Anterior Abdominal Wall And Inguinal Canal

Front 1

Quadrant in the Abdomen where Appendix lies

Back 1

Right Lower Quadrant

Front 2

Two layers of superficial fascia

Back 2

Fatty layer- Camper's

Membranous layer- Scarpa's

Front 3

Superficial fascia in males on scrotal sac

Back 3

Dartos

Front 4

Urinary extravasation can result in buildup of urine/blood here

Back 4

Deep to superficial fascia, superficial to the abdominal aponeuroses and musculature--> urine can accumulate into lower part of anterior abdominal wall deep to the membranous layer

Front 5

Place where the superficial fascia is "tied off" onto leg

Back 5

Fascia lata (broad fascia)

Front 6

Lymph channels found here

Back 6

Superficial fascia

Lymph nodes present where limb meets the trunk in the later of superficial fascia

Front 7

Line through belly button and what it demarcates (lymphatics)

Back 7

Marks the transumbilical plane; lymph will drain to axillary lymph nodes above the line and inguinal lymph nodes below the line

Front 8

The transversalis fascia is (superficial/deep) to the rectus abdominus

Back 8

Deep

Front 9

The external oblique is (superficial/deep) to the rectus abdominus

Back 9

Superficial

Front 10

Above the costal margin, the ribs, costal cartilage and transversus abdominis lie (superficial/deep) to the rectus abdominis.

Back 10

Deep. There are no oblique fibers here.

Front 11

Thoracoabdominal nerve, artery and vein lie here

Back 11

Between the aponeuroses of transversus abdominis and internal oblique

Front 12

Where all the aponeuroses meet in the midline

Back 12

Linea alba

Front 13

This oblique muscle will end laterally and bluntly

Back 13

External oblique muscle

Front 14

Origin and insertion of the rectus abdominis

Back 14

Inferiorly attaches to pubic symphysis and pubic crest

Superiorly attaches to costal cartilages of ribs 5-7 and xiphoid process

Front 15

Directionality of the obliques

Back 15

External- hands in pockets

Internal- corss your heart

Transversus abdominus- transverse or horizontal plane

Front 16

Abdominal muscles' functions

Back 16

Flex and rotate the trunk; protect contents of abdominal cavity

contraction increases intra-abdominal pressure (exhaling when diaphragm is allowed to rise, evacuating abdominal contents when diaphragm is not allowed to rise)

Front 17

Contracting the muscles of your abdominal wall will (decrease/increase) intra-abdominal pressure

Back 17

Increase

Front 18

Compress abdominal muscles--Diaphragm will go (up/down)

Back 18

Diaphragm will go up

This happens when we are talking, singing

(larynx will open and air will come out)

Front 19

Posteriorly, these two muscles will attach to the lumbar fascia

Back 19

Internal oblique and transversus abdominis

Front 20

External abdominal oblique attachments

(laterally, midline and posteriorly)

Back 20

Laterally, arises from lower 8 ribs, interdigitates with serratus anterior (upper 4 of these ribs), and latissimus dorsi (lowest 4 ribs)

In the midline, it inserts into the xiphoid and linea alba

Posteriorly- has a free edge

Front 21

External abdominal oblique attachments, inferiorly

Back 21

Lower edge is a free edge with some fibers rolled underneath and posteriorly.

The ends of the rolled edge are attached to ASIS and to the pubic tubercle and pubic crest

Front 22

The rolling of the external abdominal oblique inferiorly forms this

Back 22

The Inguinal Ligament (floor of the inguinal canal)

Front 23

The aponeurosis (is/is not) part of the muscle itself

Back 23

IS

Front 24

Inguinal ligament's bony attachments

Back 24

ASIS, pubic tubercle and pubic crest

Front 25

Inguinal ligament is support for ________ in males and ________ in females when it forms the inguinal canal

Back 25

spermatic cord; round ligament

Front 26

Pectineal Line

Back 26

Place where external oblique fibers attach deep, inferior to inguinal ligament

This attachment forms the pectineal ligament

Front 27

Internal abdominal oblique attachments

Back 27

Attached to the lower ribs (6-10), posteriorly to the lumbar fascia

Anteriorly, attached to linea alba

Inferiorly, attach to the lateral part of the inguinal ligament and to the pubic tubercle

- Between these inferior attachments, arch is formed that is part of the inguinal canal

Front 28

Conjoint Tendon

Back 28

Where the two muscles (transversus abdominis and internal abdominal oblique) come together to attach to the pubic tubercle

Front 29

Transversus Abdominis attachments

Back 29

Edge of rib cage

Linea Alba

ASIS, lateral attachment of inguinal ligament, conjoint tendon

Front 30

Neurovascular plane of the abdomen

Back 30

Between the internal abdominal oblique and transversus abdominis

Front 31

These intercostal nerves extend into this "new" neurovascular plane between internal abdominal oblique and transversus abdominis

Back 31

T7-T12

Front 32

Umbilicus dermatome

Back 32

T10

Front 33

L1 nerves

Back 33

Iliohypogastric and Ilioinguinal nerves

Front 34

T12

Back 34

Pubic tubercle

Front 35

Spinal nerve which is paired with skin of anterior scrotum or labia majora

Back 35

L1

Front 36

Indirect hernias will be characterized by:

Back 36

occuring lateral to the epigastric artery, because they are going through the deep ring which is lateral to the artery

Front 37

Direct hernias

Back 37

Medial to the inferior epigastric artery

REMEMBER: MD Medial=Direct

Front 38

During a laparoscopic examination of the deep surface of the lower anterior abdominal wall (using a lighted scope on a thin tube inserted through the wall), the attending physician noted something of interest and asked the young resident to look at the medial inguinal fossa. To do so, the young doctor would have to look at the area between the:

Back 38

Medial umbilical ligament and inferior epigastric artery

Front 39

If one were to make an incision parallel to and 2 inches above the inguinal ligament, one would find the inferior epigastric vessels between which layers of the abdominal wall?

Back 39

Transversus abdominus muscle and peritoneum

Front 40

A man is moving into a new house and during the process lifts a large chest of drawers. As he lifts he feels a severe pain in the lower right quadrant of his abdomen. He finds that he can no longer lift without pain and the next day goes to see his physician. Surgery is indicated and during the surgery the surgeon opens the inguinal region and finds a hernial sac with a small knuckle of intestine projecting through the abdominal wall just above the inguinal ligament and lateral to the inferior epigastric vessels. The hernia was diagnosed as:

Back 40

An indirect inguinal hernia

Front 41

Structures passing through the deep inguinal ring

Back 41

Spermatic cord (males)

Round ligament (females)

Front 42

Rectus Abdominus Attachments

Back 42

Inferiorly- pubic symphysis and pubic crest

Superiorly- costal cartilages of ribs 5-7 and the xiphoid process

Lateral edge- seen as the semilunar line

Front 43

Rectus sheath is composed of:

Back 43

Aponeuroses of other abdominal oblique muscles

Front 44

Anterior rectus sheath always has:

Back 44

External oblique aponeuroses

Front 45

Below ribs, above arcuate line, these make up the rectus abdominus sheath

Back 45

Aponeuroses of external and internal abdominal obliques

Front 46

Below arcuate line, these compose the rectus sheath

Back 46

Aponeuroses of external abdominal oblique, internal abdominal oblique and transversus abdominis

Front 47

Halfway between umbilicus and pubic symphysis

Back 47

Arcuate Line

Front 48

Deep to the rectus abdominus below the arcuate line

Back 48

Transveralis fascia

Front 49

Alternatative pathway for oxygenated blood (anteror)

Back 49

Internal thoracic artery--> Superior epigastric--> Inferor epigastric--> Iliacs

Will all become enlarged if aorta is blocked

Front 50

Gonad started at this position in the abdominal cavity

Back 50

On the posterior abdominal wall

Front 51

Connective tissue link which guides the gonad into its final position

Back 51

"the governor"

Front 52

In males, the _______________ allows for passage of the testes out of abdominal cavity into the ______________.

Back 52

inguinal canal; scrotal sac

Front 53

In females, ovary is guided downward and governor remains as the ________________.

Back 53

Round ligament

Front 54

Governor in female connects _________ to __________.

Back 54

ovary; labia majora

Front 55

Inguinal canal is subject to

Back 55

weaknesses and therefore hernias

Front 56

Female analog for scrotal sac

Back 56

Labia majora

Front 57

Superficial inguinal ring is in this layer (of muscle)

Back 57

External abdominal oblique

Medial crus, Intercrural fibers and Lateral crus surround

Front 58

Pubic (crest/tubercle) is more medial

Back 58

Crest

Front 59

Deep ring

Back 59

Lowest fibers of the transversus abdominus muscle and the nearby epigastric vessels mark the location of the deep inguinal ring.

Ring lies deep to muscle-- transversalis fascia is continuous with internal spermatic fascia (or fascia of the round ligament)

Front 60

Ileoinguinal Nerve path

Back 60

Travels with spermatic cord or round ligament