Anterior Abdominal Wall

Front 1

What is the transpyloric plane (TPP)?

Back 1

Halfway b/e the jugular notch and upper border of symphysis, this line crosses the tips of 9th costal cartilages anteriorly and 1st lumbar vertebra posteriorly

Front 2

What is the transtubercular plane (TTP)?

Back 2

The imaginary plane at the level of the iliac tubercles that crosses L5 posteriorly.

Front 3

What is the subcostal plane?

Back 3

The lowest point of the costal margin (margin of the 10th costal cartilage on each side. Lies at the level of the intervertebral disc b/e L2 and L3

Front 4

What is the supracrestal (supracristal) plane?

Back 4

L4; b/e the highest points of the iliac crests at L4 spinous process

Front 5

What is the interspinous plane?

Back 5

The sacral promontory: Connects the right and left ASIS (anterior superior ilial spines)

Front 6

What are the layers of the abdominal wall?

Back 6

"Savage Surgeons Should Always Make Plans To Eat People"

1. Skin
2. Superficial fascia "Camper's fascia" - contains fat
3. Superficial fascia "Scarpa's fascia" - membranous layer
4. Anterior rectus sheath
5. Muscular layer (External oblique, Internal oblique, transversus abdominis)
6. Posterior Rectus sheath
7. Transversalis fascia
8. extraperitoneal fascia
9. parietal peritoneum

Front 7

What muscle tendon divides into two to envelop the Rectus abdominus muscle?

Back 7

Tendon of Internal oblique

Front 8

What fascial layer continues inferiorly into the peritoneal region to become the superficial perineal fascia (Colles' fascia)?

Back 8

deep membranous layer (scarpa's fascia)

Front 9

What fascial layer lines the deep surface of the transversus abdominus muscle?

Back 9

Transversalis fascia

Front 10

What separates the perietal peritoneum from the transversalis fascia?

Back 10

Extraperitoneal fat

Front 11

Which way do the fibers for external oblique and internal oblique run?

Back 11

External oblique; fibers run diagonally antero-downward (like putting your hands into your front pockets)

Internal oblique; fibers run diagnoally postero-downward (like putting your hands into your back pockets)

Front 12

Which direction do the fibers of the transversus abdominus run?

Back 12

transversely across the abdomen

Front 13

Where does the external oblique become aponeurotic?

Back 13

At the midclavicular line

Front 14

Where do the fibers of the external oblique decussate?

Back 14

At the linea alba

Front 15

What tendon forms the inguinal ligament?

Back 15

The inferior border of the aponeurosis of the external oblique

Front 16

What muscles does the external abdominal oblique interdigitate with?

Back 16

External surfaces of ribs 5-12 and interdigitates w/ the serratus anterior and the pectoralis major

Front 17

What is the innervation of the external oblique?

Back 17

1. Intercostal nerves from T7 to T11
2. subcostal nerve (T12)

Front 18

What muscles work together to bring the right shoulder toward the left hip?

Back 18

Right external oblique and left internal oblique

Front 19

What is the lacunar ligament?

Back 19

The ligament that connects the inguinal ligament to the pectineal (cooper's) ligament

Front 20

What muscle contributes to the rectus sheath?

Back 20

Internal abdominal oblique

Front 21

B/e what layers of the anterior abdominal wall are the neurovascular contained?

Back 21

B/e the internal abdominal oblique and the transversus abdominis muscle

Front 22

What muscle forms the falx inguinalis? What does this structure do?

Back 22

The lower part of the transversis abdominis; this structure forms the medial part of the posterior wall of the inguinal canal.

Front 23

What muscle forms the conjoint tendon?

Back 23

The internal oblique and the transversis abdominis

Front 24

Through what triangle would a hernia pass through if it was below the 12th right, medial to the internal oblique, lateral to the quadratus lumborum/erector spinae?

Back 24

The lumbocostal/superior lumbar/Gryndfeldt triangle

Front 25

Through what triangle would a hernia pass through if it was inferior to the latissimus dorsi, superior to the iliac crest and medial to the external oblique?

Back 25

The inferior lumbar (petit) triangle

Front 26

What triangle could a herniated kidney pass through?

Back 26

Superior lumbar (Gryndfeldt) triangle

Front 27

What are the contents of the rectus sheath?

Back 27

1. Rectus abdominis muscle
2. Pyramidalis muscle
3. Superior Epigastric vessels
4. Inferior epigastric vessels
5. thoracoabdominal nerves

Front 28

What does the superior epigastric vessel originate from?

Back 28

Internal thoracic artery

Front 29

What does the inferior epigastric artery originate from?

Back 29

External iliac artery

Front 30

What is the action of the rectus abdominis?

Back 30

1. helps in respiration by depressing ribs
2. flexes and laterally rotates spine
3. assists in defecation, micturition, parturition, vomiting and coughing

Front 31

What is the origin of the iliohypogastric nerve? ilioinguinal nerve?

Back 31

First lumbar nerve (L1)

Front 32

What nerve supplies the dermatome around the umbilicus?

Back 32

T10

Front 33

What nerves supply the dermatomes from the xiphoid process to just above the umbilicus?

Back 33

T7-T9

Front 34

What nerves supply the dermatomes just below the umbilicus to the pubic region?

Back 34

T11-L1

Front 35

What does the ilioinguinal nerve supply?

Back 35

the anterior surface of the scrotum/labia majora, and sends a small cutaneous br. to the thigh

Front 36

What nerves pierce the rectus sheath?

Back 36

T7-T12

Front 37

What nerve pierces the internal abdominal oblique in front of the anterior superior iliac spine?

Back 37

iliohypogastric nerve

Front 38

What nerve pierces the external oblique aponeurosis above the superficial inguinal ring?

Back 38

Iliohypogastric nerve

Front 39

What does the iliohypogastric nerve terminate as?

Back 39

The lowest anterior cutaneous branch of the abdomen/root of the penis

Front 40

What nerves are the distal abdominal parts of the anterior rami of the inferior six spinal nerves?

Back 40

thoracoabdominal nerves

Front 41

What nerve supplies the area of the mons pubis?

Back 41

Ilioinguinal nerve

Front 42

What nerves supplies the area overlying the iliac crest

Back 42

Iliohypogastric nerve

Front 43

What does the ilioinguinal nerve supply?

Back 43

1. skin of lower inguinal region
2. mons pubis
3. anterior scrotum/labium majora
4. adjacent medial thigh

Front 44

What nerve becomes cutaneous at the superficial inguinal ring?

Back 44

Ilioinguinal nerve

Front 45

What nerve pierces the internal oblique and runs along the inguinal canal?

Back 45

Ilioinguinal nerve

Front 46

What is the origin of the inferior epigastric artery?

Back 46

External iliac artery

Front 47

What is the origin of the deep circumflex iliac artery?

Back 47

External iliac artery

Front 48

What is the origin of the superifical epigastric artery?

Back 48

Femoral artery

Front 49

What is the origin of the superficial circumflex iliac artery?

Back 49

Femoral artery

Front 50

What is the venous drainage of the anterior abdominal wall superior to the umbilicus?

Back 50

Drains to the SVC via the thoracoepigastric veins

Front 51

What is the venous drainage of the anterior abdominal wall inferior to the umbilicus?

Back 51

Drains to the IVC via the superficial epigastric vein

Front 52

What is the venous drainage of the anterior abdominal wall in the umbilical region?

Back 52

Drains to the hepatic portal system via the periumbilical veins

Front 53

What connects the SVC and IVC superficially?

Back 53

The thoracoepigastric vein

Front 54

What is the lymphatic drainage of the region superior to the transumbilical plane?

Back 54

Drains to axillary lymph nodes w/ a few going to the parasternal nodes

Front 55

What is the lymphatic drainage of the region inferior to the transumbilical plane?

Back 55

Drains to the superficial inguinal lymph nodes

Front 56

What is the lymphatic drainage of the deep tissues of the anterior abdominal wall?

Back 56

1. External iliac nodes
2. Lumbar (aortic) nodes
3. Mediastinal nodes