the median plane and the trans ever umbilical plane
What are the first three muscle layers of the abdominal wall
from superficial to deep
extenal oblique
internal oblique
and transversealis abdominus
Rectus Sheath
has anterior ( superficial layer ) and posterior layer ( deep )
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
what is in the middle of the rectus sheath ?
The rectus abdominus with the linea alba
what is the linea alba
The line of connective tissue going longitudinalto the unbilicus and in the rectus abdominus
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
what two artery anastomose in the rectuctus abdominis
the superior and inferior epigastric arteries
what nerves are in the abdomin?
The thoracoabdomical nerves
the intecostal nerves
where do the nerves of the abdomin run ?
betweenthe deepest layer muscle. the transversus abdominus and the middle layer the internal oblique muscles
which nerves of the abdomin give off the cutaneous bracnhes that create the dermatomes
the thoracoabdominal nerves
what organs are in quadrant I of the abdomen ?
what organs are in quadrant II of the abdomen ?
what organs are in quadrant III of the abdomen ?
what organs are in quadrant IV of the abdomen ?
Illiohypogastric nerve
comes off the ventral rami of the LI spinal nerve
Illio inguinal nerve
comes off the ventral rami of the LI spinal nerve
what is the blood supply to rectus abdominus ?
the inferior epigastric traveling inferior to superior and the superior epigastric traveling vice versa
they anastomose
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
what is McBerney's point
Surgeon do appendectomies at this point
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
the Processu vaginalius
this creates the inguinal canal and it is found in both males and females
what structures are in the dropped testes?
the Tunica vaginalis which has two layers paretial and visceral
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.
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
what does the umblical veins do ?
bring oxygenated blood to the fetus
arcuate line
the ending of the inferior layer of the rectus sheath
Median umbilical ligament
remnant of the urachus
posterior to the the median umbilical fold
Medial umbilical ligament is a remnant of?
remnant of the occluded umbilical artery
posterior to the medial umbilical fold
what fetal remnant is the round ligament?
The umbilican veins
what structure lay behind the lateral umbilical fold ?
the inferior apigastric artery and vein
what structure separates the lateral umbilical fold and the medial ?
the medial inguinal fossa
what structure separates the median and medial umbilical folds ?
supr vesicle fossa
what depression is above the lateral inguinal fold
the lateral inguinal fossa
what seperates the medial an lateral inguinal fossa
the lateral umbilical fold.
what is the other name for Hesselbach's triangle?
The medial inguinal fossa or the inguinal triangle
Inguinal ligament
runs from the ASIS to the public tuberucle
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
what is the structure that is vulnerable in the medial inguinal fossa
there is only aponeurosis not muscles
what is clinically significant about he femoral ring ?
it can be a sight of hernia because it is an opening
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
where do indirect hernias originate? and trevel
the lateral inguinal fossa go through the deep inguinal ring and exit through the superficial inguinal ring
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
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.
the dartos fascia of the scrotum is homologous with which structure of the abdomen