Anatomy, Lecture 9, Abdominal Wall
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Ali Al-QudsiAnatomy, Lecture 9, Abdominal Wall
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Ali Al-QudsiAbdominal Wall (2):
Inguinal Region
Inguinal Region
The inf. part of anterolateral
abdominal wall
Area of weakness:
Passage of spermatic cord
through a canal (inguinal)
Inguinal Canal
Superior & parallel to medial ½ of
inguinal ligament
Runs oblique in inferomedial direction
Contents
1:
Male: spermatic cord
Female: round lig. of uterus
2: ilioinguinal n. (L1)
Openings of Inguinal Canal
Deep inguinal ring (Internal):
entrance to the canal
above the middle of inguinal ligament
Oval opening in transversalis fascia
Superficial inguinal ring:
Triangular exit
Due to defect in ???
Lateral & Medial (margins) Borders crura
Crura: attachment site for external fascia
covering the spermatic cord
Walls of the canal
Anterior:
External oblique aponeurosis
reinforced on lat. 1/3 by:
Internal oblique aponeuroses.
Posterior:
Transversalis fascia
Reinforced medially by:
Insertion of int. oblique &
transversus m. (Conjoint tendon)
Conjoint Tendon
Merging of internal oblique aponeurosis & transversus abdominis
aponeurosis to share a common insertion into pubic crest
Located
posteromedial to
superficial ring
Walls of Inguinal Canal
Roof (superior wall):
arching fibers of Internal oblique m. & Transversus m.
Walls of Inguinal Canal
Floor (inferior wall):
Inguinal Ligament
& Lacunar lig.
Lacunar Lig.:
medial continuation of inguinal
ligament
Lacunar Lig.: a small part of inguinal ligament fibers that reflected
from pubic tubercle & attach to the pubic ramus
M - muscles Sup
A – aponeuroses Ant Post
L - ligaments
Inf
T - transversalis/Tendon
Spermatic Cord
Contents
Ductus (vas) deferens
Testicular artery
a. to vas deferens
Cremasteric a.
Testicular Vein (pampiniform plexus)
Autonomic nerve fibers
Genital branch of genitofemoral n.
(to cremaster muscle)
Lymphatic vessels
Cremaster Muscle
Extension from lower part of
internal oblique m.
Pass with spermatic cord to the
scrotum
Fxn.
In cold environment:
elevates testis superiorly
In warm environment:
relaxes & testis descend in the
scrotum
Covering Fasciae of Spermatic Cord
External Spermatic Fascia:
from external oblique m.
attached to superficial ring
Cremasteric Fascia:
the cremaster m.
from internal oblique m.
Internal Spermatic Fascia:
transversalis fascia
attached to deep ring
Inguinal Hernia
Hernia = L, rupture
Protrusion of abdominal organs to outside through abdominal
wall weakness
Diaphragmatic hernia:
usually in esophageal opening
-sliding or paraesophageal
Inguinal hernia: (in inguinal region)
Indirect (through inguinal canal)
Direct
Indirect Hernia
75% of inguinal hernias are indirect
Part of the intestine pass through the
canal
Commonly enters the scrotum
20x males than
females
Direct Hernia
Usually medial to inf. epigastric a.
In Inguinal triangle area:
inf. epig. A.
rectus abdominis
inguinal lig.
Forms an inguinal sac by
transversalis fascia
Does not enter the scrotum
Surface Anatomy
9 regions classification
Subcostal plane:
lowest costal margin,
10 cc, L3
Transtubercular plane:
iliac tubercles
what vertebral level?
Midclavicular planes:
mid clavicle
mid inguinal lig.
9 Regions
Rt. & Lf. Hypochondriac
Rt. & Lf. Lumbar
Rt. & Lf. Inguinal
Epigastric
Umbilical
Hypogastric (pubic)
4 Regions classification
Transumbilical plane
IV disc L3-L4
Midsagittal line
symphesis menti
symphesis pubis
