PROJECTION OF ORGANS ONTO THE ABDOMINAL WALL •SUPERFICIAL BORDERS OF •THE ABDOMEN •DEEP BORDERS OF THE ABDOMEN • - DIAPHRAGMA • - LINEA TERMINALIS •FACTORS INFLUENCING THE SHAPE: • - SEX • - AGE • - CONSTITUTION • - ALIMENTATION • - CONTENTS • - POSITION • - CONTRACTION OF MUSCLES • - RESPIRATION • • • • •TUBERCULUM • COSTOABDOMINALE > •ANGULUS INFRASTERNALIS • • •FOSSA •EPIGASTRICA > •UMBILICUS – L3/L4 •LINEA ALBA > • • • • •M. RECTUS ABDOMINIS •INTERSECTIONES •TENDINEAE > •PUBES > •LINEA XIPHISTERNALIS > •LINEA SUBCOSTALIS > •LINEA INTERSPINALIS > •EPIGASTRIUM > • •MESOGASTRIUM > •HYPOGASTRIUM > •REGIO EPIGASTRICA • > •REGIO HYPOCHONDRIACA •DEXTRA ET SINISTRA • • > • •REGIO UMBILICALIS > • • •REGIO LATERALIS •DEXTRA ET SINISTRA > • •REGIO PUBICA > • • •REGIO INGUINALIS •DEXTRA ET SINISTRA > •LINEA TRANSPYLORICA > •LINEA INTERCRISTALIS > File:McBurney's point.jpg •Appendix vermiformis: McBurney's point •(Monro's line) • •Fundus vesicae biliaris: •Murphy's point •Ventriculus: • •Triangle of Labbé • •transpyloric line •Papilla Vateri: •Umbilico-axillary line •- point of Desjardins •Costoarticular line •SKIN •CAMPER •SCARPA •ABDOMINAL WALL •LINEA ARCUATA •VAGINA •M. RECTI ABDOMINIS •VV. SUBCUTANEAE ABD. • •V. THORACOEPIGASTRICA •V. EPIGASTRICA SPF. •V. CIRCUMFLEXA ILIUM SPF. •VV. PARAUMBILICALES • •A. EPIGASTRICA SPF. •A. CIRCUMFLEXA ILIUM SPF. •AA. INTERCOSTALES •A. SUBCOSTALIS •AA. LUMBALES •A. EPIGASTRICA SUP. •A. EPIGASTRICA INF. •A. CIRCUMFLEXA ILIUM PROF. •AA. INTERCOSTALES •A. SUBCOSTALIS •AA. LUMBALES • •NN. INTERCOSTALES •N. SUBCOSTALIS •N. ILIOHYPOGASTRICUS •N. ILIOINGUINALIS •NODI LYMPHATICI AXILLARES •NODI LYMPHATICI INGUINALES SPF. •CANALIS INGUINALIS • •Superior wall: •M. obliquus internus abdominis •M. transversus abdominis • • - M. cremaster •CANALIS INGUINALIS • •Anterior wall: •Aponeurosis m. obliqui •externi abdominis • • Anulus inguinalis spf. • - crus mediale • - crus laterale • - fibrae intercrurales • - lig. inguinale reflexum • •CANALIS INGUINALIS • •Inferior wall: •Lig. inguinale •CANALIS INGUINALIS • •Posterior wall: •Fascia transversalis: • Anulus inguinalis prof. • Lig. interfoveolare • Trigonum inguinale • (Hesselbachi) • Falx inguinalis • (conjoint tendon) • • •Tractus iliopubicus •Anulus femoralis • •CANALIS INGUINALIS •Plica umbilicalis mediana • - lig. umbilicale medianum • (chorda urachi) •Fossa supravesicalis •Plica umbilicalis medialis • - lig. umbilicale mediale (laterale) • (pars occlusa a. umbilicalis s. • chorda umbilicalis) •Fossa inguinalis medialis • - direct inguinal hernia •Plica umbilicalis lateralis • - vasa epigastrica inf. •Fossa inguinalis lateralis • - indirect inguinal hernia A.UMBILICALIS •→ chorda umbilicalis •V. UMBILICALIS •→ ligamentum venosum • •Fossa umbilicalis •DESCENSUS TESTIUM > > > > > •TRIGONUM LUMBALE •PETITI • > • •TRIGONUM GRYNFELTI •TETRAGON KRAUSEI > •Foramen v. cavae inf. •Hiatus oesophageus •Hiatus aorticus • •Trigonum sternocostale •Trigonum lumbocostale PERITONEAL CAVITY •ascites •CAVITAS ABDOMINALIS • •P – cavitas peritonealis •A – spatium preperitoneale •R – spatium retroperitoneale •S – spatium subperitoneale • (infraperitoneale) •S •Intraparitoneal organs: •Abdominal part of the oesophagus, stomach, superior •part of the duodenum, jejunum, ileum, appendix vermiformis, •colon transversum, colon sigmoideum, liver, spleen • •Secondarily retroperitoneal organs: •Most of duodenum, pancreas, caecum, colon ascendens, •colon descendens • •Primarily retroperitoneal organs: •Kidneys, suprarenal glands, aorta, vena cava inf. •Cavitas peritonealis - pars supramesocolica, inframesocolica • •Pars supramesocolica • •Truncus coeliacus •Right infra(meso)colic •compartment • •A. mesenterica superior • •Left infra(meso)colic •compartment • •A. mesenterica inferior •Facies diaphragmatica • - pars superior (area nuda) • - pars anterior • - lig. coronarium • - lig. triangulare dextrum • - lig. triangulare sinistrum • - appendix fibrosa hepatis • - lig. falciforme hepatis • • • • •Facies visceralis •Fissura sagittalis sinistra -lig. teres hepatis -lig. venosum •Impressio renalis. suprarenalis, duodeni, colica •Impressio oesophagea, gastrica •PARS ABDOMINALIS •OF THE OESOPHAGUS •Omentum minus - lig. hepatogastricum • - lig. hepatoduodenale - a. hepatica propria • - v. portae • - ductus hepaticus • comm. • (d.choledochus) • •LIGAMENTUM HEPATODUODENALE •Omentum majus • - lig. gastrocolicum • BursaOm3 •Lig. gastrosplenicum, phrenicosplenicum, splenorenale •Mesenterium – radix mesenterii •Mesocolon transversum, mesoappendix, mesocolon •sigmoideum, lig. phrenicocolicum Pankre2 Mesent3 •PANCREAS •membrana retropancreatica (Treitz) •tuber omentale • RECESSUS PERITONEI •Bursa omentalis • •Internal hernia •Bursa omentalis •Foramen omentale/epiploicum (Winslow) •Recessus sup., splenicus, inf. Abdomen4 BursaOm7 •Recessus inferior bursae omentalis (2) BursaOm1 BursaOm2 •RECESSUS PERITONEALES • • •Recessus intersigmoideus SPATIUM RETROPERITONEALE 1.diaphragma 4. m. transversus abdominis 2.11th rib 5. m. quadratus lumborum 3.12th rib 6. m. psoas major 1.gl. suprarenalis dx. 2.liver 3.duodenum 4.flexura coli dx. 5.jejunum 1.gl. suprarenalis sin. 2.stomach 3.spleen 4.pancreas 5.flexura coli sin. 6.jejunum •SIN. 1.fascia renalis 5. corpus adiposum pararenale 2.lamina praerenalis 6. peritoneum 3.lamina retrorenalis 7. fascia transversalis 4.capsula adiposa • 1. 1. •Th XII • • • •Illustrations were copied from: •Čihák R: Anatomie 2 (Splanchnologia). Avicenum, •zdravotnické nakladatelství, Praha, 1988. •Atlas der Anatomie des Menschen/Sobotta. •Putz,R., und Pabst,R. 20. Auflage. München: •Urban & Schwarzenberg, 1993 •