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ABDOMEN

ABDOMEN. Lu Xiaoli Regional Anatomy & Operative Surgery China Medical University . BOUNDARIES . Abdominopelvic Cavity Abdominal Cavity Pelvic Cavity. P242-fig.4.21. DIVISIONS. P242-fig.4.22. P243-fig.4.23. P243-fig.4.23.

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ABDOMEN

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  1. ABDOMEN Lu Xiaoli Regional Anatomy & Operative Surgery China Medical University

  2. BOUNDARIES

  3. Abdominopelvic Cavity • Abdominal Cavity • Pelvic Cavity P242-fig.4.21

  4. DIVISIONS P242-fig.4.22

  5. P243-fig.4.23

  6. P243-fig.4.23

  7. Which one of the following is not one of the 9 regions of the abdomen? • Right hypochondriac • Left inguinal or iliac • Epigastric • Right upper • Left lumbar

  8. Which of the following is NOT true concerning the peritoneal cavity? • The peritoneal cavity is a potential space. • The peritoneal cavity contains organs inside of it. • The peritoneal cavity is filled with fluid that lubricates its contents. • The parietal and visceral peritoneum are linings of the peritoneal cavity.

  9. The usual location for an appendectomy incision is the: • left lower quadrant • left upper quadrant • right lower quadrant • right upper quadrant

  10. You were asked to assist in a surgical operation on a young patient to treat an ulcer in the first part of the duodenum. You would expect that the surgeon will approach the ulcer by doing an anterior abdominal wall incision in the following region:

  11. Epigastric • Left inguinal • Left lumbar • Right hypochondrial • Hypogastric

  12. ABDOMINAL WALL

  13. Abdominal wall Anterolateral abdominal wall Posterior abdominal wall

  14. Skin Superficial fascia Deep fascia Muscles Transversalis fascia Extraperitoneal fascia Peritoneum LAYERS

  15. Superficial fascia • Camper’s fascia • Scarpa's fascia P245-fig.4.25~4.26

  16. SUPERFICIAL ARTERIES • Lateral • Posterior intercostal a. • Subcostal a. • Lumbar a. • Median • Epigastric a. • hypogastric a. • Inferior • Superficial epigastric a. • Superficial iliac a. P255-fig.4.39

  17. Superficial veins lateral thoracic subclavian thoracoepigastric portal paraumbilical S epigastric femoral S circumflex iliac

  18. Caput Medusae(Medusa Head )

  19. INNERVATIONS • Intercostal Nerve • T7-T12 • 10th Intercostal Nerve

  20. MUSCLES Anterior Group Lateral Group • External Oblique • Internal Oblique • Transversus • Rectus Abdominis • Pyramidalis

  21. RECTUS ABDOMINIS • Tendinous Intersection (3) • Linea Semilunaris

  22. Rectus Sheath

  23. Arcuate line

  24. PYRAMIDALIS

  25. LINEA ALBA

  26. External Oblique Abdominis

  27. Oblique Internal Abdominis

  28. Transversus Abdominis

  29. Arteries • 5 intercostal arteries • subcostal arteries • 4 lumbar arteries • Superior epigastric artery—internal thoracic artery • Inferior epigastric artery -external iliac artery • Deep iliac circumflex artery- external iliac artery

  30. Inferior epigastric artery

  31. Lymphatic Drainage

  32. Innervations • Intercostal n. • Anterior cutaneous branch • Lateral cutaneous branch

  33. T7-12 thoracic n. • Iliohypogastric n. • Ilioinguinal n. • Genitofemoral n.

  34. Transversalis Fascia

  35. Extraperitoneal Fascia

  36. Parietal Peritoneum

  37. Umbilical Folds • Median -- median umbilical lig. • Medial -- chorda arteriae umbilicalis • Lateral -- inferior epigastric a. & v.

  38. INCISIONS • Longitudinal • Midline • Paramedian • Transrectal • Oblique • Subcostal • McBurney’s • Transverse • Pfannenstiel • Combined • Thoracal-abdominal

  39. The inferior border of the rectus sheath posteriorly is called the: • Falx inguinalis • Inguinal ligament • Internal inguinal ring • Arcuate line • Linea alba

  40. Following an emergency appendectomy your patient complained of having paresthesia (numbness) of the skin at the pubic region. The most likely nerve that has been injured during the operation is: • Genitofemoral • Iliohypogastric • Subcostal • Spinal nerve T10 • Spinal nerve T9

  41. An obstetrician decides to do a Caesarean section on a 25-year-old pregnant woman. A transverse suprapubic incision is chosen for that purpose. All of the following abdominal wall layers will be encountered during the incision EXCEPT the:

  42. Anterior rectus sheath • Posterior rectus sheath • Rectus abdominis muscle • Skin and subcutaneous tissue • Transversalis fascia, extraperitoneal fat, and peritoneum

  43. Surgical approaches to the abdomen sometimes necessitate a midline incision between the two rectus sheaths, i.e., through the: • Linea aspera • Arcuate line • Semilunar line • Iliopectineal line • Linea alba

  44. The internal thoracic artery is sometimes surgically cut near the caudal end of the sternum and used to supply blood to a region of the heart. In these cases, maintenance of adequate blood flow to the rectus abdominis may be dependent on increased flow through which artery?

  45. Superficial epigastric • Inferior epigastric • Umbilical • Superficial circumflex iliac • Deep circumflex iliac

  46. INGUINAL REGION

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