Anterior Abdominal Wall & Surface Anatomy
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Questions and Answers

Which muscle of the abdominal wall is NOT classified as a flat muscle?

  • Transverse abdominis
  • External oblique
  • Internal oblique
  • Rectus abdominis (correct)

    • The layers of the abdominal wall are composed of all of the following EXCEPT?

  • Skin
  • Peritoneal cavity (correct)
  • Muscles and associated fascia
  • Superficial fascia

    • How many flat muscles are present in the abdominal wall?

  • 3 (correct)
  • 2
  • 4
  • 5

    • Which structure is primarily found in the inguinal canal?

    <p>Testicular artery</p> Signup and view all the answers

    Which layer of the superficial fascia is considered membranous?

    <p>Scarpa's fascia</p> Signup and view all the answers

    What is the embryological significance of testicular descent?

    <p>It ensures proper placement for temperature regulation</p> Signup and view all the answers

    The classification of the abdominal wall muscles includes how many vertical muscles?

    <p>2</p> Signup and view all the answers

    Which of the following anatomical structures does NOT lie in the transpyloric plane?

    <p>Ileum</p> Signup and view all the answers

    Which layer of the abdominal wall is primarily responsible for temperature regulation of the testes?

    <p>Muscles and associated fascia</p> Signup and view all the answers

    Which feature characterizes the rectus sheath?

    <p>It encloses the rectus abdominis muscle.</p> Signup and view all the answers

    Which muscle is primarily responsible for contralateral rotation of the torso?

    <p>External Oblique</p> Signup and view all the answers

    What structure forms the posterior wall of the inguinal canal?

    <p>Transversalis Fascia</p> Signup and view all the answers

    Which artery primarily supplies blood to the Rectus Abdominis muscle?

    <p>Inferior Epigastric Artery</p> Signup and view all the answers

    Which layer is NOT part of the rectus sheath in the upper abdomen?

    <p>Transversalis Fascia</p> Signup and view all the answers

    What is the common cause of an indirect inguinal hernia?

    <p>Congenital defect</p> Signup and view all the answers

    Which ligament is formed by the rolled-in free lower border of the external oblique aponeurosis?

    <p>Inguinal Ligament</p> Signup and view all the answers

    What is the primary function of the transversus abdominis muscle?

    <p>Compress abdominal contents</p> Signup and view all the answers

    Which nerves primarily innervate the internal oblique muscle?

    <p>Ilioinguinal and iliohypogastric</p> Signup and view all the answers

    Which of the following structures is found in the contents of the male spermatic cord?

    <p>Vas deferens</p> Signup and view all the answers

    What is the embryological relevance of testicular descent in males?

    <p>It is necessary for spermatogenesis to occur</p> Signup and view all the answers

    Which of the following statements about the Rectus Abdominis is correct?

    <p>Thoracoabdominal nerve (T7-11) and subcostal nerve (T12).</p> Signup and view all the answers

    What is the origin of the Rectus Abdominis muscle?

    <p>Pubic crest and pubic symphysis</p> Signup and view all the answers

    Which of the following correctly describes the External Oblique muscle? (Select all that apply)

    <p>Thoracoabdominal nerve (T7-11) and subcostal nerve (T12)</p> Signup and view all the answers

    What is the blood supply of the external oblique muscle?

    <p>Lower intercostal arteries and branches from deep circumflex iliac artery or iliolumbar artery.</p> Signup and view all the answers

    What is the innervation of the Internal Oblique muscle?

    <p>Thoracoabdominal nerve (T7-11), subcostal nerve (T12), iliohypogastric nerve (L1), and ilioinguinal nerve (L1).</p> Signup and view all the answers

    What is the origin of the Internal Oblique muscle?

    <p>Lateral 2/3 of the inguinal ligament, iliac crest, and thoracolumbar fascia</p> Signup and view all the answers

    What is the correct insertion point for the Internal Oblique muscle?

    <p>Linea alba, pectineal line, pubic crest, and inferior border of ribs 9-12.</p> Signup and view all the answers

    What is the primary blood supply to the Internal Oblique muscle?

    <p>Subcostal arteries.</p> Signup and view all the answers

    What is the origin of the Transversus Abdominis?

    <p>Iliac crest, lateral 1/3 of the inguinal ligament, thoracolumbar fascia, and ribs 7-12.</p> Signup and view all the answers

    What is the blood supply and innervation of the Transversus Abdominis?

    <p>Thoracoabdominal nerve (T7-11), Subcostal arteries</p> Signup and view all the answers

    Which of the following dermatomes correspond to shoulder pain?

    <p>C3, C4, C5</p> Signup and view all the answers

    Which of the following are the correct boundaries of the inguinal canal? (Select all that apply)

    <p>Anterior: External oblique aponeurosis, reinforced by internal oblique.</p> Signup and view all the answers

    Which structure forms the roof of the inguinal canal?

    <p>Transversalis fascia, internal oblique, and transversus abdominis.</p> Signup and view all the answers

    Which of the following layers are part of the spermatic cord? (Select all that apply)

    <p>Internal spermatic fascia (transversalis fascia)</p> Signup and view all the answers

    Which of the following arteries supplies blood to the male reproductive system?

    <p>All of the above</p> Signup and view all the answers

    Which of the following nerves are associated with the Spermatic Cord? (Select all that apply)

    <p>Nerve to cremaster (from genitofemoral nerve)</p> Signup and view all the answers

    What is the correct description of the spectrum corde?

    <p>Other Components: Vas deferens, pampiniform plexus of veins, lymphatics to para-aortic nodes at L2.</p> Signup and view all the answers

    Which statement describes an Indirect Inguinal Hernia?

    <p>It is congenital; it passes through the deep ring and inguinal canal to the scrotum.</p> Signup and view all the answers

    Which of the following statements accurately describes a Direct Inguinal Hernia?

    <p>It is acquired and occurs through weakness in the transversalis fascia at the superficial ring.</p> Signup and view all the answers

    Which of the following statements is true regarding the Rectus Sheath?

    <p>The posterior wall is made up of the aponeuroses of the internal oblique and the transversus abdominus.</p> Signup and view all the answers

    Which of the following structures is located at the transpyloric plane (approximately L1)?

    <p>Pylorus of the stomach</p> Signup and view all the answers

    Which of the following structures is located at the transpyloric plane (approximately L1)?

    <p>Body of the pancreas</p> Signup and view all the answers

    What is the primary action of the Pyramidalis muscle?

    <p>Compresses abdominal contents</p> Signup and view all the answers

    Which structure forms the posterior wall of the inguinal canal?

    <p>Transversalis fascia</p> Signup and view all the answers

    What is the main function of the testicular arteries?

    <p>Supply blood to the testes</p> Signup and view all the answers

    Which nerve is responsible for innervation of the Pyramidalis muscle?

    <p>Subcostal nerve</p> Signup and view all the answers

    What is the primary cause of a direct inguinal hernia?

    <p>Increased intra-abdominal pressure from heavy lifting</p> Signup and view all the answers

    Which of the following structures is NOT a content of the male spermatic cord?

    <p>Cremasteric muscle</p> Signup and view all the answers

    Which statement accurately describes the Rectus Sheath?

    <p>It has a posterior wall above the arcuate line.</p> Signup and view all the answers

    What is a common symptom of testicular torsion?

    <p>Severe pain in the testes</p> Signup and view all the answers

    What is the origin of the External Oblique muscle?

    <p>Ribs 5-12</p> Signup and view all the answers

    Which layer of the superficial fascia is primarily fatty?

    <p>Camper's fascia</p> Signup and view all the answers

    At which lumbar vertebrae level is the umbilicus located?

    <p>L3/L4</p> Signup and view all the answers

    What is the primary action of the Rectus Abdominis muscle?

    <p>Flexes the vertebral column</p> Signup and view all the answers

    Which muscle lies closest to the midline of the abdominal wall?

    <p>Rectus Abdominis</p> Signup and view all the answers

    Which nerve innervates the External Oblique muscle?

    <p>Thoracoabdominal nerves (T7-T11)</p> Signup and view all the answers

    What structure does the Transpyloric plane cross?

    <p>Pylorus of the stomach</p> Signup and view all the answers

    What is formed from the aponeurosis of the External Oblique muscle?

    <p>Inguinal ligament</p> Signup and view all the answers

    What is the action of the Pyramidalis muscle?

    <p>Tenses the linea alba</p> Signup and view all the answers

    Which artery is NOT involved in the blood supply of the Rectus Abdominis muscle?

    <p>Testicular artery</p> Signup and view all the answers

    In which location does a Direct Inguinal Hernia typically protrude?

    <p>Medial to the inferior epigastric vessels</p> Signup and view all the answers

    What is the composition of the Rectus Sheath in the upper abdomen?

    <p>Aponeuroses of three flat muscles</p> Signup and view all the answers

    What structure primarily reinforces the anterior wall of the inguinal canal?

    <p>External oblique aponeurosis</p> Signup and view all the answers

    What is a common clinical condition associated with the spermatic cord?

    <p>Testicular torsion</p> Signup and view all the answers

    Which nerve is primarily responsible for the innervation of the Pyramidalis muscle?

    <p>Subcostal nerve</p> Signup and view all the answers

    Which of the following structures is NOT included in the contents of the male spermatic cord?

    <p>Seminal vesicle</p> Signup and view all the answers

    What structures are located at the transpyloric plane?

    <p>Pylorus of the stomach and fundus of the gallbladder</p> Signup and view all the answers

    What is the correct insertion point for the External Oblique muscle?

    <p>Iliac crest and linea alba</p> Signup and view all the answers

    Which of the following describes the action performed by the Rectus Abdominis muscle?

    <p>Flexes the trunk</p> Signup and view all the answers

    Which artery supplies blood to the Transversus Abdominis muscle?

    <p>Subcostal artery</p> Signup and view all the answers

    Which of the following is NOT a nerve that innervates the Internal Oblique muscle?

    <p>Phrenic nerve (C3-C5)</p> Signup and view all the answers

    Which part of the abdominal wall is found at the L3/L4 intervertebral disc level?

    <p>Umbilicus</p> Signup and view all the answers

    Which flat muscle of the abdominal wall is responsible for ipsilateral rotation of the trunk?

    <p>Internal Oblique</p> Signup and view all the answers

    What is the origin point of the Rectus Abdominis muscle?

    <p>Pubic crest and symphysis</p> Signup and view all the answers

    Which plane corresponds to the L1 vertebra?

    <p>Transpyloric plane</p> Signup and view all the answers

    Which structure lies at the L3/L4 intervertebral disc level?

    <p>Umbilicus</p> Signup and view all the answers

    Which artery supplies the lower half of the abdominal wall?

    <p>Inferior epigastric artery</p> Signup and view all the answers

    Which nerve innervates the rectus abdominis? A) Thoracoabdominal nerves (T7-T11) B) Phrenic nerve C) Ilioinguinal nerve D) Iliohypogastric nerve

    <p>Thoracoabdominal nerves (T7-T11)</p> Signup and view all the answers

    The inguinal ligament is formed by which muscle?

    <p>External oblique</p> Signup and view all the answers

    Which muscle is responsible for contralateral rotation of the trunk?

    <p>External oblique</p> Signup and view all the answers

    Which muscle tenses the linea alba?

    <p>Pyramidalis</p> Signup and view all the answers

    What is the origin of the internal oblique muscle?

    <p>Iliac crest, lateral 2/3 of the inguinal ligament, thoracolumbar fascia</p> Signup and view all the answers

    The rectus sheath in the upper abdomen is formed anteriorly by which aponeuroses?

    <p>External oblique and half of internal oblique</p> Signup and view all the answers

    Which flat muscle has fibers running horizontally?

    <p>Transversus abdominis</p> Signup and view all the answers

    Which structure forms the floor of the inguinal canal?

    <p>Inguinal ligament</p> Signup and view all the answers

    Which structure is contained within the inguinal canal in females? A) Ilioinguinal nerve B) Spermatic cord C) Round ligament of the uterus D) Vas deferens

    <p>Round ligament of the uterus</p> Signup and view all the answers

    An indirect inguinal hernia passes through which anatomical structure?

    <p>Deep inguinal ring</p> Signup and view all the answers

    Which structure does not contribute to the spermatic cord?

    <p>Inferior epigastric artery</p> Signup and view all the answers

    Which nerve innervates the cremaster muscle?

    <p>Genitofemoral nerve</p> Signup and view all the answers

    Which of the following is a clinical condition caused by an enlarged pampiniform plexus?

    <p>Varicocele</p> Signup and view all the answers

    In a direct inguinal hernia, the herniated organ passes through which structure?

    <p>Transversalis fascia</p> Signup and view all the answers

    Which structure is the fibrous capsule of the testis?

    <p>Tunica albuginea</p> Signup and view all the answers

    The testicular artery arises from which vessel?

    <p>Abdominal aorta</p> Signup and view all the answers

    Venous drainage from the left testis occurs into which vein?

    <p>Left renal vein</p> Signup and view all the answers

    Which clinical condition involves the twisting of the spermatic cord?

    <p>Testicular torsion</p> Signup and view all the answers

    The lymphatic drainage of the testes goes to which nodes?

    <p>Para-aortic nodes (L2)</p> Signup and view all the answers

    A collection of fluid in the tunica vaginalis is known as?

    <p>Hydrocele</p> Signup and view all the answers

    Which structure is located posterolaterally on the testis?

    <p>Epididymis</p> Signup and view all the answers

    During embryological development, the testes descend through which structure?

    <p>Inguinal canal</p> Signup and view all the answers

    Failure of the testes to descend properly is referred to as?

    <p>Cryptorchidism</p> Signup and view all the answers

    Which of the following structures is NOT part of the spermatic cord?

    <p>Ureter</p> Signup and view all the answers

    The artery supplying the cremaster muscle is derived from which vessel?

    <p>Inferior epigastric artery</p> Signup and view all the answers

    The tunica vaginalis is derived from which embryological layer?

    <p>Mesoderm</p> Signup and view all the answers

    Study Notes

    Anterior Abdominal Wall & Surface Anatomy

    Surface Anatomy and Quadrants

    • The anterior abdominal wall is divided into four quadrants by a vertical line from the xiphoid process to the pubic symphysis, and a horizontal trans-umbilical line at the level of the umbilicus.
    • Transpyloric plane (L1): This plane is located midway between the jugular notch and the pubic symphysis, crossing structures like the pylorus of the stomach, the fundus of the gallbladder, the body of the pancreas, and the hila of the kidneys.
    • Lumbar vertebrae landmarks:
      • Umbilicus is at L3/L4 intervertebral disc.
      • Transtubercular plane is at L4/L5 level.

    Layers of the Abdominal Wall

    From superficial to deep:

    1. Skin
    2. Superficial fascia:
      • Camper's fascia: A fatty layer.
      • Scarpa's fascia: A membranous deeper layer.
      • Superficial vessels and nerves lie between these layers.
    3. Muscles and associated fascia: Three flat muscles laterally and two vertical muscles near the midline.
    4. Parietal peritoneum: The innermost serous membrane lining the abdominal cavity.

    Muscles of the Abdominal Wall

    Flat Muscles (Lateral Group)

    1. External Oblique

      • Origin: Ribs 5-12.
      • Insertion: Iliac crest, linea alba.
      • Innervation: Thoracoabdominal nerves (T7-T11), subcostal nerve (T12).
      • Blood Supply: Lower intercostal arteries, branches from deep circumflex iliac or iliolumbar artery.
      • Action: Compresses abdominal contents, rotates torso contralaterally.
      • Inguinal Ligament: Formed from the external oblique's aponeurosis (extends from the ASIS to the pubic tubercle, forming part of the inguinal canal floor).

    2. Internal Oblique

      • Origin: Lateral 2/3 of the inguinal ligament, iliac crest, thoracolumbar fascia.
      • Insertion: Linea alba, pectineal line, pubic crest, and inferior borders of ribs 9-12.
      • Innervation: Thoracoabdominal nerves (T7-T11), subcostal nerve (T12), iliohypogastric and ilioinguinal nerves (L1).
      • Blood Supply: Subcostal arteries.
      • Action: Compresses abdominal contents, rotates the trunk ipsilaterally.

    3. Transversus Abdominis

      • Origin: Iliac crest, lateral 1/3 of the inguinal ligament, thoracolumbar fascia, ribs 7-12.
      • Insertion: Linea alba, pubic crest, pectineal line.
      • Innervation: Thoracoabdominal nerves (T7-T11), subcostal nerve (T12), iliohypogastric and ilioinguinal nerves (L1).
      • Blood Supply: Subcostal arteries.
      • Action: Compresses abdominal contents.

    Vertical Muscles (Midline Group)

    1. Rectus Abdominis

      • Origin: Pubic crest, pubic symphysis.
      • Insertion: Costal cartilages of ribs 5-7, xiphoid process.
      • Innervation: Thoracoabdominal nerves (T7-T11), subcostal nerve (T12).
      • Blood Supply: Inferior epigastric artery.
      • Action: Compresses abdominal contents, flexes the trunk.

    2. Pyramidalis

      • Origin: Pubic crest, pubic symphysis.
      • Insertion: Linea alba.
      • Innervation: Subcostal nerve (T12).
      • Blood Supply: Superior and inferior epigastric arteries.
      • Action: Tenses the linea alba.

    Rectus Sheath

    • Composition: The aponeuroses of the three flat muscles.
    • Upper abdomen: Anterior wall formed by the external oblique and half of the internal oblique; posterior wall by half the internal oblique and transversus abdominis.
    • Lower abdomen: All aponeuroses shift to the anterior wall, leaving the posterior wall absent (below the arcuate line).

    Inguinal Canal

    • Boundaries:
      • Anterior wall: External oblique aponeurosis, reinforced laterally by the internal oblique.
      • Posterior wall: Transversalis fascia.
      • Roof: Transversalis fascia, internal oblique, transversus abdominis.
      • Floor: Inguinal ligament, reinforced medially by the lacunar ligament.
    • Contents:
      • Males: Spermatic cord, ilioinguinal nerve.
      • Females: Round ligament of the uterus, ilioinguinal nerve.

    Spermatic Cord

    • Layers:
      1. Internal spermatic fascia (from transversalis fascia).
      2. Cremasteric fascia (from internal oblique muscle).
      3. External spermatic fascia (from external oblique muscle).
    • Contents:
      • 3 Arteries: Testicular, cremasteric, artery of vas deferens.
      • 3 Nerves: Genitofemoral nerve (cremaster), sympathetics, ilioinguinal nerve.
      • 3 Other structures: Vas deferens, pampiniform plexus of veins, lymphatics (drain to para-aortic nodes at L2).

    Inguinal Hernias

    1. Indirect Hernia (Congenital)
      • Protrudes through the deep inguinal ring and follows the inguinal canal, possibly extending into the scrotum.
      • Can be reduced and controlled at the deep ring.
    2. Direct Hernia (Acquired)
      • Protrudes through a weakness in the transversalis fascia, medial to the inferior epigastric vessels.
      • Common causes: heavy lifting, chronic cough, constipation, sports like rugby.

    Testis and Clinical Relevance

    • Anatomy:
      • Covered by the tunica albuginea (fibrous capsule) and tunica vaginalis (serous covering).
      • Epididymis: Located posterolaterally.
      • Blood Supply: Testicular arteries from the aorta (L1-2).
      • Venous Drainage: Right testicular vein drains into the inferior vena cava; left testicular vein into the left renal vein.
      • Lymphatic Drainage: Para-aortic nodes (L2).
      • Nerve Supply: Visceral sensory nerves (T10).
    • Clinical Conditions:
      • Undescended testis.
      • Testicular torsion: Twisting of the spermatic cord.
      • Testicular carcinoma.
      • Hydrocele: Fluid collection in the tunica vaginalis.
      • Varicocele: Dilated veins in the pampiniform plexus, usually on the left side.
      • Spermatocoele: Fluid-filled sac in the epididymis.

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