26-07-2017

DEFINITION OF ABDOMEN
A region of the body bounded by
the following regions:-
Superiorly thorax
Inferiorly pelvis/perineum
Posteroinferiorly back

ANATOMY OF THE ABDOMEN Inferolaterally lower limbs

BONY LANDMARKS OF THE ABDOMEN ABDOMINAL CAVITY

Xiphoid process extends btw thoracic

diaphragm & pelvic
Costal margin 7th 11th costal diaphragm
cartilages abdominopelvic cavity

Pelvic bones upper part is under cover of

the osteocartilagenous
thoracic cage
L1 L5 Lumbar vertebrae
occupied by organs of the
digestive, urogenital,
endocrine & vascular
structures.

1
 26-07-2017

CONTENTS OF THE ABDOMINAL CAVITY CONTENTS OF THE ABDOMINAL CAVITY

PLANES OF THE ABDOMEN

ABDOMINAL WALL

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

2
 26-07-2017

REGIONS OF THE ABDOMEN REGIONS OF THE ABDOMEN

QUADRANTS OF THE ABDOMEN POSITIONS OF THE ABDOMINAL ORGANS

2 planes delineate the abdominal cavity into 4 quadrants

1 vertical median
1 transverse transumbilical

3
 26-07-2017

ANTEROLATERAL ABDOMINAL WALL ANTEROLATERAL ABDOMINAL WALL

Anterior & lateral walls Anterior & lateral walls

extending from the thorax to extending from the thorax to
pelvis pelvis

Consists of the Consists of the

(1) Skin (1) Skin
(2) Fascia - (2) Fascia -
Subcutaneous & deep Subcutaneous & deep
(3) Muscles (3) Muscles
(4) Transversalis fascia (4) Transversalis fascia
(5) Extraperitoenal fat (5) Extraperitoenal fat
(6) Peritoneum (6) Peritoneum

SKIN FASCIA
Loosely attaches to the (L. panniculi apron)
superficial fascia, except at the
umbilicus. Composed of fatty tissues and
fibrous connective tissue
Varies in texture - wrinkle,
rough, smooth, scars. Divided into two layers
(1) Superficial
Thin in front and thick at the (2) Deep covers abdominal
back muscles

Distribution of hair varies with (1) Same as elsewhere and

sex, age and race. varies in amount of fat.

Natural tension lines run (1) Major site of fat storage.

horizontally around the body
wall. (1) Excessive fat deposition in
the lower anterior abdominal
wall morbid obesity

4
 26-07-2017

SUPERFICILA FASCIA/TISSUE SUPERFICIAL FASCIA

Superior to umbilicus
Consistent with other regions

Inferior to umbilicus
Reinforced by collagen and
elastic fibers

Thus 2 layers
(1) Superficial fatty layer
(Campers fascia)
Same elsewhere

(2) Deep membranous layer

(Scarpas fascia)

Membranous continues to the

perineum Colless fascia, not to
the thigh.

MUSCLES OF THE ANTEROLATERAL ABDOMINAL WALL

SUPERFICIAL FASCIA
5 pairs of muscles bilaterally 3
flat, 2 vertical

(1) External oblique

(2) Internal oblique
(3) Transversus abdominis
(4) Rectus abdominis
(5) Pyramidalis

5
 26-07-2017

EXTERNAL OBLIQUE MUSCLE INTERNAL OBLIQUE MUSCLE

O: external surfaces of 5th 12th ribs O: thoracolumbar fascia, ant 2/3 of iliac crest, lat 1/3 of inguinal ligament.
I: linea alba, pubic tubercle, ant of iliac crest I: inferior borders of 10th 12th ribs, linea alba, pecten pubis, conjoint tendon.
N: thoracoabdominal nerves (T7-T11 spinal nerves), subcostal nerve. N: thoracoabdominal nerves (T6-T12 spinal nerves), L1 nerve
A: compresses the abdomen to provide support for abdominal organs. A: compresses and supports abdominal viscera

TRANSVERSUS ABDOMINIS MUSCLE RECTUS ABDOMINIS MUSCLE

O: thoracolumbar fascia, internal surfaces of 7th-12th costal cartilages, iliac crest, O: pubic symphysis & pubic crest
lat 1/3 of inguinal ligament. I: xiphoid process & 5th-7th costal cartilages
I: linea alba, pubic crest, pecten pubis, conjoint tendon. N: thoracoabdominal nerves (T6-T12 spinal nerves)
N: thoracoabdominal nerves (T6-T12 anterior rami of spinal nerves), L1 nerve A: flexes trunk, compresses and supports abdominal organs, prevents pelvic
A: compresses and supports abdominal viscera tilting

6
 26-07-2017

ABDOMINAL MUSCLES ABDOMINAL MUSCLES

DEEP FASCIA DEEP FASCIA

Dense connective tissue layer , devoid of fat, that covers the muscles
and their aponeurosis.

3 layers superficial, intermediate & deep.

7
 26-07-2017

PYRAMIDALIS MUSCLE RECTUS SHEATH

A strong incomplete fibrous

Small, insignificant muscle.
compartment

Absent in 20% of people

Formed by decussation and
interweaving of the flat
O: pubic crest, pubic symphysis abdominal muscles.
I: linea alba
N: subcostal nerve (T12) Internal oblique
A: tenses the abdomen aponeurosis splits into two
layers: anterior & posterior
and invest the rectus
abdominis muscle.

RECTUS SHEATH 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, Posterior wall ends slightly below the umbilicus arcuate line of
lateral to rectus abdominis Douglas.
semilunar line.
The rectus abdominis is covered by the transversalis fascia posteriorly.

8
 26-07-2017

CONTENTS OF THE RECTUS SHEATH

Contents of the Rectus

Sheath.
Rectus abdominis
muscle
Pyramidalis
Superior & inferior
epigastric vessels
Intercostal nerves
(T7-T11)

RECTUS SHEATH 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.

9
 26-07-2017

NERVES OF THE ANTEROLATERAL ABDOMINAL WALL VESSELS OF THE ANTEROLATERAL ABDOMINAL WALL

(1) thoracoabdominal (1) superior epigastric artery

nerves (T7 T11)
(2) musculophrenic artery
(2) Subcostal nerve
(anterior ramus of T12)
(3) 10th & 11th post intercostal
arteries
(3) Iliohypogastric
(4) subcostal artery
(4) Ilioinguinal
(5) inferior epigastric

(6) deep circumflex iliac

(7) superficial circumflex iliac

(8) superficial epigastric

VEINS & LYMPHATICS OF THE ANTEROLATERAL ABDOMINAL WALL FUNCTIONS OF THE ABDOMINAL MUSCLES
Form a strong expandible
(1) Subcutaneous venous plexus
support for the wall

(2) Paraumbilical veins

Support organs from injuries

(3) Lateral thoracic vein

Compress to increase
intraabdominal pressure to
(4) Superficial epigastric veins facilitate expulsion

(5) superficial circumflex iliac Move trunk to maintain posture

(6) superior & inferior epigastric Assists in breathing

(7) deep circumflex iliac

(8) posterior interocstal (11th) &

subcostal veins

10