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

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Page 1: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic
Page 2: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Intertubercular PlaneL5

Transpyloric Plane( Subcostal Plane )

R9 – L1Umblical

EpigastricHypo-Chondrial

Hypo-Chondrial

Lumbar Lumbar

HypogastricOr

SuprapubicIliac Iliac

Midclavicular Line

Page 3: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic
Page 4: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Superficial fascia-SuperficialCamper’s FASCIA

-Deep Membranous layerScarpa’s Fascia

Colle’s Fascia

Deep Fascia

Page 5: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Lymph drainage

Page 6: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Serratus ant.

Latissimus dorsi

Page 7: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

2)Internal abdominal oblique

Page 8: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

3)Transversl abdominal

Page 9: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic
Page 10: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic
Page 11: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic
Page 12: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

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

Page 13: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Inguinal Canal

4 cm

Spermatic CordRound Lig.

SuperficialInguinal ring

DeepInguinal ring

Page 14: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic
Page 15: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Inguinal Herniae

a) Indirect

Page 16: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Inguinal Herniae

b) Direct

Page 17: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic
Page 18: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Peritoneal Cavity

Page 19: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Peritoneum

Tunica Serosa-Parietal-Visceral Peritoneal Cavity ( Coelum )

Extraperitoneal Tissue

Retroperitoneal

Page 20: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Nerve Supply-Phrenic nerve

-Intercostal and Lumbar nerve

-Obturator Nerve

Page 21: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Ventral Mesentery

Page 22: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Stomach

Page 23: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic
Page 24: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Lienorenal Ligament

Page 25: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Peritoneal Compartments

-Supracolic

-Infracolic

Page 26: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Transverse Mesocolon

Page 27: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Supracolic

-Gastrophernic Lig.

-Greater omentum

-Lesser omentum

Page 28: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Greater omentum

Page 29: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Gastrocolic lig.

Page 30: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Lesser omentum

-Hepatogastric Lig.

-Hepatoduodenal Lig.

Winslow foramen

Page 31: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Winslow foramen

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

Page 32: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Lesser sac ( Bursa omentalis )

-Stomach Bed

Page 33: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Lesser sac ( Bursa omentalis )

-Stomach Bed

Page 34: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Hepatorenal Pouch( Morison )

Page 35: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic
Page 36: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Mesentery

Page 37: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Infarcolic

Page 38: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic
Page 39: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Root of Mesentery

Page 40: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Root of Mesentery

Page 41: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Root of Mesentery

Page 42: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Psoas MajorPsoas MinorQuadratus lumborum

Page 43: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Quadratus lumborum

Page 44: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Genitofemoral n.

Page 45: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Laparoscopy

Page 46: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Abdominal Esofhagus

T10

Ostium CardiacumT11 (R7)

Page 47: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Abdominal Esofhagus

Post.

Page 48: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Abdominal Esofhagus

Post.Left subphrenic a.

Page 49: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic
Page 50: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

StomachGaster

Ostium cardiacumT11 (R7)

Ostium PyloricL1 (1.25 cm)ConsrtictionPrepyloric vein ( mayo)

Page 51: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic
Page 52: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

FundusBodyPars pylorica

Page 53: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Coeliac Trunk

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

Page 54: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Lesser sac ( Bursa omentalis )

-Stomach Bed

Page 55: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Autonomic nerve

Page 56: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Ant. Vagal Trunk

More from left vagus nerve

-Greater ant. Gastric nerve Gastric branches

-Pyloric br.

-Hepatic br.

-Celiac br.

Page 57: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Post. Vagal Trunk

More from right vagus nerve

-Greater post. Gastric nerve Gastric branches

-Celiac br.

Page 58: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic
Page 59: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

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)

Page 60: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Duodenum

1) Sup. Part

Duodenal cap

Page 61: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Duodenum

1)Sup. Part

Post:

Page 62: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Duodenum

1)Sup. Part

Post:

Gastrodeodenal a.Common bile ductPortal vein

Page 63: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Duodenum

2)Descending Part

Post:

Page 64: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Duodenum

2)Descending Part

Post:Right kidneyI.V.C

Page 65: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic
Page 66: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Vater

Page 67: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Duodenum

3)Transverses Part

Post:Aortic + I.V.C

Page 68: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Duodenum

3)Transverses Part

Post:Aortic + I.V.C

Page 69: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic
Page 70: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Small Intestine

Ileum 60-80 cm fromIleocecal valve

Diverticulum ilei3-5 cm lengthStomach or pancreas ectopic tissue

Page 71: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Large Intestine

-Cecum

-Appendix

-Ascending colon

-Transverses colon

-Descending colon

-Sigmoid (pelvic)

-Rectum

Page 72: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Large Intestine

Right colic flexureLeft colic flexure

Page 73: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Meso Tenia haustra Epiploic appendices

Cecum - 3 + -

Vermiform

appendix+ - - -

Ascending Colon

- 3 + +

Transverse Colon

+ 3 + +

Descending colon

- 3 + +

Sigmoid colon

+ 2 + +++

Rectum - - - -

Page 74: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Ileocecal Valve

-FrenulumMed. and Lat.

Page 75: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Appendix vermiform

-Meso-PositionMedial of cecumRetrocolic Retrocecal

Pelvic (31%)

PreilealPostileal

65%

5%

Page 76: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Lumbar Plexus

Page 77: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Ascending Colon

15 cm

Page 78: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Ascending Colon

Page 79: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Descending Colon

25 cm

Page 80: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Descending Colon

Post:

Page 81: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Descending Colon

Post:

Page 82: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Sup. Mesenteric a.

-L1

Page 83: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Sup. Mesenteric a.

Page 84: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Sup. Mesenteric a.

1-Inf. Pancreaticoduodenal a.

2-jejunal and ileal a.

3-Iliocolic a.

4-Right Colic a.

5-Middle Colic a.

Page 85: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Inf. Mesenteric a.

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

Page 86: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Marginal a.

Page 87: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Spleen v. + Sup. Mesenteric vein Portal Vein

Page 88: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Abdominal Esophagus

Page 89: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Portal Hypertension

Esophageal varicel

Page 90: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Caput Meduza

Page 91: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Spleen (Lien)

Surface:

-Diaphragmatic

-Visceral Gastric Renal Colic

Border:

-Sup.

-Inf.

Page 92: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Spleen (Lien)

Helium

Page 93: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Pancreas

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

Page 94: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Pancreas

Post:

Page 95: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

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

Page 96: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Surface:

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

Page 97: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Diaphragmatic (Sup.):

-falciform lig. Round lig.

Page 98: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Visceral (Inf.) Surface:

-Porta hepatis (H)

Page 99: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Visceral (Inf.) Surface:

-Porta hepatis (H)

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

Page 100: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

LobeAnatomy and Physiology

-Right

Ant.Post.

-Left

MedialLateral

Page 101: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

LobeAnatomy and Physiology

-Right

Ant.Post.

-Left

MedialLateral

Page 102: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Right and Left Hepatic ducts

Common Hepatic Duct

Cystic Duct

Common Bile Duct(Choledocus)

Page 103: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Gallbladder

-30-50 cc

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

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Suprarenal Gland

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Suprarenal Gland

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Suprarenal Gland Artery

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

Suprarenal Gland Vein

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

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Kidney

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Renal Fascia (Gerota)

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Kidney

Ant:

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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.

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I.V.C

L5-T8

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I.V.C

Ant:

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

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ANATOMY PELVIS

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Pelvis :

- Hip - Sacrum - Coccygeus

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Pelvis Joint

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HIP

Surface:-Lateral

AcetabulumObturator Foramen

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HIP

Surface:-Lateral

AcetabulumObturator Foramen

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HIP

Surface:

Obturator Foramen

Male: Female:

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HIP

Obturator Foramen

Obturator memberaneObturator Canal Nerve Artery Vein NAV

Obturator Canal

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Hip:

Border1-Superior

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

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Hip:

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

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Hip:Border4-Posterior

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

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Hip:Border4-Posterior

-Greater sciatic Notch-Lesser Sciatic Notch

Sacrotuberous Lig.Sacrospinous Lig.

-Greater sciatic Foramen-Lesser Sciatic Foramen

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Sacrum

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

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Pelvis Types

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

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Pelvic Muscles

Pelvic Walls:PiriformisObturator internus

Pelvic Floor:Levator AniCoccygeus

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Pelvic Diaphragm

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Peritoneum

Female:

Rectoutrine Pouch

Utrovesical pouch

Male:

Rectovesical pouch

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Bladder

Page 132: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Bladder

-Apex

-Base(Posterior Surface)

-Superior Surface

-Inferior lateral Surface

-Neck

Page 133: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Peritoneum

Female:

Rectoutrine Pouch

Utrovesical pouch

Male:

Rectovesical pouch

Bladder

Page 134: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Bladder

Neck

Male

Female

Page 135: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Bladder

Detrusor Muscle

Rugae

Trigone

Interureteric Crest

(Bar of Muscle)

(Bells Muscle)

Internal Meatus

Page 136: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Ureter

-Pelvic

Male

Page 137: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Male Genital Organs

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

Page 138: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Scrotum

Nerve Supply

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

Page 139: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Scrotum

Septum

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Testis

Page 141: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Testicular a.

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Testicular Vein

Page 143: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Prostate

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

Glands + Fibromuscular Stroma

Page 144: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Prostate

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

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Uterine Tube (Fallopian)

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

Page 146: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Uterus

-8x5x2.5-Fundus-Body-Cervix

Page 147: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Uterus

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

Page 148: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Uterus

-Anteflexion-170 ْْْْ

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Uterus

-Anteversion-90 ْْْْ

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Uterus

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

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Uterus

-Perituneum

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Page 153: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Uterus

Perituneum

Brod Lig.

-Mesovarium

Page 154: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Rectum

-12-13cm

-S3

-Rectal Valves

(Houston)

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Page 156: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Anal Canal

-4 cm

-Anal Columns

10

-Anal Valves

-Anal Sinus

-Pectinal Line

Page 157: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Anal Sphincter

-Internal Upper ¾

-ExternalLower 3/4SubcutaneousSuperficialDeep

Pudendal n.-Inf. Rectal n.

Page 158: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

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

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Perineum

Page 160: Intertubercular Plane L5 Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Epigastric Hypo- Chondrial Hypo- Chondrial Lumbar Hypogastric Or Suprapubic

Perineum

Urogenital Region

-Skin

-Superficial fascia

Fats (Campers)

Membranous (Colles)

-Superficial Perineal Space

-Perineal Membrane

-Deep Perineal Space

Deep

Superficial

Skin

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