History

Planes of ref.
Body cavities
Abdominal wall
Diaphragm
ANATOMY: THE ABDOMEN
Alimentary tract
Urinary tract
Peritoneal cavity
Blood supply Dr. dr. Mohd. Andalas, SpOG. FMAS
Lymph nodes
Nerve supply
Department of Obstetrics and Gynecology
Faculty of Medicine University of Syiah Kuala
History

Leonardo Da Vinci
History
Planes of ref.
History
Planes of ref.
History
Planes of ref.
History
Planes of ref.
Body cavities
History
Planes of ref.
Body cavities
Abdominal wall
History Anterior muscles
Planes of ref.
Body cavities
Abdominal wall

Rectus abdominis originates from the pubic crest-pubic tubercle and end at 5th, 6th
and 7th rib cartilages. Passing across 3-4 tendinous intersections.
Line alba a midline structure formed by interlacing of the aponeurosis of the oblique
and transversus abdominal muscle
History
Planes of ref.
Body cavities
Abdominal wall
History Rectus sheath
Planes of ref.
Above the umbilicus
Body cavities
Abdominal wall

External oblique muscle

At the level of umbilicus

Internal oblique muscle

Transversalis muscle

Below the umbilicus

History Anterior-lateral muscles
Planes of ref.
Body cavities
Abdominal wall

External oblique: from eight lowest ribs to illiac creast . Aponeurosis between SIAS and
pubic tubercle is strong, thick  the inguinal ligament
Transverse abdominis: from the lower costal cartilages, the lumbar fascia, the illiac crest
and the inguinal ligament
Internal oblique: from upper surface of the inguinal ligament, illiac crest and the lumbar
fascia to the lowest ribs
History Posterior muscles
Planes of ref.
Body cavities
Abdominal wall

Psoas major

Anterior

Middle

Posterior

Erector spinae

Lumbar fascia has three layers: posterior, middle and anterior

History Posterior muscles
Planes of ref.
Body cavities
Abdominal wall

Psoas major

Quadratus lumborum

Psoas major: from transverse process of the five lumbar vertebrae the 12th thoracic
and the intervening discs
Quadratus lumborum: from iliolumbar ligament and posterior part of the illiac crest,
the lumbar transverse process and the last rib
History
Planes of ref.
Body cavities
Abdominal wall
Diaphragm

The diaphragm is a domed sheet separating the thorax and abdomen

Convex upwards, but its central area is lower than the summits of the lateral areas
History
Planes of ref.
Body cavities
Abdominal wall
Diaphragm

The diaphragm is broached by three apertures for the passage of tubes from thorax to
abdomen:
(1). Level T12: aorta, thoracic duct, azygos and hemy-azygos
(2). Level T10: oesophagus, vagus nerve, symphatetic nerves
(3). Level T8: inferior vena cava
History
Planes of ref.
Body cavities
Abdominal wall
Diaphragm
Alimentary tract
History Stomach
Planes of ref.
Body cavities Cardiac

Abdominal wall Oesophagus

Diaphragm
Alimentary tract

Pylorus

Duodenum

A distensible muscular sac continuous with the oesophagus at the cardiac

orifice proximally and with the duodenum at the pylorus
History Stomach
Planes of ref.
Body cavities
Abdominal wall
Diaphragm
Alimentary tract

Arteries to the stomach from: the coeliac trunk (left gastric), the common hepatic artery
(right gastric and gastroepiploic), the splenic artery (left gastroepiploic and short
gastric)
History Small intestine
Planes of ref.
Body cavities
Abdominal wall
Diaphragm
Alimentary tract

Located below the transverse colon, behind the greater omentum, between the
ascending and descending colon. From pylorus to the illeocaecal opening. 5 m long.
Some loops fall into the pelvis.
History Duodenum
Planes of ref.
Body cavities
Abdominal wall
Diaphragm
Alimentary tract

The duodenum, into which the stomach opens, is about 25 cm long, C-shaped and begins at the pyloric
sphincter. It is almost entirely retroperitoneal and is the most fixed part of the small intestine.
The duodenum is described as having four parts:
Part one, superior part (SD); Part two, descending part (DD); Part three, horizontal part (HD); Part four,
ascending part (AD)
The fourth part of the duodenum terminates at the duodenojejunal flexure DJF with the jejunum.
The ligament of Treitz is a musculofibrous band that extends from the upper aspect of the ascending part
of the duodenum to the right crus of the diaphragm and tissue around the celiac artery.
History
Jejunum Ileum
Planes of ref.
Body cavities
Abdominal wall
Diaphragm
Alimentary tract

The jejunum is about 2.5m (8ft) long and passes imperceptibly into the ileum, which is about 4m (12ft)
long. this part of the small intestine occupies a central position in the abdominal cavity, below the liver
and the stomach, and behind the transverse mesocolon, the transverse colon and the greater omentum
History Mesentery
Planes of ref.
Body cavities
Abdominal wall
Diaphragm
Alimentary tract

The mesentery of the small intestine arises a straight line from the duodeno-jejunal
flexure to the upper part of the right sacroilliac joint.
Between its two peritoneal surface lie ileo-jejunal branches of the superior
mesenteric artery, veins, nerve plexuses, lymphatics, mesenteric lymph nodes,
connective tissue and fat
History Large intestine
Planes of ref.
Body cavities
Abdominal wall
Diaphragm
Alimentary tract

Begins in the right illiac fossa as the caecum to the inferior surface of the right lobe
of the liver (ascending colon), turn left at the right colic flexure, transverse colon
directed generally upwards and curved upwards and downwards between the lower
part of the spleen and the tail of the pancreas, descending colon, to the sigmoid
History Large intestine
Planes of ref.
Body cavities
Abdominal wall
Diaphragm
Alimentary tract

Large intestine longitudinal coat is condensed along three bands (taenia coli)
between which the wall is puckered into sacculations (haustra)
History Large intestine
Planes of ref.
Body cavities
Abdominal wall
Diaphragm
Alimentary tract

The vermiform appendix, a narrow blind tube 2-20 cm (usually 9 cm) long, rises from
the postero-medial aspect of the caecum 2-3 cm below the ileocaecal opening.
The mesoappendix is a small triangular peritoneal fold attached to the back of the
mesentary near the ileo-caecal junction. It contains the appendicular vessels,
nerves, lymph vessels and often a lymph node
History
Planes of ref.
Body cavities
Abdominal wall
Diaphragm
Alimentary tract
History
Planes of ref.
Body cavities
Abdominal wall
Diaphragm
Alimentary tract
History Kidney
Planes of ref.
Body cavities
Abdominal wall
Diaphragm
Alimentary tract
Urinary tract

Lies retroperitonelly one on either side of the vertebral column surrounded by fat and
enveloped in renal fascia. Size approximately 11 x 6 x 3 cm, weighing 140 g. The right
kidney lies slightly lower than the left.
The broad upper pole of each kidney is capped by the suprarenal gland.
History Ureter in the abdomen
Planes of ref.
Body cavities
Abdominal wall
Diaphragm
Alimentary tract
Urinary tract

The upper two-thirds of the ureter li in the

abdomen – runs downwards and medially
on the psoas major to enter the pelvis
crossing the common or external illiac
artery – wholly retroperitoneal and roughly
in line with the tips of the lumbar
transverse processes – crossed obliquely
by the ovarian vessels
History
Planes of ref.
Body cavities
Abdominal wall
Diaphragm
Alimentary tract
Urinary tract
Peritoneal cavity

The potential space, lined with moistened mesothelium, allow abdominal and pelvic
organs to adjust their relative positions during respiration, peristalsis, filling and
emptying.
Visceral peritoneum fuses with connective tissue of the invested organ. Parietal
peritoneum is more loosely attached to the abdominal wall by extraperitoneal
connective tissue except along the linea alba and under the diaphragm.
History
There are three groups of branches:
Planes of ref.
Posterior branches: supply the
Body cavities diaphragm (inferior phrenic a.), muscle of
the back and abdominal wall (lumbar a.),
Abdominal wall the front of the sacrum and back of the
Diaphragm rectum (median sacral a.)
Lateral branches: the renal arteries.
Alimentary tract
Ovarian arteries: arise antero-laterally just
Urinary tract below the renal, running retroperitoneally
by crossing common or external illiac a. in
Peritoneal cavity
the infundibulopelvic fold
Blood supply Ventral branches: Coeliac trunk divides
into the left gastric, common hepatic
and splenic arteries
Superior mesenteric artery
Inferior mesenteric artery
Common illiac arteries
History
Planes of ref.
Body cavities
Abdominal wall
Diaphragm
Alimentary tract
Urinary tract
Peritoneal cavity
Blood supply
Lymph nodes

Grouped: para-aortic, external illiac artery, internal illiac artery

History
Planes of ref.
Body cavities
Abdominal wall
Diaphragm
Alimentary tract
Urinary tract
Peritoneal cavity
Blood supply
Lymph nodes
Nerve supply
History
Planes of ref.
Body cavities The symphatetic supply is from the
thoracolumbar outflow – release
Abdominal wall noradrenaline

Diaphragm Parasymphatetic – release acetylcholine

cranial outflow in the vagus – transverse
Alimentary tract colon
sacral outflow (S2,S3,S4, S5) – remaining
Urinary tract gut, bladder, genital organs, pelvic blood
Peritoneal cavity vessels
Symphatetic – contracts spinchters,
Blood supply
lessening peristalsis
Lymph nodes Parasymphatetic – increases glandular
Nerve supply and peristalsis action
History
Planes of ref.
L1 – iliohypogastric – lateral
Body cavities cutaneous branch, cutaneous
branch above the pubis and
Abdominal wall ilioinguinal nerves – inguinal canal,
Diaphragm mons and labium
L1 + L2 – genitofemoral nerve –
Alimentary tract genital branches: inguinal canal and
Urinary tract femoral, enter the thigh
L2 + L3 – lateral cutaneous nerve
Peritoneal cavity
L2 – L4 – the femoral nerve – into
Blood supply the thigh
Lymph nodes L2 – L4 (ventral rami) – the
obturator nerve – lies behind the
Nerve supply
common illiac
Thank You