What are the borders of the inguinal canal?
anterior- External oblique aponeurosis
posterior- transversalis fascia
superior- arching IO & transverse abdominis muscles
inferior- Inguinal ligament
What are the attachment points of the Inguinal ligament?
attaches to the Anterior superior iliac spine (ASIS )and pubic tubercle
What forms the inguinal ligament?
thickened band of external oblique aponeurosis
What are the layers of the anterior abdominal wall superficial to deep?
Skin--> Superficial fascia (1. campers 2. scarpas)--> Deep (investing) fascia-->muscles (external, internal, transverse, rectus abdominis) --> transversalis fascia--> parietal peritoneum
What makes up the anterior rectus sheath?
above arcuate line- EO and IO aponeurosis
below arcuate line- EO, IO, & transverse abdominis aponeurosis
Where do you dinf a weakness in the abdominal wall and why?
below the arcuate line because there is no posterior rectus sheath
What is the course of blood from the femoral artery and vein?
femoral--> superfical epigastric--> (anatomises) thoracoepigastric vein--> lateral thoracic vein--> axillary vein
if a patient has significant liver cirrhosis causing blockage of portal vein what do you expect?
blood cant go through liver to return to heart so blood is rerouted through paraumbilical veins--> superficial epigastric vein--> femoral vein--> IVC
or paraumblical vein--> thoracoepigastric vein--> axillary vein--> SVC
the veins take in more blood causing caput medusa
what does the paraumbilical veins connect with?
surround the umbilicus and go deep to connect with the portal vein, superficial epigastric, and thoracoepigastric vein
What gives off the inferior epigastric artery?
external iliac artery
what makes up the lateral umbilical fold?
overlies the inferior epigastric artery and vein
What is another name for Hesselbach's triangle? What are the borders?
medial rectus abdominis
lateral- inferior epigastric vessels
inferior- inguinal ligament
A hernia in the inguinal triangle is considered what type of hernia?
Direct inguinal hernia
A hernia medial to the inferior epigastric vessels is considered what type of hernia?
Direct inguinal hernia
A hernia outside of hesselbach's triangle is considered what type of hernia?
A hernia protruding through the deep inguinal canal is considered what type of hernia?
A hernia lateral to the inferior epigastric vessels is considered what type of hernia?
What type of hernia is commonly congenital ?
Where can you visualize the cutaneous intercostal nerves of the abdomen?
b/w the internal oblique and transverse abdominis muscle
Where can you find the intercostal nerves of the rib cage?
between the internal and innermost intercostal muscles
What nerve branch innervates the top of abdomen?
T7 cutaneous branch of Anterior ramus (first nerve below the xyphoid)
What nerve innervates the belly button region?
T10 anterior ramus
L1 nerve gives of what braches?
1. iliohypogastric (superior to inguinal ring)
2. ilioinguinal (dives deep to enter superficial inguinal canal then goes to scrotum)
What type of tissue makes up camper's fascia?
What type of tissue makes up scarpas fascia?
What passes through the inguinal canal?
males- spermatic cord
females- round ligament of the uterus
Where course of the spermatic cord?
begins in the deep inguinal ring--> inguinal canal--> superficial inguinal ring--> ends in the scrotum at the testes root
What are the contents of the spermatic cord?
What could happen as a result of a persistent processus vaginalis in males?
potential pathway for a indirect hernia through inguinal canal to scrotum