Re: Questions for the Abdominal Wall

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: : Answer to Questions for the Abdominal Wall : : True/False - August 23, 2011 (selection limited by earthquake) : : 1. The paraumbilical veins communicate with lateral thoracic vein and, thus, contribute to a portacaval shunt. : : True—unsure of reasoning : Unintentionally False. This is not the best question. The paraumbilical veins certainly communicate with the thoracoepigastric vien but they are not generally said to directly communicate with the lateral thoracic vein although they perhaps do. The answer could be effectively argued to be true or false. : : 2. The superficial epigastric vein has a communicating branch to the lateral thoracic vein known as the thoracoepigastric vein. : : True : Agree. Again, not the best question. The thoracoepigastric vein is vein in its own right. Not a branch of the superficial epigastric vein. : : 3. Scarpa's fascia extends are far inferior as the thigh. : : True-Scrapa’s fascia extends just below the inguinal ligament where it fuses with the fascia lata of the thigh : Agree. By definition; inferior to the inguinal ligament is thigh. : : 4. The thoracoepigastic vein resides deep to Scarpa's fascia but superficial to deep fascia. : : False—it is superficial to Scarpa’s fascia : Agree. The space defined by the attachments of Scarpa's fascia is a potential space. It is empty under non-pathological conditions. : : 5. The umbilicus A/P projection is to the T10 vertebra and the cutaneous innervation is by the L3 spinal nerve. : : False-the A/P projection IS to the T10 vertebra BUT the cutaneous innervation is by the T10 spinal nerve : Agree. But..., the umbilicus projects to L3 and includes the T20 dermatome. : : 6. The transversus abdominis muscle contributes to the same fascial plane as the innermost intercostal muscles. : : False—the TA muscle is deep the ribs : True. It is the deepest muscle layer of three muscles making up the anterior wall and it defines the deep wall of the neurovascular plane. : : 7. The arcuate line is a feature of the anterior lamina of the rectus sheath that occurs 3/4 of the way inferior along the sheath. : : True : False. Posterior wall of the rectus sheath. : : 8. The aponeurosis of the internal oblique, inferior to the arcuate line, has two lamina that contribute to the anterior and posterior walls of the rectus sheath. : : False—inferior to the arcuate line, all three lamina contribute to the anterior wall of the rectus sheath and there is no posterior wall of the rectus sheath : Agree. Except to say that the posterior wall of the rectus sheath inferior to the arcuate line is immediately served by transversalis fascia. : : 9. The internal oblique takes origin, in part, from the lateral 2/3 of the linea alba. : : False—the internal oblique INSERTS on the linea alba, and takes origin, in part from the lateral 2/3 of the internal oblique : Agree. This origin places the internal oblique "in the way" of the deep ring. : : 10. The transversus abdominis takes origin, in part, from the later 1/3 of the linea alba. : : False—the TA INSERTS on the linea alba, and takes origin, in part from the lateral 1/3 of the inguinal ligament : Agree. This origin places the transversus away from the deep ring. Thus, the transversus abdominis does not contribute a layer to the spermatic cord. : : 11. The inferior epigastric artery enters the rectus sheath at a location inferior to the arcuate line. : : False-the inferior epigastric artery is deep to the rectus abdominis muscles and the posterior rectus is only present above the arcuate line. Therefore, the inferior epigastric vein cannot enter the rectus sheath below the arcuate line : True. I am not following your logic. The inferior epigastric artery invaginates the transversalis fascia inferior to the arcuate line to gain access to the rectus sheath. The rectus sheath extends inferior to the pubic crest. Have you read a contradictory account of the posterior wall of the rectus sheath? : : 12. Stability of the vertebral column is enhanced by well toned abdominal oblique muscles due to increased intraabdominal pressure. : : True—unsure of exact reasoning : Agree. Glue a piece of string to a deflated longitudinal balloon. No blow up the balloon. The string is stabilized. Thus, prescribe weight loss and crunches for chronic back pain that is not irritated by exercise. : : 13. The transversalis fascia lines the internal surface of the transversus abdominis muscle and is limited by the attachments of transversus abdominis. : : False—While the transversalis fascia does line the surface of the transversus abdominis muscle, it lines the entire abdominal cavity and continues into the pelvis. : Agreed. In fact, the transversalis fascia defines the abdominopelvic cavity and peritoneum defines the peritoneal cavity. : : 14. The rectus abdominis, inferior to the arcuate line, rests directly on transversalis fascia. : : True : Agree. : : 15. The superficial epigastric artery is a branch of the femoral artery. : : False—it is a branch of the internal thoracic artery : True. The superficial epigastric artery is a branch of the femoral artery. Remember the cribriform fascia? The superior epigastric artery is a terminal branch of the internal thoracic artery.

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