Case

An 18-year-old college student complains of abdominal pain that began 12 hours ago around their umbilicus and then shifted to the right lower quadrant (RLQ) and flank. They indicate they have been nauseous over the past several hours. Their temperature is 38°C. On physical examination, there is abdominal tenderness, particularly in the RLQ. Laboratory analysis of urine is normal.

Question 2/2 - Type into the boxes layers that you have to pass through when making an incision through the abdominal wall at McBurney's point?

(hint, if counting typical layers there are 10...or 11 depending on definition of a layer)

Click on the answer list below to check your work.

Case Complete

























- Skin - Epidermis
          - Dermis
          - Fatty layer of the superficial fascia (Camper's fascia)
          - Membranous layer of the superficial fascia (Scarpa's fascia)
- Deep fascia over the external abdominal oblique muscle
- External abdominal oblique muscle
- Internal abdominal oblique muscle
- Transversus abdominis muscle
- Transversalis fascia
- Pre-peritoneal fat (...not really a clearly defined 'layer', but may be considered one)
- Parietal peritoneum

Note, since we are making the incision inferior to the umbilicus the superficial fascia (hypodermis) has the two layers of fatty and membranous. Above the umbilicus these are indistinct and rarely defined layers.