Lect 3: Anterior Abdominal Wall, Inguinal Region, and Peritoneum Flashcards
Transumbilical Plane (Location)
@ L3/L4 separates 4 quadrants of abdomen (along with median plane - vertical)
Lesser vs. Greater curvature of stomach
Lesser - faces right Greater - faces left
Subcostal Plane (Location)
L3
Transtubercular plane (location)
L5
Transpyloric plane (location, intersections)
@ L1 and 9th costal cartilage *Intersects: - pyloric sphincter of stomach - funds of gallbladder - duodenojejunal junction - neck of pancreas - hiatus of kidneys
Umbilicus (location)
L3-L4
Linea semilunaris
depression at lateral edge of each rectus abdominus muscle
Lowest level of costal margin
L3
Iliac crest (location)
L4
2 types of superficial fascia of abdomen
- Camper’s 2. Scarpa’s
Camper’s fascia
- fatty, superficial fascia - continuous with tunica dartos in the scrotum (muscle that contracts when cold)
Scarpa’s fascia
- membranous, superficial fascia - blends with fascia of thigh (although can be separated) - continuous with Colles’ fascia of perineum
Superficial Arteries of Abdomen
- Anterior perforating arteries (from superior and inferior epigastric A. - inferior epigastric from the external iliac A) 2. Lateral cutaneous arteries (from lower intercostal, subcostal, and lumbar A)
Superficial Arteries of Inguinal Region
From femoral A: 1. superficial epigastric (to lower abdomen) 2. superficial circumflex iliac (to lower abdomen above inguinal ligament) 3. superficial external pudendal (to pubic region)
Anterior perforating veins drain to the
superior and inferior epigastric VV
Lateral cutaneous veins drain to the
thoracoepigastric V (then will travel up to axillary vein or down to femoral vein)
Superficial inguinal vein drain to the
femoral V
Paraumbilical vein drain to the
portal V –> umbilical V (along the falciform ligament)
Caput medusae
portal drainage obstructed –> build-up of pressure –> drainage to tributaries of umbilical vein (distinctive pattern of visible superficial veins results)
Superficial lymphatics of abdomen
- above umbilicus –> anterior axillary nodes - below umbilicus –> superficial inguinal nodes
Deep lymphatics of abdomen
- parasternal (follows internal thoracic A) - lumbar (follows abdominal aorta) - external iliac nodes (follows external iliac A)
Cutaneous Nerves to abdomen (lateral, anterior, and pubic)
- lateral and anterior –> from T7 - T12 2. L1: - iliohypogastric N (lower hypogastric region) - ilioinguinal N (inguinal region)
Key features at T7, T10, and L1 dermatomes
T7 - just below xiphoid process T10 - umbilicus L1 - inguinal ligament and pubic symphysis
External spermatic fascia
- from external oblique aponeurosis and fascia - outermost fascia of spermatic cord