Regional Anatomy III Week 8

What are the layers of the abdominal wall, superficial to deep?

Skin

Superficial fatty layer of subcutaneous tissue (Camper fascia)

Deep membranous layer of subcutaneous tissue (Scarpa fascia)

Investing (deep) fascia - superficial, intermediate, and deep

External oblique

Internal oblique

Transversus abdominis

Extraperitoneal fat

Endoabdominal (transversalis) fascia

Parietal peritoneum

What is the condition where an organ or fatty tissue squeezes through a weak spot in a surrounding muscle or connective tissue?

Hernia

What type of hernia occurs at Hesselbach's triangle?

Inguinal

What type of hernia results form a surgery?

Incisional

What type of hernia occurs at the outer groin?

Femoral

What type of hernia occurs at the belly button?

Umbilical

What is an AKA for a hiatal hernia?

Diaphragmatic

What type of inguinal hernia traverses the inguinal canal along the same course as the spermatic cord?

Indirect hernia

Which gender is more affected by indirect hernias?

Males

What type of inguinal hernia is characterized by a bulge through weakened fascia of the abdominal wall?

Direct hernia

What is the term for the condition that develops when excessive swelling or bleeding expands the muscle body beyond the ability of the fascia to stretch?

Compartment syndrome

What is the most common site of compartment syndrome?

Lower leg

What causes acute compartment syndrome?

Injury with internal bleeding or swelling

What causes chronic compartment syndrome?

overtraining

What allows for explosive or plymoetric movement?

Fascia

What is fascia made out of?

Matrix of collagen and elastic fibers suspended in gelatinous ground substance

Which part of fascia is formed by Scarpa's fascia that blends with the dermis of the skin and subcutaneous fat?

Superficial fascia

Which part of the fascia is relatively thick and dense and encloses muscle groups?

Deep fascia

What is the term for superficial fascia which is interdigitated between dermis and subcutaneous fat?

Cellulite

What is the term for inflammation of the fascia?

Fascitis

What fascial disorder results from over extensibility of the fascia, increasing risk of hernias?

Weakness or reduced resilience

What % of people is the pyramidal muscle absent in?

20%

What is the origin of the external oblique?

Outer surface of lower 8 ribs

what is the insertion of the external oblique?

intercostals, iliac crest, and linea alba

Where does the line alba attach?

Xiphoid process and pubic bone

What forms the inguinal ligament?

Lower border of the external oblique aponeurosis

Where does the inguinal ligament attach?

fascia lata

Where is the superficial inguinal ring?

The external oblique aponeurosis, immediately above the pubic tubercle

What is the origin of the internal oblique?

thoracolumbar fascia, iliac crest, and lateral part of inguinal ligament

What is the isnertion of the internal oblique?

lower 3 or 4 ribs and their costal cartilages, also intercostals, iliac crest, and linea alba

What is the origin of the transverses abdominis?

deep surface of lower 6 costal cartilages, thoracolumbar fascia, iliac crest, and lateral part of inguinal ligament

What is the insertion of the transverses abdominis?

continuous with aponeurosis

What is the first step in a cesarean section?

The uterus is exposed through the abdominal wall

What is the second step in a cesarean section?

The muscles of the uterus are separated, producing a hole for delivery of the infant

What is the third step of a cesarean section?

The infant is delivered through the opening created in the uterine wall

What is the origin of the rectus abdominis?

Public symphysis and pubic crest

What is the insertion of the rectus abdominis?

5th-7th costal cartilages and xiphoid process

What is the name of the transverse fibrous bands that divide the Rectus abdominis?

Tendinous inscriptions

What are the functions of the oblique abdominal muscles?

Lateral flexion and rotation of the trunk

What is the function of the rectus abdominis

trunk flexion

What is the function of the oblique muscles

lateral flexion

rotation of trunk

What is the function of the transversus abdominis?

Maintain posture

increase intra-abdominal pressure

stabilization of spine for movement

What is the name of the maneuver where you close the glotts and increase intra-abdominal pressure

Valsalva

What forms the rectus sheath?

Aponeurosis of 3 flat abdominal muscles

What are the contents of the rectus sheath?

Rectus abdominis

Pyramidalis

Terminal parts of lower 5 intercostal and subcostal nerves

Superior and inferior epigastric vessels

What is the name of the curved line that marks the lower end of the posterior aponeurotic wall of the rectus sheath?

Arcuate line

Where is the arcuate line located?

Halfway between the umbilicus and pubic symphysis

How long is the inguinal canal?

4 cm

What structures are found in males' inguinal canals?

spermatic cord and related structures

What structures are found in Females' inguinal canals?

Roung ligament of the uterus

What structure is found in the inguinal canal of both sexes

Ilioinguinal nerves

What direction does the inguinal canal run from the deep to superficial inguinal ring?

Anterior, inferior, medial

Where does the deep inguinal ring open into?

Transversalis fascia

What passes medial to the deep inguinal ring?

Inferior epigastric vessels?

What does the superficial inguinal ring open into?

Aponeurosis of external oblique (immediately superior to pubic tubercle)

What is the anterior wall of the inguinal canal?

Aponeurosis of external oblique

What is the posterior wall of the inguinal canal?

transversals fascia

What is the inferior border of the inguinal canal?

Inguinal ligament

What is the superior border of the inguinal canal?

arching lowest fibers of internal oblique and transverses abdominis

What artery is the superior epigastric artery the terminal branch of?

Internal thoracic artery

What does the superior epigastric artery anastomose with?

Inferior epigastric artery

What does the inferior epigastric artery originate from?

Distal part of external iliac artery

What ligament is formed by the inferior epigastric artery in utero?

Lateral umbilical ligament

What artery does the deep circumflex iliac artery originate from?

Distal part of the external iliac artery

What supplies the lower part of the anterior abdominal wall?

Deep circumflex iliac artery

What connects the superficial epigastric vein and lateral thoracic vein?

Thoracoepigastric vein

Which deep vein drains into the thoracic vein?

Superior epigastric

Which deep veins drain into the external iliac vein?

Inferior epigastric and deep circumflex iliac veins

Which veins drain into the azygos or hemiazygos veins?

Posterior intercostal and subcostal veins

Which vein do the lumbar veins drain into?

inferior vena cava

What is the T7 dermatome?

Immediately inferior to tip of xiphoid process

What is the T10 dermatome?

Level of umbilicus

What is the L1 dermatome?

just above inguinal ligament and pubic symphysis