Anterior Abdominal Wall Flashcards

1
Q

Where does the abdominal cavity span from?

A

Just under the diaphragm superiorly to the pelvic inlet inferiorly

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2
Q

What are the nine regions of the abdominal cavity?

A

R and L Hypochondrium, R and L Flank, R and L Groin, Epigastric, Umbilical, and Pubic

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3
Q

What is the chondrium?

A

The cartilage inferior to the thorax

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4
Q

What are the nine layers of the anterolateral wall of the abdomen?

A

Skin, Camper’s fascia, Scarpa’s fascia, external oblique muscle, internal oblique muscle, transversus abdominis muscle, transversalis fascia, extraperitoneal fat, parietal peritoneum

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5
Q

What is Camper’s fascia also called?

A

Superficial fascia

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6
Q

What is Scarpa’s fascia also called?

A

Deep fascia

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7
Q

What are six pack abs muscles called?

A

Rectus abdominis muscle

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8
Q

What is the linea alba?

A

This is the medial most part of the abdominal wall

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9
Q

What direction do the external oblique and aponeurosis of the external oblique fibers run?

A

lateral superiorly to medial inferiorly, or at a rough 45 degree angle

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10
Q

What direction do the internal oblique and aponeurosis of the internal oblique fibers run?

A

Mostly medially

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11
Q

The rectus abdominis muscle has breaks in it that create the six pack abs, what are the breaks called?

A

Intramuscular attachments or tendenous intersections

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12
Q

These are the three muscles of the anterior abdominal wall that have aponeurosis that insert into the linea alba…

A

External oblique, internal oblique, and transversus abdominis

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13
Q

Medially the rectus abdominis muscle is surrounded by three layers of aponeurosis called what?

A

Rectus sheath

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14
Q

What direction does the rectus abdominis muscle run?

A

Completely horizontal

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15
Q

What two muscles are in the rectus sheath?

A

Rectus abdominis and pyramidalis muscles

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16
Q

What is the arcuate line?

A

A line that is midway between the umbilicus and pubic symphysis

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17
Q

Superior to the arcuate line the anterior layer of the rectus sheath is formed by what?

A

Aponeurosis of EO and 1/2 of IO

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18
Q

Superior to the arcuate line the posterior layer of the rectus sheath is formed by what?

A

Aponeurosis of 1/2 IO and TA, and transversalis fascia

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19
Q

Inferior to the arcuate line the anterior layer of the rectus sheath is formed by what?

A

Aponeurosis of EO, IO, and TA

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20
Q

Inferior to the arcuate line the posterior layer of the rectus sheath is formed by what?

A

Transversalis fascia

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21
Q

What are the five infraumbilical peritoneal folds?

A

Median umbilical fold, 2 medial umbilical folds, and 2 lateral umbilical folds

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22
Q

Where does the one median umbilical fold run from?

A

Urinary bladder to umbilicus

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23
Q

What does the one median umbilical fold cover?

A

Median umbilical ligament

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24
Q

What do the two medial umbilical folds cover?

A

Medial umbilical ligaments, and occluded portions of the umbilical arteries

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25
Q

What do the lateral umbilical folds cover?

A

Inferior epigastric vessels

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26
Q

What are the two superficial vessels of the anterior abdominal wall?

A

Circumflex iliac a. and v. and the epigastric a. and v.

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27
Q

What does the circumflex iliac vein drain?

A

Drains region of inguinal ligament to the femoral v.

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28
Q

What does the epigastric v. drain?

A

Drains abdomen inferior to umbilicus and that drains to the femoral v.

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29
Q

The circumflex iliac and epigastric aa. and vv. are in what tissues?

A

Superficial fat and fascia

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30
Q

The circumflex iliac a. originates from what and supplies what?

A

Branch of femoral a. and supplies region of inguinal ligament

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31
Q

The epigastric a. originates from what and supplies what?

A

Branch of femoral a. and supplies abdomen inferior to umbilicus

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32
Q

The deep circumflex iliac vessels are branch of what?

A

External iliac vessels

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33
Q

The deep circumflex iliac vessels run between what?

A

IO and TA

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34
Q

What do the deep circumflex iliac vessels supply?

A

Inferior lateral abdominal mm.

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35
Q

The inferior epigastric vessels are a branch of what?

A

External iliac vessels

36
Q

Where do the inferior epigastric vessels enter the posterior rectus sheath?

A

At the arcuate line

37
Q

What do the inferior epigastric vessels supply?

A

Lower rectus abdominus mm.

38
Q

The inferior epigastric vessels anastomose with what?

A

Superior epigastric

39
Q

Superior epigastric vessels are a branch of what?

A

Branch of internal thoracic (mammary)

40
Q

The superior epigastric vessels enter the rectus sheath where?

A

Lateral to the sternum

41
Q

What do the superior epigastric vessels supply?

A

Upper rectus abdominus mm.

42
Q

The superior epigastric vessels anastomose with what?

A

Inferior epigastric vessels

43
Q

Any time the word “phrenic” is used what should you think of?

A

Diaphragm

44
Q

The musculophrenic vessels are a branch of what?

A

Internal thoracic (mammary)

45
Q

The musculophrenic vessels run along what?

A

Costal cartilages

46
Q

The musculophrenic vessels supply what?

A

Upper abdominal mm. and diaphragm

47
Q

What generally innervates the anterior wall of the abdomen?

A

Ventral rami of T7-L1

48
Q

T7, T8, and T9 innervate what?

A

Supply region above umbilicus

49
Q

T10 innervates what?

A

Umbilical region

50
Q

T11, T12, and L1 innervate what?

A

Supply region below umbilicus

51
Q

Injury to T11, T12, and L1 nerves cause what?

A

Weakens the muscles in the inguinal region

52
Q

Rami comes from what?

A

Spinal nerves

53
Q

Where is the inguinal region?

A

Inferior lateral abdominal region, superior to thigh, medial to ilium, and lateral to pubic bone

54
Q

What are the four major things in the inguinal region?

A

Inguinal ligament, canal (male and female), superficial and deep rings of the inguinal canal, walls of the canal

55
Q

The inguinal ligament extends between what two structures?

A

Extends from ASIS to pubic tubercle

56
Q

What is the inguinal ligament made up of?

A

Folded inferior border of the EO aponeurosis

57
Q

How long is the inguinal canal?

A

3 to 5 cm

58
Q

What does the inguinal canal run along?

A

Runs parallel and superior to inguinal ligament

59
Q

What does the inguinal canal transverse?

A

Anterior abdominal wall

60
Q

What runs through a male inguinal canal?

A

Contains spermatic cord (vas defrens, testicular nn. and vessels, cremasteric muscle and fascia) and ilioinguinal n. (L1)

61
Q

What is contained in a female inguinal canal?

A

Round ligament of the uterus (corresponds to spermatic cord in male) and ilioinguinal n. (L1)

62
Q

What and where is the superficial ring of the inguinal canal?

A

An opening in EO aponeurosis. Obvious triangular opening lateral to pubic tubercle

63
Q

What and where is the inferior ring of the inguinal canal?

A

Opening in transversalis fascia. Subtle piercing just lateral to inferior epigastric vessels

64
Q

Which ring is more cranially located?

A

The deep ring

65
Q

What makes up the anterior wall of the inguinal canal?

A

EO aponeurosis

66
Q

What makes up the posterior wall of the inguinal canal?

A

Transversalis fascia and conjoint tendon. Fusion of IO, TA aponeurosis medially

67
Q

What makes up the roof of the inguinal canal?

A

IO and TA muscles (superior)

68
Q

What makes up the floor of the inguinal canal?

A

Inguinal ligament (inferior)

69
Q

What is the definition of an abdominal hernia?

A

An outpouching of abdominal viscera within a sac

70
Q

Hernial sac is composed of what three layers?

A

Peritoneum, peritoneal fat, and transversalis fascia

71
Q

Where does an indirect inguinal hernia extend?

A

Extends through entire inguinal canal

72
Q

What does the indirect inguinal hernia commonly enter?

A

Scrotum or labia majora

73
Q

What is the most common type of hernia?

A

Indirect inguinal hernia (more common in males than females)

74
Q

What is a direct inguinal hernia?

A

One that goes through the inguinal triangle (Hesselbach’s)

75
Q

What does the direct inguinal hernia emerge through?

A

Emerges through conjoint tendon by or at superficial ring

76
Q

What is a direct inguinal hernia usually associated with?

A

Weakened abdominal muscles

77
Q

Are direct inguinal hernias more common in males or females?

A

Males

78
Q

Are indirect inguinal hernias medial or lateral to the inferior epigastric muscles?

A

Lateral

79
Q

Are direct inguinal hernias medial or lateral to the inferior epigastric vessels?

A

Medial

80
Q

What is a femoral hernia?

A

One that passes through the femoral ring and canal

81
Q

Are femoral hernias more common in males or females?

A

Females

82
Q

What is an umbilical hernia?

A

One that passes through the umbilical ring

83
Q

Who do umbilical hernias happen commonly with?

A

Most common in new borns and common in females and extremely common in obese

84
Q

What is an epigastric hernia?

A

One that passes through the lina alba

85
Q

Who is commonly affected by epigastric hernias?

A

Those over 40 and obese