Professional Documents
Culture Documents
Abdominal Wall
KATRINA BALMORES, MD
NOVEMBER 04, 2015
References
The Abdomen
Respiration
Posture
Locomotion
The Abdomen
Anterolaterally: Musculoaponeurotic
walls
Superiorly: Diaphragm
The Abdomen
Suspended and supported
by:
Pelvic girdle
The Abdomen
Voluntary/involuntary contraction
Respiration
Straining
Vomiting
Urinating
Giving birth
The Abdomen
Distends
considerably!
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Fat
Pelvic inlet
plane/superior pelvic
aperture
Superior: 4th
intercoastal space
Inferior: Greater
pelvis
Abdominal Regions
TRANSVERSE/
HORIZONTAL PLANES
Midclavicular
planes
Midpoint of clavicle
(~9cm from
midline) to
midinguinal points
(midpoints of ASIS
and pubic tubercles)
Subcostal plane
Transtubercular plane
Transpyloric planes
Interspinous plane
SAGITTAL/
VERTICAL PLANES
2 Midclavicular
planes
Midpoint of clavicle
(~9cm from
midline)
midinguinal points
(midpoints of ASIS
and pubic tubercles)
TRANSVERSE
PLANES
Transpyloric
planes
Sup border
manubrium and
L1
Subcostal plane
SAGITTAL/
VERTICAL PLANES
2 Midclavicular
planes
Midpoint of clavicle
(~9cm from
midline)
midinguinal points
(midpoints of ASIS
and pubic tubercles)
TRANSVERSE
PLANES
Transtubercular
plane
Through iliac
tubercles (~5cm
posterior to ASIS
and body of L5)
Interspinous
plane
Passes through
Abdominal Reference
Planes
Transpyloric plane
LANDMARK FOR:
Gallbladder fundus
Pancreas neck
Root of transverse
mesocolon
Duodeno-jejunal junction
Kidney hila
Transpyloric
Interspinous
9 Abdominal Regions
4 Quadrants
Transumbilical plane
Umbilicus
intervertebral disc L3
and L4 vertebrae
Median plane
Longitudinally
through body
4 Quadrants
Transverse
transumbilical plane
Umbilicus and
intervertebral disc
between L3 and L4
vertebrae
Vertical
median plane
Longitudinally through
body
Musculoaponeurotic wall
Anterolateral abdominal
wall
Inferior: inguinal
ligament, superior
margins of iliac crest,
pubic crest, pubic
symphysis
Skin
Fat
Muscle
Aponeuroses
Deep fascia
Extraperitoneal fat
Parietal peritoneum
Skin
Attaches loosely to
subcutaneous tissue
except at UMBILICUS
3 musculotendinous
layers
Surface Anatomy
As we go deeper
Fascia of Anterolateral
Abdominal Wall
Fascia of Anterolateral
Abdominal Wall
Subcutaneous tissue
*Morbid obesity
Panniculi/sagging folds
Fascia of Anterolateral
Abdominal Wall
INFERIOR to
umbilicus
Reinforced by elastic
& collagen fibers
Campers fascia
Superficial fatty
Scarpas fascia
Deep membranous
Continues inferiorly
as Colles fascia
Fascia of Anterolateral
Abdominal Wall
LAYERS OF
INVESTING
FASCIA
Superficial
Intermediate
Deep
*epimysium
Fascia of Anterolateral
Abdominal Wall
Internal
aspect
membrano
us
and areolar
sheets
Fascia of Anterolateral
Abdominal Wall
Lines deep
surface of
transversus
abdominis
muscle and
its
aponeurosi
s
Fascia of Anterolateral
Abdominal Wall
Extraperitoneal
fat in between
transversalis
fascia and
parietal
peritoneum
Muscles of Anterolateral
Abdominal Wall
5 paired muscles
3 flat
External oblique
Internal oblique
Transversus
abdominis
2 vertical
Rectus abdominis
Pyramidalis
*rectus sheath
*linea alba
External Oblique
Largest
Most superficial
Inguinal/Poupart Ligament
Lacunar Ligament
External Oblique
External oblique
Inguinal ligament (Poupart ligament)
Internal Oblique
Internal Oblique
Transversus Abdominis
Neurovascualr plane
between
Transversus Abdominis
Contributes to the
formation of the
rectus sheath
Transversus Abdominis
*Neurovascular plane of the anterolateral
abdominal wall
Rectus Abdominis
Powerful flexor
of the thoracic
and especially
lumbar regions
of the
vertebral
column
Rectus Abdominis
Paired
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Pyramidalis
Small, insignificant,
triangular
Absent in 20%
Attachment of the
pyramidalis to the linea alba
Rectus Sheath
Contents:
Lymphatic vessels
Rectus Sheath
Rectus Sheath
Arcuate Line
Crescentic
Linea Alba
Umbilical Ring
Nervous Supply
VESSELS OF ANTEROLATERAL
ABDOMINAL WALL
Primary blood vessels
Lymphatic Drainage
Superficial
Superior
Few
Lymphatic Drainage
Superficial
Deep
VESSELS OF
ANTEROLATERAL
ABDOMINAL
WALL
VESSELS OF ANTEROLATERAL
ABDOMINAL WALL
Clinical Correlation
Inguinal Ligament
Deep
Superior
Iliopubic Tract
Inguinal Canal
Also contains
Ilio-inguinal nerve
Deep/internal ring
Superficial/external ring
Deep (internal)
inguinal ring
Superficial (external)
inguinal ring
THANK YOU!