Anterior Abdominal Wall Ii

Front 1

What is the order from most superficial to deepest of the layers of the abdominal wall?

Back 1

Skin,
camper fascia,
scarpa fascia,
investing (deep) fascia,
external oblique,
internal oblique,
transversus abdominus,
transversalis fascia,
extraperitoneal fat,
peritoneum

Front 2

What is the fatty layer (Camper's)?

Back 2

More superficial
Continuous with the superficial fatty layers in the thorax, thigh, and peritoneum

Front 3

What is the membranous layer (Scarpa's)?

Back 3

Deeper
Continuous with the fascia lata in the thigh and with the deep perineal fascia

Front 4

Which layer of the superficial fascia holds sutures?

Back 4

The deep fascia (investing fascia)

Front 5

T or F: There is a potential space between the Scarpa's and the deep fascia of the external abdominal oblique.

Back 5

True

Fluid can leak into this space

Front 6

What is the rectus sheath?

Back 6

Formed by the fusion of the abdominal muscles and their associated fascias

Front 7

What is the function of the rectus sheath?

Back 7

Encloses the rectus abdominis and pyramidalis muscles

Front 8

T or F: The arrangement of the layers of fascia and aponeuroses of the rectus sheath is the same in both the upper and lower abdominal wall.

Back 8

False

Different arrangements between upper and lower

Front 9

What is the arcuate line?

Back 9

The line where the arrangement of the rectus sheath changes. Located about halfway between umbilicus and pubic symphysis

Front 10

What are the layers of the rectus sheath above the arcuate line?

Back 10

Skin
Camper's
Scarpa's
Aponeurosis of external obliques (2 layers)
Aponeurosis of internal oblique (1 layer)
Rectus abdominus
-------------------------------
Aponeurosis of internal oblique (1 layer)
Aponeurosis of transversus abdominus (2 layers)
Transversalis fascia
Extraperitoneal tissue
Parietal peritoneum

Front 11

What are the layers of the rectus sheath below the arcuate line?

Back 11

Skin
Camper's
Scarpa's
Aponeurosis of external oblique (2 layers)
Aponeurosis of internal oblique (2 layers)
Aponeurosis of transversus abdominis (2 layers)
Rectus abdominis
-----------------------------------
Transversalis fascia
Extraperitoneal tissue
Parietal peritoneum

Front 12

Why is the anterior rectus sheath thicker below the arcuate line?

Back 12

Necessary to hold the rectus abdominis muscle in place

Front 13

Where do the deep arteries of the anterior abdominal wall originate from (superiorly, mid, inferiorly)?

Back 13

Superiorly from the subclavian artery via the internal thoracic
Branches in mid abdomen from abdominal aorta
Inferiorly from the external iliac artery

Front 14

Where do the superficial arteries of the anterior abdominal wall originate from (superiorly, inferiorly)?

Back 14

Superiorly from perforating branches
Inferiorly from branches of femoral artery

Front 15

What are the deep arteries of the anterior abdominal wall?

Back 15

Musculophrenic
Super and inferior epigastric
Intercostal
Subcostal
Lumbar
Deep circumflex iliac

Front 16

What are the superficial arteries of the anterior abdominal wall?

Back 16

Superficial circumflex iliac
Superficial epigastric
External pudendal

Front 17

Where are the veins in the anterior abdominal wall for deep drainage and what do they drain to?

Back 17

Within abdominal wall muscles along with arteries.
Drain to subclavian, external iliac, lumbar and intercostal veins

Front 18

Where are the veins in the anterior abdominal wall for superficial drainage and what do they drain to?

Back 18

Within the Camper's fascia
Drain to thoracoepigastric, lateral thoracic, and superficial epigastric veins

Front 19

What are the sensory dermatomes for T7, T10, and L1?

Back 19

T7 - xiphoid region
T10 - umbilicus
L1 - inguinal fold

Front 20

What nerve is responsible for T7-T11?

Back 20

Intercostal nerve

Front 21

What nerve is responsible for T12?

Back 21

Subcostal nerve

Front 22

What nerve is responsible for L1-L4?

Back 22

Lumbar nerve

Front 23

Where do the cutaneous branches of the ventral rami and intercostal nerves lie?

Back 23

Between internal oblique and transversus abdominis

Pierce rectus sheath to innervate rectus abdominis muscles

Front 24

T or F: L1 and L2 are part of the lumbar plexus

Back 24

True

Front 25

Describe the iliohypogastric nerve. (Exit, entrance, and supplies)

Back 25

L1
Exits posterior ab wall between quadratus lumborum and psoas muscles
Enters aterolateral ab wall and runs between posterior part of transversus abdominis and obliquus internus abdominis
Branches into lateral and anterior cutaneous branches
Supplies suprapubic region

Front 26

Describe the ilioinguinal nerve. (Exit, entrance, and supplies)

Back 26

L1
Exits posterior ab wall between quadratus lumborum and psoas muscles
Enters anterolateral ab wall between transversus abdominis and obliquus internus
Enters inguinal canal and emerges through the superficial inguinal ring
Supplies groin, thigh, and scrotum/labium

Front 27

Where does the genitofemoral nerve exit?

Back 27

Posterior ab wall through psoas muscle and runs between peritoneum and psoas muscle

Front 28

What does the genital branch of the genitofemoral nerve do?

Back 28

Enters inguinal canal through deep inguinal ring and exits through superficial inguinal ring
Innervates cremaster muscle (men) or cutaneous to labium (females)

Front 29

Where does the femoral branch of the genitofemoral nerve exit?

Back 29

Inferior to the inguinal ligament

Front 30

Into what lymph nodes does the anterior ab wall drain into superficially? (superiorly and inferiorly)

Back 30

Superiorly from umbilical region to anterior axillary and sternal nodes
Inferiorly from umbilical region to superficial inguinal nodes

Front 31

Into what lymph nodes does the anterior ab wall drain into deep?

Back 31

Along posterior intercostal and lumbar vessels to deep ab nodes
From testes to deep ab nodes

Front 32

Describe umbilical hernias in infants.

Back 32

Involve umbilicus
Scar of umbilicus didnt heal completely
Usually small and wider transversely
Heal spontaneously

Front 33

Describe umbilical hernias in adults.

Back 33

Result from weakened abdominal wall around umbilicus
Usually superior to umbilical scar
More common in women
Require surgery

Front 34

What is an epigastric hernia?

Back 34

Hernia of the linea alba
Does not involve umbilicus
More common in men