The Abdomen The Abdomen Department of Human Anatom School of Medicine of Zhejiang University Xiaoming Zhang
Dec 24, 2015
The AbdomenThe Abdomen
Department of Human Anatom School of Medicine of Zhejiang University
Xiaoming Zhang
IntroductionIntroduction
Formation: Abdominal wall, Abdominal cavity and contentsBoundaries
Superior boundary Inferior boundary
Abdominal wall Anterior Abdominal Wall posterior abdominal wall
Abdominal cavity Division
4 abdominal quadrants4 abdominal quadrants
right epigastric region
left epigastric region
right hypogastric region
left hypogastric region
Ⅲ.The abdominal wall
The layers of the anterior abdominal wall:
skin superficial fascia muscles transverse fascia extraperitoneal fascia
parietal peritoneum
II Anterior Abdominal Wall Anterior Abdominal Wall
Layers and structures
Superficial structures1.skin
2.superficial fascia superficial layer — Camper‘s fascia deep layer — Scarpa‘s fascia, Colles’ fascia
3.superficial vessels and cutaneous nerves
Superficial structuresSuperficial structures
superficial arteries : three groups
• The branches of posterior intercostal A., sub
costal A., and lumbar A. ;• Superior and inferior epigastric A. ;• Superficial epigastric A. and superfical iliac
circumflex.
Superficial structuresSuperficial structuresthe superficial veins:
—umbilical venous network above the umbilicus below the umbilicus
Superficial lymphatic vessels:
upper→axillary lymph nodes lower→superficial inguinal lymph nodes anastomise with the lymphatics of the liver
the cutaneous nerves
II Anterior Abdominal Anterior Abdominal WallWallDeep Structures
Deep fasciaMuscular layersrectus abdominis the sheath of rectus abdominis
anterior layer of the sheath is formed
by the aponeurosis of the obliquus exter-
nus and the ant. layer of the aponeurosis
of the obliquus internus.
The linea alba is extending between the xiphoid process and the pubic symphysis,
formed by the decussating of the aponeu-
roses of the three flat muscles.
The posterior layer of the
sheath is formed by the
aponeurosis of the trans-
versus and the post. Layer
of the aponeurosis of the
obliquus internus.
The posterior layer of the
sheath is lack of at the
arcuate line(about 4cm
below the omphalo)
II Anterior Abdominal Wall Anterior Abdominal Wall
Deep Structures Muscular layers obliquus externus abdominis linea alba) superficial inguinal ring reflected ligament external spermatic fascia Inguinal ligament lacunar ligament pectineal ligament(Cooper )
(3) The internus abdominis
—arises from the lateral 2/3 of the inguinal lig.,the iliac crest and the
thoracolumbar fascia.The
muscular fibers is replace
by the aponeurosis(ant. And
post. layers) at the lateral
margin of the rectus.
—cremaster
—inguinal falx
(4) The transverse abdominis
—arises from the lateral 1/3 of the inguinal lig.,the iliac crest and the
thoracolumbar fascia and
internal aspect of lower 6
costal cartilage.
—cremaster
—inguinal falx
——inguinal canalinguinal canal1. position —parallel to,and above the inguinal lig. I1. position —parallel to,and above the inguinal lig. Immediately.mmediately. About 4cm long. About 4cm long.2. Structures — two orifices (1) the deep inguinal ring lies a transverse finger breadth(2cm)above the midpoint of inguinal lig. formed by the transverse fascia. (2)(2)sup. Inguinal ringsup. Inguinal ring formed by the aponeurosis of the obliquus exter formed by the aponeurosis of the obliquus externus.nus. triangular defect in shape. triangular defect in shape. medial and lateral crus medial and lateral crus
—four walls
(1) ant. wall is mainly formed by aponeurosis of the obliquus ext.,and laterally is reinforced by the beginning part of the obliquus internus. (2) inf. wall is formed by the inguinal ligament (3) Post.wall is formed by the transverse fascia, inguinal falx and the reflected lig.. (4) Sup. wall is formed by the arched fibers of the obliquus internus and transverse abdominis
The contents male spermetic cord, ilioinguinal nerve
female round ligament and ilioinguinal nerve
The inguinal triangle —boundaries inf. boundary medial half of the inguinal ligament medial boundary lateral border of the rectus abdominis lateral boundary inf. epigastric a..**direct inguinal hernia
I Anterior Abdominal WallI Anterior Abdominal WallDeep Structures
extraperitoneal fascia parietal peritoneum Five longitudinal folds Median umbilical fold
Medial umbilical fold
Lateral umbilical fold
inguinal medial fossa and inguinal lateral fossa
Summary of anterior abdominal Summary of anterior abdominal wallwall
Superficial structures skin superficial fascia :Camper and Scarpa superficial vessels and cutaneous nerves
Deep Structures Deep fascia Muscular layers The vessels and nerves transversalis fascia extraperitoneal fascia parietal peritoneum
II Inguinal regionII Inguinal region
Boundaries Superior boundary—from anterior iliac spine to lat
eral margin of rectus Medial boundary—lateral margin of rectus Inferior boundary—inguinal ligament inguinal trangle(Hesselbach trangle ) laterally —inferior epigastric A. medially —the lateral border of the rectus abdomini
s inferiorly —medial half of the inguinal ligament