3-Anterior Abdominal Wall

Front 1

What is the osteological and soft tissue superior boundary of the abdomen?

Back 1

costal margin ribs 10-12 & xiphoid
resp diaphragm

Front 2

What is the osteological and soft tissue posterior boundary of the abdomen?

Back 2

lumbar vertebrae
posterior muscles

Front 3

What is the osteological and soft tissue anterolateral boundary of the abdomen?

Back 3

no osteologic
4 muscles (External & Internal Abdominal Obliques, transversus & rectus abdominis

Front 4

What is the osteological and soft tissue inferior boundary of the abdomen?

Back 4

pelvic brim
pelvic diaphragm

Front 5

The inferior edge of the costal margin is associated with which plane? What organs lie at this plane?

Back 5

subcostal plane
liver & spleen

Front 6

What is the umbilicus? Which plane is it associated with? Which vertabrae level is it aligned with?

Back 6

tissue remnant of umbilical cord
transumbilical plane
L3-4

Front 7

What is the name of the midline plane of the abdomen? What does it mark?

Back 7

linea alba
junction of L&R aponeuroses of anterior wall muscles

Front 8

What is the linea semilunaris?

Back 8

paramedian furrow at lateral edge of L&R rectus muscles

Front 9

What is the name of the transverse borders of the rectus muscles that give a washboard appearance?

Back 9

tendinous intersections

Front 10

What is the superior margin of the iliac bone?

Back 10

iliac crest

Front 11

What is the distal attachment point for the inguinal ligament? medial?

Back 11

ASIS
pubic tubercle

Front 12

Which nerve is associated with the location of the ASIS? What else is associated w/ this area?

Back 12

iliohypogastric nerve
appendectomy incision

Front 13

Which plane are the iliac tubercles associated with?

Back 13

transtubercular plane

Front 14

What are the R&L pubic bones separated by?

Back 14

symphysis pubis

Front 15

What helps approximate the midsagittal plane?

Back 15

linea alba

Front 16

Which planes divide the abdomen into quadrants?

Back 16

midsagittal and transumbilical

Front 17

Which transverse planes help divide the abdomen into 9 regions?

Back 17

transpyloric and transtubercular

Front 18

Which vertical planes divide the abdomen into 9 regions?

Back 18

midclavicular/midinguinal

Front 19

Name the medial regions (of the 9) from superior to inferior. From which gut derivative does each come?

Back 19

epigastric (foregut), umbilical (midgut), hypogastric (hindgut)

Front 20

Name the lateral regions (of the 9) from superior to inferior).

Back 20

hypochondriac, lumbar, inguinal

Front 21

Discuss the location of primary blood vessels in the abdomen.

Back 21

localized in defined areas and relatively void in other areas

Front 22

Name the 7 layers of the abdominal wall.

Back 22

skin, superficial fascia, deep fascia, muscles, transversalis fascia, subserous fascia, peritoneum

Front 23

What are the natural lines of folding in skin due to orientation of collagen fibers?

Back 23

langer lines

Front 24

What are the two layers of the superficial fascia?

Back 24

hypodermis, subcutaneous tissue

Front 25

What are the 2 layers of subcutaneous CT (2 names for each)?

Back 25

superficial fatty layer or Camper's fascia
superficial membranous layer or Scarpa's layer

Front 26

Which type of subcutaneous CT is only found in the lower 1/3 of the abdominal wall?

Back 26

Scarpa's layer

Front 27

What are the 3 different parts of the Scarpa's layer?

Back 27

false suspensory (or fundiform) ligament
Dartos Fascia and Colles fascia

Front 28

What does the false susensory ligament cover?

Back 28

penis/clitoris

Front 29

What does the Dartos FAscia cover?

Back 29

scrotum of males, labia majora of female

Front 30

What does the Colles fascia attach to?

Back 30

posterior edge of the urogenital diaphragm

Front 31

What type of injury is it when the urethra is torn below the urogenital diaphragm?

Back 31

Straddle Injury

Front 32

Which layer of the abdominal wall encloses the muscles?

Back 32

deep fascia

Front 33

Where is the transversalis fascia?

Back 33

posterior surface of transverse abdominis muscle

Front 34

What is the deepest layer of the abdominal wall?

Back 34

peritoneum

Front 35

Name the 3 flat muscles of the abdominal wall.

Back 35

external and internal abdominal obliques and transversus abdominis

Front 36

What nerves innervate the external and internal abdominal obliques and the transversus abdominis?

Back 36

T7-12 and L1

Front 37

What is the action of the external & internal abdominal obliques?

Back 37

compress, flex, rotate torso and protect internal organs

Front 38

What is the action of the transversus abdominis?

Back 38

compress abdomen and protect internal organs

Front 39

What does the aponeurosis of the external abdominal obliques form?

Back 39

inguinal ligament

Front 40

The common insertion area of the internal oblique and transversus is triangulated between the pecten pubis and the linea alba. What is this called?

Back 40

Conjoint Tendon (Falx Inguinalis)

Front 41

What is the origin and insertion of the external abdominal obliques?

Back 41

o-outer surface ribs 5-12
i-iliac & pubic crests; linea alba

Front 42

What is the origin and insertion of the internal abdominal oblique?

Back 42

o-iliac crest & posterior fascia & inguinal ligament
i-edge of ribs 7-12, linea alba, pubic crests

Front 43

What is the origin and insertion of the transversus abdominis?

Back 43

o-inner surface of ribs 7-12; iliac crest & posterior fascia; inguinal ligament
i-linea alba & pubic crests

Front 44

What is the origin and insertion of the rectus abdominis muscles?

Back 44

o-costal cartilage ribs 5-8 & xiphoid process

Front 45

What is the innervation of the rectus abdominis muscle?

Back 45

thoracic spinal nerves 7-12

Front 46

What is the action of the rectus abdominis?

Back 46

compress and protect abdomen; weak flexors of vertebral column

Front 47

What forms the washboard abs of the rectus abdominis?

Back 47

tendinous intersections (3)

Front 48

What is the vertical skin furrow createdc by the lateral edge of the rectus abdominis?

Back 48

linea semilunaris

Front 49

What forms the rectus sheath?

Back 49

aponeuroses of the 3 'flat' muscles extending medially to surround the recti muscles

Front 50

Which part of the rectus sheath is incomplete? Is it incomplete on the anterior or posterior side?

Back 50

lower 1/4
posterior

Front 51

Where are the superior epigastric vessels located?

Back 51

within the sheath on the posterior surface of the recti

Front 52

What is the line between the complete rectus sheath and incomplete sheath?

Back 52

arcuate line

Front 53

What is the name of the posterior sheath of the abdomen?

Back 53

transversalis fascia

Front 54

Where are the inferior epigastric vessels located?

Back 54

on posterior surface of recti

Front 55

What determines the dermatomes of the abdomen? (Specifically which nerves)

Back 55

peripheral distribution of spinal nerves T7-L1

Front 56

What is the reason for hypoplasia?

Back 56

dermatomes overlap, so w/ ablation of one nerve there is reduced senasation rather than anesthesia

Front 57

Which nerve(s) supply the epigastric region?

Back 57

T7-9

Front 58

Which nerve(s)supply the umbilical region?

Back 58

T10

Front 59

Which nerve(s) supply the upper hypogastric region?

Back 59

T11

Front 60

Which nerve(s) supply the middle hypogastric region? What is another name for the nerve at this level?

Back 60

T12
subcostal nerve

Front 61

Which nerves come from L1?

Back 61

iliohypogastric and ilioinguinal nerves

Front 62

What does the iliohypogastric nerve supply? Is it deep or superficial?

Back 62

lower hypogastric region
becomes superficial when it pierces EOM

Front 63

Where is the iliohypogastric N located w/ respect to the superficial inguinal ring?

Back 63

superior

Front 64

Which nerve emerges from the inguinal canal? What does it supply?

Back 64

ilioinguinal N
anteriomedial upper thigh, anterior scrotal wall and root of penis (or labia majora and clitoris in females)

Front 65

What does the superior epigastric artery stem from? Where is it located?

Back 65

from internal thoracic A
posterior to rectus abdominis

Front 66

What does the inferior epigastric A stem from? Where is it located?

Back 66

from External iliac
posterior to rectus

Front 67

What is the superfical epigastric artery stem from? What does it branch toward?

Back 67

femoral A
toward umbilicus

Front 68

What do the circumflex iliacs supply?

Back 68

inguinal regions

Front 69

What vein(s) drain the lumbar and hypochondriac regions?

Back 69

posterior intercostals

Front 70

What does the superior epigastric vein drain? What does it drain to?

Back 70

posterior surface of recti muscles
internal thoracic

Front 71

What is the connecting channel between the epigastric veins and lateral thoracic veins?

Back 71

thoracoepigastric

Front 72

Which vein(s) are in the falciform ligament of the liver?

Back 72

paraumbilical veins

Front 73

What do the paraumbilical veins link?

Back 73

superficial veins to the left branch of the portal vein

Front 74

Where does the blood from the lower quadrants of the abdomen drain?

Back 74

great saphenous

Front 75

Which veins empty blood from the abdomen into the great saphenous?

Back 75

superficial external pudendal, superficial circumflex iliac, superficial epigastric and inferior epigastric

Front 76

What are 5 normal protrusions of the abdomen?

Back 76

fat, flatus, feces, fluid, fetus

Front 77

What does the inguinal canal contain?

Back 77

spermatic cord or round ligament of the uterus, ilioinguinal nerve, genitofemoral nerve, fascia and CT, vascular & lymphatic vessels

Front 78

What is the extension of the aponeurosis of the external abdominal oblique that covers the spermatic cord?

Back 78

external spermatic fascia

Front 79

What is the superficial (external) inguinal ring?

Back 79

natural 'defect' in the EAO aponeurosis

Front 80

What are the borders of the inguinal ring called?

Back 80

medial and lateral crura

Front 81

What are the aponeurotic fibers that reinforce the superior margin of the ring? How does this attach to the crura?

Back 81

intercrural fibers
perpendicular to the crura

Front 82

What forms the 'roof' of the inguinal canal? What does it attach to?

Back 82

aponeurosis of internal abdominal oblique and aponeurosis of transversus abdominis
both attach medially to pubic tubercle, laterally to inguinal ligament

Front 83

The aponeurosis of internal abdominal oblique and the aponeurosis of transversus abdominis blend medially to form what?

Back 83

conjoined tendon

Front 84

What is the lateral inferior edge of the aponeurosis of transversus abdominis a border for?

Back 84

deep (internal) inguinal ring

Front 85

What is the deep inguinal ring filled with? What does this inner part extend over?

Back 85

transversalis fascia
internal spermatic fascia

Front 86

What forms the posterior wall of the inguinal canal?

Back 86

transversalis fascia and conjoint tendon

Front 87

What distinguishes inguinal hernias?

Back 87

their relationship to the inferior epigastric artery and their presence or absence within the inguinal canal

Front 88

What type of inguinal hernia is medial to the inferior epigastric artery? Does this type of hernia go through the inguinal triangle?

Back 88

direct
yes

Front 89

What binds the inguinal (Hesselbach's) triangle?

Back 89

inguinal ligament, lateral margin of rectus muscle and inferior epigastric artery

Front 90

What type of inguinal hernia is lateral to the inferior epigastric artery? Where does this type of hernia pass?

Back 90

indirect
goes into the passageway of the inguinal canal

Front 91

Which type of inguinal hernia is congenital? acquired?

Back 91

congenital-indirect
acquired-direct