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