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17 Cards in this Set
- Front
- Back
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Which major arteries are linked by the epigastric arcades?
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External iliac and subclavian arteries
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Where is the origin of the DIEA?
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From ext iliac, proximal to inguinal ligament
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What is the course of the DIEA?
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Runs superomedially, enters rectus and divides into two main branches to supply rectus and overlying skin, coalesces in epigastric region; also connects to terminal lower six intercostal arteries and ascending deep circumflex iliac artery
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Which arteries share the watershed area between xiphoid and umbilicus?
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Anastomotic channels in this area between DIEA, superior epigastric artery (from internal mammary), intercostals, ascending deep circumflex iliac artery
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Which is dominant in perfusion of the abdominal wall, DIEA or SEA?
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DIEA (larger, yields more cutaneous perforators)
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What do DIEA perforators supply?
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Some supply rectus and skin, some mostly skin; some circumvent rectus and supply only skin (targets in flap!)
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What is the course of DIEA perforators?
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Variable; some vertical, some horizontal. Generally arborize until they join the subdermal plexus under the skin.
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Which arterial branches meet in the subdermal plexus of the abdomen?
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Perforators from the DIEA, cutaneous branches of SEA, lower intercostals, deep and circumflex iliac arteries, SIEA, superficial external pudendal artery, and contralateral DIEA perforators
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What is the origin of the SIEA?
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17%: Common femoral artery 2-3 cm below the inguinal ligament
48%: Common trunk with superficial circumflex iliac artery 35%: absent or hypoplastic, replaced by large branch of superficial circumflex iliac artery |
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What is the course of the SIEA?
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Through subcutaneous fat towards anastomoses with large periumbilical perforators
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What is the venous drainage of the rectus and overlying skin?
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Rectus drained by deep inferior epigastric veins (to ext iliac vein);
SIEA has two venae comitantes which drain to common femoral vein or saphenous bulb (these may be absent) |
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What is the venous analog of the SIEA?
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The SIEV, medial and more superficial to the SIEA, is not accompanied by artery; tributary of greater saphenous vein, connects to perforating veins from DIEV
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What is the motor and sensory innervation of the abdominal wall?
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Intercostal nerves 7-12, some contribution by iliohypogastric and ilioinguinal nerves
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What is the dominant arterial supply of the lower abdominal flap?
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Two! DIEA. Length 16cm, diameter 3.5mm. Also SIEA, length 5cm diameter 1.6mm
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What is a minor arterial supplier of the lower abdominal wall?
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SEA. Length 6cm, diameter 2mm. Can be used in addition to DIEA or SIEA to extend territory of flap.
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What is the primary venous drainage of the abdominal flap?
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Deep and superficial epigastric veins. SIEV may be dominant over the deep system in some cases.
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What is the secondary venous drainage of the abdominal flap?
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Venae comitantes of SIEA, SEA, circumflex iliac, lower intercostals.
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