| Question |
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| Answer |
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| Origin and insertion of rectus abdominus |
origin: pubic symphysis and crest --> insert at xiphoid and 5th-7th costal cartilages |
| Origin and insertion of external oblique |
External surfaces of 5th – 12th ribs insert at Linea alba, pubic tubercle, anterior ½ of iliac crest |
| Origin and insertion of internal oblique |
Thoacolumbar fascia, anterior 2/3 of iliac crest, lateral 1/3 of inguinal ligament insert at inf. Border of 10th-12th ribs, linea alba, and pecten pubis via conjoined tendon |
| Origin and insertion of transversus abdominus |
Internal surfaces of 7th-12th costal cartilages, thoracolumbar fascia, iliac crest, lateral 1/3 of inguinal ligament insert at linea alba, pecten pubis via conjoined tendon |
| Name the layers of the abdomen from outside in |
Skin, Camper's fascia, Scarpa's Fascia, external oblique, internal oblique, transversus abdominus, transversalis fascia, pre-pertioneal fat, parietal peritoneum |
| Name the muscles used to twist the torso |
external oblique, internal oblique, transversus abdominus |
| Name the order of the abdomen examination |
Inspection, Auscultation, Percussion, Palpation |
| Name the area above the appendix |
McBurney's Point; 2/3 from umbilicus to anterior iliac spine |
| What is located 1/3 below umbilicus and marks the end of the posterior sheath? |
Arcuate Line; 3/4 of rectus located above this point, important when making and closing incisions |
| The superior epigastric arteries are the continuation of which arteries? |
internal mammary (thoracic) artery. They travel posterior to rectus muscle within posterior rectus sheath |
| Where do the inferior epigastric arteries originate? |
the last branch of the external iliac artery anastomoses with the superior |
| Where are the deep circumflex iliac arteries located? |
In the lower abdomen |
| Superficial areas above the umbilicus drain to which lymphatic region? |
Axillary |
| Superficial areas below the umbilicus drain to which lymphatic region? |
Inguinal |
| Deep areas above the umbilicus drain to which lymphatic region? |
Para-aortic nodes, internal mammary nodes |
| Deep areas below the umbilicus drain to which lymphatic region? |
inguinal, external iliac, common iliac |
| Which nerves innervate the xiphoid? |
T5-6 |
| Which nerve innervates the umbilicus? |
T10 |
| Which nerve innervates the pubis? |
L1 |
| A spinal cord transection from a car accident causes cutaneous loss of sensation where? |
Xiphoid |
| Name the function of the psoas muscle |
Flexes the spine; hip |
| Name the function of the iliacus |
Flexes the hip/thigh |
| Where do the ileopsoas muscles (psoas major, psoas minor, iliacus) originate and insert? |
Originates at ileac fossa and lumbar spine and inserts into the lesser trochanter of the femur. |
| Which muscle group will be inflammed in appendicitis? |
Ileopsoas muscles |
| Which muscle extends and laterally flexes the spine? |
Quadratus lumborum; spans from iliac crest to lowest rib and to vertebrae |
| Which muscle runs laterally around the appendix? |
Psoas muscle; Psoas Test: Patient in supine position tries to flex right hip against resistance; pain in pelvis during this maneuver is a positive test |
| List the attachments of the diaphragm |
Sternal: posterior aspect of xiphoidCostal: last 6 costal cartilagesLumbar: L1-L3 (crura) |
| Name the three structures pass through the central tendon of the diaphragm |
IVC: T8Esophagus: T10(Vagus nerve also passes through with esophagus)Aorta: T12 |
| In what position is the diaphragm lowest? |
Standing |
| CDH |
Congental Diaphragmatic Hernia; Failure of the diaphragm to fuse during fetal developmentUnilateral with pulmonary hypoplasiaOccurs in approximately 1/2200 live births50% mortalitySurgical correction |
| Which structures can herniate in an abdominal hernia? |
extraperitoneal fat, peritoneum, omentum, bowel, or other viscera through a defect in the transversalis fascia |
| Name the structures that go through the inguinal canal. |
Contains spermatic cord(M)/round ligament of uterus(F) and ilioinguinal nerve (M+F) |
| Name the boundaries of the inguinal canal. |
Floor: top of inguinal ligamentCeiling: aponeurosis of internal oblique and transverse abdominal musclesAnterior: external obliquePosterior: transversalis fascia |
| Name the origin and insertion of the inguinal ligament |
anterior-superior iliac spine to the pubic tubercle |
| Which structure pulls the testes into the scrotum and at what point of development does this occur? |
Gabernaculum; 7 months in utero |
| Where does an indirect hernia occur? |
Through the process vaginalis |
| Where does a direct hernia penetrate? |
Through a weakness in the wall |
| This is a fascial defect lateral to inferior epigastric vessels through which the testes pass by means of the process vaginalis into the scrotum |
Internal (deep) inguinal ring |
| Name the borders of Hesselbach's triangle. |
bounded by the inguinal ligament inferiorly, the lateral border of the rectus muscle medially and the inferior epigastric vessels laterally; direct hernia's occur within the triangle |
| This type of hernia passes lateral to the inferior epigastrics, is congenital and more common, enters the inguinal canal through the deep ring. |
Indiret hernia |
| Passes medial to epigastrics ( in Hesselbach’s triangle)Aquired weakness in abdominal wallUsually in adults |
Direct hernia |
| List the contents of the spermatic cord. |
Vas DeferensTesticular artery- a branch of the abdominal aortaCremasteric artery-a branch of the inferior epigastric arteryArtery of the vas deferens- a branch of the inferior vessicle arteryPampiniform Plexus of VeinsCremasteric MuscleSympathetic nerve f |
| Name the hernia that is inferior to the inguinal ligament and which occur 70% of the time in women |
Femoral hernia |
Poultry
