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The Abdomen
Xiaoming Zhang
Department of Human Anatom
School of Medicine of Zhejiang University
Introduction
Formation: Abdominal wall, Abdominal cavity
and contents
Boundaries
 Superior boundary
 Inferior boundary
Abdominal wall

Anterior Abdominal Wall

posterior abdominal wall
Abdominal cavity
Division
4 abdominal quadrants
right epigastric region
left epigastric region
right hypogastric
region
left hypogastric region
9 abdominal regions
hypogastric region
Abdominal Wall
Anterior Abdominal Wall
Ⅲ.The abdominal wall
The layers of the anterior abdominal wall:
skin superficial fascia muscles transverse
fascia extraperitoneal fascia
parietal peritoneum
I Anterior Abdominal Wall
Layers and structures
Superficial structures
1.skin
2.superficial fascia
 superficial layer — Camper‘s fascia
 deep layer — Scarpa‘s fascia, Colles’ fascia
3.superficial vessels and cutaneous nerves
Superficial structures
superficial arteries：three groups
• The branches of posterior intercostal A.,
subcostal A., and lumbar A. ；
• Superior and inferior epigastric A. ；
• Superficial epigastric A. and superfical iliac
circumflex.
Superficial structures
the superficial veins:
 —umbilical venous network
 above the umbilicus
 below the umbilicus
Superficial lymphatic vessels:
 upper→axillary lymph nodes
 lower→superficial inguinal lymph nodes
 anastomise with the lymphatics of the liver
the cutaneous nerves
I Anterior Abdominal Wall
Deep Structures
Deep fascia
Muscular layers
rectus abdominis
the sheath of
rectus abdominis
anterior layer of the sheath is formed
by the aponeurosis of the obliquus externus and the ant. layer of the aponeurosis
of the obliquus internus.
The linea alba is extending between the xiphoid
process and the pubic symphysis,
formed by the decussating of the aponeuroses of the three flat muscles.
The posterior layer of the
sheath is formed by the
aponeurosis of the transversus and the post. Layer
of the aponeurosis of the
obliquus internus.
The posterior layer of the
sheath is lack of at the
arcuate line(about 4cm
below the omphalo)
I Anterior Abdominal Wall
Deep Structures
Muscular layers
obliquus externus abdominis
 linea alba)
 superficial inguinal ring
 reflected ligament
 external spermatic fascia
 Inguinal ligament
 lacunar ligament
 pectineal ligament(Cooper ）
(3) The internus abdominis
—arises from the lateral 2/3 of the inguinal
lig.,the iliac crest and the
thoracolumbar fascia.The
muscular fibers is replace
by the aponeurosis(ant. And
post. layers) at the lateral
margin of the rectus.
—cremaster
—inguinal falx
(4) The transverse abdominis
—arises from the lateral 1/3 of the inguinal
lig.,the iliac crest and the
thoracolumbar fascia and
internal aspect of lower 6
costal cartilage.
—cremaster
—inguinal falx
—inguinal canal
1. position —parallel to,and above the inguinal lig.
Immediately.
About 4cm long.
2. Structures
— two orifices
(1) the deep inguinal ring lies a transverse finger
breadth(2cm)above the midpoint of inguinal lig.
formed by the transverse fascia.
(2)sup. Inguinal ring
formed by the aponeurosis of the obliquus
externus.
triangular defect in shape.
medial and lateral crus
—four walls
(1) ant. wall is mainly formed by aponeurosis of the
obliquus ext.,and laterally is reinforced by the
beginning part of the obliquus internus.
(2) inf. wall is formed by the inguinal ligament
(3) Post.wall is formed by the transverse fascia,
inguinal falx and the reflected lig..
(4) Sup. wall is formed by the arched fibers
of the obliquus internus and transverse abdominis
The contents
male spermetic cord, ilioinguinal nerve
female
round ligament and ilioinguinal nerve
The inguinal triangle
—boundaries
inf. boundary
medial half of the inguinal ligament
medial boundary
lateral border of the rectus abdominis
lateral boundary
inf. epigastric a..
**direct inguinal hernia
I Anterior Abdominal Wall
Deep Structures
extraperitoneal fascia
parietal peritoneum
 Five longitudinal folds
 Median umbilical fold
 Medial umbilical fold
 Lateral umbilical fold
 inguinal medial fossa and inguinal lateral fossa
Summary of anterior abdominal wall
Superficial structures
 skin
 superficial
fascia :Camper and Scarpa
 superficial vessels and cutaneous nerves
Deep Structures
 Deep fascia
 Muscular layers
The vessels and nerves
transversalis fascia
extraperitoneal fascia
parietal peritoneum
II Inguinal region

Boundaries
 Superior boundary—from anterior iliac spine to
lateral margin of rectus
 Medial boundary—lateral margin of rectus
 Inferior boundary—inguinal ligament
 inguinal trangle(Hesselbach trangle ）
 laterally —inferior epigastric A.
 medially —the lateral border of the rectus
abdominis
 inferiorly —medial half of the inguinal ligament
III The incisions of anterolateral
wall of abdomen
Rectus incision
Median incision
Inferior median
incision
McBurney’s
incision