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STUDY OF HUMAN ANATOMY
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ANATOMY OF THE ABDOMEN
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A region of the body bounded by the following regions:-
DEFINITION OF ABDOMEN A region of the body bounded by the following regions:- Superiorly – thorax Inferiorly – pelvis/perineum Posteroinferiorly – back Inferolaterally – lower limbs
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BONY LANDMARKS OF THE ABDOMEN
Xiphoid process Costal margin – 7th – 11th costal cartilages Pelvic bones L1 – L5 Lumbar vertebrae
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ABDOMINAL CAVITY extends btw thoracic diaphragm & pelvic diaphragm – abdominopelvic cavity upper part is under cover of the osteocartilagenous thoracic cage occupied by organs of the digestive, urogenital, endocrine & vascular structures.
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CONTENTS OF THE ABDOMINAL CAVITY
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CONTENTS OF THE ABDOMINAL CAVITY
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ABDOMINAL WALL
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PLANES OF THE ABDOMEN 4 planes divide the abdominal cavity into 9 regions 2 vertical (midclavicular), midclavicular to midinguinal 2 transverse – ( subcostal & transtubercular) Subcostal – pass through 10th costal cartilage Transtubercular – pass through iliac tubercle
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REGIONS OF THE ABDOMEN
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REGIONS OF THE ABDOMEN
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QUADRANTS OF THE ABDOMEN
2 planes delineate the abdominal cavity into 4 quadrants 1 vertical – median 1 transverse – transumbilical
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POSITIONS OF THE ABDOMINAL ORGANS
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ANTEROLATERAL ABDOMINAL WALL
Anterior & lateral walls extending from the thorax to pelvis Consists of the (1) Skin (2) Fascia - Subcutaneous & deep (3) Muscles (4) Transversalis fascia (5) Extraperitoenal fat (6) Peritoneum
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ANTEROLATERAL ABDOMINAL WALL
Anterior & lateral walls extending from the thorax to pelvis Consists of the (1) Skin (2) Fascia - Subcutaneous & deep (3) Muscles (4) Transversalis fascia (5) Extraperitoenal fat (6) Peritoneum
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SKIN Loosely attaches to the superficial fascia, except at the umbilicus. Varies in texture - wrinkle, rough, smooth, scars. Thin in front and thick at the back Distribution of hair varies with sex, age and race. Natural tension lines run horizontally around the body wall.
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FASCIA (L. panniculi – apron) Composed of fatty tissues and fibrous connective tissue Divided into two layers (1) Superficial (2) Deep – covers abdominal muscles (1) Same as elsewhere and varies in amount of fat. (1) Major site of fat storage. (1) Excessive fat deposition in the lower anterior abdominal wall – morbid obesity
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SUPERFICILA FASCIA/TISSUE
Superior to umbilicus Consistent with other regions Inferior to umbilicus Reinforced by collagen and elastic fibers Thus 2 layers – (1) Superficial fatty layer (Camper’s fascia) Same elsewhere (2) Deep membranous layer (Scarpa’s fascia) Membranous continues to the perineum – Colles’s fascia, not to the thigh.
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SUPERFICIAL FASCIA
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SUPERFICIAL FASCIA
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MUSCLES OF THE ANTEROLATERAL ABDOMINAL WALL
5 pairs of muscles bilaterally – 3 flat, 2 vertical (1) External oblique (2) Internal oblique (3) Transversus abdominis (4) Rectus abdominis (5) Pyramidalis
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EXTERNAL OBLIQUE MUSCLE
O: external surfaces of 5th – 12th ribs I: linea alba, pubic tubercle, ant ½ of iliac crest N: thoracoabdominal nerves (T7-T11 spinal nerves), subcostal nerve. A: compresses the abdomen to provide support for abdominal organs.
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INTERNAL OBLIQUE MUSCLE
O: thoracolumbar fascia, ant 2/3 of iliac crest, lat 1/3 of inguinal ligament. I: inferior borders of 10th – 12th ribs, linea alba, pecten pubis, conjoint tendon. N: thoracoabdominal nerves (T6-T12 spinal nerves), L1 nerve A: compresses and supports abdominal viscera
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TRANSVERSUS ABDOMINIS MUSCLE
O: thoracolumbar fascia, internal surfaces of 7th-12th costal cartilages, iliac crest, lat 1/3 of inguinal ligament. I: linea alba, pubic crest, pecten pubis, conjoint tendon. N: thoracoabdominal nerves (T6-T12 anterior rami of spinal nerves), L1 nerve A: compresses and supports abdominal viscera
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RECTUS ABDOMINIS MUSCLE
O: pubic symphysis & pubic crest I: xiphoid process & 5th-7th costal cartilages N: thoracoabdominal nerves (T6-T12 spinal nerves) A: flexes trunk, compresses and supports abdominal organs, prevents pelvic tilting
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ABDOMINAL MUSCLES
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ABDOMINAL MUSCLES
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DEEP FASCIA Dense connective tissue layer , devoid of fat, that covers the muscles and their aponeurosis. 3 layers – superficial, intermediate & deep.
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DEEP FASCIA
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PYRAMIDALIS MUSCLE Small, insignificant muscle. Absent in 20% of people O: pubic crest, pubic symphysis I: linea alba N: subcostal nerve (T12) A: tenses the abdomen
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RECTUS SHEATH A strong incomplete fibrous compartment Formed by decussation and interweaving of the flat abdominal muscles. Internal oblique aponeurosis splits into two layers: anterior & posterior and invest the rectus abdominis muscle.
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RECTUS SHEATH Anterior wall – external oblique, anterior layer of internal oblique Posterior wall – transversus abdominis and posterior layer of internal oblique. All aponeuroses fuse in the midline – linea alba. In the midline, it contains the umbilical ring. A defect where fetal umbilical vessels pass to the placenta. Splitting of internal oblique, lateral to rectus abdominis – semilunar line.
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RECTUS SHEATH Posterior wall ends slightly below the umbilicus – arcuate line of Douglas. The rectus abdominis is covered by the transversalis fascia posteriorly.
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CONTENTS OF THE RECTUS SHEATH
Rectus abdominis muscle Pyramidalis Superior & inferior epigastric vessels Intercostal nerves (T7-T11)
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RECTUS SHEATH
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ENDOABDOMINAL FASCIA A membranous and areolar sheets. Named according to muscle or aponeurosis it lines. Transversalis fascia as it lines the transversus abdominis muscle. A variable amount of fat separates the fascia above from the peritoneum – extraperitoneal fat. Peritoneum – a single layer of epithelial cells and connective tissue.
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NERVES OF THE ANTEROLATERAL ABDOMINAL WALL
(1) thoracoabdominal nerves (T7 – T11) (2) Subcostal nerve (anterior ramus of T12) (3) Iliohypogastric (4) Ilioinguinal
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VESSELS OF THE ANTEROLATERAL ABDOMINAL WALL
(1) superior epigastric artery (2) musculophrenic artery (3) 10th & 11th post intercostal arteries (4) subcostal artery (5) inferior epigastric (6) deep circumflex iliac (7) superficial circumflex iliac (8) superficial epigastric
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VEINS & LYMPHATICS OF THE ANTEROLATERAL ABDOMINAL WALL
(1) Subcutaneous venous plexus (2) Paraumbilical veins (3) Lateral thoracic vein (4) Superficial epigastric veins (5) superficial circumflex iliac (6) superior & inferior epigastric (7) deep circumflex iliac (8) posterior interocstal (11th) & subcostal veins
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FUNCTIONS OF THE ABDOMINAL MUSCLES
Form a strong expandible support for the wall Support organs from injuries Compress to increase intraabdominal pressure to facilitate expulsion Move trunk to maintain posture Assists in breathing
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FINIS
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