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Abdomen 1
2.1 Surface anatomy
2.2 Anterior abdominal wall
Albert van Schoor
GNK 288 (SA4 Anatomy dissection)
2.1.1 Surface anatomy
• Identify and name the bony landmarks of
the abdomen which are palpable on
abdominal examination and state if
possible their corresponding vertebral
heights on the cadaver, yourself and on a
radiograph
• Schematically illustrate and discuss the
nine abdominal regions and list which
organs lie approximately in each region
2.1.1 Surface Anatomy
2.1.1 Surface anatomy
• Identify and name in which of the nine surface
anatomical regions you would expect to feel
tenderness in appendicitis, cholecystitis,
gastritis and cystitis
• Identify other surface anatomy lines e.g.
transpyloric line, transumbilical line, linea alba
and linea semilunaris. You should be able to
say how these lines are formed and to discuss
the intra-abdominal events occurring on the
transpyloric line
2.1.1 Surface Anatomy
Referred pain
2.1.1 Surface Anatomy
2.1.1 Surface Anatomy
2.1.1 Surface Anatomy
2.1.1 Surface Anatomy
• Transpyloric
plane
– Hilum of the
kidneys
– Pylorus of the
stomach
– Body of
pancreas
– Fundus of the
gall bladder
2.1.1 Surface Anatomy
2.1.1 Surface anatomy
• Schematically illustrate and discuss the surface
anatomy of the kidneys, ureters and spleen on
the posterior abdominal wall [2.5, 2.8]
• Discuss and identify the surface anatomy of the
liver [2.4]
• Briefly discuss the surface anatomy of the
diaphragm and the vertebral heights of its three
major orifices [2.9]
• Identify the various dermatomes of the anterior
abdominal wall
• Indicate whether the bladder is an abdominal
organ or not. Explain
2.1.1 Surface Anatomy
2.2 Anterior abdominal wall
2.2.1 Skin and superficial fascia
2.2.2 Muscles
2.2.3 Transversalis fascia
2.2.4 Peritoneum
2.2.5 Rectus sheath
2.2.6 Inguinal area
2.2.7 Osteology
2.2.1 Skin and superficial fascia
• Identify the fatty superficial layer
(Camper's fascia)
• Identify and shortly discuss the
membranous superficial layer (Scarpa's
fascia) according to its distribution and
borders. State what this fascia is called
inferior to the superficial inguinal ring
2.2.2 Muscles
• Identify and discuss the three major
abdominal muscles as follows:
– Major attachments to the following points: Linea
alba, crista iliaca and inguinal ligament where
applicable,
– Direction of fibres,
– Nerve supply and
– Function
• Identify the neurovascular plane
• Identify the ilio-inguinal and iliohypogastric
nerves. Also state their origin and area of
supply
2.2.2 Muscles
External oblique
Origin
Muscular slips
from the outer
surfaces of
the lower
eight ribs (ribs
5-12)
Insertion Innervation Function
Lateral lip of
Anterior rami of
iliac crest;
lower six thoracic
aponeurosis Table
spinal nerves (T7
ending in
to T12)
midline raphe
(linea alba)
Compress
abdominal
contents; both
muscles flex
trunk; each
muscle bends
trunk to same
side, turning
anterior part
of abdomen to
opposite side
2.2.2 Muscles
Internal oblique
Origin
Insertion
Thoracolumbar
fascia; iliac
crest between
origins of
external and
transversus;
lateral twothirds of
inguinal
ligament
Inferior border of
the lower three or
four ribs;
aponeurosis
ending in linea
alba; pubic crest
and pectineal line
Innervation
Anterior rami of
lower six thoracic
spinal nerves (T7
to T12) and L1
Function
See External
Oblique
2.2.2 Muscles
Transverse abdominis
Origin
Insertion
Thoracolumbar
fascia; medial
lip of iliac crest;
lateral one-third
of inguinal
ligament; costal
cartilages lower
six ribs (ribs 712)
Aponeurosis
ending in linea
alba; pubic crest
and pectineal line
Innervation
Anterior rami of
lower six thoracic
spinal nerves (T7
to T12) and L1
Function
Compress
abdominal
contents
2.2.2 Muscles
Neurovascular plane
Ant
Post
2.2.3 Transversalis fascia
• Identify the transversalis fascia
2.2.4 Peritoneum
• Identify the folds and associated
underlying structures of the peritoneum
on the posterior aspect of the anterior
abdominal wall: [2.3.3]
– Plica umbilicalis mediana,
– Plica umbilicalis medialis,
– Plica umbilicalis lateralis,
– Falciform ligament
2.2.5 Rectus sheath
• Identify the rectus sheath and how it is
formed on the following levels:
– Superior to the arcuate line
– Inferior to the arcuate line
• Identify and briefly discuss rectus abdominis
as follows:
– major attachments,
– nerve supply and
– function
• Name and identify the structures on the
posterior wall of the rectus sheath
2.2.5 Rectus sheath
2.2.5 Rectus sheath
Rectus abdominis
Origin
Pubic crest,
pubic tubercle,
and pubic
symphysis
Insertion
Innervation
Function
Costal cartilages
of ribs 5-7;
xiphoid process
Anterior rami of
lower seven
thoracic spinal
nerves (T7 to T12)
Compress
abdominal
contents; flex
vertebral
column; tense
abdominal wall
2.2.6 Inguinal area
• Identify and briefly discuss the inguinal canal
as follows:
– Surface anatomy,
– Borders,
– Openings
Inguinal canal
Surface anatomy
2.2.6 Inguinal area
2.2.6 Inguinal area
Indirect inguinal hernia
Inguinal canal
Borders
2.2.6 Inguinal area
491-8
2.2.6 Inguinal area
• Know the positions of the superficial and deep
inguinal rings and femoral canal.
• Identify the inguinal ligament and the
structures posterior to it from lateral to medial.
2.2.6 Inguinal area
Femoral canal
Ant
Post
2.2.6 Inguinal area
Femoral hernia
2.2.6 Inguinal area
N.A.V.E.L
Contents
• N.A.V.E.L (lat. - med.)
–
–
–
–
Femoral nerve
Femoral artery
Femoral vein
Empty space (femoral
canal)
– Lacunar ligament
N
AV
E
L
2.2.6 Inguinal area
• List the contents of the spermatic cord.
Compare the content in males and females
• Identify the inferior epigastric artery and its
relation to the deep inguinal ring
• Identify and list the borders of the inguinal
triangle (Hesselbach's triangle)
• Name and identify the inguinal falx (conjoint
tendon)
2.2.6 Inguinal area
Spermatic cord
• 3 Fascia layers
– External spermatic fascia
– Cremasteric fascia
– Internal speratic fascia
• 3 Arteries
– Testicular artery
– Cremasteric artery
– Artery to ductus deferens
• 3 Nerves
– Genito-femoral nerve
– Ilio-inguinal nerve
– Sympathetic autonomic plexus
• 3 Other structures
– Lymphatic vessels
– Ductus deferens
– Pampiniform venous plexus
2.2.6 Inguinal area
Spermatic cord
2.2.6 Inguinal area
Hesselbach’s triangle
2.2.6 Inguinal area
Direct inguinal hernia
2.2.6 Inguinal area
Conjoint tendon
2.2.7 Osteology
• Identify the following bony points of the os
coxa:
– Anterior superior iliac spine (ASIS)
– Anterior inferior iliac spine (AIIS)
– Crista iliaca
– Posterior superior iliac spine (PIIS)
– Pubic tubercle
– Pubic crest
– Symphysis pubis
2.2.7 Osteology