Pelvis

• What are the layers of the anterior abdominal wall?

  Skin

  Superficial fascia - fatty layer (Camper's fascia)

  Superficial fascia - membranous layer (Scarpa's fascia)

  External oblique

  Internal oblique

  Transversus abdominis

  Tranversalis fascia

  Extraperitoneal fat

  Parietal peritoneum
• What is Colles' fascia?

  Continuation of Scarpa's fascia
• Fill in the blanks

  A) fascia lata

  B) Colles' fascia

  C) dartos fascia

  D) superficial penile fascia

  
• Fill in the blanks

  A) Rectum

  B) Pelvic diaphragm

  C) Anal canal

  D) Anal apeture

  E) Urogenital diaphragm

  F) Urethra

  G) Bladder

  H) Vagina

  I) Uterus

  J) Ovary

  K) Uterine tube

  
• Fill in the blanks

  A) Rectum

  B) Pelvic diaphragm

  C) Anal canal

  D) Anal aperture

  E) Bladder

  F) Urethra

  G) Urogenital diaphragm

  H) Ejaculatory duct

  I) Prostate

  J) Vas deferns

  K) Seminal vesicle

  
• What happens when there is rupture of the spongy urethra in the bulb of the penis?

  Urine into superficial perineal space

  Urine & blood may spread into scrotum, penis & inferior abdominal wall

  
• What happens when there is rupture of the membranous urethra?

  Extravasation of urine & blood into deep perineal compartment

  Fluid may pass superior through urogenital hiatus & distribute extraperitonally -> around prostate & bladder

  
• What is the blood supply to the abdominal wall?

  Intercostal

  Epigastric

  Branches of segmental lumbar arteries (posterior abdominal wall)
• Venous drainage of abdo wall

  Intercostals -> drain into azygous system

  Superior & inferior epigastric -> subclavian & femoral veins
• Lymph drainage of abdo wall

  Axillary nodes

  Inguinal nodes
• What is Hesselbach's triangle?

  Where direct inguinal hernias occur

  Medial to inferior epigastric vessels

  Borders

  • Rectus abdominis (medial)
  • Inferior epigastric vessels (lateral)
  • Inguinal ligament (inferior)
• Where do indirect inguinal hernias occur?

  Lateral to inferior epigastric vessels

  Through deep inguinal ring
• Where do femoral hernias occur?

  Through femoral ring into femoral sheath

  Below inguinal ligament

  Lateral to pubic tubercle
• What is Spigelian hernia?

  Protrusion of extraperitoneal fat or peritoneal sac through defect in abdominal wall (intersection of semilunar line with arcuate line)
• What is a varicocele?

  Abnormal dilation & tortuosity of the pampiniform venous plexus within spermatic cord

  Almost all are left sided
• What is the most common cause of scrotal enlargement?

  Hydrocele
• What is a hydrocele?

  Excessive accumulation of serous fluid within tunica vaginalis
• What is paraphimosis?

  Retracted foreskin that is too tight to be brought forward over glans penis

  Constricts penis & may obstruct blood flow
• What is phimosis?

  Tight foreskin that cannot be retracted over glans penis

  Normal in boys < 3 yrs
• Testicular torsion is a urological emergency.