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2.1 Surface anatomy

2.2 Anterior abdominal wall

Albert van Schoor

GNK 288 (SA4 Anatomy dissection)

Abdomen 1

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2.1.1 Surface anatomy

Identify and name the bony landmarks of

the abdomen which are palpable on

abdominal examination and state if

possible their corresponding vertebral

heights on the cadaver, yourself and on a

radiograph

Schematically illustrate and discuss thenine abdominal regions and list which

organs lie approximately in each region

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2.1.1 Surface Anatomy

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Identify and name in which of the nine surface

anatomical regions you would expect to feel

tenderness in appendicitis, cholecystitis,gastritis and cystitis

Identify other surface anatomy lines e.g.

transpyloric line, transumbilical line, linea alba

and linea semilunaris. You should be able tosay how these lines are formed and to discuss

the intra-abdominal events occurring on the

transpyloric line

2.1.1 Surface anatomy

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Referred pain

2.1.1 Surface Anatomy

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2.1.1 Surface Anatomy

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2.1.1 Surface Anatomy

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2.1.1 Surface Anatomy

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Transpyloric

plane Hilum of thekidneys

Pylorus of the

stomach

Body of

pancreas

Fundus of the

gall bladder

2.1.1 Surface Anatomy

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2.1.1 Surface Anatomy

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Schematically illustrate and discuss the surfaceanatomy of the kidneys, ureters and spleen onthe posterior abdominal wall [2.5, 2.8]

Discuss and identify the surface anatomy of theliver [2.4]

Briefly discuss the surface anatomy of thediaphragm and the vertebral heights of its threemajor orifices [2.9]

Identify the various dermatomes of the anteriorabdominal wall

Indicate whether the bladder is an abdominalorgan or not. Explain

2.1.1 Surface anatomy

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2.1.1 Surface Anatomy

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2.2 Anterior abdominal wall

2.2.1 Skin and superficial fascia

2.2.2 Muscles

2.2.3 Transversalis fascia

2.2.4 Peritoneum

2.2.5R

ectus sheath2.2.6 Inguinal area

2.2.7 Osteology

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2.2.1 Skin and superficial fascia

Identify the fatty superficial layer

(Camper's fascia) Identify and shortly discuss the

membranous superficial layer (Scarpa's

fascia) according to its distribution and

borders. State what this fascia is called

inferior to the superficial inguinal ring

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2.2.2 Muscles

Identify and discuss the three majorabdominal muscles as follows:

Major attachments to the following points: Linea

alba, crista iliaca and inguinal ligament where

applicable,

Direction of fibres,

Nerve supply and

Function

Identify the neurovascular plane

Identify the ilio-inguinal and iliohypogastric

nerves. Also state their origin and area of

supply

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2.2.2 Muscles

External oblique

Table

Origin Insertion Innervation Function

Muscular slips

from the outer

surfaces of

the lower

eight ribs (ribs

5-12)

Lateral lip of

iliac crest;

aponeurosis

ending in

midline raphe

(linea alba)

Anterior rami of

lower six thoracic

spinal nerves (T7

to T12)

Compress

abdominal

contents; both

muscles flex

trunk; each

muscle bendstrunk to same

side, turning

anterior part

of abdomen to

opposite side

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2.2.2 Muscles

Internal oblique

Origin Insertion Innervation Function

Thoracolumbar

fascia; iliaccrest between

origins of

external and

transversus;

lateral two-thirds of

inguinal

ligament

Inferior border of

the lower three orfour ribs;

aponeurosis

ending in linea

alba; pubic crest

and pectineal line

Anterior rami of

lower six thoracicspinal nerves (T7

to T12) and L1

See External

Oblique

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2.2.2 Muscles

Transverse abdominis

Origin Insertion Innervation Function

Thoracolumbar

fascia; mediallip of iliac crest;

lateral one-third

of inguinal

ligament; costal

cartilages lowersix ribs (ribs 7-

12)

Aponeurosis

ending in lineaalba; pubic crest

and pectineal line

Anterior rami of

lower six thoracicspinal nerves (T7

to T12) and L1

Compress

abdominalcontents

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Neurovascular plane

2.2.2 Muscles

Ant Post

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2.2.3 Transversalis fascia

Identify the transversalis fascia

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2.2.4 Peritoneum

Identify the folds and associated

underlying structures of the peritoneum

on the posterior aspect of the anteriorabdominal wall: [2.3.3]

Plica umbilicalis mediana,

Plica umbilicalis medialis, Plica umbilicalis lateralis,

Falciform ligament

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2.2.5 Rectus sheath

Identify the rectus sheath and how it is

formed on the following levels:

Superior to the arcuate line

Inferior to the arcuate line Identify and briefly discuss rectus abdominis

as follows:

major attachments,

nerve supply and

function

Name and identify the structures on the

posterior wall of the rectus sheath

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2.2.5 Rectus sheath

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Rectus abdominis

2.2.5 Rectus sheath

Origin Insertion Innervation Function

Pubic crest,

pubic tubercle,and pubic

symphysis

Costal cartilages

of ribs 5-7;xiphoid process

Anterior rami of

lower seventhoracic spinal

nerves (T7 to T12)

Compress

abdominalcontents; flex

vertebral

column; tense

abdominal wall

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2.2.6 Inguinal area

Identify and briefly discuss the inguinal canal

as follows:

Surface anatomy, Borders,

Openings

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Inguinal canal

Surface anatomy

2.2.6 Inguinal area

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Indirect inguinal hernia

2.2.6 Inguinal area

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Inguinal canal

Borders

2.2.6 Inguinal area

491-8

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2.2.6 Inguinal area

Know the positions of the superficial and deep

inguinal rings and femoral canal.

Identify the inguinal ligament and thestructures posterior to it from lateral to medial.

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Femoral canal

2.2.6 Inguinal area

Ant

Post

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Femoral hernia

2.2.6 Inguinal area

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N.A.V.E.L

2.2.6 Inguinal area

Contents

N.A.V.E.L (lat. - med.)

Femoral nerve

Femoral artery Femoral vein

Empty space (femoral

canal)

Lacunar ligament

NA V E

L

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2.2.6 Inguinal area

List the contents of the spermatic cord.

Compare the content in males and females

Identify the inferior epigastric artery and itsrelation to the deep inguinal ring

Identify and list the borders of the inguinal

triangle (Hesselbach's triangle) Name and identify the inguinal falx (conjoint

tendon)

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Spermatic cord 3 Fascia layers

External spermatic fascia

Cremasteric fascia

Internal speratic fascia

3 Arteries

Testicular artery Cremasteric artery

Artery to ductus deferens

3 Nerves

Genito-femoral nerve

Ilio-inguinal nerve Sympathetic autonomic plexus

3 Other structures

Lymphatic vessels

Ductus deferens

Pampiniform venous plexus

2.2.6 Inguinal area

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Spermatic cord

2.2.6 Inguinal area

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Hesselbachs triangle

2.2.6 Inguinal area

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Direct inguinal hernia

2.2.6 Inguinal area

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Conjoint tendon

2.2.6 Inguinal area

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2.2.7 Osteology

Identify the following bony points of the os

coxa:

Anterior superior iliac spine (ASIS)Anterior inferior iliac spine (AIIS)

Crista iliaca

Posterior superior iliac spine (PIIS)

Pubic tubercle

Pubic crest

Symphysis pubis

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2.2.7 Osteology