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Ant.Abdominal&Inguinal Region
Anterior Abdominal Wall & Inguinal Region
67
Anatomy
Graduate
06/27/2007

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Cards

Term
Bony Landmarks of Anterior Abdominal Wall
Definition
iliac crest, pectinal line, ASIS, pubic symphysis, pubic tubercle
Term
Divisions of Anterior Abdominal Wall
Definition
*4 Regions (R and L upper and lower quadrants) using a vertical and horizontal line through umbilicus-located at L4 vertebral level.
*OR 9 regions using two vertical (mid-clavicular/mid-inguinal) and two horizontal (subcostal and intertubercular) lines.
Term
Sensory Innervation and Dermatomes of the Anterior Abdominal Wall
Definition
*Thoracoabdominal nerve: T6-T11 intercostal nerves. T10-sensory to umbilicus
*Subcostal nerve: T12-sensory to ASIS and hip.
*Iliohypogastric nerve: L1-sensory to hypogastric region and iliac crest.
*Ilionguinal nerve: L1-passes through the inguinal canal and is sensory to the labia majora, mons pubis, scrotum, and medial thigh.
Term
Thoracoabdominal nerve
Definition
T6-T11 intercostal nerves. T10-sensory to umbilicus
Term
Subcostal nerve
Definition
T12-sensory to ASIS and hip.
Term
Iliohypogastric nerve
Definition
L1-sensory to hypogastric region and iliac crest
Term
Ilioinguinal nerve
Definition
L1-passes through the inguinal canal and is sensory to the labia majora, mons pubis, scrotum, and medial thigh
Term
Abdominal Pain and Referred Pain
Definition
viscera from other areas of the body may refer pain to the abdomen and abdominal structures may refer pain to other parts of the body. Diaphragm irritation and pain is usually referred to the ipsilateral shoulder.
*appendicitis pain may initially be referred to the epigastric or periumbilical region rather than to the actual location of the appendix-pain will move to the appendix's location when adjacent peritoneum becomes irritated by the inflammation.
*pain is only generated in the intestines by distension/dilation (over-stretched walls)
*pain generated by structures of the posterior half of the abdomen may be referred to the back (such as pain from leaking or ruptured AAA or from pancreatitis)
*pain in the upper abdomen may be referred from the heart
*genital or urinary tract problems may cause lower abdominal discomfort/pain.
*kidney and urinary tract pain may be referred to the flanks or genitals
Term
Superficial Fascia of the Abdominal Wall
Definition
*Camper's fascia
*Scarpa's fascia
Term
Camper's fascia
Definition
superficial fatty layer in abdominal wall; variable in thickness
Term
Scarpa's fascia
Definition
membranous layer deep to Camper's fascia (seen primarily on the inferior abdominal wall)
*clinical importance! fascia is dense enough to hold sutures.
Term
Muscles of Abdominal Wall
(3 flat muscles and 1 vertical strap-like muscle)
Definition
*external oblique
*internal oblique
*transverse abdominus
*recuts abdominus
*pyramidalis**
Term
External Oblique Muscle
Definition
O: external surfaces of ribs 5-12

I: anterior iliac crest, fascia of iliopsoas muscle, linea alba, pubic bone

A: compresses abdominal contents; laterally flexes and rotates vertebral column; stablizes pelvis; aids in forced expiration

IN: T6-L2 VPRs
Term
External Oblique Muscle Description
Definition
*most superficial and largest of the flat muscles
*fibers run in an inferomedially ("hands in your front pockets") direction
*anterior half of the muscle has a strong flat tendon called external oblique aponeurosis
*inferior edge of aponeurosis thickens to form inguinal ligament
Term
Internal Oblique Muscle
Definition
O: iliopsoas fascia, iliac crest, and thoracolumbar fascia

I: inferior borders of ribs 10-12, linea alba, pubic crest, pubic pectin, and pectineal ligament

A: compresses and supports abdominal viscera; aids in forced expiration

IN: T6-L2 VPRs
Term
Internal Oblique Description
Definition
*lies immediately deep to external oblique muscle
*muscle fibers run upwards and medially at roughly right angles to external oblique
*aponeurosis of internal oblique fuses with transverse abdominus aponeurosis to form the conjoined tendon that inserts onto the pubic tubercle
*aponeurosis splits into two layers to contribute to both the anterior and posteror rectus sheathes
*inferior portion of the internal oblique muscle descends as the cremaster muscle within the spermatic cord
Term
diaphragm irritation and pain is usually referred to...
Definition
ipsilateral shoulder
Term
appendicitis pain may be initially referred to the .... and then move to appendix location when adjacent peritoneum becomes irritated/inflamed.
Definition
epigastric or periumbilical region
Term
pain in generated in intestines by...
Definition
distension/dilation
Term
pain generated by structures of the posterior half of the abdomen, such as leaking/ruptured AAA or pancreatitis, may be referred to...
Definition
the back
Term
pain in upper abdomen may be referred to...
Definition
the heart
Term
genital or UT problems may cause...
Definition
lower abdominal comfort/pain
Term
pain in flanks or genitals may be caused by...
Definition
kidney and UT
Term
scarpa's fascia is important clinically because...
Definition
its dense enough to hold sutures
Term
the inferior edge of the external oblique aponeurosis forms...
Definition
inguinal ligament
Term
aponeurosis of internal oblique fuses with transversus abdominus aponeurosis to form...
Definition
conjoined tendon
Term
inferior portion of internal oblique muscles descends as...
Definition
cremaster muscle within the spermatic cord
Term
sustained involuntary contraction of abdominal wall musculature to protect inflamed or painful intra-abdominal structures is known as..
Definition
guarding
Term
sign of peritoneal inflammation/irriatation may be pronounced when...
Definition
an acute abdomen is being palpated
Term
the rectus sheath encases...
Definition
the two rectus abdominus muscles, pyramidalis muscles, sup. and inf. epigastric vessels, and VPRs of T7-T12 spinal nerves
Term
inguinal region is important clinically because...
Definition
most hernias happen here
Term
superficial inguinal ring is kept from expanding by the presence of... that run b/w medial and lateral crus
Definition
intercrural fibers
Term
the lateral crus fibers roll inferiorly to the pectineal line and form....

this.... attaches to pectineal ligament
Definition
lacunar ligament
Term
medial and lateral crus inserts on...
Definition
pubic crest and tubercle
Term
lacunar ligament fuses to the...
Definition
sup. ramus of pubis
Term
inguinal canal is found... to the inf. epigastric artery
Definition
lateral
Term
Inguinal canal boudries:
floor:
roof:
ant.:
post.:
Definition
floor:inguinal ligament and lacunar ligament

roof:inf. edge of internal oblique and transversus abdominus muscles

ant.:aponeurosis of ext. oblique muscles

post.:transversalsis fascia and conjoint area
Term
contents of inguinal canal
Definition
*round ligament of uterus
*ilioinguinal nerve
*spermatic cord
Term
the cremaster muscle is responsible for...
Definition
raising and lowering testes in response to temperature changes
Term
ductus (vans) deferens enter the... and exits through.... and turns medially to travel to...
Definition
superficial inguinal canal

deep inguinal canal

prostate gland
Term
ducuts (vas) deferens converys sperm and secretions from.... to...
Definition
epididymis

ejaculatory ducts
Term
gonadal arteries (testicular and ovarian) are branches off...
Definition
abdominal aorta
Term
the testicular artery (gonadal) descends along the posterior abdominal wall to enter the... and exit the... to provide blood to....
Definition
deep inguinal ring

superficial inguinal ring

testes
Term
testicular plexus provides...
Definition
sympathetic autonomic innervation; carries vasomotor and pain and pressure fibers
Term
hernias are based on their relationship to...
Definition
inferior epigastric vessels
Term
Hesselbach's triangle borders are...
Definition
lateral edge or rectus abdominus muscles

inguinal ligament

inferior epigastric vessels
Term
Hesselbach's triangle is where... hernias occur
Definition
direct
Term
direct hernias are... to inf. epigastric vessles and herniate through...
Definition
medial

hesselbach's triangle
Term
indirect hernia's are ... to epigastric vessles and through....
Definition
lateral

inguinal canal
Term
indirect hernias are more likely to cause...
Definition
strangulation
Term
hernias may present swelling in the...
Definition
groin or scrotal area
Term
testes develop in the... slightly inferior to...
Definition
posterior abdominal cavity

kidneys
Term
during the descent of the testes, they attach to a ligament called...
Definition
gubernaculum testis ligament
Term
the gubernaculum testis ligament guides the testes down the posterior abdominal wall through the.... into the.... by becoming successively shorter.
Definition
inguinal canal

scrotal sac
Term
the scrotum sac is compased of a heavily pigmented skin outer layer and and inner layer that contains... musclce
Definition
dartos
Term
the scrotum response to cold temperature by....
Definition
wrinkling to decrease heat loss
Term
testes are suspended in scrotum by the...
Definition
spermatic cord
Term
the .... and ... cover the testes
Definition
tunica vaginalis

tunica albuginea
Term
the epididymis serves to...
Definition
stores sperm
Term
metastasis of testicular cancer is via .... nodes since the testes develop in the posterior abdominal cavity
Definition
lumbar
Term
metastasis of scrotal cancer is via ..... nodes (anteriorly)
Definition
superficial inguinal
Term
the ... of the epididyis is continuous with...
Definition
tail

ductus (vas) deferens
Term
The inf. edge of the external oblique aponeurosis thickens to form...
Definition
inguinal ligament
Term
The inf. edge of the external oblique aponeurosis thickens to form...
Definition
inguinal ligament
Term
what structure travels through both the male and female inguinal canal?
Definition
ilioinguinal nerve
Term
A 26 year old man is seen in the ER for treatment of injuries sustained when he was stabbed in his lower abdomen. The stab wound completely penetrated his recuts abdominus muscle about halfway between the umbilicus and superior pubic ramus inferior to th
Definition
skin--> camper's fascia--> scarpa's fascia--> anterior layer of rectus sheath--> rectus abdominus muscles--> transversalis fascia--> peritoneum
Term
vascetomy
Definition
the ductus deferens are isolated on each side and transected or a small section of it is removed. sperm can no longer pass to urethra; they degenerate in the epididymis and proximal end of the ductus deferens
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