Anterior Abdominal Wall and Inguinal Region

Comprehensive practice flashcards reviewing the anatomical regions, abdominal wall layers, fascia, musculature, rectus sheath, neurovasculature, inguinal canal, spermatic cord, scrotum, and peritoneal folds and compartments.

What is the location of the abdomen

In trunk Between thorax and pelvis — contains most organs of the alimentary system and parts of the urogenital system

IT IS FLEXIBLE

What is the anterolateral border of the abdomen?

Musculoaponeurotic wall

What is the superior border of the abdomen?

The diaphragm

What is the inferior border of the abdomen?

The muscles of the pelvis

Contraction of abdominal muscles do what?

increase abdominal pressure, helps eliminate air from thoracic cavity

can also eliminate fluid (urine), feces, or fetuses
Muscles can also distend - ingestion, pregnancy, fat desposition

What is the muscle action to expel urine and fetuses?

Valsalva maneuver

Is there physical seperation between abdominal and pelvic cavity?

No they are continuous with each other

Where does the abdomiopelvic cavity extend from?

Thoracic diaphragm to the pelvic diaphragm

What forms the floor of the pelvic cavity?

Pelvic diaphragm

What muscles form the pelvic diaphragm

levator ani muscle and coccygous muscle

What forms the floor of the abdominal cavity?

Arbitrarily the plane of pelvic inlet (superior pelvic aperture) separates the abdominal and pelvic cavities

The greater pelvis is in what cavity?

the abdominal cavity

The lesser pelvis is in what cavity?

Pelvic cavity

What is the greater pelvis?

Portion of pelvis extending superiorly — supports and protects the abdominal viscera (part of ileum, cecum, and sigmoidal colon)

Abdominal cavity extends superiorly into…

osseocartilagenous thoracic cage

The osseocartilagenous thoracic cage protects what organs of the abdominal cavity?

spleen, liver, part of kidneys, and stomach

What is the pelvic inlet?

entrance to pelvic cavity

What is the relative location of pelvic cavity to abdominal cavity

posteroinferior to abdominal cavity

What is the entrance to the pelvic cavity?

The pelvic inlet

What bones contribute to pelvic outlet?

inferior part of pubis, ischium, and coccyx

How many regions/quadrants is the abdomen divided into

9/4

What is the abdominal plane that separates left and ride side of the body

Vertical plane/Saggital plane= MIDCLAVICULAR PLANES (2)

What are the transverse/horizontal planes of the abdominal regions

Subcostal plane

Transtubercular plane

What is the transtubercular plane

Transverse Plane passing through the iliac tubercles and the body of L5 vertebra

What is the subcostal plane?

Transverse plane; passes through inferior border of the 10th costal cartilage on each side

What is the middle superior region of the abdomen?

epigastric region (E)

What is the right superior region of the abdomen?

Right hypochondriac region (RH)

What is the left superior region of the abdomen?

Left hypochondriac region (LH)

What is the middle middle region of the abdomen?

umbilical region (U)

What is the middle right region of the abdomen called?

Right lumbar (RL) region OR Right flank

What is the middle left region of the abdomen called?

Left lumbar (LL) region OR Left flank

What is the inferior middle region of the abdomen called?

Hypogastric (H) OR Pubic (P) region

What is the inferior right region of the abdomen called ?

Right inguinal region (RI)

What is the inferior left region of the abdomen called ?

Left inguinal region (LI)

What is the point on the abdomen that separates the quadrants?

The umbilicus (belly button)

What Plane separates the left quadrants and right quadrants of the abdomen?

Mid-sagittal or Median plan

What plane separates the upper and lower quadrants of the abdomen?

The transumbilical plane

What is the superior boundary of the anterolateral abdominal wall?

costal cartilages 7th – 10th and xiphoid process

What is the inferior boundary of the anterolateral abdominal wall?

inguinal ligament and superior margin of anterolateral aspect of pelvis

Where does the inguinal ligament start and end?

start: superior anterior illiac spine

end: pubic tubercle of pubic bone

Layers of anterolateral abdominal wall

1. Skin

2. Superficial fascia (2 layers)

   1. Superficial fatty later

   2. Deep membranous layer

3. Muscles

4. Deep Fascia (3 specific fascia for each muscle)

   1. Transversalis Fascia

   2. Extraperitoneal fat

   3. Parietal peritoneum

What are the 2 superficial fascial layers in the anterolateral abdominal wall?

1. Camper Fascia - superficial fatty later made of adipose tissure

2. Scarpa fascia- deep membranous layer made of collagenous connective tissue

What is unique about the Scarpa fasica of the anterolateral abdominal fascia?

Continuous inferiorly in the perineum as the superficial perineal fascia (Colles

fascia) and with the scrotum as Dartos fascia

What are the muscles of the abdomen

External oblique m., internal oblique m., transverse abdominis m.

What is the fascia deep to the transversus abdominis muscle?

Transversalis fascia - lines the deep surface of the

transversus abdominis muscle and its aponeurosis

What is the endoabdominal fascia?

The transversalis fascia

What is deep to the transversalis fascia?

Extraperitoneal fat- more abundant in posterior abdominal wall, especially around kidneys and pelvic floor

What is deep to the extraperitoneal fat of the abdomen?

Parietal peritoneum- serous membrane lining internal surface of abdominal wall. continuous with visceral peritoneum

Order from superfiical to deep of anterolateral abdominal wall

Skin

Campers Fascia

Scarpas fascia

External oblique m

Internal oblique m

Transversus abdominis m

Transversalis fascia

Extra peritoneal fat

Parietal peritoneum

What is the largest and most superficial flat muscle of the anterolateral abdominal wall?

External oblique muscle

What is the inferior margin of the external oblique muscle and what does it form? fix this question

Engrossed as a fibrous band forming the inguinal ligament

External oblique muscle is innervated by?

thoracoabdominal (T7-T11) nerves and subcostal nerves

What direction to the fibers of the external oblique run in comparison to internal oblique?

running perpendicular to each other creating a right triangle

What is the function of the external oblique

Compresses abdomen and supports viscera, flexes trunk, active in forced

expiration

What is the internal oblique muscle innervated by?

iliohypogastric n.,

ilioinguinal n.

subcostal n.

thoracoabdominal n.

What is the intermediate anterolateral abdominal mall muscle?

Internal oblique m

What is the function of the internal oblique muscle

Compresses abdomen and supports viscera, flexes trunk, active in forced

expiration

Innervation of the Transversus abdominis muscle?

thoracoabdominal nerves (T7 – T12)

iliohypogastric n

ilioinguinal n. (L1)

What is the long, strap-like vertical mostly enclosed in the rectus sheath and

anchored transversely by the tendinous intersections?

The Rectus Abdominis muscle

What is the function of the rectus abdominis m?

Flexes trunnk, compresses abdomen, and supprts viscera

Control tilt of pelvis

What is the rectus abdominis innervated by?

Thoracoabdominal nerves and subcostal nerves

Who forms the inguinal ligament

The engrossment of the aponeurosis of the external oblique muscle

The point where both pubic bones meet is called

Pubic symphysis

What is the innermost of the flat muscles of the abdomen?

Transversus abdominis muscle

The superior continuation of the superior gastric artery is?

Internal thoracic artery

Other than the superior epigastric artery what is the other terminal branch of the internal thoracic artery?

Musculophrenic artery

Where do the aponeurotic fibers of the transversus abdominis begin?

At the midclavicular line (MCL) medially and spinoumbilical line inferiorly.

Where do the aponeurotic fibers of the transversus abdominis decussate (cross)?

At the linea alba.

Where is the neurovascular plane of the anterolateral abdominal wall located? What structures travel through the neurovascular plane?

Between the internal oblique and transversus abdominis muscles.

Nerves and blood vessels supplying the anterolateral abdominal wall.

What are the main functions of the transversus abdominis?

Compresses the abdomen, supports abdominal viscera, and assists in forced expiration.

What structure encloses most of the rectus abdominis muscle?

The rectus sheath

What structures anchor the rectus abdominis transversely?

Tendinous intersections.

What forms the rectus sheath?

The interweaving and decussation (crossing) of the aponeuroses of the three flat abdominal muscles.

What are the three flat abdominal muscles that contribute to the rectus sheath?

External oblique (EO), internal oblique (IO), and transversus abdominis (TA)

What structures are contained within the rectus sheath?

Rectus abdominis, superior and inferior epigastric arteries and veins, lymphatic vessels, and portions of the thoracoabdominal nerves

What forms the anterior rectus sheath in the superior 3/4?

External oblique (EO) and internal oblique (IO) aponeuroses.

What forms the posterior rectus sheath in the superior 3/4?

Internal oblique (IO) and transversus abdominis (TA) aponeuroses.

What forms the anterior rectus sheath in the inferior 1/4?

All three aponeuroses: EO, IO, and TA.

What lies posterior to the rectus abdominis in the inferior 1/4?

Transversalis fascia.

What is the arcuate line?

The line marking the transition between the superior 3/4 and inferior 1/4 of the rectus sheath.

What is the linea alba?

A midline fibrous structure running along the anterior abdominal wall that separates the right and left rectus sheaths.

What is the course of the musculophrenic artery? What does the musculophrenic artery supply?

Runs along the costal margin.

Superficial and deep abdominal walls of the hypochondriac region.

What is the course of the superior epigastric artery?

Runs inferiorly within the rectus sheath.

What does the superior epigastric artery supply?

Superior rectus abdominis and superficial and deep walls of the epigastric and umbilical regions.

What artery does the superior epigastric artery anastomose with? Where does it anastomose?

Inferior epigastric artery.

Umbilical region

Which intercostal arteries contribute to the anterolateral abdominal wall?

10th and 11th intercostal arteries.

What is the course of the 10th–11th intercostal and subcostal arteries? What do they supply?

Extend beyond the ribs and run between the internal oblique (IO) and transversus abdominis (TA). — Origin = Aorta

Superficial and deep abdominal walls of the lateral region

What artery is continuous inferiorly with external illiac artery?

femoral artery

What two arteries arise from the external iliac artery?

Inferior epigastric artery and deep circumflex iliac artery.

Where does the inferior epigastric artery originate?

From the external iliac artery, superior to the inguinal ligament.

What does the external iliac artery supply?

the lower limb

What does the inferior epigastric artery supply? and what is its course?

Lower rectus abdominis and deep abdominal wall of the pubic and inferior umbilical regions.

Runs within the rectus sheath.

What artery dos the inferior epigastric artery anastomose with? Where do they anastomose?

Superior epigastric artery; umbilical region

What artery gives rise to the deep circumflex iliac artery?

External iliac artery.

What is the course of the deep circumflex iliac artery? what does it supply?

Runs parallel to the inguinal ligament, deep within the anterior abdominal wall. Supplies: Deep inguinal region, iliac fossa, and iliacus muscle.

Internal thoracic vein drains into

brachiocephalic vein

What two superficial arteries arise from the femoral artery?

Superficial circumflex iliac a.

superficial epigastric a.

Lateral thoracic vein drains into…

axillary vein

What is the course of the superficial circumflex iliac artery? What does it supply

Runs through subcutaneous tissue along the inguinal ligament.

Supplies: the superficial inguinal region

The common iliac vein drains into what structure?

Inferior Vena Cava