Introduction to the Abdomen - 2023 PDF

Prof. Ghada Wassif Dr.Eyad Tolba Prof. Ghada Wassif Dr.Eyad Tolba  GENERAL DESCRIPTION: The abdomen (the belly, tummy, or stomach) is the part of the body between the thorax (chest) and pelvis, in humans and in other vertebrates.. The area occupied by the abdomen is called...

Prof. Ghada Wassif Dr.Eyad Tolba Prof. Ghada Wassif Dr.Eyad Tolba  GENERAL DESCRIPTION: The abdomen (the belly, tummy, or stomach) is the part of the body between the thorax (chest) and pelvis, in humans and in other vertebrates.. The area occupied by the abdomen is called the abdominal cavity Prof. Ghada Wassif Dr.Eyad Tolba  GENERAL DESCRIPTION: The abdomen is a roughly cylindrical chamber extending from the inferior margin of thorax to the superior margin of pelvis & lower limb. -This chamber enclosed by the abdominal wall contains a single large peritoneal cavity. *Superiorly: the inferior thoracic aperture closed by diaphragm. *Inferiorly: is continuous with the pelvic wall at the pelvic inlet. Prof. Ghada Wassif Dr.Eyad Tolba *Functions of abdomen: 1-Houses and protects major viscera: 2-Breathing: 3-Changes in intra-abdominal pressure: Prof. Ghada Wassif Dr.Eyad Tolba  Anatomical Landmarks Bony Landmarks q Xiphoid process. q Costal margin. q Iliac crest. q Anterior sup iliac spine. q Pubic tubercle. q Pubic symphysis. q Pubic crest. q Pectineal line on the superior pubic ramus Prof. Ghada Wassif Dr.Eyad Tolba  Component parts 1. Abdominal Wall 2. Abdominal cavity 1) Wall: The abdominal wall consists partly of bone but mainly of muscle. - The skeletal elements of the wall are: 1. The five lumbar vertebrae and their intervening IV discs, 2. Bony components of the inferior thoracic wall including the xiphoid process, costal margin and rib XII, the end of rib XI. PELVIC INLET 3. The superior expanded parts of the pelvic bones.  Abdominal walls 1) Wall: The abdominal wall consists partly of bone but mainly of muscle. - Muscles make up the rest of the abdominal wall: A) Anterolateral parts of the RECTUS abdominal wall EXT. OBL INT. OBL 1. External oblique TRANSV 2. Internal oblique 3. Transversus abdominis Prof. Ghada Wassif Dr.Eyad Tolba  Abdominal walls Prof. Ghada Wassif Dr.Eyad Tolba External oblique Internal oblique Transversus Abdominis  Rectus Abdominis *2 vertical muscles, near the midline, enclosed within a tendinous sheath ( rectus sheath) 1-Rectus abdominis 2-Pyramidalis Prof. Ghada Wassif Your rectus abdominis is sometimes called your "six-pack abs." Dr.Eyad Tolba  Abdominal walls ‫ العض"ت‬tendons‫ تكون بسبب التقاء ل‬linea alba‫ال‬ ‫ بصورة اخرى‬extrnal,internal and transverse ‫الث"ث‬ ‫ لهم‬insertion‫نقدرنقول انه ال‬ The linea alba is a thin band of connective tissue that runs down the front of your abdomen. It separates the left and right sides of your rectus abdominis. It begins from the lower end of sternum and ends at the pubic bone. It received the insertion of the abdominal muscles Prof. Ghada Wassif Dr.Eyad Tolba  Abdominal walls 1) Wall: The abdominal wall consists partly of bone but mainly of muscle. - Muscles make up the rest of the abdominal wall: B)Posterior abdominal wall (Lateral to the vertebral column) Quadratus lumborum Psoas major Iliacus 1. Psoas major, 2. Quadratus lumborum, and 3. Iliacus muscles. Prof. Ghada Wassif Dr.Eyad Tolba  Abdominal cavity 2) Abdominal cavity contains A. large peritoneal cavity B. Abdominal viscera include: Ø Major elements of the gastrointestinal system, liver, gallbladder and pancreas. Ø The spleen. Ø Components of the urinary system-kidneys, ureters & the suprarenal glands. Ø Major neurovascular structures Prof. Ghada Wassif Dr.Eyad Tolba  Surface Topography -Used to describe the location of abdominal organs & the pain associated with abdominal problems. *The two schemes most often used: -Four-quadrant pattern. -Nine-region organizational description. IV disc betw. L3 & L4  Surface Topography -Used to describe the location of abdominal organs & the pain associated with abdominal problems. *The two schemes most often used: -Four-quadrant pattern. -Nine-region organizational description. body of L3 vb. body of L5 vb. Prof. Ghada Wassif Dr.Eyad Tolba The nine-region is based on 2 horizontal & 2 vertical planes: 1. The vertical planes pass from the midpoint of the clavicles superiorly to a point midway between the anterior superior iliac spine and symphysis pubic inferiorly (mid-inguinal point). 2. The superior horizontal plane (the subcostal plane) is immediately inferior to the costal margins, which places it at the lower border of the costal cartilage of rib X and passes posteriorly through the body of L3 vertebrae (Note that the transpyloric plane halfway between the jugular notch and the symphysis pubis or halfway between the inferior end of the body of the sternum and the umbilicus, passing posteriorly through the lower border of vertebrae LI and intersecting with the costal margin at the ends of the ninth costal cartilages is used instead). 3. The inferior horizontal plane (the intertubercular plane) connects the tubercles of the iliac crests, which are palpable structures 5 cm posterior to the anterior superior iliac spines, and passes through the upper part of the body of vertebra L5. Prof. Ghada Wassif Dr.Eyad Tolba These 4 planes establish the topographical divisions in the 9 region organization: 1. Superiorly, the right hypochondrium, the epigastric region & the left hypochondrium; 2. Inferiorly, the right groin (inguinal region)iliac , suprapubic region & left groin (inguinal region) iliac; 3.Prof. Ghada In the middle, the right flank (lateral region) lumbar, the umbilical region & the left Wassif Dr.Eyad Tolba flank(lumbar).  Layers of the Abdominal Wall q Skin. q Superficial fascia q No deep fascia ??? below the umbilicus q Muscles. q Fascia transversalis. q Extra peritoneal fatty tissue. q Parietal peritoneum. q Visceral peritoneum. There is no deep fascia in the anterior abdominal wall so, no restriction of visceral movements or distension. Prof. Ghada Wassif Dr.Eyad Tolba  Skin Hairy, loosely attached to the underlying structures except at the umbilicus -The umbilicus is a scar representing the site of attachment of umbilical cord in the linea alba. Langer’s (cleavage) lines ? - They correspond to the natural orientation of collagen fibers in the dermis - Runs horizontally. - Incisions parallel to Langer's lines heal better and produce minimal scaring. - Incisions perpendicular to Langer's lines have a tendency to wrinkle and produce more scaring. Prof. Ghada Wassif Dr.Eyad Tolba  2-The superficial fascia (subcutaneous tissue of abdomen): *In supra-umbilical part: usually a single layer *In infra-umbilical part: Forms 2 layers: a-Superficial fatty layer (Camper's fascia): - In men, the Camper's fascia continues over the penis to form the superficial fascia of the penis - Men continues into the scrotum where it forms a smooth muscle fibers (the Dartos muscle). b-Deeper membranous layer (Scarpa's fascia): Prof. Ghada Wassif Dr.Eyad Tolba Prof. Ghada Wassif Dr.Eyad Tolba b-Deeper membranous layer (Scarpa's fascia): -Inferiorly, continues into the thigh till just below the inguinal ligament, fuses with the deep fascia of the thigh(fascia lata). -In the midline, it is firmly attached to the linea alba and the symphysis pubis. Prof. Ghada Wassif Dr.Eyad Tolba b-Deeper membranous layer (Scarpa's fascia): -In men, Forms a tubular sheath for the penis (Buck’s fascia). & continue into the scrotum where they form the Dartos fascia and continue in the perineum as Colle’s fascia). -In women, the membranous layer of the superficial fascia continues into the labia majora and the anterior part of the perineum. Prof. Ghada Wassif Dr.Eyad Tolba  The abdominal Cavity GIT Prof. Ghada Wassif Dr.Eyad Tolba  Transverse colon Ascending colon Descending colon Caecum Appendix Sigmoid (pelvic) colon Large Intestine Prof. Ghada Wassif Dr.Eyad Tolba  Spleen Prof. Ghada Wassif Dr.Eyad Tolba  Development of the GI Tract Embryo folds & GI tube present in the midline of body cavity Foregut Midgut Hindgut Prof. Ghada Wassif Dr.Eyad Tolba  The abdominal Organs The major duodenal papilla is Foregut the site of junction between foregut and midgut Hindgut Midgut It lies at the junction of Rt 2/3 and Lt 1/3 of transverse colon Prof. Ghada Wassif Dr.Eyad Tolba  Foregut Midgut Hindgut Prof. Ghada Wassif Dr.Eyad Tolba  Coeliac trunk Superior mesenteric a Inferior mesenteric a Prof. Ghada Wassif Dr.Eyad Tolba  Abdominal aorta Foregut Coeliac trunk T12 Superior mesenteric artery L1 Midgut Inferior mesenteric artery L3 Hindgut Prof. Ghada Wassif Dr.Eyad Tolba Prof. Ghada Wassif Dr.Eyad Tolba Primary retroperitoneal organs Left Right Prof. Ghada Wassif Dr.Eyad Tolba  Parietal peritoneum. Visceral peritoneum. Visceral peritoneum Left Right Prof. Ghada Wassif Dr.Eyad Tolba Secondary retroperitoneal organs c r ea s P a n Duodenum  Ascending Descending colon colon Prof. Ghada Wassif Dr.Eyad Tolba Prof. Ghada Wassif Dr.Eyad Tolba Prof. Ghada Wassif Dr.Eyad Tolba ‫يمكن بعض االسئلة تكون ملحاضرات بعدين النه هذي بس ‪.intro‬‬