复旦大学：《局部解剖学 Regional Anatomy》教学课件（英文）Part 13 – Abdomen（Part 1）Abdominal anterolateral wall

Regional Anatomy Part 13- Abdomen(Part 1) Abdominal anterolateral wall INTERNATIONAL EDITION Hongqi zhang(张红旗) Dissector Dept of Anatomy, Histoembryology Emailzhanghg58@126.com

1 Regional Anatomy Part 13 – Abdomen (Part 1) Abdominal anterolateral wall Hongqi Zhang (张红旗 ) Dept. of Anatomy,Histoembryology Email: zhanghq58@126.com

Boundaries of the abdomen Boundaries o Superiorly- xiphoid process, costal arch, 11 th and 12th ribs, vertebra T12 9 Inferiorly- spinous process of L5; iliac crest; ant. sup. iliac spine inguinal lig; pubic tubercle; pubic crest; sup. border of pubic symphysis 9 Actually the volume of abdominal cavity is more than that of the abdomen

Boundaries of the abdomen Boundaries  Superiorly － xiphoid process, costal arch,11th and 12th ribs, vertebra T12  Inferiorly － spinous process of L5; iliac crest; ant. sup. iliac spine; inguinal lig; pubic tubercle; pubic crest; sup. border of pubic symphysis  Actually :the volume of abdominal cavity is more than that of the abdomen

Bony landmark of the abdomen Body of Esophagus Fundus Angular notch Liver stomach Xiphisternal junction Costal Xiphoid cartilages process Pyloric part of Costal margin Duodenum tLeft colic L2 Ilium Gallbladder Iliac crest Sacral Right colic Jejunum Tubercle of iliac crest promontory Sacrum Iliac fossa Ascendin Descending Anterior ileocecal iliac spine ligament Cecum Sigmoid Pubic tubercle Pubic symphysis and pubic crest Anal canal

Bony landmark of the abdomen

Surface anatomy of the abdomen 1 xiphoid process 2 costal margin 3 tip of ninth costal cartilage 4 tendinous intersections 5 umbilicus 6 iliac crest 7 ant. sup iliac spine 8 linea semilunaris 9 linea alba 10 inguinal lig 11 pubic tubercle 12 pubic crest 13 pubic symphysis

1 xiphoid process 2 costal margin 3 tip of ninth costal cartilage 4 tendinous intersections 5 umblicus 6 iliac crest 7 ant.sup.iliac spine 8 linea semilunaris 9 linea alba 10 inguinal lig. 11 pubic tubercle 12 pubic crest 13 pubic symphysis Surface anatomy of the abdomen

Abdominal region -nine regions (By 2-transverse lines 2-vertical lines) 1 Right hypochondriac region 2 Epigastric region 3 Left hypochondriac region 4 Right lateral (lumbar) region 5 Umbilical region 6 6 Left lateral (lumbar region 7 Right iliac(inguinal) region 6 8 Hypogastric(pubic) region 9 Left iliac(inguinal) region A-at the level of the lowerest point of costal arch B-at the level of both anterior superior iliac spine

Abdominal region-nine regions 1 Right hypochondriac region 2 Epigastric region 3 Left hypochondriac region 4 Right lateral (lumbar) region 5 Umbilical region 6 Left lateral (lumbar) region 7 Right iliac (inguinal) region 8 Hypogastric (pubic) region 9 Left iliac (inguinal) region (By 2-transverse lines & 2-vertical lines) A-at the level of the lowerest point of costal arch B-at the level of both anterior superior iliac spine

Quadrants of abdomen(four regions According two vertical lines cross the navel Right upper left upper quadrant(RUQ) RUQ LUQ quadrant (LUQ) Right lower Left lower quadrant(RLQ RLQ LLQ quadrant (LLQ)

Right upper quadrant(RUQ) Right lower quadrant（RLQ） left upper quadrant（LUQ） Left lower quadrant（LLQ） RUQ LUQ RLQ LLQ Quadrants of abdomen (four regions) According two vertical lines cross the navel

Anterolateral abdominal wall f obliquus- intemus abdominis Intermus Fatty layer obliquus externus Membranous layer frmembraneou of obliquus I. layer externus abdominis umbilicus transversus 这3 Layers(from sup. 1. Skin 2. Superficial fascia-two layers 3. Anterolateral muscles(3+1) 4. Transverse fascia 5. Extraperitoneal fascia 6. Parietal peritoneum

Anterolateral abdominal wall Layers (from sup.) 1. Skin 2. Superficial fascia-two layers 3. Anterolateral muscles(3+1) 4. Transverse fascia 5. Extraperitoneal fascia 6. Parietal peritoneum 1 2 3 4 5 6 Fatty layer Membranous layer

肋间神经前皮支 肋间神经外侧皮 f 6th intercostal n anterior cutaneus branch of intercostal n teral cutaneous branch 殷外斜肌 第8肪间神经外侧皮支 腹壁上动脉 凹 supenor epigastric a, 瘦直肌 intercostal n 第8肋间神经 of 10th intercostal h intercostal n 第9肋间神经 9th intercostal n 腹直肌鞘 腹横肌 第10肋间神经前皮 transversus abdominis lOth intercostal n 腹内斜肌 腹外斜肌腱膜 umbilicus 腹直肌鞘后层 aponeurosis of ok posterior layer of 腹外斜肌 髂腹下神经 obliquus extremus 腹下神经 iliohypogastric n. 腹壁浅动脉 覆壁浅静脉 superficial epigastric v. circumflex iliac a 股外侧皮神经 旋髂浅静脉 腹内斜肌 superficial circumflex us Intents 腹股沟韧带 髂腹股沟神经 ilioinguinal n 腹外斜肌腱膜 perficial circumflex extemal pudendal v 大隐静脉 great sapl spermatic cord great saphenous 阴茎背动脉、神经 股外侧浅静脉 supernca atera temo Lower 6 thoracic nn. locate between Int. and transverse abdominal mm Superficial blood vessels nerves of anterolateral abdominal wall

Superficial blood vessels & nerves of anterolateral abdominal wall Lower 6 thoracic nn.locate between Int. and transverse abdominal mm

Arteries of the anterolateral abdominal wall intercostal a artery to falciform ligament musculophrenic a superior epigastrIc rectus abdominis agma Superficial aa 尘 bliquus internus abdominis Deep aa obliquus externus abdominis transversus abdominis of rectus abdominis ascendin arcuate line branch of deep circumflex iliac a Inferior epigastrIc a. ircumflex illac a temoral a Superficial circumflex iliac a

Arteries of the anterolateral abdominal wall Superficial circumflex iliac a. Superficial aa. Deep aa

Anterolateral group External oblique m Muscles of anterolateral internal oblique m. abdominal wall Transversus abdominis Rectus abdominis Rectus abdominis Transversus abdominis Internal oblique m External oblique m

Muscles of anterolateral abdominal wall Anterolateral group External oblique m. internal oblique m. Transversus abdominis Rectus abdominis External oblique m. Rectus abdominis Transversus abdominis Internal oblique m