1. Department of Human Anatom School of Medicine of Zhejiang University
The Abdomen
Xiaoming Zhang
Department of Human Anatom
School of Medicine of Zhejiang University

2. Introduction Formation: Abdominal wall, Abdominal cavity and contents
Boundaries
Superior boundary
Inferior boundary
Abdominal wall
Anterior Abdominal Wall
posterior abdominal wall
Abdominal cavity
Division

3. 4 abdominal quadrants right epigastric region left epigastric region
right hypogastric region
left hypogastric region

4. 9 abdominal regions
hypogastric region

5. Anterior Abdominal Wall

6. Ⅲ.The abdominal wall The layers of the anterior abdominal wall: skin superficial fascia muscles transverse fascia extraperitoneal fascia parietal peritoneum

7. I Anterior Abdominal Wall
Layers and structures
Superficial structures
1.skin
2.superficial fascia
superficial layer — Camper‘s fascia
deep layer — Scarpa‘s fascia, Colles’ fascia
3.superficial vessels and cutaneous nerves

8. Superficial structures
superficial arteries：three groups
The branches of posterior intercostal A., subcostal A., and lumbar A. ；
Superior and inferior epigastric A. ；
Superficial epigastric A. and superfical iliac circumflex.

10. Superficial structures
the 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

12. I Anterior Abdominal Wall
Deep Structures
Deep fascia
Muscular layers
rectus abdominis
the sheath of

13. 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.

14. 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.
sheath is lack of at the
arcuate line(about 4cm
below the omphalo)

17. I 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 ）

19. (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

20. (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

21. —inguinal canal 1. position —parallel to,and above the inguinal lig
—inguinal canal 1. position —parallel to,and above the inguinal lig. Immediately. 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)sup. Inguinal ring formed by the aponeurosis of the obliquus externus triangular defect in shape medial and lateral crus

22. —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

26. 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

28. I Anterior Abdominal Wall
Deep Structures
extraperitoneal fascia
parietal peritoneum
Five longitudinal folds
Median umbilical fold
Medial umbilical fold
Lateral umbilical fold
inguinal medial fossa and inguinal lateral fossa

30. Summary of anterior abdominal wall
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

31. II Inguinal region Boundaries
Superior boundary—from anterior iliac spine to lateral 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 abdominis
inferiorly —medial half of the inguinal ligament

32. III The incisions of anterolateral wall of abdomen

33. Rectus incision
Median incision
Inferior median incision
McBurney’s incision

34. Thank You!