ABDOMEN
Between diaphragm + pelvic inlet
ABDOMINAL REGIONS
→ Theoretical areas
clinicians use to help
localise + identify +
diagnose patients'
symptoms
Abdominal Quadrants
→ Transumbilical plane
– passes through
umbilicus (IVD
between L3 +L4)
, 9 Abdominal Regions
2 Combinations
→ Subcostal plane - passes through
inf border 10th cc
→ Transtubercular plane – passes
through iliac tubercles (L5)
→ Midclavicular lines – from
midpoint clavicle to mid inguinal
point
→ Transpyloric plane – passes through pylorus of stomach in supine position (L1)
→ Interspinous plane – passes through ant sup iliac spines (ASIS)
→ Semilunar lines – either side of rectus abdominis muscle (site of fusion of layers
of rectus sheath)
, NERVES AND BLOOD VESSELS OF ANTEROLATERAL
ABDOMINAL WALL
Nerves of Anterolateral Abdominal Wall
→ Intercostal nerves 7 – 11 (thoraco-abdominal
nerves) + subcostal (T12) + iliohypogastric + Ilio-
inguinal nerves (L1)
→ Lat + ant cutaneous branches (not ilio-inguinal)
supply band of skin
→ *Due to considerable overlap in distribution,
damage only results in diminished sensation in area
of supply
→ Thoracoabdominal nerves between int oblique +
transverse abdominal muscles supply abdominal
skin + muscles
→ Lat cutaneous branches emerge from muscles to enter subcutaneous tissue
along ant axillary line
→ Ant cutaneous branches pierce rectus sheath lat to median plane
Vessels of Anterolateral Abdominal Wall
Near midline:
→ Sup epigastric artery (B musculophrenic)
, → Inf epigastric artery (B EIA)
Sides:
→ Post intercostal + subcostal
arteries (B descending aorta)
→ Lumbar arteries (B
descending aorta)
→ Deep circumflex iliac artery
(EIA)
Inguinal region:
→ Superficial epigastric artery
→ Superficial circumflex iliac
artery
→ Branches of femoral artery
→ Deep circumflex iliac artery
(B EIA)
Cutaneous veins + lymphatic vessels drain in 2 directions from level of umbilicus
→ Up - to lat thoracic + axillary veins + axillary nodes
→ Down - to superficial epigastric + femoral veins + superficial inguinal nodes
→ 2 channels connecter to thoracoepigastric vein
→ Subcutaneous veins near umbilicus anastomose with portal vein along
ligamentum teres of liver (paraumbilical vein)
Between diaphragm + pelvic inlet
ABDOMINAL REGIONS
→ Theoretical areas
clinicians use to help
localise + identify +
diagnose patients'
symptoms
Abdominal Quadrants
→ Transumbilical plane
– passes through
umbilicus (IVD
between L3 +L4)
, 9 Abdominal Regions
2 Combinations
→ Subcostal plane - passes through
inf border 10th cc
→ Transtubercular plane – passes
through iliac tubercles (L5)
→ Midclavicular lines – from
midpoint clavicle to mid inguinal
point
→ Transpyloric plane – passes through pylorus of stomach in supine position (L1)
→ Interspinous plane – passes through ant sup iliac spines (ASIS)
→ Semilunar lines – either side of rectus abdominis muscle (site of fusion of layers
of rectus sheath)
, NERVES AND BLOOD VESSELS OF ANTEROLATERAL
ABDOMINAL WALL
Nerves of Anterolateral Abdominal Wall
→ Intercostal nerves 7 – 11 (thoraco-abdominal
nerves) + subcostal (T12) + iliohypogastric + Ilio-
inguinal nerves (L1)
→ Lat + ant cutaneous branches (not ilio-inguinal)
supply band of skin
→ *Due to considerable overlap in distribution,
damage only results in diminished sensation in area
of supply
→ Thoracoabdominal nerves between int oblique +
transverse abdominal muscles supply abdominal
skin + muscles
→ Lat cutaneous branches emerge from muscles to enter subcutaneous tissue
along ant axillary line
→ Ant cutaneous branches pierce rectus sheath lat to median plane
Vessels of Anterolateral Abdominal Wall
Near midline:
→ Sup epigastric artery (B musculophrenic)
, → Inf epigastric artery (B EIA)
Sides:
→ Post intercostal + subcostal
arteries (B descending aorta)
→ Lumbar arteries (B
descending aorta)
→ Deep circumflex iliac artery
(EIA)
Inguinal region:
→ Superficial epigastric artery
→ Superficial circumflex iliac
artery
→ Branches of femoral artery
→ Deep circumflex iliac artery
(B EIA)
Cutaneous veins + lymphatic vessels drain in 2 directions from level of umbilicus
→ Up - to lat thoracic + axillary veins + axillary nodes
→ Down - to superficial epigastric + femoral veins + superficial inguinal nodes
→ 2 channels connecter to thoracoepigastric vein
→ Subcutaneous veins near umbilicus anastomose with portal vein along
ligamentum teres of liver (paraumbilical vein)
