Anterior Abdominal Wall Anatomy PDF

ANTERIOR ABDOMINAL WALL ANATOMY  Abdominal Cavity Superiorly → Diaphragm Inferiorly → pelvic inlet Anteriorly → skin, subcutaneus tissue, anterior abdominal wall muscles Posteriorly → 5 lumbar vertebrae, intervertebral disc, psoas major and q...

ANTERIOR ABDOMINAL WALL ANATOMY  Abdominal Cavity Superiorly → Diaphragm Inferiorly → pelvic inlet Anteriorly → skin, subcutaneus tissue, anterior abdominal wall muscles Posteriorly → 5 lumbar vertebrae, intervertebral disc, psoas major and quadratus lumborum Abdominal Quadrants Regions of the abdomen Vertical lines: Lateral bourder of rectus abdominus muscle Midpoint of inguinal ligament Mid-clavicular line Horizontal lines Subcostal line (inferior margin of 10th costal cartilag) Transpyloric line (tip of the 9th costal cartilage) Intersinous line (between the two anterior superior iliac spin R. HYPOCHONDRIUM EPIGASTRIUM L. HYPOCHONDRIUM R. LUMBAR UMBLICAL L. LUMBAR R. ILIAC HYPOGASTRIUM (INGUINAL) L. ILIAC (INGUINAL) Abdominal Quadrants Abdominal Regions Superficial fascia of the anterior abdominal wall Superficial layer (Camper’s Fascia) Deep membranous layer (Scarpa’s fascia) Transversals fasica is contious with fasica lata Dortos facia and colles fasia are continuations of scarpa fascia Innervation of anterior abdominal wall Anterior rami of lower 6 thoracic spinal nerves 1st lumbar spinal nerve (iliohypogastric & ilioinguinal nerves) Arterial supply anterior abdominal wall Superior epigastric artery Inferior epigastric artery Intercostal arteries Lumbar arteries Venous Drainage anterior abdominal wall Axillary vein Femoral vein Paraumblical veins  Muscles of the Anterior Abdominal wall 1. External abdominal obliques 2. Internal abdominal obliques 3. Transversus abdominis 4. Rectus abdominis 5. Cremasteric 6. Pyramidalis Muscles of the Abdominal Wall Muscles of the Anterior Abdominal Wall Muscles of the Anterior Abdominal Wall External abdominal obliques O: Outer surface of lower 8 ribs I: Xiphoid proc. linea alba, pubic crest & ant. Half of iliac crest N: ventral rami of lower 6 thoracic spinal nerves Linea alba It is tendinous raphe extends between xiphoid process & symphsis pubis Superficial inguinal ring Δ defect on the lower medial aspect of external abdominal aponeurosis Inguinal ligament (Poupart ligament) Extends between the anterior superior iliac spine & pubic tubercle. Lacunar ligament (Gimbernart Ligament) Medial end of the inguinal ligament expands and attaches to the pecten pubis Reflected ligament (Colles ligament) Medial end of the inguinal ligament passes upwards & attaches to the rectus sheath & linea alba Internal abdominal obliques O: lumbar fascia, ant. 2\3 of iliac crest, lat. 1\3 of inguinal ligament I: Lower border of lower 3 ribs, xiphoid proc. linea alba, pubic symphysis N: ventral rami of lower 6 thoracic & L1 spinal nerves Transversus abdominis O: lumbar fascia, ant. 2\3 of iliac crest, lat. 1\3 of inguinal ligament & internal aspect of lower 6 ribs I: Xiphoid proc. linea alba, pubic symphysis N: ventral rami of lower 6 thoracic & L1 spinal nerves  Rectus abdominis O: 2 heads pubic symphysis, pubic crest I: 5th, 6th and 7th ribs & xiphoid proc. N: ventral rami of lower 6 thoracic & L1 spinal nerves Functions of the anterior abdominal wall muscles Retains the abdominal viscera in possition Assists the diaphragm during inspiration Assists in forced expiration by pulling down the ribs and sternum Contracting simuntaneously they increase the intra-abdominal pressure helping micturition, defecation, vomiting and parturition  Contents of the rectus sheath Which one of the structures below is not seen in recturs sheath 1. Rectus muscle 2. Pyramidalis muscle 3. Ant. Rami of lower 6 thoracic spinal nerves 4. Superior & inferior epigastric vessels 5. Lymphatics H Cremasteric Muscle Loosely encloses the spermatic cord F: pulls the testis towards the superficial inguinal ring N. Genital branch of genitofemoral nerve Pyramidalis Muscle O: anterior surface of Pubis I: Linea alba F: Tenses the linea Alba N: Lumbar nerve  Inguinal canal Anteriorly: skin, superficial fascia, aponeurosis of ext. abd. oblique muscle Posteriorly: medial 1\3 by the conjoint tendon & transversalis fascia Superiorly: Arched fibers of the int. abd. oblique & Transversus abdominus muscle Inferiorly: inguinal ligament Deep İnguinal ring It is an oval opening situated in the transversalis fascia  Contents of the inguinal Canal Male: *Spermatic cord: -vas deferens -testicular artery -testicular vein -autonomic nerves Female: Round ligament of the uterus Both: ilioinguinal nerve  Abdominal Hernias Femoral hernia Umblical hernia Epigastric hernia Inguinal hernia Direct inguinal hernia Indirect inguinal hernia  Inguinal hernias Indirect inguinal Hernia Enters the inguinal canal through the deep inguinal ring & extend as far as superficial inguinal ring Direct inguinal hernia Bulges directly through the posterior wall of the inguinal canal