Ab organs protected by
Thoracic cage and pelvis
9 regions of abdoment
Epigastric Umbilical Pubic Left/R hypochondriac R/L lateral (lumbar) L/R Inguinal
Sucostal plane
Divides top and middle row
Transtubercular plane
Divides middle and lower rows
Midclavicular pplanes divide
Right and Left from middle row
Anterolateral ab wall superficial fascai
Fatty superficial (Camper's) Deep membranous (Scarpas)
What is Scarpas renamed
Colles in inguinal region
Anterolateral deep fascia
Deep investing fascia
External abdominal oblique fibers run
Inferiorly and medially (hands in pockets)
Internal abdominal oblique fibers run
Perpindicular to external oblique (superiorly and medially)
Internal ab oblique changes direction at ____ to _____
ASIS
Medial and inferior
Transversus abdominus fibers run ____ and how to do they change?
Horizontally…inferiro to ASIS, fibers run same as internal oblique
Inguinal ligament formed by
Inferior free border of aponeuorsis of external ab obqliue between ASIS and pubic tubercle
Rectus abdominis runs ____ and enclosed by _____
Vertical
Enclosedb y aponeuroses of muscle
Tendinous intersections
Interruptions of rect abdom by horizontal bands
Rectus sheath composed of what and formed by what?
Longitudinal pocket of anterior rectus sheath and posterior rectus sheath
Formed by aponeuroses of ext ab oblique, internal ab oblique, and transversus abdominus
Linea semilunaris
Where anterolateral ab wall muscles continuous with retus sheath
Actions of anterlateral ab muscles
Support and compress viscera
Flex vertebral column with bilateral contraction
Lateral flexion of column with unilat contract
Rotation of trunk when internal ab oblique and contralateral external ab oblique contract simulataneous (turns toward internal ab oblique side)
Innervation of anterolateral wall muscles
Intercostal nerves T7-T12 and L1
Ipsilateral contraction of external and internal oblique results in
Lateral trunk flexion toward side of contraction
Contralateral contraction of external and internal oblique results in
Twitsting of trunk toward the internal side
How are internal oblique and contralateral external oblique connected?
Aponeuroses - digastric muscle
During rotation, rectus abdominis acts as a
Fixed post
Peritoneum
Serous lining of ab cavity and organs
Types of peritoneum and description
Parietal - lines ab wall and drapes into pelvis
Visceral - covers external surface of ab viscera
Functions of periotoneum
Reduce friction
Resists infection by exuding fluid and cells
Stores fat
Layers of abdominopevlic fascia
Transversalis fascia Diaphragmatic fascia Quadratus lumborum fascia Pelvic fascia Fascia lata
Blood, lymph, nerves relative to fascial lining of abdominopelvic
Blood and lymph vessels lie in the lining
Nerves lie outside
Abdominopelvic fascia special function
Below ASIS, it is only anterior wall strucutre posterior to rectus abdominus
Dorms inguinal ring and extends ofver spermatic cord as internal spermatic fascia
Arcuate line
Line at ASIS
Inferior to arcuate, what separates rectus abdominus from ab contents
Transversalis fascia and peritoneum
Transversalis fascia
Internal later of deep investing fascia of ab wall muscles
Similar to endothoracic fascia of thorax
What is continous with endopelvic fascia of pelivs
Transversalis fascia
Posterior rectus sheath below acruate line
Disappears
Most important arteires of ab cavity
Superior epigastric and inferior epigastric
Superior epigastric arises from
Internal thoracic from subclavian
Inferior epigastric arises from
External iliac
Where do inferior and superior epigastric anastomose
Imbilical region of anterior ab
Inguinal canal
Extends above and parallel to inguinal ligament from deep to superficial inguinal rings
Deep inguinal ring and location
Entrance of inguinal canal into transversalis fascia
On deep side of wall lateral to inferior epigastric artery, superior to inguinal ligament
Superficial inguinal ring
Exit of inguinal canal in the aponeurosis of the external ab oblique
Lateral crus and medial crus
Which is stronger
Lateral - also part of ligament
Borders of superficial ring
Intercrural fibers
Aponeurotic fibers at superior part of superficial ring that reinforce opening
What travles through inguinal canal to scrotum
Spermatic cord
Contents of spermatic cord
Testicular artery Pampinform plexus of veins (testicular veins) Ductus deferens (transporting sperm) Genital branch of genitofemoral nerve Lymphatics Vestige of processus vaginalis
Gubernaculum
Guides descent of testis into scrotum
What part of peritoneum pulled into scortum
Processus vaginalis
Tunica vaginalis
Sac of peritoneum on the testes
External spermatic fascia continuous with
External ab oblique fascia
Cremaster muscle and innervation
Strands of internal oblique pulled down into spermatic cord
Reflexive retraction of testis by stimulation of genitofemoral nerve
Internal spermatic fascia contiuous with
Transversalis fascia
Tunica vaginalis
Peritoneal extension covering tests on anterior and lateral sides
Hydrocele
Persistent processus vaginalis
Excess fluid filled sac in scortum
Inguinal canal broders
Ant - aponeurosis of ext ab oblique
Posterior - transversalis fascia
Roof - internal ab oblique and trasnversus ab
Floor - inguiinal ligament
Fibers of transversus abdominis do NOT contribute to
Spermatic cord because it arches over inguinal ring
Inferior epigastric artery enters
Rectus sheath below arcuate line
Ductus deferens leave
deep inguinal ring and descends into pelvis
Testicular artery leaves
Surface of psoas major and enters deep inguinal ring with testicular veins
Genital br. of genitofemoral nerve enter
Ring and run with spermatic cord
Inguinal triangle boundaries
lat - inferior epigastric artery
Medial - lateral border of rec abodminis
Inferior - inguinal ligament
Where does spermatic cord emerge from ab cavity relative to inguinal trianlge?
Lateral
Inguinal triangle clinical significance
Area of weakness..Site for abdominla hernia to push int o anterior ab wall
Direct inguinal hernia
Hernia emerges medial to inferior epigastric artery and only trasnverse superficial inguinal ring
INdirect inguinal hernia
herniation through deep inguinal ring, inguinal canal, and superficial ring
Can go into scrotum
Emerges lateral to inferior epigastric artery
What is patent in indirect inguinal hernia
Processus vaginalis
Inguinal vs femoral hernia
Inguinal - above and medial to pubic tubercle
Femoral - below and lateral to pubic tubercle
Mesentery
Double layer of periotoneum neither parietal nor visceral
Continuation of both
Mesentary acts as
Conduit
Peritoneum lies deep to
Transversalis fascia
Greater omentum
Fat infused sheet like peritoneal fold hanging from greater curvature of stomach where transverse colon attached
greater omentum ligaments
Gastrocolic
Gastrosplenic
Gastrophrenic
Lesser omentum connects
Lesser curvature and durodenum to the liver
What runs in free edge of lesser omentum (lateral to medial)
Common bile duct, prtal vein, hepatic artery
Lesser omentum ligaments
Hepatogastric ligaments
Hepatoduodenal ligament
Mesenteries connecting stomach, portions of small intestine and portions of large intestine to body wall (post)
Mesogastrium, transverse mesocolon, mesentery proper, sigmoid mesocolon
Ligaments of peritoneum
Double layer connecting organ with another of ab wall
Folds of peritoneum
Reflection with often sharp border due to vessels within
Recess of peritoneum
Fold forming a blind pouch opening into peritoneal cavity
Lesser sac…how formed, what from, location
Formed by rotation of GI tract
Remnant of right half of coelemic cavity
Posterior to stomach
Greater sac formed from
Remainder of peritoneal cavity
Epiploic foramen
How lesser and greater sac communicate
Peritoneal folds above umbilicus
Falciform ligament contains ligamentum teres (from umbilical vein)
Peritoneal folds below umbilicus
Median umbilical fold (1)
Medial umbilical folds (2)
Lateral umbilical folds (2)
Median umbilical fold
Peritoneum covered urachus (pathway of fetal urine)
Medial umbilical folds
Periotneal covered obliterated umbilical artery
Laterla umbilical folds
Peritoneum covered inferior epigastric artery and vein
Layers covering tests superficial to deep
Tunica vaginalis
Parietal
Visceral
Covering spermatic cord superficial to deep
External spermatic fascia from external oblique
Cremaster muscle from internal oblique
INternal spermatic fascia from transversalis fascia