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1

Where is thoracic cavity?

Deep to rib cage, above diaphragm

2

Where is the abdominal cavity?

From diaphragm to pelvic inlet

3

Where is the pelvic cavity ?

Under/dep to pelvic inlet

4

L to R, Top to Bottom, what are the 9 areas of the Abdomen?

1) Right hypochondrium
2) epigastric region
3) Left hypochondrium
4) Right flank
5) Umbilical region
6) Left flank
7) Right groin
8) Pubic region
9) Left groin

5

What are the layers of the abdominal wall?

Skin, Superficial (camper's) fascia - fatty layer, Superficial (scarpa's) fascia - membranous layer, muscular layer, transversalis fascia, extraperitonial fascia, parietal peritoneum

6

What are the Superficial Muscles of the Abdominal Wall?

External oblique (has an aponeurosis)

7

What are the Deep Muscles of the Abdominal Wall?

Rectus abdominis muscle, internal oblique

8

Other muscle?

Transversus abdominis muscles

9

True or false, all 3 muscles have midline aponeurosis running into line alba.

True

10

What is the rectus sheath?

An Aponeurotic (tendinous) sheath that Envelops rectus abdominus & pyramidalis mm. It Consists of anterior & posterior layers.

*Structure of the sheath is relative to the arcuate line. (midway between umbilicus & pubic symphysis)



11

What is layering organization Superior to Arcuate line?

Anterior layer – formed by aponeuroses of EO & ½ IO

Posterior layer – formed by aponeuroses of ½ IO & TA, & transversalis fascia

12

What is layering organization Posterior to Arcuate line?

Anterior layer – formed by aponeuroses of EO, IO, TA

Posterior layer – formed by transversalis fascia

13

What are the Infraumbilical peritoneal folds?

median umbilical fold
medial umbilical folds (2)
lateral umbilical folds (2)

14

Where is the median umbilical fold?

from urinary bladder to umbilicus
covers median umbilical ligament

15

Where are the medial umbilical folds?

covers medial umbilical ligaments
occuded portions of umbilical aa.

16

Where are the lateral umbilical folds?

covers inferior epigastric vessels

17

What are the superficial vessels?

Circumflex Iliac a.
br. of femoral a.
supplies region of inguinal ligament

Epigastric a.
br. of femoral a.
supplies abdomen infr. to umbilicus.

Circumflex Iliac v.
drains to femoral v.
drains region of inguinal ligament

Epigastric v.
drains to femoral v.
drains abdomen infr. to umbilicus.

*All vessels run in superficial fat & fascia

18

What are the Deep Circumflex Iliac vessels?

Br. of External Iliac
Runs between IO & TA
Supplies inferior lateral abdominal mm.

*All veins are similarly placed and drain to Ext. Iliac v.

19

What are the Inferior Epigastric vessels?

Br. of External Iliac

Enters posterior rectus sheath at arcuate line

Supplies lower rectus abdominus mm.

anastomoses with Sup. Epigastric

*All veins are similarly placed and drain to Ext. Iliac v.

20

What are the Superior Epigastric vessels?

Br. of Internal Thoracic (Mammary)

Enters posterior rectus sheath lat. to sternum

Supplies upper rectus abdominus mm.

Anastomoses with Inf. Epigastric

*All veins are similarly placed and drain to internal thoracic v.

21

What are the Musculophrenic vessels?

Br. of Internal Thoracic (Mammary)

Runs along costal cartilages

Supplies upper abdominal mm. & diaphragm

*All veins are similarly placed and drain to internal thoracic v.

22

What are the nerves of the abdominal wall?

-Ventral rami of T7-L1 spinal nn.
-T7, T8 & T9 – supply region above umbilicus
-T10 – supplies umbilical region
-T11, T12 & L1 – supply region below umbilicus
-Run between IO and TA mm.

-Injury to last 3 nn. weakens mm in inguinal region
-Predisposes to developing direct inguinal hernias

23

Where is the inguinal region?

-Inferior lateral abdominal region

-superior to thigh
-medial to ilium
-lateral to pubic bone

-{Area extends between the anterior superior iliac spine (ASIS) and the pubic tubercle.}

-Inguinal ligament, canal (male & female), superficial and deep rings of the inguinal canal, walls of the canal

24

What is the inguinal ligament?

-Folded inferior border of the EO aponeurosis
-Extends from ASIS to pubic tubercle

25

What is the inguinal canal?

-Obliquely set tunnel 3 to 5 cm long
-Traverses ant. abdominal wall
-Runs parallel & superior to inguinal ligament

26

What is in the male inguinal canal?

-Contains spermatic cord & its contents
-(vas deferens, testicular nn & vessels, cremasteric m & fascia) & Ilioinguinal n. (L1)

27

What is in the female inguinal canal?

-Contains round ligament of uterus (corresponds to spermatic cord in males)
-Ilioinguinal n. (L1)

28

What are the Inguinal Canal Rings?

Superficial Ring = opening in EO aponeurosis
obvious triangular opening lateral to pubic tubercle

Deep Ring = opening in transversalis fascia
subtle piercing just lateral to inferior epigastric vessels

NOTE: Canal extends between superficial and deep rings

29

What are the walls of the inguinal canal?

Anterior wall = EO aponeurosis

Posterior wall = transversalis fascia & conjoint tendon
fusion of IO, TA aponeuroses medially

Roof = IO & TA muscles (superior)

Floor = inguinal ligament (inferior)

30

What is the conjoint tendon of the Inguinal Canal Wall?

Anterior = EO apon.
Posterior = transversalis fascia & conjoint tendon
fusion of IO, TA aponeuroses medially
Roof = IO & TA muscles
Floor = inguinal ligament