ribs below origin site. Sloped inferomedially when viewed anteriorly.

Nervous Innovation: anterior rami of thoracic nerves (intecostal nerve)

Action: Elevate ribs and support

Incompleate incompleate anteriorly continuation of the external intercostal membrane that connects the sternum/costal margin.

Question 19

How can we distinguish the innermost intercostals from the external and internal intercostals?

Answer 19

1. Innermost intercostals are connected to the parietal plura via the endothoracic fascia.
2. Fibre direction
3. Innermost intercostals originate on the internal surface of the inferior borders of the ribs

Question 20

What ligmanents span over the psoas mj and quadratus lumborum?

Answer 20

Medial arcuate ligament passes over the psoas major. Lateral archuate ligament passes over the quadratus lumborum

Question 21

Which embryological section of the embryo do the abdominal flank muscles belong?

Answer 21

Hypaxial. prevertebral muscles.

Question 22

Which fascial structures separates the posterior layer of the rectus sheath from the peritoneum?

Answer 22

Transversalis fascia

Question 23

Features of the Median Umbilical ligament

Answer 23

only one

most medial

obliterated urachus

fiberous reminant of canal connecting fetal bladder to umbilicus

Question 24

Features of the Medial Umbilical ligament

Answer 24

Two

Contains left and right umbilical ligaments

reminance of umbilical arteries

Question 25

Features of Lateral umbilical folds

Answer 25

Two contain inferior epigastric artery, branch of external illiac most latera of the 3

Question 26

What is the fascia of the abdominal body wall?

Answer 26

Posterior + laterally : thoracolumbar fascia Anteriorly: rectus sheath

Question 27

Thoracic hypomeres: OUTER LAYER: External abdominal oblique (EAO)

Answer 27

Origin: Lower 8 ribs Insertion: anterior, superior iliac spine. half of the iliac creast, pubic tubercle, linear alba. becomes apponurotic in the MCL Direction of fasicles: lateral to medial, superior to inferior

Question 28

Abdominal hypomere: Abdominal Body wall: INTERMEDIATE LAYER Internal abdominal Oblique (IAO)

Answer 28

Deep to the EAO Origin: thoracolumbar fascia. iliac creast. inguinal ligament Insertion: Lower 4 ribs. Linear alba. pubic creast via conjoint tendon contributes to the cremastor muscle. directions of the fibers: inferior to superior, lateral to medial.

Question 29

Thoracic hypomers: Abdominal wall: INNER LAYER: Transversus abdominis

Answer 29

Deepest of lateral abdominal body wall lies deep to NV PLANE Origin: Thoracolumbar fascia, costal margin, illiac crest, inguinal ligament Insertion: linear alba, pubic crest via conjoint tendon Becomes apponurotic in the MCL Fascial direction: transversely orientated.

Question 30

Thoracic hypomeres: Abdominal body wall VENTRAL LONGITUDINAL LAYER: Rectus Abdominus

Answer 30

Origin: pubic symphasis. pubic crest Insertion: Xiphoid process. costal cartilages Muscle fibers are interupted by tendenous sections

Question 31

Abdominal body wall: VENTRAL LONGITUDINAL LAYER: Pyramidalis:

Answer 31

Present in 80% of people tenses linear alba lies within the rectus sheath anterior to inferior fibers of rectus abdominus

Question 32

Is the Inguinal Ligament a true ligament?

Answer 32

Not a true ligament but a fold in the apponurosis of EAO

Question 33

What runs through the inguinal cannal in females?

Answer 33

Round ligament illioinguinal nerve genitofemoral nerve blood and lymphatic vessles

Question 34

whats runs through the inguinal ligament in males?

Answer 34

Illioinguinal nerve genitofemoral nerve lympatics and blood vessles Spermatic chord

Question 35

What are the spermatic chord layers

Answer 35

Ductus deferins tunica vaginalis intenal spermatic fascia cremastor muscle external spermatic fascia skin

Question 36

What structures pass through the superficial inguinal ring?

Answer 36

no

Question 37

What structures makes up the inguinal canal?

Answer 37

Floor: inguinal ligmanent Roof: EAO, IAO, TA Sides: Transversalis fascia and EAO (wrapped around)

Question 38

What forms the deep and superficial rings?

Answer 38

Hiatus in the transversalis fascia forms the deep inguinal ring Hiatus in the EAO forms the superficial inguinal ring

Question 39

Name the 2 pelvic floor walls

Answer 39

obturator internus (lateral wall) Piraformis (posteriorsuperior wall)

Question 40

Name the pelvic floor

Answer 40

ischio coccygeus levator ani puborectalis (medial) levator ani pubococcygeus (intermediate) levator ani illiococcygeus (lateral)

Question 41

Name the two pelivic floor hiatus

Answer 41

Urogenital Anorectal

Question 42

What are the are the 3 muscles that form the levator ani

Answer 42

- levator ani puborectalis - levator ani pubococcygeus - levator ani illiococcygeus

Question 43

What are the external surfaces that make up the two perineum triangles?

Answer 43

Anterior: pubic symphysis Posterior: coccyx Lateral: ishial tuberosities