Introduction of abdomenAnterior Abdominal wall

UmbilicusDr. Pratik Mistry

Introduction

Two hollow tubular system

Gastro Intestinal System

Genito urinary system

• Extensive serous membrane

Peritoneum

Boundaries of abdomen

Roof

Floor

• Pelvic diaphragm• Urogenital diaphragm

Anterior wall

• Skin• Superficial fascia• External oblique• Internal oblique• Transverse abdominis• Fascia transversalis• Extra-peritoneal tissue• Parietal paritonium

Posterior wall

Retroperitoneal organPrincipal vessels and

nerves

Regions of abdomen

Anterior abdominal wall• Extension

Firm but elastic

• Layers– Skin– Superficial Fascia– External oblique muscle and its aponeurosis– Internal oblique muscle and its aponeurosis– Transverse abdominis muscle and its aponeurosis– Fascia transversalis– Extra peritoneal tissue– Parietal peritoneum

1.Skin

Median Longitudinal groove

Cutaneous nerves

• Anterior cutaneous nerveAnterior

cutaneous nerve(7 in nos)

Lower five intercostal nerve

T7-T11

Subcostal nT12

Iliohypogastric nL1

Lateral cutaneous nerve

• Two in nos.– Lower two intercostal nerves (T10, T11)

Umbilicus

• Introduction• Normal scar

– Dense fibrous tissue– Foetal end of umbilical cord

• Position• Between L3 & L4

Anatomical Importance of umbilicus

• Congenital anomalies• Watershed line• Portocaval anastomosis

Rapsberry tumor

• Watershed line

– Umbilicus

Axillary lymph node

Superficial inguinal lymph node

• Caput medusae

Embryogical importance

2.Superficial Fascia

Structure between two layers

Superficial circumflex iliacSuperficial epigastricSuperficial external pudendal Superficial inguinal LN

3. External oblique muscle and inguinal ligament

• Origin• Insertion• External oblique AponeurosisUpper and lower

attachment of aponeurosis

Inguinal ligament• Thickening of EOA• 12-14 cm in length• Attachment• extension

Extension• Lacunar lig• Reflected part• Pectineal lig of Cooper

Structure attached to the inguinal ligament

• Grooved upper surface– Internal oblique– Transversus

abdominis

• Lower surface– Fascia lata

Posterior margin• Fascia transversalis• Fascia iliaca

Relation of inguinal ligament