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Abdomen & Pelvis
Mehrez M. JadaonFaculty of Allied Health Sciences
Kuwait University
Faculty of Allied Health SciencesCourse 210 anatomy
Semester II – 2012/2013
Objectives
- To define the abdomen and pelvis in the human body
- To describe the abdominal regions- To describe the different components of the
abdominopelvic cavity, including skin, fascia, muscles, peritoneum, bones, blood vessels, nerves and internal organs.
Abdomen-pelvis(Abdominopelvis)
Abdom
en pelvis
Abdomen-pelvis
The abdomen (the belly): Space between thorax (chest) and pelvis. The diaphragm muscle forms the upper barrier.At the level of the pelvic bones, the abdomen ends and the pelvis begins.
The pelvis (the basin) is the area Below the abdomen (at the level of the pelvic bones) and ends at the area between the thighs.
• Superiorly extends to the 4th intercostals space (level of the male nipple)
• The upper part of the abdomen is protected by the bony thoracic cage (cartilage of ribs 7-10 & tips of ribs 11 & 12)
• The lower part of the abdomen is protected by the bony pelvis, and continues into pelvic cavity
• The posterior part of the abdomen is protected by the vertebral column (L1-L5)
• The anterior part and lateral part of the abdomen is protected by the muscular wall
- Xiphoid process X - Costal cartilages (ribs 7-10) - Tips of ribs 11 & 12 - Vertebrae L1-L5 - Iliac crests IC - Tubercle of the crest TC - Anterior superior iliac spine ASIS - Anterior inferior iliac spine AIIS - Inguinal ligament IL - Pubic tubercle PT - Pubic crest PC - Pubic symphysis PS - Pelvic brim PB
Abdomen
Abdominal regionsSurface anatomy
Abdominal regionsSurface anatomy
Trans-umbilical Plane(L3 & L4)
Median plane dividing body into 2 halves)
Abdominal regionsSurface anatomy
Abdominal regionsSurface anatomy
Right hypochondriac
Lefthypochondriac
Right Lumbar
LeftLumbar
Right Iliac
LeftIliac
Epigastric
Umbilical
Hypogastric
Abdominal regionsSurface anatomy
Abdomen structure
- Abdominal wall- Internal organs
- Abdominal wall- Internal organs
Abdominal wall:- Anterior wall- Right and Left Lateral walls- Posterior wall
Anterolateral abdominal wall
Abdomen structure
Anterolateral abdominal wall From outside inwards:
- Skin- Superficial Fascia (fat) - 3 Muscles (with
deep fascia in between)
- Parietal peritoneum
Abdomen structure
Abdomen structure
Anterolateral abdominal wall
SkinSuperficial Fascia 3 Muscles Parietal peritoneum
Abdomen structure
Abdomen structure
Anterolateral abdominal wall
3 Flat anterolateral muscles(from outside inwards):
1- External Oblique2- Internal Oblique3- Transverse abdominal
Right & Left musclesConnected anteriorly byRectus sheath, with central Linea alba
Abdomen structure
Abdomen structure
Anterolateral abdominal wall4th anterolateral muscle:Rectus Abdominis muscle (within Rectus sheath), having Tendinous intersections
and Linea alba
Abdomen structure
Rectus Abdominis muscle (within Rectus sheath)
Abdomen structureAnterolateral abdominal wall muscles
Abdomen structureAnterolateral abdominal wall musclesOrigin, Insertion, Innervation, and action
Abdomen structurePosterior abdominal wall muscles
Abdomen systems and organs
Most of digestive organs and accessories
Kidneys and uretersSpleenAdrenal glands + Isles of
Langerhans
[Muscles, bones, nerves, blood vessels]
Digestive System:
Abdomen systems and organs
Digestive System:
Abdomen systems and organs
Digestive System:
Abdomen systems and organs
Abdomen systems and organs
Digestive System:
Abdomen systems and organs
Digestive System:
EsophagusLower part penetrates the diaphragm through opening
[esophageal hiatus]
StomachCardia, Fundus, Body
& PylorusGreater and lesser
curvatures
Abdomen systems and organs
Digestive System:
Small IntestinesDuodenum, Jejunum, Ileum
Large Intestines (colon)Cecum and AppendixAscending, Descending,
Transverse and sigmoid colonRectum and Anus
Abdomen systems and organs
Digestive System:
Liver- Covered by peritoneum except bare area (posterior)
contacting the diaphragm.- Main two lobes (right and left) + Caudate and Quadrate
lobes- Infereior vena vaca forms a groove within the bare area- Falcifarm ligament, round ligament- Gallbladder
Abdomen systems and organs
Digestive System:
Liver
Anterior view Posterior view
Bare areaGastric area
Duodenalarea
Pyloricarea
Abdomen systems and organs
Digestive System:
Pancreas
Stomach
Pancreas
Small Intestines
Liver
LargeIntestines
Level of L2
Head adjacent to Stomach pylorusBody Tail is anterior to Left kidney and in position with splenic Hilum and left colic flexure
Abdomen systems and organs
Digestive System:
Pancreas
Abdomen systems and organs
Spleen
Abdomen systems and organs
Spleen Surrounded by: Stomach from anteriorDiaphragm from posterior
Left (splenic) flexure of colon from inferiorLeft kidney from medial
Abdomen systems and organs
Spleen Surrounded by: Stomach from anteriorDiaphragm from posterior
Left (splenic) flexure of colon from inferiorLeft kidney from medial
Abdomen systems and organs
Spleen
Abdomen systems and organs
Spleen
Abdomen systems and organs
Urinary system
Abdomen systems and organs
Urinary system
KidneysLie deep to the 12th rib posteriorlyOpposite to T12-L3Right kidney is little lower because of liver
Posterior view
Abdomen systems and organs
Urinary system
Ureters
From hilum of kidneys, going inferiorly towardsthe urinary bladder, anterior to the tipsof the transverse processes of thelumbar vertebrae
Abdomen systems and organs
Urinary system
Adrenal glands (suprarenal)
Abdomen systems and organs
Urinary system
Posterior view
PeritoneumEpithelia + connective tissue, folds, - binds organs to each other and to the abdominal
wall- contains blood and lymph vessels and nerves
(provide passage or routes).
1- Parietal peritoneumLines abdominal walls from inside
Peritoneal cavity (serous fluid)
2- Visceral peritoneum (=serosa layer)Surround organs from outside
Abdomen systems and organs
Peritoneum
Extensions:- Greater omentum: Folded membrane hanging from stomach
(greater curvature) and proximal duodenum to cover the intestines, folding back to transverse colon.
- Lesser omentum: suspending stomach (lesser curvature) andproximal duodenum from liver
- Mesentry: attaching the small intestine to the posterior wall- Mesocolon: attaching the colon to the posterior wall- Mesoappendix: appendix to cecum and ileum- Ligaments: folds connecting organs together:
e.g. Falciform ligament: attaching the liver to the anterior wall and the diaphragm
e.g. Gastrosplenic ligamente.g. Gastrocolic ligamente.g. splenorenal ligament
Abdomen systems and organs
Peritoneum
Abdomen systems and organs
Peritoneum
Abdomen systems and organs
Abdomen systems and organsPeritoneum
Peritoneum
Male
Abdomen systems and organs
Peritoneum
Female
Abdomen systems and organs
Abdomen systems and organsPeritoneum
Abdomen systems and organsPeritoneum
Abdomen systems and organsPeritoneum
Abdomen systems and organsPeritoneum
Abdomen systems and organsPeritoneum
Mesocolon
Mesoappendix
Abdomen systems and organs
Peritoneum
- Peritoneal organsDigestive organs that keep their mesentery
- Retroperitoneal organs Behind the peritoneume.g. kidneys, ureter, part of colon, rectum, reproductive organs
Abdomen systems and organs
Peritoneum
- Peritoneal organs- Retroperitoneal organs
PelvisInferior and posterior to abdomen, separate it from
lower limbs
Margins: - Anterior: inferior anterolateral abdominal wall- Posterior: gluteal region of lower limbs- Inferior: Perineum (area between thighs containing
external sex organs and the anus)Lesser & Greater PelvesInside: Pelvic Cavity surrounded by bony Pelvic GirdlePelvic Girdle: Hip bones (Rt & Lt Ilium, Ischium & Pubis)
+ Sacrum (fused sacral bones S1-5)Pelvic cavity is separated from the perineum by pelvic diaphragm muscle
Pelvis
Pelvis
PelvisPelvic Girdle: Hip bones (Rt & Lt Ilium, Ischium & Pubis)
+ Sacrum (fused sacral bones S1-5)
Pelvic systems and organsUrinary System
UretersUrinary BladderUrethra
Pelvic systems and organsReproductive SystemMale
(Pelvic cavity and perineum)
Pelvic systems and organsReproductive SystemMale
Tunica albuginea:
white connective tissuecovering testis and extend internally
Pelvic systems and organsReproductive SystemFemale
Pelvic systems and organsReproductive SystemFemale
2 ovaries, almond shape & sizeFixed by ligaments: Mesovarium: double layer of peritonium surrounds ovaries Ovarian ligament: attach to uterus Suspensory ligament:
attach to pelvic wall
Pelvic systems and organsReproductive SystemFemale
Pelvic systems and organsReproductive SystemFemale
UterusBroad ligament
Blood Vessels & Nerves
Abdomen systems and organs
Blood VesselsDiaphragm openings:
T8
T10
T12
Inferior
Abdomen systems and organs
Blood Vessels
Abdomen systems and organs
Blood Vessels
Abdomen systems and organs
Blood Vessels
ArteriesAorta Many branchesIn abdomen: Abdominal Aorta:
- passes through the diaphragm at the level of T12 vertebra.(through aortic hiatus)
- passes inferiorly on the bodies of the lumbar vertebrae.
- divides into the common iliac arteries at the level of L4.
Abdomen systems and organs
Blood Vessels
ArteriesAorta Many branchesIn abdomen: Abdominal Aorta: Branches:
1) Parietal branches (to body wall structures)2) Visceral branches (to the visceral organs)
Abdomen systems and organs
Blood Vessels
ArteriesAbdominal Aorta 1) Parietal branches 3 branches: first two are paired and the third is unpaired:1- Inferior phrenic arteries: First paired branches of the abdominal aorta. supply the inferior surface of the diaphragm and adrenal gland2- Lumbar arteries: Four pairs arise from the posterior-lateral surface of
the abdominal aorta. Supply the lumbar vertebrae, spinal cord and its menenges and the muscles and skin of the lumbar region at the back
3- Median sacral: Supplies the sacrum and coccyx
Abdomen systems and organs
Blood Vessels
ArteriesAbdominal Aorta 1) Parietal branches
Abdomen systems and organs
Blood VesselsArteriesAbdominal Aorta 1) Parietal branches
Left lumbers
Median sacral
Abdomen systems and organs
Blood Vessels
ArteriesAbdominal Aorta 2) Visceral branches
6 branches:
- 3 paired visceral branches arise from the lateral surface of the abdominal aorta.
- 3 unpaired visceral branches arise from the anterior surface of the abdominal aorta.
Abdomen systems and organs
Blood Vessels
ArteriesAbdominal Aorta 2) Visceral branches [from up downwards]:
3 Paired visceral branches:
1- Suprarenal arteries- Supplies the adrenal gland 2- Renal arteries- Supplies kidneys, adrenal gland and ureter 3- Gonadal:
Testicular in males- Supply testes, epididymis and uretersOvarian in females- Supply ovaries, uterine tube
and ureters
Abdomen systems and organs
Blood Vessels
ArteriesAbdominal Aorta 2) Visceral branches [from up downwards]:
3 Unpaired visceral branches:
1- Celiac trunk (unpaired branches) 2- Superior mesenteric artery (unpaired branches) 3- Inferior mesenteric artery (unpaired branches)
Abdomen systems and organs
Blood Vessels
ArteriesAbdominal Aorta 2) Visceral branches [from up downwards]:All
1- Celiac trunk (unpaired branches) 2- Superior mesenteric artery (unpaired branches)3- Suprarenal (adrenal) middle arteries
(paired: left & right)4- Renal arteries (paired: left & right)5- Gonadal (testicular or ovarian) arteries
(paired: left & right)6- Inferior mesenteric artery (unpaired branches)
Abdomen systems and organs
Blood Vessels
ArteriesAbdominal Aorta 2) Visceral branches
Abdomen systems and organs
Blood VesselsArteriesAbdominal Aorta 2) Visceral branches
Abdomen systems and organs
Blood Vessels
Arteries
Abdomen systems and organs
Blood Vessels
Arteries
Abdomen systems and organs
Blood Vessels
Arteries
1
Abdomen systems and organs
Blood Vessels
Arteries
Abdomen systems and organs
Blood Vessels
Arteries
Abdomen systems and organs
Blood Vessels
Arteries 2
Abdomen systems and organs
Blood Vessels
Arteries
Abdomen systems and organs
Blood Vessels
Arteries
6
Abdomen systems and organs
Blood Vessels
Arteries
Abdomen systems and organs
Blood Vessels
Arteries
Abdomen systems and organs
Blood Vessels
VeinsInferior vena cava
Abdomen systems and organs
Blood Vessels
VeinsInferior vena cava
Abdomen systems and organs
Blood Vessels
Veins
Abdomen systems and organs
Blood Vessels
Veins
Abdomen systems and organs
Blood Vessels
Veins
Abdomen systems and organs
Blood Vessels
VeinsUnlike arteries, veins from small and large intestines, spleen and pancreas go first to the liver before going to inferior vena cava through hepatic veins (hepatic portal circulation)
Abdomen systems and organs
Blood Vessels
Veins
Abdomen systems and organs
Blood Vessels
Veins
Inferior mesenteric vein
Splenic
Superiormesenteric vein
Abdomen systems and organs
Blood Vessels
Abdomen systems and organs
Blood Vessels
Abdomen systems and organs
Blood Vessels
Abdomen systems and organs
Blood Vessels
Abdomen systems and organs
Blood Vessels
Abdomen systems and organs
Nerves
Anterior rami (branches) of the lower six thoracic (T7-12) and first lumbar nerves (L1):
- T7-T11: Thoracoabdominal- Anterior ramus of T12:
Subcostal- First lumbar nerve L1: Iliohypogastric and ilioinguinal nerves.
Abdomen systems and organs
Nerves
Abdomen systems and organs
Nerves
Abdomen systems and organs
Nerves
Abdomen systems and organs
NervesSympathetic and parasympathetic (autonomic) nerves Internal organs (viscera)
The Vagus nerves (CN X, right and left) penetrating diaphragm at esophageal hiatus anterior and posterior vagal trunks
The abdominopelvic splanchnic nerves:1. Lower thoracic:
- Greater splanchnic (T5-T9 or T10)- Lesser splanchnic (T10-T11)- Least splanchnic (T12)
2. Lumbar splanchnic (L1-L3)Pelvic splanchnic (S2-S4)
Plexuses & ganglia organs
Abdomen systems and organs
Nerves
Abdomen systems and organs
Nerves
Abdomen systems and organs
NervesSympathetic and parasympathetic (autonomic) nerves Internal organs (viscera)
The Vagus nerves (CN X, right and left) penetrating diaphragm at esophageal hiatus anterior and posterior vagal trunks
The abdominopelvic splanchnic nerves:1. Lower thoracic:
- Greater splanchnic (T5-T9 or T10)- Lesser splanchnic (T10-T11)- Least splanchnic (T12)
2. Lumbar splanchnic (L1-L3)Pelvic splanchnic (S2-S4)
Plexuses & ganglia organs
Abdomen systems and organs
Nerves
Abdomen systems and organs
Nerves
Abdomen systems and organs
Nerves
Abdomen systems and organs
Nerves
Plexuses: Nerve networks surrounding blood vessels or organse.g. Abdominal (para-aortic) autonomic plexuses surrounding
abdominal aorta and its branches: celiac, superior mesenteric and inferior mesenteric plexuses
Ganglia: Mass of nerve cells or fibers. They interact and form plexuses.e.g. celiac ganglion, superior and inferior mesenteric ganglia
Abdomen systems and organs
NervesPlexuses & Ganglia:
*
*
Abdomen systems and organs
NervesPlexuses & Ganglia:
Abdomen systems and organs
NervesPlexuses & Ganglia: