Download SESSION 4 - Anterior Abdominal Wall - Hatzalah of Miami-Dade

SESSION 4 - Anterior Abdominal Wall
1. The external oblique muscle arises from the last
(a) 6 ribs
(b) 8 ribs
(c) 10 ribs
2. As the external oblique arises it interdigitates with two other muscles. Which
ones and on which ribs?
3. The lower free edge of the external oblique is the inguinal ligament. To which
two bony points does it attach?
4. Does the external oblique reach posteriorly enough to attach to the
lumbosacral fascia?
5. The external oblique becomes aponeurotic below a line joining which two
points?
6. On reaching the pubic tubercle the inguinal ligament curls backwards and
upwards to give which ligament? This ligament then becomes the medial wall
of which canal? The ligament also extends along the superior pubic ramus and
changes its name to which ligament?
7. The superficial inguinal ring is a triangular shaped defect in the lower medial
part of the external oblique. What makes the base of the triangle? What are the
two sides of the triangle called? What prevents the splitting of the upper outer
fibres of the ring?
8. In order to arise from the lumbosacral fascia, to how much of which part of the
iliac crest must the internal oblique be attached?
9. In order to lie anterior to the deep inguinal ring, to how much of which part of
the inguinal ligament must the internal oblique be attached?
10. The lowest fibres of the internal oblique that arise from the inguinal ligament
curl over the inguinal canal and attach to the pubic crest and pectineal line.
(a)
(b)
(c)
(d)
What additional structure do they form?
What other fibres join them?
What is the nerve supply to this new structure?
What type of hernia do you get if there is weakness of this new
structure?
11. As the fibres of the internal oblique extend medially over the abdomen they
become aponeurotic and provide a sheath for the rectus abdominis muscle. In
the upper abdomen does this sheath
(a) lie anterior to the rectus muscle only
(b) lie posterior to the rectus muscle only
(c) Split to lie anterior and posterior
12. What is the arcuate line?
13. What is the linea alba?
14. From how much of the iliac crest and inguinal ligament does the transversus
abdominis rise? Does it lie lateral or anterior to the deep inguinal ring?
15. Does transversus abdominis lie anterior or posterior to the rectus abdominis
muscle below the arcuate line?
16. Between which two muscles do neurovascular bundles run in the abdominal
wall?
17. What is the name of the structures that bind the rectus abdominis muscle to the
anterior rectus sheath in the upper abdomen and give a six pack appearance?
18. In the suprapubic region what two layers of tissue separate the rectus muscle
from the bowel?
19. What is the main action of the rectus abdominis?
20. Which is the last costal cartilage to attach to the sternum? Does this
knowledge help to remember the nerve supply of the abdominal wall muscles?