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Abdominal Wall

What is aponeurosus? A very broad and flat tendon that goes to the midline from the muscles
What do the transversalis fascia and peritoneum do? They encase everything inside of the abdomen
What is camper's fascia? Superficial fascia
What is deep to camper's fascia? Scarpa's fascia, Membranous layer which is more developed in the lower part than the upper part of the abdomen
What is scarpa's fascia called in the peritoneum? On the penis? Superficial perinelor Colles fascia, Dartos fascia
Where can blood or urine from a perineal injury leak into? Into abdominal wall between the scarpa's fascia and aponeruorsos or anterior abdominal wall
How are injuries evident on the abdominal wall due to scarpa's fascia? You can peel off scarpa's fascia layer
What is Mondor's disease? When the thoracoepigastric vein is compressed and the vein clots off.
Where does the external obliques end? Ends at free edge (inguinal ligament), Inferior attaches to superior part of iliac crest
Where is the external oblique merging from? From between the attachments of serratus anterior and fibers underneath the latissimus dorsi
Where is the internal obliques attached to? Attachment to thoraco lumbar fascia posteriorly
Which way does the aponeurosus run on external obliques? Internal obliques? Runs anterior on external, runs posterior on internal
Where are the transversus abdominus? Runs transversely across the abdomen (deep to internal oblique)
What is the transversus abdominus attached to? Attached to thoracolumbar facia, iliac crest and inguinal ligament
Where are the rectus abdominus located? Medial to all the muscles, from ribs 5-7, from xiphoid/anterior ribs to pubis
What are the rectus abdominus contained in? The aponeuorotic layers form a sheath that contains the rectus muscles. Each rectus has a compartment of their own
What do the tendious intersections help do? The tendious intersections help segmentize the muscles
What are the rectus abdominus attached to? Attached to anterior part of rectus sheath but not posterior part
Where is there potential for a hernia in the muscles? When you have a gap in muscle coverage
Can you separate the aponeurosus from the external and internal oblique? No, nearly impossible to do
What is the spermatic cord? Entity that carries structures to and from the testicle
What is the cremaster muscle? Muscle that rasises the testicle when it contracts (too cold outside), lowers it when it relaxes (too hot outside)
What is the cremasteric reflex? When you stimulate the abdominal wall and induce a reflex and have it contract
What is the acruate line? Where there is a transition, you see posterior rectus sheath and then it disappears inferior to acruate line
What is the linea semilunaris? Lateral edge of rectus sheath where everything runs anterior. Everything is coming together on both sides of the linea alba in the midline
What does the decussion of the fibers of linea alba mean? Crisscross in the midline of the external oblique aponeurosus
Where is the linea semicicularis/arcuate line located? About the third of the way down to half way to the pubis
Where do the inferior epigastric vessels enter the rectus sheath? Posteriorly at the acruate line
Is there rectus sheath above the arcuate line? Yes
Where does the abdominal aorta bifurcate and goes into the arteries? What do the arteries supply? The aorta splits into 2 major branches (right and left common iliacs) below the umbilicus at L4 that will supply the legs
What structure is running through the midline of the median umbilical fold? The remnant of urachus
What happens if the urachus is patent? You can get umbilical cysts that contain urine and communicate with the bladder. Urine can come through your belly
What causes a recuts hematoma? Tearing of anterior epigastric vessels
What happens if epigastric vessels tear above the arcuate line? Blood goes inside the rectus sheath
What happens if epigastric vessels tear below the arcuate line? Blood goes outside the rectus sheath
What happens if epigastric vessels tear inside rectus sheat? It will bleed between the peritoneum and transversalis fascia
What can a rectus hermatoma cause the abdominal wall to do? It causes it to stiffen. Extensive bleeding can extend to the pelvis
When you contract your abdominal muscles what happens? Pressure on pelvis that help defication
What keeps you erect? Muscles on front and back of spinal column
What is diastasis? A movement apart of the rectus muscles with a thinning of the linea alba
How does the abdomen get blood supply and innervation? From the superior and inferior epigastric arteries. Inferior is a branch of iliac artery. (Blood supplies mix and mingle) Innervation from intercostal nerves.
What innervates the pubis? T-12
Where should T-8 be located? Midway the umbilicus and xiphoid process
Where is the ilionigunial nerve? It is at L-1 and runs between muscle layers. Kind of overlaps with T-12
What comes out anterior and inferior to the inguinal ligament? Spermatic cord comes out anteriorly and femoral vessels exit inferiorly
What are the external iliac vessels called once the cross the plane of the inguinal ligament? Femoral vessels
What hapens when the processus vaginalis does not oblierate? You can have a hernia with intestines coming all the way to the scrotum
Where is the deep inguinal ring? Superior to inguinal ligament
Superficial inguinal ring? Go through the external oblique aponeurosus
Where is hesselbach's triangle? Posterior wall of inguinal canal
Vas deferens or ductus deferens go through where? THe deep and superficial inguinal ring
What is a hernia above the inguinal ligament called? Next to external iliac or femoral vein? Inguinal hernia and femoral hernia
Where is a direct hernia? Indirect hernia? Direct can still get into inguinal canal and is medial to the vessels. Indirect is inside pocket of peritoneum and is lateral to vessels
What is a spighelian hernia? Petite hernia? Umbilical hernia? Epigastric hernia? Incisional hernia? Spighelian: where linea semilunaris meets linea semicircularis. Petite: Gap between external obliaue and latissimus dorsi. Umbilical: through the belly button. Epigastric: anywhere above belly button. Incisional: anywhere you make incision



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