intertubercular plane l5 transpyloric plane ( subcostal plane ) r9 – l1 umblical epigastric hypo-...

Intertubercular PlaneL5

Transpyloric Plane( Subcostal Plane )

R9 – L1Umblical

EpigastricHypo-Chondrial

Hypo-Chondrial

Lumbar Lumbar

HypogastricOr

SuprapubicIliac Iliac

Midclavicular Line

Superficial fascia-SuperficialCamper’s FASCIA

-Deep Membranous layerScarpa’s Fascia

Colle’s Fascia

Deep Fascia

Lymph drainage

Serratus ant.

Latissimus dorsi

2)Internal abdominal oblique

3)Transversl abdominal

Action of Muscle

-Supports of abdominal contents -Compresses abdominal contents-Assists in flexing and rotation of trunk-Defecation-Partuition-Vomiting-Expiration-Tenses the lina alba

Inguinal Canal

4 cm

Spermatic CordRound Lig.

SuperficialInguinal ring

DeepInguinal ring

Inguinal Herniae

a) Indirect

Inguinal Herniae

b) Direct

Peritoneal Cavity

Peritoneum

Tunica Serosa-Parietal-Visceral Peritoneal Cavity ( Coelum )

Extraperitoneal Tissue

Retroperitoneal

Nerve Supply-Phrenic nerve

-Intercostal and Lumbar nerve

-Obturator Nerve

Ventral Mesentery

Stomach

Lienorenal Ligament

Peritoneal Compartments

-Supracolic

-Infracolic

Transverse Mesocolon

Supracolic

-Gastrophernic Lig.

-Greater omentum

-Lesser omentum

Greater omentum

Gastrocolic lig.

Lesser omentum

-Hepatogastric Lig.

-Hepatoduodenal Lig.

Winslow foramen

Winslow foramen

-Ant: Lesser omentum ( Triad )-INF: Duodenum-Sup: Caudate process-Post: IVC

Lesser sac ( Bursa omentalis )

-Stomach Bed

Lesser sac ( Bursa omentalis )

-Stomach Bed

Hepatorenal Pouch( Morison )

Mesentery

Infarcolic

Root of Mesentery

Root of Mesentery

Root of Mesentery

Psoas MajorPsoas MinorQuadratus lumborum

Quadratus lumborum

Genitofemoral n.

Laparoscopy

Abdominal Esofhagus

T10

Ostium CardiacumT11 (R7)

Abdominal Esofhagus

Post.

Abdominal Esofhagus

Post.Left subphrenic a.

StomachGaster

Ostium cardiacumT11 (R7)

Ostium PyloricL1 (1.25 cm)ConsrtictionPrepyloric vein ( mayo)

FundusBodyPars pylorica

Coeliac Trunk

1-Left Gastric a.2-Common Hepatic a.3-Splenic a.

Lesser sac ( Bursa omentalis )

-Stomach Bed

Autonomic nerve

Ant. Vagal Trunk

More from left vagus nerve

-Greater ant. Gastric nerve Gastric branches

-Pyloric br.

-Hepatic br.

-Celiac br.

Post. Vagal Trunk

More from right vagus nerve

-Greater post. Gastric nerve Gastric branches

-Celiac br.

Duodenum

1) Sup. Part (5 cm) Bulbus Duodenal Cap

2) Descending part (8-10 cm)

3) Horizontal part (10 cm)

4) Ascending part (2.5 cm)

Duodenum

1) Sup. Part

Duodenal cap

Duodenum

1)Sup. Part

Post:

Duodenum

1)Sup. Part

Post:

Gastrodeodenal a.Common bile ductPortal vein

Duodenum

2)Descending Part

Post:

Duodenum

2)Descending Part

Post:Right kidneyI.V.C

Vater

Duodenum

3)Transverses Part

Post:Aortic + I.V.C

Duodenum

3)Transverses Part

Post:Aortic + I.V.C

Small Intestine

Ileum 60-80 cm fromIleocecal valve

Diverticulum ilei3-5 cm lengthStomach or pancreas ectopic tissue

Large Intestine

-Cecum

-Appendix

-Ascending colon

-Transverses colon

-Descending colon

-Sigmoid (pelvic)

-Rectum

Large Intestine

Right colic flexureLeft colic flexure

Meso Tenia haustra Epiploic appendices

Cecum - 3 + -

Vermiform

appendix+ - - -

Ascending Colon

- 3 + +

Transverse Colon

+ 3 + +

Descending colon

- 3 + +

Sigmoid colon

+ 2 + +++

Rectum - - - -

Ileocecal Valve

-FrenulumMed. and Lat.

Appendix vermiform

-Meso-PositionMedial of cecumRetrocolic Retrocecal

Pelvic (31%)

PreilealPostileal

65%

5%

Lumbar Plexus

Ascending Colon

15 cm

Ascending Colon

Descending Colon

25 cm

Descending Colon

Post:

Descending Colon

Post:

Sup. Mesenteric a.

-L1

Sup. Mesenteric a.

Sup. Mesenteric a.

1-Inf. Pancreaticoduodenal a.

2-jejunal and ileal a.

3-Iliocolic a.

4-Right Colic a.

5-Middle Colic a.

Inf. Mesenteric a.

1-Left Colic a.2-Sigmoid a.3-Sup.Rectal a.

Marginal a.

Spleen v. + Sup. Mesenteric vein Portal Vein

Abdominal Esophagus

Portal Hypertension

Esophageal varicel

Caput Meduza

Spleen (Lien)

Surface:

-Diaphragmatic

-Visceral Gastric Renal Colic

Border:

-Sup.

-Inf.

Spleen (Lien)

Helium

Pancreas

Ant:-Root of Mesocolon-Sup. Mesenteric a. and v.-Stomach bed

Pancreas

Post:

Pancreas

Post:

-I.V.C-Aorta-Treitz lig.-Right renal vein-Left renal-Left suprarenal-Diaphragm cruse-Sup. Mesenteric a. and v.-Portal vein-Common bile duct

Surface:

-Diaphragmatic (Sup.)-Post.-Visceral (Inf.)

Diaphragmatic (Sup.):

-falciform lig. Round lig.

Visceral (Inf.) Surface:

-Porta hepatis (H)

Visceral (Inf.) Surface:

-Porta hepatis (H)

Sulcus for Teres lig. ( Left umbilical vein)Sulcus for Venosum lig.GallbladderI.V.C

LobeAnatomy and Physiology

-Right

Ant.Post.

-Left

MedialLateral

LobeAnatomy and Physiology

-Right

Ant.Post.

-Left

MedialLateral

Right and Left Hepatic ducts

Common Hepatic Duct

Cystic Duct

Common Bile Duct(Choledocus)

Gallbladder

-30-50 cc

-Fundus-Body -Infundibulum (Hartmann’s Pouch)-Neck(Spiral Valve of Heister)

Suprarenal Gland

Suprarenal Gland

Suprarenal Gland Artery

-Sup. Suprarenal a.-Middle Suprarenal a.-Inf. Suprarenal a.

Suprarenal Gland Vein

-Right ….. I.V.C-Left …….. left Renal Vein

Kidney

Renal Fascia (Gerota)

Kidney

Ant:

Abdominal Aorta

-Coeliac Trunk-Sup. Mesentric a.-Inf. Mesentric a.-Inf. phrenic a.-Renal a.-Gonadal a.-Middle Supra renal a.-Lumbar a.-Median sacral a.

Common Iliac a.

I.V.C

L5-T8

I.V.C

Ant:

Right Common Iliac a.Part 3 of duodenumRoot of MesenteryGonoadal a.PancreasPart 1 of DuodenumWinslow ForamenLiver

ANATOMY PELVIS

Pelvis :

- Hip - Sacrum - Coccygeus

Pelvis Joint

HIP

Surface:-Lateral

AcetabulumObturator Foramen

HIP

Surface:-Lateral

AcetabulumObturator Foramen

HIP

Surface:

Obturator Foramen

Male: Female:

HIP

Obturator Foramen

Obturator memberaneObturator Canal Nerve Artery Vein NAV

Obturator Canal

Hip:

Border1-Superior

-Iliac crest Ant. Sup. Iliac Spine: ASIS Post. Sup. Iliac Spine

Hip:

Border3-Anterior-ASIS-Ant. Inf. Iliac Spine-IlioPectinal Eminence-Pectinal Surface-Pubic Tubercle-Pubic Crest

Hip:Border4-Posterior

-Post. Sup. Iliac. Spine-Post. Inf. Iliac. Spine-Greater sciatic Notch-Ischial spine-Lesser Sciatic Notch-Ischial Tuberosity

Hip:Border4-Posterior

-Greater sciatic Notch-Lesser Sciatic Notch

Sacrotuberous Lig.Sacrospinous Lig.

-Greater sciatic Foramen-Lesser Sciatic Foramen

Sacrum

Surface:-Post. (Dorsal)Median sacral crestSpinous TubercleSacral HiatusSacral CornuIntermediate sacral CrestDorsal Sacral ForamenLateral Sacral Crest

Pelvis Types

-Gynaecoid 41%-Android 33%-Platypelloid 2%-Anthropoid 24%

Pelvic Muscles

Pelvic Walls:PiriformisObturator internus

Pelvic Floor:Levator AniCoccygeus

Pelvic Diaphragm

Peritoneum

Female:

Rectoutrine Pouch

Utrovesical pouch

Male:

Rectovesical pouch

Bladder

Bladder

-Apex

-Base(Posterior Surface)

-Superior Surface

-Inferior lateral Surface

-Neck

Peritoneum

Female:

Rectoutrine Pouch

Utrovesical pouch

Male:

Rectovesical pouch

Bladder

Bladder

Neck

Male

Female

Bladder

Detrusor Muscle

Rugae

Trigone

Interureteric Crest

(Bar of Muscle)

(Bells Muscle)

Internal Meatus

Ureter

-Pelvic

Male

Male Genital Organs

-Scrotum-Testis-Epidydimis-Ductus Deferens-Seminal Vesicle-Prostate

Scrotum

Nerve Supply

-Ilioinguinal L1-Genitofemoral L1-Perineal S3-Post. Femoral Cutaneous S2

Scrotum

Septum

Testis

Testicular a.

Testicular Vein

Prostate

-False Prostatic Capsule-Prostatic Venous Plexus -True Prostatic Capsule

Glands + Fibromuscular Stroma

Prostate

Lobe-Ant.-Middle-Post.-Lat.

Uterine Tube (Fallopian)

-10 cm-Infundibulum Fimbriae-Ampulla-Isthmus-Interstitial

Uterus

-8x5x2.5-Fundus-Body-Cervix

Uterus

Cervix-Supravaginal-Vaginal-Internal Os.-External Os.-Fornix Ant. Post. Lat.

Uterus

-Anteflexion-170 ْْْْ

Uterus

-Anteversion-90 ْْْْ

Uterus

-Transverse Cervical ig. Cardinal Lig.-Pubocervical Lig.-Sacrocervical Lig.

Uterus

-Perituneum

Uterus

Perituneum

Brod Lig.

-Mesovarium

Rectum

-12-13cm

-S3

-Rectal Valves

(Houston)

Anal Canal

-4 cm

-Anal Columns

10

-Anal Valves

-Anal Sinus

-Pectinal Line

Anal Sphincter

-Internal Upper ¾

-ExternalLower 3/4SubcutaneousSuperficialDeep

Pudendal n.-Inf. Rectal n.

Male

-Obliterated Umblical a.

-Sup. Vesical a.

-Inf. Vesical a.

-Middle Rectal a.

-Obturator a.

-Inf. Gluteal a.

-Int. Pudendal a.

Female

-Obliterated Umblical a.

-Sup. Vesical a.

-Vaginal a.

-Uterine a.

-Middle Rectal a.

-Obturator a.

-Inf. Gluteal a.

-Int. Pudendal a

Pelvic VesselsInternal Iliac a.Ant. Division

Perineum

Perineum

Urogenital Region

-Skin

-Superficial fascia

Fats (Campers)

Membranous (Colles)

-Superficial Perineal Space

-Perineal Membrane

-Deep Perineal Space

Deep

Superficial

Skin