Notes in Anterior Abdominal Wall, Inguinal Canal

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Published	01/20/2024	Containment of organs by musculo‐aponeuroticwalls• The diaphragm superiorly, and the musclesof the pelvis inferiorly• Suspended/supported by two bony …
Published	01/20/2024	Abdominal cavity extends superiorly into the {{c1::4th intercostal space}}
Published	01/20/2024	Expiring against closed larynx ({{c1::Valsalva maneuver}}) – increasesboth the intrathoracic and intra‐abdominal pressures
Published	01/20/2024	The abdominopelvic cavity can, through voluntary or reflexivecontraction of its muscular roof, anterolateral walls, and floor canraise internal (intra…
Published	01/20/2024	Abdominopelvic Cavity can significantly increase the rigidity of the torso during weightlifting or be used to proactively check various medical condit…
Published	01/20/2024	{{c1::Median}} plane ‐ dividing it into evenright and left halves
Published	01/20/2024	{{c1::Transumbilical}} plane ‐ through theumbilicus, at disc between L3/L4
Published	01/20/2024	{{c1::Subcostal}} plane ‐ passing through the inferiorborder of the 10th costal cartilage on eachside
Published	01/20/2024	{{c1::Midclavicular}} plane ‐ a line drawn from themidpoint of the clavicle down to the middle ofthe inguinal ligament
Published	01/20/2024	{{c1::Intertubercular}} plane ‐ passing through theiliac tubercles and the body of the L5 vertebra,~5 cm posterior to the ASIS on each side
Published	01/20/2024	The boundary between the anterior andlateral walls is indefinite; therefore, it is often referred toas the anterolateral abdominal wall ‐ extending fr…
Published	01/20/2024	{{c1::Camper’s}} fascia ‐ superficial fatty layer,much like anywhere else in the body
Published	01/20/2024	{{c1::Scarpa’s}} fascia ‐ deep membranous layer inferior to the umbilicus
Published	01/20/2024	Scarpa’s fascia ‐ deep membranouslayer• continues inferiorly into theperineal region as the membranouslayer of subcutaneous tissue of theperineum – {{…
Published	01/20/2024	Scarpa's fascia, the deeper membranous layerof superficial fascia, continues as:• below the inguinal ligament to the {{c1::fascia lata}}of thigh
Published	01/20/2024	Scarpa's fascia, the deeper membranous layerof superficial fascia, continues as:• Into the perineum as {{c1::Colles'}} fascia (superficialperineal)
Published	01/20/2024	Scarpa's fascia, the deeper membranous layerof superficial fascia, continues as:• to the penis/labia & scrotum to become the{{c1::Dartos}} layer
Published	01/20/2024	Scarpa's fascia, the deeper membranous layerof superficial fascia, continues as:• attached to the pubic symphysis and thepenis to form the {{c1::fundi…
Published	01/20/2024	Scarpa's fascia, the deeper membranous layerof superficial fascia, continues as:continues onto penis as {{c1::superficial penilefascia}}
Published	01/20/2024	Fascia of Anterolateral Abdominal {{c1::Endoabdominal}} fascia – lines the internal aspect ofthe abdominal wall, continuous sheets ofmembranous a…
Published	01/20/2024	Fascia of Anterolateral Abdominal WallConsists ofMuscles and their aponeuroses• Superficial, intermediate, and deep layers of{{c1::investing fascia}} …
Published	01/20/2024	{{c1::Transversalis}} fascia – is theendoabdominal fascia lining deep surfaceof the transversus abdominis muscle
Published	01/20/2024	{{c1::Parietal peritoneum}} – serous lining of theabdominal cavity, a single layer ofepithelial cells and supporting connectivetissue
Published	01/20/2024	Parietal peritoneum is innervated by {{c1::somatic}} nerves
Published	01/20/2024	Parietal peritoneum• Deep to transversalis fascia, may beseparated from it by a variableamount of {{c1::extraperitoneal}} fat
Published	01/20/2024	{{c1::Parietal peritoneum}} – lines the bodywalls (pain sensitive, innervated bysomatic nerves)
Published	01/20/2024	Visceral peritoneum – covers andsuspended organs by mesenteries (notsensitive to pain, innervated by{{c1::splanchnic}} nerves)
Published	01/20/2024	Two vertical muscles – vertically tense theabdominal wall• {{c1::Rectus abdominus}}• {{c1::Pyramidalis}}
Published	01/20/2024	Three flat muscles ‐ have varying orientationsbut all are compressors of the abdominalcontents, continued anteriomedially as strong,sheet‐like aponeur…
Published	01/20/2024	What muscle of the three flat muscles does not originate posteriorly from thoracolumbar fascia?{{c1::External oblique }}
Published	01/20/2024	Aponeurosis of external oblique m. forms the{{c1::inguinal ligament}} ‐ attached to anteriorsuperior iliac spine and pubic crest
Published	01/20/2024	Action of External Oblique Muscle:{{c1::Compresses & supports abd. visceraFlexes and rotates trunk}}
Published	01/20/2024	N. of External Oblique:{{c1::Anterior rami of T7‐T12, subcostal n}}
Published	01/20/2024	Action of internal oblique:{{c1::Compresses & supports abd. visceraFlexes and rotates trunk}}
Published	01/20/2024	N. of internal oblique:{{c1:: Anterior rami of T6‐T12, Iliohypogastric & ilioinguinal (L1)}}
Published	01/20/2024	Transversus AbdominisAction: {{c1::Compresses & supports abd. viscera}}
Published	01/20/2024	N. of Transversus Abdominis{{c1::Anterior rami of T6‐T12, Iliohypogastric & ilioinguinal (L1)}}
Published	01/20/2024	The aponeuroses then interweave with theirfellows of the opposite side, forming a midlineraphe, the linea alba, which extends from the{{c1::xiphoid pr…
Published	01/20/2024	Between the midclavicular line and the midline,the aponeuroses form the tough, aponeurotic,tendinous {{c1::rectus sheath}} enclosing the rectusabdomin…
Published	01/20/2024	{{c1::Linea alba}} – a single avascular line inmidline of the anterior abdominalwall formed by the fusion of thelayers of the rectus sheath medial tot…
Published	01/20/2024	{{c1::Linea semilunaris}} (semilunar line,Spigelian line) – bilateral verticalcurved line in the anteriorabdominal wall where the layers ofthe rectus …
Published	01/20/2024	{{c1::Umbilicus}} ‐ small round defect in the linea alba, a fibrous remnant of the umbilical cord attachment. Found at the level of L3‐L4 disc, served…
Published	01/20/2024	Three things that cause an outie:{{c1::Extra skinUmbilical herniapregnancy, strain, physical injury }}
Published	01/20/2024	{{c1::Sister Mary Joseph nodule}} ‐ a rare finding dueto metastasis• A palpable lump found in the umbilicus• Firm and may be painful to touch, may als…
Published	01/20/2024	Upper 3/4th of rectus sheath – internal oblique aponeurosis splitsinto 2 layers; anterior layer passes anterior to rectus abdominis with{{c1::external…
Published	01/20/2024	Lower 1/4th of rectus sheath below the arcuate line – all 3 aponeuroses pass anteriorly. From this point inferiorly, the {{c1::rectus abdominis}} musc…
Published	01/20/2024	What does the neurovascular plane and the rectus sheath sit between?{{c1::internal oblique and transversus abdominis mm. }}
Published	01/20/2024	{{c1::Sup. (int. thoracic)}} and {{c1::inf. epigastric(ext. Iliac)}} arteries anastamose near theumbilicus
Published	01/20/2024	{{c1::Rectus Abdominis}} ‐ a long, broad, strap‐like musclethat is the principal vertical muscle in the anteriorabdominal wal
Published	01/20/2024	The intersections, indicated by grooves in the skinbetween the muscular bulges, usually occur at thelevel of the {{c1::xiphoid process}}, at the {{c1:…
Published	01/20/2024	Action of rectus abdominis {{c1::Flexes trunk at lumbar vertebrae, compresses abdominal viscera,stabilizes & controls antilordotic (posterior…
Published	01/20/2024	N of the rectus abdominis:{{c1::Anterior rami of T6‐T12}}
Published	01/20/2024	Pyramidalis action:{{c1::tense the linea alba, abdomen}}
Published	01/20/2024	N of pyramidalis:{{c1::Subcostal n. (T12)}}
Published	01/20/2024	These four nerves supply skin and muscle of abdominal walls:{{c1::Intercostal nerves (T7‐11)}}{{c1::Subcostal nerve (T12)}}{{c1::Iliohypogastric (L1)}…
Published	01/20/2024	{{c1::Genitofemoral (ant. rami L1 & L2)}} –supplies skin of• Femoral br. ‐ ant. upper thigh• Genital br. ‐ ant. scrotum/monspubis & labia maju…
Published	01/20/2024	The rectus abdominis is an exception; it can betransected because:• Its muscle fibers run short distancesbetween {{c1::tendinous intersections}}• The …
Published	01/20/2024	{{c1::Median incisions}} ‐ can be made rapidly without cuttingmuscle, major blood vessels, or nerves
Published	01/20/2024	{{c1::Pfannenstiel}} incision ‐ a type of transverse skin incisionplaced just above the pubis. The most common incisionused for caesarean sections. Li…
Published	01/20/2024	Subcostal incisions ‐ provide access to the {{c1::gallbladder}}and {{c1::biliary ducts}} on the right side and the {{c1::spleen}} on theleft. The inci…
Published	01/20/2024	{{c1::McBurney}} incision (gridiron/muscle splitting) ‐is a surgical approach used primarily for openappendectomies
Published	01/20/2024	{{c1::Transverse incisions}} ‐ can be increased laterallyas needed to increase exposure but are notutilized for exploratory procedures becausesuperior…
Published	01/20/2024	{{c1::Supraumbilical}} territory ‐ drains primarily into theaxillary lymph nodes (anterior and pectoral nodes),with a small portion reaching the paras…
Published	01/20/2024	{{c1::Infraumbilical}} territory ‐ follows the superficialepigastric vessels and drains into the superficialinguinal lymph nodes
Published	01/20/2024	Deep – which drains both the musculature andtissues• Primarily drains into the {{c1::internal iliac}} lymph nodes,located deep within the pelvic cavit…
Published	01/20/2024	Some vessels from the lower abdominal wall of the deep lymphatic drainage may bypass the internal iliac nodes and join the{{c1::superficial inguinal}}…
Published	01/20/2024	The skin and subcutaneous tissue of the abdominal wall areserved by an intricate subcutaneous venous plexus, draining• superiorly to the {{c1::interna…
Published	01/20/2024	{{c1::Thoracoepigastric vein}} – may exist or develop (if venousflow is altered)• Connects axillary vein to femoral vein• Important communication betw…
Published	01/20/2024	{{c1::Caput medusae (Lt. "head of Medusa" )}} ‐ theappearance of distended and engorged superficialepigastric veins, which are seen radiating fro…
Published	01/20/2024	A 65‐year‐old woman presents in the Dermatology clinic with a lesion on the skin located in the right hypochondriac region. A biopsy of the lesion was…
Published	01/20/2024	Inguinal Region The region between anterior abdominal wall andthigh, extends between the ASIS and pubictubercleAn important area• it is a region …
Published	01/20/2024	Inguinal ligament (of Poupart) ‐ Formed from the lowerborder of the {{c1::external oblique}} aponeurosis, attaches to theanterior superior iliac spine…
Published	01/20/2024	Specialized fibers{{c1::Lacunar ligament (of Gimbernat)}}‐ crescent‐shapedextension of fibers at the medial end of the inguinalligament{{c2::Pectineal…
Published	01/20/2024	Initially gonads are created higher up in the{{c1::posterior abdominal wall}}
Published	01/20/2024	The {{c1::gubernaculum}}, a cord‐like band of tissue, directs thepath of the testes into the scrotum and ovaries into thepelvis, it extends from infer…
Published	01/20/2024	The gubernaculum forms• {{c1::Round ligament of the uterus}} ‐ whichdoes pass through the inguinal canal• {{c1::Ligament of ovary}}
Published	01/20/2024	When gonads start descending, a finger‐likeperitoneal evagination – the {{c1::processusvaginalis}} is formed in both sexes
Published	01/20/2024	The gubernaculum persists as the {{c1::scrotalligament}}, keeping the testes are attached toscrotum
Published	01/20/2024	Due to intraabdominal origin lymphatic drainage of testisgoes to {{c1::para‐aortic lymph}} nodes.From scrotum, the lymphatics go to {{c1::superficial …
Published	01/20/2024	{{c1::Cryptorchidism}} – failure of one or both testes to descendto the scrotum before birth. Occurs in approximately 3% offull‐term and 30% of premat…
Published	01/20/2024	n females, it should completelyobliterate, but may persist as the {{c1::Canalof Nuck}} ‐ a potential indirect hernia/hydrocele site
Published	01/20/2024	In males, only the proximal regions ofthe {{c1::processus vaginalis}} obliterate. Thedistal end expands to enclose testis inscrotum, that forms double…
Published	01/20/2024	The surface of each testis is covered by thevisceral layer of the tunica vaginalis, exceptwhere the testis attaches to the {{c1::epididymis}} and{{c1:…
Published	01/20/2024	The testes have a tough fibrous outersurface, the {{c1::tunica albuginea}}, thatthickens into a ridge on its internal,posterior aspect as the mediasti…
Published	01/20/2024	The seminiferous tubules are joined bystraight tubules to the {{c1::rete testis}}, anetwork of canals in the mediastinum ofthe testis
Published	01/20/2024	Blood supply – Testicular artery• which arises from the {{c1::abdominal aorta}}at L2
Published	01/20/2024	Venous drainage ‐ carried by the {{c1::pampiniformplexus}} of veins, forms veins in spermatic cordemerging from deep inguinal ring• Right Testes …
Published	01/20/2024	{{c1::Superficial inguinal ring}} ‐ situated superior and lateral to pubic tubercle. It is a triangular opening inthe aponeurosis of external oblique
Published	01/20/2024	{{c1::External spermatic fascia}} – is derived from the external oblique aponeurosis and its investing fascia
Published	01/20/2024	The {{c1::conjoint tendon}} (inguinal falx) ‐ the combined insertion of the transversus abdominis and internaloblique muscles into the pubic crest and…
Published	01/20/2024	{{c1::Cremasteric fascia}} – is derived from the investing fascia of both the superficial and deep surfaces of theinternal oblique muscle
Published	01/20/2024	Three fascias enclose the contents of the spermatic cord• The external spermatic fascia (most superficial layer) ‐arises from the aponeurosis of the {…
Published	01/20/2024	Inguinal canal contains:The {{c1::spermatic cord}} in men• The {c1::round ligament of the uterus}} in women
Published	01/20/2024	What can be damaged in a McBurray incision?{{c1::Ilioinguinal nerve}}
Published	01/20/2024	The cremasteric fascia contains loops of {{c1::cremaster}} muscle, which is formed by the lowermost fascicles of the {{c2::internal oblique}} muscle.
Published	01/20/2024	The pampiniform plexus of veins can become varicosed (dialated & tortuous), feels like bag of worms in the spermatic cord, known as a {{c1::varico…
Published	01/20/2024	The posterior scrotum is innervated by scrotal branchesof the {{c1::perineal (br. of pudendal)}} nerve and by theperineal branch of the {{c1::posterio…
Published	01/20/2024	The {{c1::Genital}} branch of the Genitofemoral nerveinnervates the cremaster muscle
Published	01/20/2024	The {{c1::Femoral}} branch of the Genitofemoral andIlioinguinal nerve innervates skin on the inner part ofthe thigh
Published	01/20/2024	Cremasteric ReflexAfferent limb ‐ {{c1::Femoral}} branch of genitofemoral (L1,L2) and {{c1::ilioinguinal}} nerve (L1) of skinEfferent limb ‐ {{c1::Gen…
Published	01/20/2024	{{c1::Testicular torsion}} ‐ loss of the reflex due to a painful conditionwhere the spermatic cord twists, cutting off blood supply to thetesticle
Published	01/20/2024	Ventral hernias• {{c1::Epigastric}} ‐ upper part of the abdomen between sternumand the umbilicus• {{c1::Umbilical}}• {{c1::Incisional}} ‐ at the site …
Published	01/20/2024	Groin hernias• {{c1::Inguinal}} – may be direct or indirect• {{c1::Femoral}} – at the femoral canal, more common in females
Published	01/20/2024	Pelvic hernias• {{c1::Obturator}} – at the obturator foramen• {{c1::Sciatic}} – through the greater or lesser sciatic foramen• {{c1::Perineal}} – at t…
Published	01/20/2024	Flank hernias• {{c1::Lumbar}} ‐ through a weak spot in the lower back
Published	01/20/2024	{{c1::Herniotomy}} ‐ removal of thehernial sac only
Published	01/20/2024	{{c1::Herniorrhaphy}} ‐ herniotomy plusrepair of posterior wall of inguinalcanal
Published	01/20/2024	{{c1::Hernioplasty}} ‐ herniotomy plusreinforcement of posterior wall ofinguinal canal with a syntheticmesh
Published	01/20/2024	Certain medical conditions ‐ {{c1::Cystic fibrosis}}, {{c1::Marfansyndrome}}, and {{c1::Ehlers‐Danlos}} syndrome can weakenconnective tissue and incre…
Published	01/20/2024	{{c1::Reducible hernia}}• Hernial contents completely return to theabdominal cavity through the abdominal walldefect• Usually seen as an {{c1::asympto…
Published	01/20/2024	An {{c1::incarcerated}} hernia occurs when tissue protrudes through aweak spot in the abdominal wall and becomes trappedand cannot be reduced into the…
Published	01/20/2024	Incarcerated Hernia {{c1::Irreducible}} nontender mass
Published	01/20/2024	An {{c1::obstructed}} hernia is a type of incarcerated hernia where thetrapped tissue, usually intestine, becomes blocked, preventingthe normal passag…
Published	01/20/2024	{{c1::Strangulated}} hernia• Ischemia and necrosis of the hernial contents dueto compromised vascular supply
Published	01/20/2024	Strangulated hernia can lead to {{c1::intestinal gangrene}} ‐ the lack of blood flow can quickly lead to tissue death. Any compromised intestinal tiss…
Published	01/20/2024	Hernial sac of {{c1::indirect inguinal}} hernias enters the deep inguinal ring and passes through inguinal canal. If the hernia is large, it cancome o…
Published	01/20/2024	Whats the most common groin hernia in females? {{c1::Indirect inguinal hernias}}
Published	01/20/2024	{{c1::Direct inguinal}} hernia The hernial sac does not enter the deepinguinal ring• Traverses the medial 1/3 rd of inguinal canal
Published	01/20/2024	Direct inguinal hernias are less likely to beincarcerated due to a {{c1::wider neck}}• They are typically larger and more noticeableearlier than indir…
Published	01/20/2024	Borders of Hesselbach's triangle :Superolateral ‐ {{c1::Inferior epigastric artery}}Medial – lateral edge of the {{c1::Rectus abdominis}}Inferiolatera…
Published	01/20/2024	Hesselbach's TriangleServes as an important anatomical landmarkfor surgeons to differentiate between directand indirect inguinal hernias.• Direct hern…
Published	01/20/2024	{{c1::Hydrocele}} is a fluid collection within the tunicavaginalis
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