Abdominal Wall and Accessory Structures 6-1
Umbilicus
Abdominal anterior and lateral cutaneous nerves Skin and muscles supplied by T7 through T12, plus L1.
Dermatomes of the anterolateral abdominal wall Nerves T7 to T12 and L1 supply branches to the anterolateral abdominal wall muscles and the underlying parietal peritoneum All terminate by supplying skin Optional slide
Subcostal nerve Contributes to T12 dermatome
Iliohypogastric nerve Ventral ramus of L1 spinal nerve
Genitofemoral nerve Ventral ramus L1 and L2
Serratus Anterior m.
Superficial fascia (Fatty and Membranous layer)
External abdominal oblique m. Innervation: T7 through T12
Internal abdominal oblique m. Innervation: T7 through T12, plus L1
Transversus abdominis m. Innervation: T7 through T12, plus L1
Pyramidalis m. Innervation: T12
Rectus abdominus m.
Tendinous intersections of rectus abdominis m.
Anterior rectus sheath Consist of the aponeurosis of the external oblique and half of the aponeurosis of the internal oblique
Posterior rectus sheath Consists of the other half of the aponeurosis of the internal oblique and the aponeurosis of the transversus abdomins.
Rectus Sheath Top picture : upper three-quarters of the rectus abdominis m. Bottom picture : the lower one-quarter of the rectus abdominis m. No posterior rectus sheath Arcuate line – marking the point of transition
Arcuate line
Linea alba Formed by rectus sheaths
Inguinal ligament
Lacunar ligament
Superficial inguinal ring Formed by the aponeurosis of the external oblique m.
Lateral (inferior) Crus Prevents further widening of the superficial ring with medial crus
Medial (superior) Crus Prevents further widening of the superficial ring with lateral crus
Deep inguinal ring Formed by transversalis fascis
Inguinal Canal Roof – the transversus abdominis and internal oblique muscles Floor – the inguinal ligament Anterior wall – Aponeurosis of external oblique Posterior wall – Transversalis fascia Content Male : the spermatic cord Female : the round ligament of the uterus and the genitofemoral nerve
Conjoined tendon (falx inguinalis) Forms the posterior wall of the inguinal canal with transversalis fascia
Round ligament of the uterus
Superior epigastric artery The veins follow the artery
Inferior epigastric artery The veins follow the artery
Deep circumflex Iliac artery The veins follow the artery
Fundiform ligament of penis
Semilunar line AKA Linea Semilunaris
Epididymis
Epididymis: Head
Epididymis: Body
Epididymis: Tail
Tunica Vaginalis Testis Parietal Layer Visceral Layer
Tunica Albuginea
Ductus deferans
Ductus Deferens
Anterior Scrotal Branch Ilioinguinal Nerve
External Spermatic Fascia
External spermatic fascia
Cremaster Muscle
Testis
Spermatic cord
Spermatic cord
Testicular artery
Pampiniform Plexus of Veins
Parietal Peritoneum
Extraperitoneal Connective Tissue
Transversalis Fascia
Median Umbilical Fold and Ligament
Medial Umbilical Fold and Ligament
Lateral Umbilical Fold and Ligament
Supravesical Fossa
Medial Inguinal Fossa
Lateral Inguinal Fossa
Falciform Ligament
Round Ligament of the Liver
Greater Omentum
Gastrosplenic Ligament
Quiz
Umbilicus
Abdominal anterior and lateral cutaneous nerves
Subcostal nerve
Iliohypogastric nerve
Genitofemoral nerve
Serratus Anterior m.
Superficial fascia (Fatty and Membranous layer)
External abdominal oblique m.
Internal abdominal oblique m.
Transversus abdominis m.
Pyramidalis m.
Rectus abdominus m.
Tendinous intersections of rectus abdominis m.
Anterior rectus sheath
Posterior rectus sheath
Arcuate line
Linea alba
Inguinal ligament
Lacunar ligament
Superficial inguinal ring
Lateral (inferior) Crus
Medial (superior) Crus
Deep inguinal ring
Inguinal Canal
Conjoined tendon (falx inguinalis)
Round ligament of the uterus
Superior epigastric artery The veins follow the artery
Inferior epigastric artery The veins follow the artery
Deep circumflex Iliac artery The veins follow the artery
Fundiform ligament of penis
Semilunar line