Linea alba is the vertical line running down the middle of the rectus abdominus muscles. The semilunar lines are vertical lines running through MCL dissecting lateral two sets of rectus abdominus muscles from medial two sets of rectus abdominus muscles
What are the linea alba and semilunar lines?
Horizontal line running at waistband below rectus abdominus muscles on intertubercular plane between superior anterior iliac spines
What is the arcuate line?
Stomach and Spleen
What abdominal viscera lie in the left hypochondriac region?
Skin, Superficial fascia (Camper and Scarpa), Deep Fascia, Muscles, Transversalis Fascia, Extraperitoneal Fat, Parietal Peritoneum
What are the layers of the abdominal wall?
Posterior Inferior running fibers in the External oblique and there are Arching fibers in Internal Oblique and Transverse Muscles
Describe the direction that the fibers course in the: External and Internal Oblique Muscles and Transverse Muscles
External Oblique, Internal Oblique and Transverse Muscles
What are the three muscle layers of the abdominal wall lateral to the rectus sheath?
Direct Inguinal, Indirect Inguinal, Femoral, Umbilical, Epigastric, Incisional, Spigelian, Lumbar, and Internal hernias
Name abdominal wall (ventral) hernias.
Inferior and Superior Epigastric Arteries and lower six Intercostal Arteries
What anastomotic arteries lie posterior to the rectus abdominis muscle?
Aponeuroses of external oblique, internal oblique and transverse muscles (conjoned tendon)
What layers form the anterior lamina of the rectus sheath below the arcuate line?
Failure of embryonic closure of the deep inguinal ring which protrudes through superficial inguinal ring between Tunica vaginialis and internal spermatic fascia
What is an indirect inguinal hernia?
genital branch of the genitofemoral nerve, which innervates the cremaster muscle
What nerve is in the spermatic cord, and what does it innervate?
Failure of embryonic closure of the deep inguinal ring which protrudes through superficial inguinal ring between Tunica vaginialis and internal spermatic fascia
What is an indirect inguinal hernia?
Triangle bordered by Linea Semilunaris medially, laterally by inferior Epigastric Vessels, and inferiorly by Inguinal Ligament
What is the inguinal (Hesselbach's) triangle?
The Peritonium, banded between layers or the broad ligament of the liver, the diaphragm above and the liver below
What structure can limit spread of a suprahepatic abscess across the midline?
The Superior epigastric stems from the Internal Thoracic Artery and the Inferior epigastric stems from the External Iliac Artery
Which vessel gives rise to the: Superior epigastric artery? Inferior epigastric artery?
Inguinal Hernias can block or cause ischemia in the inferior epigastric artery
What is the significance of the inferior epigastric artery with respect to inguinal hernias?
T4 for the Xiphoid process, T10 for the Umbilicus and L1 for the Inguinal ligament
Which approximate dermatomal level is represented by the: Xiphoid process? Umbilicus? Inguinal ligament?
Abdominal Peritoneum: Parietal Peritoneum, Visceral Peritoneum (double layer called Mesentery) and Peritoneal Cavity with serous fluid
The intercostal nerves run between which layers of the abdominal wall?
Location of Direct Inguinal Hernias
What is the clinical significance of the inguinal triangle (Hesselbach's triangle)?
Intercostal, Iliohypgastric, Ilioinguinal and Subcostal Nerves
What are the major nerves of the anterior abdominal wall?
The cutaneous lymph vessels above the level of the umbilicus drain upward into the anterior axillary lymph nodes. The vessels below this level drain downward into superficial inguinal nodes
Describe the lymphatic drainage of the anterior abdominal wall.
Iliohypogastric and Ilioinguinal Nerves
Which 2 nerves arise from the LI segment of the lumbar plexus?
Between the Pubic Tubercle and the Anterior Superior Iliac Spine
The inguinal ligament (Poupart's ligament) extends between which 2 structures?
External Abdominal Oblique Aponeurosis
What forms the inguinal ligament?
Traingular shaped opening in the aponuerosis of the external oblique muscle and immideately above and lateral to the pubic tubercle
Which structures form the Superficial (external) inguinal ring?
The Deep Inguinal Ring is and opening of the fascia transversalis right above the midpoint of the inguinal ligament and is the lateral and deep opening of the inguinal canal and lateral to the inferior epigastric vessels.
Which structures form the Deep (internal) inguinal ring?
Aponueroses of the external and internal oblique muscles (A), transverse fascia and conjoint tendon (P), inguinal ligament (I) and arching fibers of internal and tranverse muscles (S)
What forms the walls of the inguinal canal: Anteriorly? Posteriorly? Superiorly? Inferiorly?
In Men: ilioinguinal nerve and structures to and from testis, in Women: round ligament of the uterus from the uterus to the labium majus and ilioinguinal nerve
Which major structures pass through the inguinal canal in: Men? Women?
Autonomic nerves, vas deferens, testicular artery, testicular veins (paminiform plexus), testicular lymph vessels, processus vaginalis, cremasteric artery, artery of the vas deferns, genital branch of the genitofemoral nerve
What structures comprise the spermatic cord?
Abnormal enlargement of the vein in the scrotum draining the testicles
What is a varicocele?
The muscle layer of the musculus cremaster is formed from fibers of the oblique internal and transverse muscles
From what abdominal muscle layer is the cremaster muscle derived?
NAVEL, Medially Femoral Nerve, Femoral Artery, Femoral Vein, Empty Space, and Ligament laterally
What is the orientation of the femoral vessels and nerve inferior to the inguinal ligament?
Loop of intestine protruding through the femoral ring and through the saphenous opening in the deep fascia of the thigh, bulging upwards under the skin of the abdominal wall
What is a femoral hernia?
Scarpa's (membranous) Fascia
Which is the deepest layer of the abdominal wall that is involved in bulge in inguinal area?