SGT 111 Fuller Chapter 22: General
Surgery: Abdominal Wall and the Repair
of Hernias
transverse plane - Answer- -horizontal division of the body into upper and lower
portions
-Superior= above; toward head; upper half
-Inferior= below; away from head; lower half
sagittal plane - Answer- -divides body into left and right
-Areas closer to the midline are called medial
-Areas moving away from midline are lateral
frontal (coronal) plane - Answer- -divides the body into anterior and posterior parts
-Anterior = front (ventral)
-Posterior = back (dorsal)
distal - Answer- Farther from the trunk of the body
proximal - Answer- Nearer to the trunk of the body
Ipsilateral - Answer- same sides of the body
contralateral - Answer- opposite sides of the body
right upper quadrant - Answer- Liver, Gallbladder, Portion of Colon, Portions of small
intestine
left upper quadrant - Answer- Stomach, Pancreas, Spleen, Colon, Portions of small
intestines, kidney, adrenal glands, Descending aorta, Ureters
right lower quadrant - Answer- Appendix, Right Ureter, Right Ovary, Fallopian tube
and ascending colon
left lower quadrant - Answer- Left Kidney, Left ureter, Left Ovary, Fallopian tube,
Descending colon, Sigmoid colon,
tissues of abdominal wall deep to superficial - Answer- abdominal peritoneum,
muscles, fascia, subcutaneous (fat), skin (subcuticular)
abdominal peritonium - Answer- 0-PDS or Prolene on large needle (CT, CT-1, TP)
, muscles - Answer- 2-0 or 3-0 Vicryl (CT, CT-1)
fascia usually w/ peritoneum - Answer- 0 or 2-0 Vicryl, Prolene (CT, CT-1)
subcutaneous (fat) - Answer- 3-0 Vicryl (SH, CT-1)
skin (subcuticular) - Answer- 3-0 or 4-0 Vicryl or Monocryl, Staples
upper midline incision - Answer- allows access to lower esophagus, stomach, small
intestine, liver Biliary system, spleen, pancreas, proximal colon
sub-costal kocher incision - Answer- allows access to gallbladder, liver, biliary system,
spleen
McBurney incision - Answer- allows access to appendix
Pfannenstiel incision - Answer- allows access to uterus, adnexa, bladder, c-section
lower midline incision - Answer- allows access to sigmoid colon
Inguinal oblique incision - Answer- allows access to muscles and facia of the inguinal
abdominal wall
hernia - Answer- protrusion of an organ or fascia through the wall of a cavity that
normally contains it
indirect hernia - Answer- -where the peritoneal sac enters the inguinal canal through
the deep inguinal ring
-Herniated tissue may extend through the superficial (external) ring in the spermatic
cord into the scrotum or labia.
-Usually from congenital weakness in the inguinal canal.
direct hernia - Answer- -where the peritoneal sac enters the inguinal canal though the
posterior wall of the inguinal canal
-defect in inguinal floor
-Protrusion of abdominal or inguinal tissue directly through the transversalis fascia.
-Usually in older men.
-acquired, usually in adulthood, due to weakening in the abdominal musculature
-located in Hesselbach triangle
muscle layers - Answer- rectus abdominal, external oblique, internal oblique,
tranversus abdominus
femoral hernia - Answer- -Arising from a weakness in the transversalis fascia below
the inguinal ligament.
-Occurs mostly in women and may require surgery to prevent tissue incarceration
