Anterolateral Abdominal Wall

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Where can pain from acute appendicitis be elicited?

McBurney's Point
Anterolateral abdominal wall muscles
- Transversus abdominis
- Internal oblique
- External oblique
- Rectus abdominis
What demarcates the rectus sheath?
- Linea semilunaris (semilunar line)
- Linea alba (midline)
Structure at transpyloric plane (level?)

SMA (L1)
Structure at subcostal plane (level?)

IMA (L3)
Structure at supracristal plane (level?)

Bifurcation of aorta (L4)
Structure at transtubercular plane (level?)

Formation of IVC (L5)
At what level is the transumbilical plane?

L3/4 IV disc
What planes divide the abdomen into quadrants?
- Midsagittal plane (midline)
- Transumbilical plane (L3/4 IV disc)
What planes divide the abdomen into 9 regions?
- Right / Left MCL
- Subcostal plane (L3)
- Transtubercular plane (L5)
Contents of RUQ (9)
- Liver (right lobe)
- Gallbladder
- Pylorus
- Duodenum
- Pancrease (head)
- R. Kidney / adrenal
- Hepatic colic flexure
- Ascending colon (superior part)
- Transverse colon (right half)
Contents of LUQ (9)
- Liver (left lobe)
- Spleen
- Stomach
- Jejunum / proximal ileum
- Pancreas (body & tail)
- L. Kidney / adrenal
- Splenic colic flexure
- Transverse colon (left half)
- Descending colon (superior part)
Contents of RLQ (7)
- Distal ileum (most of ileum)
- Cecum
- Veriform appendix
- Ascending colon (inferior part)
- R. Ureter
- R. Ovary
- R. Uterine tube
Contents of LLQ (5)
- Descending colon (inferior part)
- Sigmoid colon
- L. Ureter
- L. Ovary
- L. Uterine tube
Layers of anterolateral abdominal wall
- Skin
- Superficial fascia (2 layers)
- External oblique (m/a/f)
- Internal oblique (m/a/f)
- Transversus abdominis (m/a/f)
- Transversalis fascia
- Extraperitoneal fascia
- Peritoneum (parietal)
What are the 2 layers of the superficial fascia
- Camper's fascia (fatty)
- Scarpa's fascia (membranous)
What is contained in camper's fascia?
- Adipose
- Superficial veins
What ligament does scarpa's fascia give rise to?

Fundiform ligament of penis
Veins in anterolateral abdominal wall
- Paraumbilical vv. (drain into portal v.)
- Superficial epigastric vv. (drain into femoral v.)
- Anastomoses between portal and systemic venous drainage
What structures are continuous w/ scarpa's fascia?
- Tunica dartos (scrotum)
- Superficial penile fascia
- Extends as colles' fascia (perineum)
Where does scarpa's fascia adhere to?

Fascia lata of thigh (below inguinal ligament)
What forms the inguinal ligament?

Extension of the external oblique aponeurosis
Common insertion of all anterolateral abdominal muscles

Linea alba
Gives rise to internal spermatic fascia

Transversalis fascia
Gives rise to cremaster muscle

Internal oblique m.
Gives rise to superficial spermatic fascia

Fascia of external oblique m.
What muscles form the conjoint tendon (a.k.a. falx inguinalis)?
- Internal oblique m.
- Transversus abdominis m.
Only ______ forms the posterior wall of the rectus sheath ______ to arcuate line
- Transversalis fascia
- Inferior
What is the cutaneous innervation to the umbilicus

T10 dermatome
What innervates the region of the inguinal ligament as well as the anterior scrotum? (level?)

Ilioinguinal n. (L1)
Median umbilical fold
- Fold of peritoneum covering remnant of urachus
- umbilicus -> superior surface of bladder
Medial umbilical fold
(a.k.a. medial umbilical ligaments)

Fold of peritoneum over the obliterated fetal umbilical aa.
Lateral umbilical fold

Fold of peritoneum over the inferior epigastric vessels
Landmark - inferior epigastric vessels
- Vessels within posterior rectus sheath
- Deep inguinal ring (lateral)
- Superficial inguinal ring (medial)
Borders of Hesselbach's Triangle
(Inguinal triangle)
- Epigastric vessels (superior / lateral)
- Inguinal ligament (inferior / lateral)
- Rectus abdominis (medially)
Rectus sheath aponeuroses (above arcuate line)
- External oblique m.
- *Internal oblique m.
- Rectus abdominis m.
- *Internal oblique m.
- Transversus abdominis m.
- Transversalis fascia
Rectus sheath aponeuroses (below arcuate line)
- External oblique m.
- Internal oblique m.
- Transversus abdominis m.
- Rectus abdominis m.
- Transversalis fascia
Innervation of parietal peritoneum

Same innervation as the body wall
Innervation of visceral peritoneum

Same innervation as the viscera it covers

Author

mnm2186

34363

Card Set

Anterolateral Abdominal Wall

Description

Exam 3

Updated

2010-09-19T22:50:02Z

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