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Questions and Answers
Which of the following structures forms the superior boundary of the abdominal cavity?
Which of the following structures forms the superior boundary of the abdominal cavity?
What is the primary function of the external abdominal obliques?
What is the primary function of the external abdominal obliques?
Which of the following arteries provides blood supply to the anterior abdominal wall?
Which of the following arteries provides blood supply to the anterior abdominal wall?
What is the anatomical term for the tendinous raphe that extends between the xiphoid process and the symphysis pubis?
What is the anatomical term for the tendinous raphe that extends between the xiphoid process and the symphysis pubis?
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Which layer of the superficial fascia of the anterior abdominal wall is known as Scarpa's fascia?
Which layer of the superficial fascia of the anterior abdominal wall is known as Scarpa's fascia?
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Which spinal nerves primarily innervate the anterior abdominal wall?
Which spinal nerves primarily innervate the anterior abdominal wall?
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What is the significance of the inguinal ligament?
What is the significance of the inguinal ligament?
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Which muscle of the anterior abdominal wall is responsible for compressing the abdominal contents?
Which muscle of the anterior abdominal wall is responsible for compressing the abdominal contents?
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Which muscle originates from the anterior surface of the pubis?
Which muscle originates from the anterior surface of the pubis?
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What is the function of the internal abdominal obliques muscle?
What is the function of the internal abdominal obliques muscle?
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Which structure is not typically found within the rectus sheath?
Which structure is not typically found within the rectus sheath?
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What are the origins of the transversus abdominis muscle?
What are the origins of the transversus abdominis muscle?
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How do the anterior abdominal wall muscles contribute to micturition?
How do the anterior abdominal wall muscles contribute to micturition?
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Where does the reflected ligament attach posteriorly?
Where does the reflected ligament attach posteriorly?
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Which nerve innervates the cremasteric muscle?
Which nerve innervates the cremasteric muscle?
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What is the primary function of the lacunar ligament?
What is the primary function of the lacunar ligament?
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Study Notes
Anterior Abdominal Wall Anatomy
- Superior boundary: Diaphragm, separating respiratory and abdominal cavities
- Inferior boundary: Pelvic inlet
- Anterior structures: Skin, subcutaneous tissue, and anterior abdominal wall muscles
- Posterior structures: 5 lumbar vertebrae, intervertebral discs, psoas major, and quadratus lumborum muscles
Abdominal Cavity
- Includes structures superior to the diaphragm
- The diaphragm separates the respiratory and abdominal cavities
- The pelvic inlet is the inferior boundary of the abdominal cavity
- The abdominal cavity has layers of skin, subcutaneous tissue, and muscles
- The posterior aspect includes parts of the vertebral column, discs, psoas, and quadratus lumborum muscles
Abdominal Quadrants
- The abdomen is divided into four quadrants
- Right upper quadrant: Liver, gallbladder
- Left upper quadrant: Stomach, spleen
- Right lower quadrant: Ascending colon, anterior superior iliac spine, inguinal ligament, and pubic tubercle
- Left lower quadrant: Descending colon, sigmoid colon, and iliac spine
Regions of the Abdomen
- The abdomen is sectioned into various areas
- Vertical lines: Lateral border of rectus abdominus muscle, midpoint of inguinal ligament, mid-clavicular line
- Horizontal lines: Subcostal line (inferior margin of 10th costal cartilage), transpyloric line (tip of the 9th costal cartilage), intertubercular/interspinous line (between the two anterior superior iliac spines)
- Body regions: hypochondriac (uppermost area), lumbar (middle area, lateral to the rectus abdominis muscles), and iliac (lowermost, lateral to the rectus abdominis muscles)
- Different areas have different anatomical structures
Superficial Fascia of Anterior Abdominal Wall
- Superficial layer: Camper's fascia (fatty layer)
- Deep layer: Scarpa's fascia (membranous layer)
- Structures involved in this layer include the skin, penis, Scrotum, dartos fascia, and fascia lata
Layers of Abdominal Wall
- The abdominal wall has multiple layers and structures
- Superficial layer includes skin, Camper's fascia, and Scarpa's fascia; superficial fascia layers
- Deep layers include muscles and connective tissues; external oblique, internal oblique, transversus abdominis, and rectus abdominis muscles.
- Posterior wall of rectus abdominis sheath, external oblique, internal oblique, transversus abdominis, and transversalis fascia
Innervation
- Anterior abdominal wall: Lower 6 thoracic spinal nerves, 1st lumbar spinal nerve (iliohypogastric & ilioinguinal nerves)
- Nerves of the anterior abdominal wall: Lateral cutaneous branches of intercostal nerves, anterior cutaneous branch of T10, lateral cutaneous branch of subcostal nerve, lateral cutaneous branch of iliohypogastric nerve
Arterial Supply
- Upper extremity: Superior epigastric artery
- Lower extremity: Inferior epigastric artery
- Thoracic: Intercostal arteries
- Lumbar: Lumbar arteries
Venous Drainage
- Axillary vein drains thorax area superiorly, and femoral vein drains down.
- Drainage is also present via paraumbilical veins into the portal structures
Muscles of Anterior Abdominal Wall
- External abdominal obliques
- Internal abdominal obliques
- Transversus abdominis
- Rectus abdominis
- Cremasteric muscle
- Pyramidalis muscle
Muscles of the Abdominal Wall
- Includes muscles important to the abdominal wall
- These muscles include layers of external oblique, internal oblique, and transversus abdominis.
- The abdominal wall also contains rectus abdominis and pyramidalis muscles.
Inguinal Canal
- The inguinal canal is a passageway in the anterior abdominal wall
- Anteriorly: skin, superficial fascia, aponeurosis of external oblique muscle
- Posteriorly: medial 1/3 by conjoint tendon and transversalis fascia
- Superiorly: arched fibers of internal oblique and transversus abdominis muscle
- Inferiorly: inguinal ligament
Inguinal Region
- The inguinal region is the junction of the anterior abdominal wall and thigh; various structures and nerves pass through
- Structures include inguinal canal, deep inguinal ring, superficial inguinal ring, spermatic cord (male), round ligament of the uterus (female) and lymphatic vessel connections
Contents of Inguinal Canal
- Male: Spermatic cord (vas deferens, testicular artery, testicular vein, and autonomic nerves)
- Female: Round ligament of the uterus
- Both: Ilioinguinal nerve (sensory and motor innervation)
Abdominal Hernias
- Types : Femoral, umbilical, epigastric, and inguinal hernias (direct and indirect)
- Ventral hernias is used to refer to hernias in general, and not be confused with inguinal hernias
Deep Inguinal Ring
- Oval opening in the transversalis fascia
- Important passageway for structures and vessels in the groin
- Critical for understanding the anatomy of the groin and the structures related to reproductive organs
Pyramidalis Muscle
- Origin: Anterior surface of the pubis
- Insertion: Linea alba
- Function: Tenses the linea alba; small muscle
- Innervation: Lumbar nerve;
Contents in Rectus Sheath
- Muscle tissue and important vessels and nerves
- Important structures : rectus muscle, pyramidalis muscle, anterior rami of lower 6 thoracic spinal nerves, superior and inferior epigastric vessels, and lymphatic vessels
Arterial Supply to Abdominal Wall
- Superior epigastric artery (upper abdominal wall)
- Inferior epigastric artery (lower abdominal wall)
- Intercostal arteries (thoracic portion)
- Lumbar arteries (inferior portion)
Venous Drainage
- Upper extremity : Axillary vein
- Lower extremity : Femoral vein
- Includes smaller veins that accompany the arteries.
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