Anterior Abdominal Wall

what binds the abdominal cavity superiorly and inferiorally

superior: diaphragm

inferior: pelvic inlet

what divides the abdominal cavity into quadrants

transumbilical plane horizontally with the vertical median plane (midsaggital line)

where does the transumbilical plane run

passes through the umbilicus and intervertebral disc between L3-L4

what are the two horizontal planes that create the 9 regions of the abdomen

subcostal plane (superior)

intertubercular plane (inferior)

where does the subcostal plane run

inferior border of 10th costal cartilage (L3)

where does the intertubercular plane run

connects the tubercles of the iliac crests (LV)

where do the vertical planes that create the 9 regions run

midclavicular line

contents of the RUQ

liver and gallbladder

contents of LUQ

stomach and spleen

contents of RLQ

cecum and appendix

LLQ contents

descending colon and sigmoid colon

referred pain from the foregut is felt where

epigastric region

referred pain of midgut is felt where

umbilical region

referred pain of hindgut is felt where

pubic regions

central regions of the 9 region system (from superior to inferior)

epigastric

umbilical

pubic

uppermost corners of the 9 region

right and left hypochondrium

middle sides of the 9 region

right and left flank

lower sides of the 9 region system

right and left groin

boundaries of the abdominal wall

superior: xiphoid process and costal margins

posterior: vertebral column

inferior: upper parts of the pelvic bones

layers of the abdominal wall from superficial to deep

skin

superficial fascia

muscles + their deep fascias

extraperiotenial fascia

parietal peritoneum

muscles of the anterior wall from superficial to deep

external oblique

internal oblique

transversus abdominis

layers of the superficial fascia

camper's fascia

scarpa's fascia

which is the fatty layer of superficial fascia

camper's

which is the membranous layer of superficial fascia

scarpa's fascia

what are the vertical anterolateral muscles

rectus abdominis

pyramidalis

the flat muscles of the anterior wall turn into _ at the midline

aponeurosis

the vertical muscles of the anterior wall are enclosed within _

a tendinous sheath formed by the aponeuroses of the flat muscles

contraction of the anterior wall muscles assists in what kind of breathing

quiet and forced expiration

contraction of the anterior wall muscles has what effect on intra-abdominal pressure

increases

ligaments associated with the external oblique

inguinal ligament

lacunar ligament

cooper's ligament

each of the flat muscles is covered by _ on anterior and posterior surfaces

deep/investing fascia

which. muscle has the most significant fascia

transverse abdominis

the transversalis fascia lines what

the abdominal cavity

where does the transversalis fascia continue into

the pelvic cavity

what intersects the rectus abdominis muscle

tendinous intersections

what forms the rectus sheath

layering of the aponeuroses of the oblique muscles + transversus abdominis

what is enclosed in the rectus sheath

rectus abdominis m

pyramidialis m

where is the rectus abdominis muscle in direct contact with the transversalis fascia

the posterior surface of the lower quarter

_ is deep to the transversalis fascia

extraperitoneal fascia

what separates the transversalis fascia from the peritoneum

extraperitoneal fascia

innervation of the anterior abdominal wall

T7-T12 and L1 spinal nerves (anterior rami)

branches of the L1 nerve

iliohypogastric nerve

ilio-inguinal nerve

what do nerves T7-T9 provide sensation to

skin from xiphoid process to above umbilicus

what does nerve T10 supply sensation to

skin around the umbilicus

what nerves supply sensation below the umbilicus

T11, T12, L1

what does the ilio-inguinal nerve supply sensation to

anterior surface of the genitals

medial upper thigh

superficial arterial supply of the anterior abdominal wall

superior: musculophrenic artery

inferior: superficial epigastric arterally and superficial circumflex iliac artery

deep arterial supply of the abdominal wall

SUPERIOR:

superior epigastric artery

10th and 11th intercostal arteries,

subcostal artery

INFERIOR:

inferior epigastric artery

deep circumflex iliac artery

external iliac artery

what blood vessels enter the rectus sheath

superior and inferior epigastric arteries

superficial lymphatic drainage of the abdominal wall

above umbilicus -> axillary nodes

below umbilicus -> superficial inguinal nodes

deep lymphatic drainage of the anterior abdominal wall

parasternal nodes

lumbar nodes

external iliac nodes

the groin is the area of junction between _

anterior abdominal wall and the thigh

contents of the inguinal canal

spermatic cord (males)

round ligament of the uterus (females)

genital branch of the genitofemoral nerve

ilio-inguinal nerve

which nerve passes through the inguinal ring

ilio-inguinal nerve

structures in the spermatic cord

ductus deferens + its artery

testicular artery

paminiform plexus of veins (testicular veins)

cremasteric artery and vein

genital branch of genitofemoral nerve

sympathetic + parasympathetic nerve fibres

lympathics

fascias involved with the spermatic cord

internal spermatic

creamsteric

external spermatic

what causes an inguinal hernia

protrusion of the periotenal sac through part of the inguinal canal

indirect inguinal hernia passes through:

deep inguinal ring

direct inguinal hernia passes through:

posterior wall of the inguinal canal

what usually causes indirect inguinal hernia

part of the embryonic processus vaginalis remains open

what gives rise to the inguinal canal

processus vaginalis

gubernaculum

where do the testes and ovaries originate

high in the posterior abdominal wall

inferior boundary of abdominal cavity

pelvic inlet

how high can the abdominal cavity rise

4th intercostal space

mcburney's point marks the location of

appendix

deepest layer of the abdominal wall

parietal peritoneum

groups of muscles in the anterior abdominal wall

flat

vertical

actions of anterior wall muscles

trunk flexion

forceful expiration

external oblique innervation

T7-T12 intercostal nerves

external oblique action

compress abdominal organs

trunk flexion (bilaterally)

contralateral lateral flexion (unilaterally)

internal oblique innervation

T7-T12 and L1

internal oblique action

compress abdominal organs

trunk flexion (bilaterally)

ipsilateral lateral flexion (unilaterally)

transversus abdominis innervation

T7-T12 and L1

transverse abdominis action

compress abdominal contents

stabilize abdomen

rectus abdominis innervation

T7-T12

arcuate line marks what

where the internal oblique aponerosus moves anteriorally and results in the rectus abdominis being directly exposed to the transversalis fascia

which dermatome is associated with appendicitis

T10

branches of the external iliac artery

inferior epigastric and deep circumflex iliac

where do parasternal lymph nodes drain

along the intrnal thoracic artery

where do lumbar nodes drain

along the abdominal aorta

where do external iliac nodes drain

external iliac artery

why do the testes migrate from the abdomen

temperature in the abdomen is not optimal for sperm production

where does the inguinal canal run

runs downward and medially above the inguinal ligament

how long is the inguinal canal

4 cm

what is the extent of the inguinal canal

deep inguinal ring to superficial inguinal ring

the superficial ring is an opening where

external oblique aponeurosis

what forms the deep ring of the inguinal canal

evagination of transversalis fascia

anterior wall of inguinal canal is formed by

external oblique aponeurosis

posterior wall of inguinal canal

fascia transversalis

where is the weak point to cause hernia

fascia transversalis

The floor of the inguinal canal is formed by

inguinal ligament

roof of the inguinal canal is formed by

arching fibers of the transversus abdominis and internal oblique muscles

pathway of a direct hernia

protrudes directly through the posterior wall of the inguinal canal

direct hernia relation to inferior epigastric artery

medial

indirect hernia relation to inferior epigastric artery

lateral

anatomical defect of a direct inguinal hernia

Weakness of transversalis fascia within Hesselbach's triangle

anatomical defect of an indirect inguinal hernia

Patent processus vaginalis (congenital)

which hernia type occurs within hesselbach's triangle

direct

which hernia type commonly passes through the scrotum

indirect inguinal hernia

what covering does a direct inguinal hernia acquire

external spermatic fascia