Clinical Relationships Anatomy Exam Iii

Front 1

Dermatomes of Abdomen are?

Back 1

xiphoid process at T7, umbilicus at T10, pubic tubercle at L1, and iliac crest at L1

Front 2

Fascia holds sutures well is?

Back 2

Scarpa's

Front 3

What is the Cremaster Reflex?

Back 3

Cremaster reflex is where the clinician strokes the inside of the thigh to elicit a response with the cremaster muscle. Elevate testes testing L1 which is the ilioinguinal nerve L1(according to this note packet).

Front 4

Abdominal reflex tests what nerves segments for upper and lower quadrants?

Back 4

Upper quadrants test T7-T9 and lower quadrants test T10-T12.

Front 5

Planter reflex tests what nerve segments?

Back 5

testing L5-S1

Front 6

Anal reflex reflex tests what nerve segments?

Back 6

testing S2-S4 (makes it pucker or wink)

Front 7

Median Surgical Incisions

Back 7

avoids muscle, major vessels and nerves and involves the linea alba

Front 8

Paramedian Surgical Incisions?

Back 8

is made in the sagittal plane and involves the rectus sheath

Front 9

Oblique McBurney or Gridiron surgical incisions

Back 9

a muscle splitting abdominal incision employed in appendectomies. It parallels the course of the external oblique muscle, a few cm from the right anterior superior iliac spine, through the external oblique to the internal oblique and transversalis, separating their fibers.

Front 10

Transverse Lanz Surgical Incisions

Back 10

is situated in the right iliac fossa, and as compared to McBurney's incision it differs as follows: more transverse in orientation, generally extends more medially towards rectus abdominis, and lies nearer to the anterior superior iliac crest

Front 11

Transverse Lanz Surgical Incisions endanger what nerves and predispose patient to what?

Back 11

iliohypogastric and ilioinguinal nerves, and predispose inguinal herniation later in patients

Front 12

Pfannenstiel or suprapubic Surgical Incisions are used for what?

Back 12

is a curved surgical incision that may be used for a caesarian section or urinary bladder surgery. It is a transverse incision through the external sheath of the recti muscles, just above the pubes. It follows natural folds of the skin and curves over the mons pubis in such a way that the pubic hairs cover the incision after surgery.

Front 13

What is a Transverse Lanz Surgical incisoin commonly used for?

Back 13

A Lanz incision is used commonly for access to the appendix and caecum. A mirror image incision in the left iliac fossa can be used to access the left colon but not the rectum.

Front 14

What canal does the ilioinguinal nerve travel within?

Back 14

inguinal canal

Front 15

What are the most common of all abdominal hernias and occur lateral to the inferior epigastric artery?

Back 15

Indirect Inguinal Hernia. Such a hernia enters the deep inguinal ring or the canal of Nuck in females. It is also termed a congenital inguinal hernia which has a hernial sac formed by a persistent processus vaginalis. In males, it is a type of hernia that usually traverses the entire canal, and commonly enters the scotum.

Front 16

What type of hernia leaves the abdominal cavity medial to the inferior epigastric artery?

Back 16

Direct Inguinal Hernia. It protrudes through an area of weakness in the posterior wall of the inguinal canal. The hernial sac is formed by the transversalis fascia. It occurs outside the processes vaginalis and is usually obliterated, parallel to the spermatic cord. Thus, it is outside one or two of the fascial coverings of the cord. It will not traverse the entire canal and protrudes through the wall of the inguinal canal. It emerges from or about the conjoint tendon to reach the superficial inguinal ring. Thus, it gains an outer covering of external spermatic fascia, inside or parallel to that of the cord. In males, it usually does not enter the scrotum.

Front 17

Importance of Intercristal line?

Back 17

Spinal Tap level. L4. Just below Transumbilical plane of the quadrants that is located @ L3/L4

Front 18

linea semilunaris (semilunar) lines are clinically important becasue why?

Back 18

Usually incisions are not made along the semilunar lines because doing so would interrupt the multiple nerves and vessels that supply the rectus muscle. (Verticle lines and medial to midclavicular lines)

Front 19

How many regions and planes are there in the abdominal wall?

Back 19

9 regions and 5 planes

Front 20

What organs does the transpyloric plane or line cross?

Back 20

left kidney hila, right kidney superior border, neck of pancreas, duodenojunjual junction. @ L1 vertebra.

Front 21

Interspinous plane crosses what two structures?

Back 21

From Left ASIS to Right ASIS

Front 22

Intertubercular or tanstubercular plane connect what?

Back 22

Illac crests at L5/S1.

Front 23

arises from the anterior rami of L1-L3 and part of L4 (communicates with T12), and is embedded within the psoas major muscle and has major branches and segmental derivations.

Back 23

lumbar plexus

Front 24

(T7-11) are a continuation of the lower intercostal nerves, which courses between the 2nd and 3rd layers of the abdominal muscles (IO & TA).

Back 24

thoracoabdominals nerves

Front 25

arises from the ventral ramus of the 12th thoracic nerve and runs along the inferior border of the 12th rib.

Back 25

subcostal nerve

Front 26

arises from the ventral ramus of L1 and pierces the transverse abdominal muscle and branches (these pierce the external oblique aponeurosis).

Back 26

iliohypogastric nerve

Front 27

arises from the ventral ramus of L1 and passes between the 2nd and 3rd layers of the abdominal muscles and through the inguinal canal and lateral to the spermatic cord or round ligament of the uterus.

Back 27

ilioinguinal nerve

Front 28

arises via L1-L2 spinal nerves and has two major, named branches: 1) femoral branch (supplies femoral triangle of thigh) and 2) genital branch (supplies anterolateral surface of scrotum or labia majora).

Back 28

genitofemoral nerve

Front 29

What are the most common of all abdominal hernias and occur lateral to the inferior epigastric artery?

Back 29

Indirect Inguinal Hernia. Such a hernia enters the deep inguinal ring or the canal of Nuck in females. It is also termed a congenital inguinal hernia which has a hernial sac formed by a persistent processus vaginalis. In males, it is a type of hernia that usually traverses the entire canal, and commonly enters the scotum.

Front 30

Tansumbilical plane at what level?

Back 30

It is at L3/L4
this the dividing line of the quadrants
a key reference for 3 arteries the umbilical artery, left umbilical vein, and umbilical cord

Front 31

What are the two superficial fascia and their importance?

Back 31

Scrapa's adhered to deep fascia, holds sutures, and fuses with fascia lata (laterally in the inguinal area) Camper's most superficial and lots of fat Both fuse together in the medial inguinal area to form the Dartos layer (outter layer) and Colles layer (inner layer) of the scrotum and shaft and colles continues to perinium

Front 32

What are the three layers of the deep fascia?

Back 32

Investing fascia layer -- invests external oblique, internal oblique, and transverse abdominal muscles.
Transversalis Layer -- Middle layer layer and deep to the transverse abdominal muscle
Parietal peritoneum -- Deepest abdominal fascia layer best develped inferior of umbilicus.

Front 33

The three flat muscles of anterior abdominal wall are?

Back 33

The external abdominal oblique -- has aponeurotic part
internal abdominal oblique -- The cremaster muscle is formed by the lowermost part of this fascia and muscle
transverse abdominal -- has a neurovascular plane which lies between the IO and TA and includes several nerves T7-T11 (thoracoabdominal), T12 (subcostal), and L1 (iliohypogastric, ilioinguinal) and arteries (e.g., inferior intercostal, subcostal, lumbar, and deep circumflex).

Front 34

The two verticle muscles of anterior abdominal wall are?

Back 34

rectus abdominis muscle
pyramidalis muscle

Front 35

The two medial fossae lie posterior to Hesselbach’s area, which is a potential site for?

Back 35

A direct hernia.

Front 36

The lateral fossae are the locations where the exit for what type of inguinal hernia may occur?

Back 36

Indirect