Anterior Abdominal wall

Question 1

What are the 9 regions of the abdomen?

Answer 1

(right to left, top to bottom)

• Right hypochondrium
• Epigastric region
• Left Hypochondrium
• right flank
• umbilical region
• left flank
• right groin
• pubic region
• left groin

Question 2

What are the layers of the Anterolateral wall?

Answer 2

• Skin
• Superficial fatty layer (Camper fascia)
• External oblique M.
• Internal oblique M.
• Transversus abdominis M
• Endo-abdominal fascia
• Extraperitoneal fat
• Parietal Peritoneum

Question 3

What are the muscles of the abdominal wall?

Answer 3

• External oblique M
• Rectus abdominus muscle (Abs)
• Internal Oblique muscle
• Transversus abdominus muscle

Question 4

What is the Linea alba?

Answer 4

the medial border of the rectus muscles.

Question 5

What is the Rectus Sheath?

Answer 5

a Aponeurotic (tendinous) sheath that envelopes the rectus abdominus & Pyramidialis muscles.
*Consists of Ant. & Post. layers.

Question 6

What is the Arcuate line?

Answer 6

Dividing line between rectus sheath and transversals fascia (Pubic area fascia) *rectus sheath is superior.

Question 7

What forms the Anterior layer of the Superior Rectus sheath?

Answer 7

Formed by aponeuroses of EO & 1/2 IO

Question 8

What forms the Posterior layer of the superior rectus sheath?

Answer 8

Ford by aponeuroses of 1/2 IO & TA & Transversalis fascia

Question 9

What forms the anterior layer of the inferior (to arcuate line) rectus sheath?

Answer 9

Formed by aponeuroses of EO, IO & TA

Question 10

What forms the posterior layer of the inferior rectus sheath?

Answer 10

Formed by transversalis fascia

Question 11

What are the three Infraumbilical peritoneal folds?

Answer 11

• Median fold = from urinary tract to umbilicus, covers median umbilical ligament.
• Medial fold (2) = covers medial umbilical ligaments,, occulded portions of umbilical arteries
• Lateral Umbilical Folds (2) = covers inferior epigastric vessels.

Question 12

Name the 4 superficial vessels of the Ant. abdominal wall…

Answer 12

• Circumflex Iliac A. = branch of femoral A. supplies region of inguinal ligament.
• Circumflex Iliac V. = drains to femoral V. drains region of inguinal ligament.
• Epigastric A. = branch of femoral A. supplies abdomen inferior to umbilicus
• Epigastric V. = Drains to femoral V. drains abdomen inferior to umbilicus

Question 13

What are the Deep Circumflex vessels?

Answer 13

• Branches of External Iliac
• Runs between IO & TA
• Supplies inferior lateral abdominal muscle.

Question 14

Describe the Inferior Epigastric vessels…

Answer 14

• Branches of External Iliac
• Enters posterior rectus sheath at arcuate line
• Supplies lower rectus abdominus muscle.
• anastomoses with Sup. Epigastric

Question 15

Describe Superior Epigastric vessels…

Answer 15

• Branch of Internal Thoracic
• Enters posterior rectus sheath lat. to sternum.
• Supplies upper rectus muscles.
• Anastomoses with Inf. Epigastric.

Question 16

Describe Músculophrenic vessels….

Answer 16

• branch of internal Thoracic
• Runs along costal cartilages
• supplies upp abdominal muscles and diaphragm.

Question 17

__, ___ & _____ supply innervation to regions above umbilicus.

Answer 17

(Ventral rami)T7, T8 & T9 (Spinal nerve)

Question 18

_____ supplies innervation to umbilical region.

Answer 18

(Ventral rami) T10 (Spinal nerve)

Question 19

____, ____ & ____ supply innervation to region below umbilicus (Runs between IO and TA muscles)

Answer 19

(Ventral rami) T11, T12 & L1 (Spinal nerve)

Question 20

Clinical significance of injury to Ventral rami of T11, T12 & L1?

Answer 20

Injury weakens muscles in inguinal region and predisposes to developing direct inguinal hernias.

Question 21

Where is the Inguinal region?

Answer 21

Inferior lateral abdominal region

• Superior to thigh
• medial to illum
• lateral to pubic bone

Question 22

What is the Inguinal ligament?

Answer 22

Folded inferior border of the Eo Aponeurosis

- Extends from ASIS to pubic tubercle

Question 23

What is the Inguinal canal?

Answer 23

obliquley set tunnel 3-5cm long that transverse the anterior abdominal wall.
*Runs parallel & Superior to inguinal ligament

Question 24

What is the difference between the male inguinal canal and female inguinal canal?

Answer 24

Male = contains spermatic cord & its contents (& Ilioinguinal nerve L1)

Female = Contains round ligament of uterus (& Ilionguinal nerve L1)

Question 25

Describe the two Inguinal canal rings….

Answer 25

Superficial ring = opening in EO aponeurosis (triangular opening lateral to pubic tubercle.)

Deep Ring = opening in transversalis fascia (Subtle piercing just lateral to inferior epigastric vessels.)
*NOTE: THE CANAL EXTENDS BETWEEN THE TWO RINGS!

Question 26

What are the borders of the Inguinal Canal?

Answer 26

Ant. Wall = EO aponeurosis
Post. Wall = transversalis fascia & Conjoint tendon
Roof = IO & TA muscles
Floor = Inguinal ligament

Question 27

%90 of hernias occur in the _____ region

Answer 27

Inguinal region

Question 28

_______ is a outputting of abdominal viscera within a sac.

Answer 28

Abdominal hernia

Question 29

The Hernial sac is composed of 3 layers, what are they?

Answer 29

• Peritoneum
• extraperitoneal fat
• Trasversalis fascia

Question 30

Define a Indirect Inguinal Hernia…

Answer 30

• extends through entire Inguinal canal

- Most common type (More common in males)

Question 31

Define a Direct Inguinal Hernia…

Answer 31

• Herniation thru the inguinal triangle
• emerges thru conjoint tendon by or at superficial ring.
• Usually does not enter the scrotum or labia majora
• More common on males.
• Usually associated with weak abdominal wall.

Question 32

Femoral ring hernia definition?

Answer 32

• Herniation thru femoral ring & canal (More common in women)

Question 33

Umbilical hernia defintion?

Answer 33

• Herniation thru umbilical ring
• most common in newborns
• more common in women and obese people.

Question 34

Epigastric Hernia definition?

Answer 34

• Herniation thru the linea alba
• most common in over 40 crowd
• Usually associated with obesity.