Lecture #56

  1. what planes divide the abdominal wall?
    the median plane and the trans ever umbilical plane
  2. What are the first three muscle layers of the abdominal wall
    • from superficial to deep
    • extenal oblique
    • internal oblique 
    • and transversealis abdominus
  3. Rectus Sheath
    has anterior  ( superficial layer ) and posterior layer  ( deep )
  4. what contributes to the rectus sheath
    • external blique aponeurosis , the trasnversus abdominus aponeurosusis( AP) 
    • and the lamina of the internal oblique AP that has both an anterior and posterior
  5. what is in the middle of the rectus sheath ?
    The rectus abdominus with the linea alba
  6. what is the linea alba
    The line of connective tissue going longitudinalto the unbilicus and in the rectus abdominus
  7. what happens to the recuts sheath arrangement inferior versus superior to the umbiluchus ?
    • above and in line with the umbilicus the posterior lamina of the IO AP (in front) and the transversus abdominus are not positioned behind the rectus abdominus.
    • but below it is in front
  8. what two artery anastomose in the rectuctus abdominis
    the superior and inferior epigastric arteries
  9. what nerves are in the abdomin?
    • The thoracoabdomical nerves
    • the intecostal nerves
  10. where do the nerves of the abdomin run ?
    betweenthe deepest layer muscle. the transversus abdominus and the middle layer the internal oblique muscles
  11. which nerves of the abdomin give off the cutaneous bracnhes that create the dermatomes
    the thoracoabdominal nerves
  12. what organs are in quadrant I of the abdomen ?
  13. what organs are in quadrant II of the abdomen ?
  14. what organs are in quadrant III of the abdomen ?
  15. what organs are in quadrant IV of the abdomen ?
  16. Illiohypogastric nerve
    comes off the ventral rami of the LI spinal nerve
  17. Illio inguinal nerve
    comes off the ventral rami of the LI spinal nerve
  18. what is the blood supply to rectus abdominus ?
    • the inferior epigastric traveling inferior to superior and the superior epigastric traveling vice versa 
    • they anastomose
  19. how to make incision ins abdominal surgery ?
    • It has to be parrallel to the tentsion lines of the skin and parralell to the muscles fiber of muscles 
    • this promotes healing
  20. what is McBerney's point
    Surgeon do appendectomies at this point
  21. descent of the testes
    • the testes start out inside of the abdominal wall and their path is guided by the Gubernaculum
    • as it does through the gubernaculum it becomes absorbed by the body 
    • there is an out pocketing og the anterior ab wall called the processus vaginalis that the testestes eventually sit in
  22. the Processu vaginalius
    this creates the inguinal canal and it is found in both males and females
  23. what structures are in the dropped testes?
    the Tunica vaginalis which has two layers paretial and visceral
  24. what vestige of the embryonic male testes can be left over and why does it have clinical significance.
    • the processus vaginalis .
    • this can make males more susceptible to hernia because content of the abdomen have a direct canal to the tested through this structure.
  25. what are the layer of the tested from superficial to deep?
    • skin of the abdomen/ skin of th scrotium
    • scarpa's fascia
    • external oblique spermatic fascia / EO aponeurosis
    • IO muscle + fascia/ cremaster muscle and fascia
    • transeveralis fascia / internal spermatic fascia 
    • peritoneum /tunica vaginalis
  26. what does the umblical veins do ?
    bring oxygenated blood to the fetus
  27. arcuate line
    the ending of the inferior layer of the rectus sheath
  28. Median umbilical ligament
    • remnant of the urachus 
    • posterior to the the median umbilical fold
  29. Medial umbilical ligament is a remnant of?
    • remnant of the occluded umbilical artery  
    • posterior to the medial umbilical fold
  30. what fetal remnant is the round ligament?
    The umbilican veins
  31. what structure lay behind the lateral umbilical fold ?
    the inferior apigastric artery and vein
  32. what structure separates the lateral umbilical fold and the medial ?
    the medial inguinal fossa
  33. what structure separates the median and medial umbilical folds ?
    supr vesicle fossa
  34. what depression is above the lateral inguinal fold
    the lateral inguinal fossa
  35. what seperates the medial an lateral inguinal fossa
    the lateral umbilical fold.
  36. what is the other name for Hesselbach's triangle?
    The medial inguinal fossa or the inguinal triangle
  37. Inguinal ligament
    runs from the ASIS to the public tuberucle
  38. what is the structure that is vulnerable in the lateral inguinal fossa
    • the deep inguinal vein opening 
    • where contents of the inner ab could push out
  39. what is the structure that is vulnerable in the medial inguinal fossa
    there is only aponeurosis not muscles
  40. what is clinically significant about he femoral ring ?
    it can be a sight of hernia because it is an opening
  41. Inguinal Canal
    • oblique orientation
    • it closes with increased pressure

    • has both a superficial and deep rings
    • larger in males because of the spermatic cord
    • pressure can tear and weaken these walls
  42. where do indirect hernias originate? and trevel
    the lateral inguinal fossa go through the deep inguinal ring and exit through the superficial inguinal ring
  43. where do direct hernias orginate and travel
    • the medial inguinal fossa and goes through the path of exit of the supeficial inguial ring 
    • these have a shorter path
  44. how is an indirect vs. direct hernia dianoses ?
    physician can put their finger in the space between the superficial inguinal ring and ask the patient to cough and this should reveal how the deviating strucutre is travel and from where.
  45. the dartos fascia of the scrotum is homologous with which structure of the abdomen
    the scarpa's fascia
Card Set
Lecture #56
Anterior abdominal wall and Inguinal Canal