Anatomy Unit 30: Anterior Abdominal Wall And Inguinal Reigon

Front 1

Sacral Promontory

Back 1

Imaginary line which separates abdominal and pelvic cavity.

Front 2

Vertebral level of iliac crest

Back 2

LV 4

Front 3

Vertebral level of Tubercle of iliac crest

Back 3

LV5

Front 4

Planes which separate abdomen into 4 quadrants and the quadrants themselves.

Back 4

Mid-saggital plane and and horizontal plane which pass through umbilicus.
Upper right, Upper left, Lower right, Lower left

Front 5

2 Vertical planes which help separate body into 9 regions

Back 5

Mid-inguinal planes (aka midclavicular planes) - Pass between midpoints of clavicals and inguinal ligaments.
Lateral rectus planes - run lateral to rectus abdominus muscles

Front 6

4 Horizontal planes which help separate body into 9 regions

Back 6

Superior Planes:
Transpyloric plane - @ midpoint between jug. notch and symphisis pubis @ level of LV1
Subcostal Plane - Through 10th costal cartilage @ LV 3
Inferior:
Transtubercular plane - through tubercle of iliac crest @ LV5
Interspinous plane - through anterior superior iliac crest

Front 7

9 body regions

Back 7

Right/left hypochondriac, epigastric, Right/left lumbar, umbilical, Right/left inguinal, hypogastric

Front 8

Verticle lines of the ab muscles

Back 8

Linea alba - in the middle
linea semilunaris (aka lateral rectus line) - on lateral sides. From cartilage of 9th rib to pubic tubercle.

Front 9

Location of Gaul bladder via planes

Back 9

@ intersection of lateral rectus and transpyloric planes

Front 10

Important dermatomes

Back 10

T4 = nips
T6 = xiphoid
T10 = Umbilicus
L1 = Inguinal Ligament

Front 11

Lymphatic drainage of anterior abdominal wall

Back 11

Skin above umbilicus goes to axilary region, skin below drains into proximal thigh

Front 12

Important Sensory nerves on anterior abdominal wall

Back 12

Both cutaneous branches from L1, Iliohypogastric is above ilioinguinal

Front 13

External Abdominal oblique muscle

Back 13

Origin: Lower 8 ribs
Inserts: Runs hands in pockets. Inserts on linea alba, pubic symphisis, crest and tubercle of pubis, ASIS and crest of ilium.
Action: Flexes and rotates trunk, compresses and supports abdominal viscera

Front 14

Clinical signs of appendicitis

Back 14

McBurney's Point - Located 1/3 of way from ASIS to umbilicus.
McBurney's sign - Pain when pushing on point
Aarons sign - pain when releasing preasure from point.

Front 15

Inguinal Ligament

Back 15

Thickening of lower margin of aponeurosis of external oblique muscle. Attaches to ASIS and pubic tubercle.

Front 16

Internal Abdominal Muscle

Back 16

Origin: Iliac crest and inguinal ligament
Inserts: Costal margin, linea alba, pubic crest, pectineal line.
Action: Flexes and rotates trunk, compresses and supports abdominal viscera

Front 17

Conjoint Tendon

Back 17

Aka falx inguinalis. Common tendon of internal oblique and transversus muscles. Formed by lower part of transversus abdominis muscle and part from the internal oblique muslce. Inserts on crest of pubis and pectinal line.

Front 18

Tranversus Abdominis muscle

Back 18

Origin: Inner surface of coastal margin, iliac crest, inguinal ligament, and transverse process of lumbar vertebrae via anterior lamella of thoracocolumbar fascia.
Inserts: Linea alba, pubic crest, and pectineal line
Action: Compresses and supports abdominal viscera

Front 19

Rectus Abdominis Muscle

Back 19

Origin: Pubic crest
Inserts: On ribs 5,6,7. Has 3 or 4 tendinous inscriptions.
Action: Flexes and compresses abdominal viscera

Front 20

Superficial Fascia

Back 20

Has one layer above umbilicus. Has 2 layers below; Camper's layer (outer fatty) and Scarpa's layer (inner membranous)

Front 21

Superior Part of Rectus sheath

Back 21

Superior 3/4s. Made from aponeurosis of external and internal oblique and transversus abdominis muscles.
Anterior lamella: From costal margin to LV 4. Consists of aponeurosis from external oblique and anterior part of internal oblique
Posterior lamella: Consists of posterior part of internal oblique aponeurosis and aponeurosis of transversus muscle. Inferior margin is called Arcuate line (linea semicircularis)

Front 22

Inferior part of rectus sheath

Back 22

Inferior 1/4 of rectus sheath. Below arcuate line, only anterior lamella exists consisting of aponeurosis of all 3 abdominal muscles.

Front 23

Transversalis Fascia

Back 23

Lines inner surface of muscular wall.
Inferior diaphragmatic fascia - continuous with fascia on inferior aspect of diaphragm.
Psoas and quardatus fascia - continuous with fascia of the posterior abdominal wall
Obturator fascia and superior fascia of the pelvic diaphragm - continuous with fascia of pelvis

Front 24

Parietal Peritoneum and fossa's

Back 24

Innermost layer of abdominal wall, encloses whole abdominopelvic cavity.
Supravesicular fossa - between the median and middle umbilical folds.
Medial Inguinal fossa - Between medial and lateral umbilical folds.
Lateral Inguinal fossa - Lateral to the lateral umbilical folds.

Front 25

What extraperitoneal space structures make peritoneal lines?

Back 25

Between the parietal peritoneum and the transversalis fascia.
Median Umbilical fold - Unpaired down midline. Formed by median umbilical ligament. Remnant of fetal urachus.
Medial Umbilical Folds - Lateral to median umbilical fold. Formed by medial umbilical ligament. Remanents of fetal umbilical arteries.
Lateral Umbilical Folds - Most lateral folds. Created by internal epigastric vessels

Front 26

Superior Epigastric Artery

Back 26

Descends from internal thoracic. Runs between rectus abdominis muscle and posterior rectus sheath. Anastamoses with inferior epigastric artery.

Front 27

Musculophrenic Artery

Back 27

Branch off the internal thoracic.

Front 28

Inferior Epigastric Artery

Back 28

Ascends from External iliac artery. Runs deep to rectus abdominis muscle and enters rectus sheath at arcuate line.

Front 29

Femoral Artery

Back 29

When external iliac artery passes below inguinal ligament, becomes femoral.

Front 30

Superficial Circumflex Iliac artery

Back 30

Branch of femoral artery. Runs in superficial fascia along line of inguinal ligament.

Front 31

Superficial Epigastric Artery

Back 31

Branch of femoral artery. Ascends upward in superficial fascia.

Front 32

Deep Circumflex artery

Back 32

From external iliac artery. Runs deep to transversus abdominis, then deep to internal oblique.

Front 33

Lumbar Vessels

Back 33

Only 4 (despite 5 lumbar vertebrae). Branch of abdominal aorta.

Front 34

Thoracoepigastric Vein

Back 34

Formed by superficial epigastric and lateral thoracic. Collateral route between superior and inferior vena cava.

Front 35

Paraumbilical Veins

Back 35

Collateral route between the portal and systemic circulations. Run with round ligament of liver. Become enlarged in portal hypertension.

Front 36

General Nerve supply to anterior abdominal wall

Back 36

Ventral primary rami of T6-L1

Front 37

Inguinal Triangle Borders (Hasselbach's Triangle)

Back 37

Medially: Rectus Abdominis/ linea semilunaris of rectus sheath
Superior/Lateral: Inferior Epigastric Vessels
Inferior: Inguinal Ligament

Front 38

What passes through inguinal canal?

Back 38

Spermatic chord in males, round ligament in females.

Front 39

Boundaries of Inguinal Canal

Back 39

Anterior: Aponeurosis of external oblique muscle reinforced by fibers of internal oblique
Posterior: Transversalis fascia reinforced by the conjoint tendon (common tendon of internal oblique and transversus muscle)
Roof: Arching fibers of internal oblique and transversus abdominis
Floor: Inguinal Ligament Reinforced by the lacunar ligament

Front 40

Lacunar Ligament

Back 40

Connects inguinal ligament to pectinal ligament near where they both insert on the pubic tubercle.

Front 41

Deep Inguinal Ring

Back 41

Beginning of inguinal canal. Located superior to inguinal ligament and lateral to inferior epigastric vessels. Formed by transversalis fascia

Front 42

Superficial Inguinal Ring

Back 42

Ending of inguinal canal. Evaginates aponeurosis of of external oblique. Has thickend margins called crus/crura.

Front 43

Processus Vaginalis

Back 43

Loop of peritonium which overs the testes when they descend. Forms tunica vaginalis of testes but part in spermatic chord atrophies.

Front 44

Layers of the spermatic chord.

Back 44

Transversalis fascia becomes internal spermatic fascia.
Internal oblique muslce becomes cremasteric muscle and fascia.
External oblique aponeurosis become external spermatic fascia.

Front 45

Contents of spermatic chord

Back 45

Ductus Deferens
Testicular artery
Pampiniform plexus of veins
Autonomic testicular nerves
Genital branch of genitofemoral nerve
lymphatics of testes

Front 46

Indirect Inguinal Hernia

Back 46

Conjenital and more common than direct. Omentum or intestine passes through deep inguinal ring and enters spermatic chord. Can travel to scrotum/labium major.
Lateral to inferior epigastric vessels. Above and medial to pubic tubercle.

Front 47

Direct Inguinal Hernia

Back 47

Common in older men. Weakness in inguinal triangle allows hernia to bulge through. Medial to inferior epigastric vessels.

Front 48

Umbilical Hernias

Back 48

Congenital: Present at birth, failure of midgut to retract into abdominal cavity during fetal life.
Acquired infantile: Small, in the scar of umbilicus, usually disappears without treatment.
Acquired Adult: Paraumbilical, more common in women, requires surgery.

Front 49

Tunica Vaginalis

Back 49

Serous cavity around scrotum with parietal and visceral layers. Remenant of processes vaginalis.

Front 50

Tunica albuginea

Back 50

Thick white capsule covering testes.

Front 51

Femoral Hernia

Back 51

Hernia below inguinal canal through femoral canal ending in femoral triangle of thigh.

Front 52

Lymph drainage of testes and scrotum

Back 52

scrotum = superficial inguinal lymph nodes
testes = aortic lymph nodes

Front 53

Contents of scrotum

Back 53

Testis, epididymis (head, body, tail), and spermatic cord.