Download - Anatomy, Lecture 9, Abdominal Wall (2)
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8/8/2019 Anatomy, Lecture 9, Abdominal Wall (2)
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Abdominal Wall (2):Abdominal Wall (2):Inguinal RegionInguinal Region
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Inguinal RegionInguinal Region
The inf. part of anterolateralabdominal wall
Area of weakness:
Passage of spermatic cordthrough a canal (inguinal)
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Inguinal CanalInguinal Canal
Superior & parallel to medial of inguinal ligament
Runs oblique in inferomedial direction
Contents1:
Male: spermatic cord
Female: round lig. of uterus
2: ilioinguinal n. (L1)
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O penings of Inguinal CanalO penings of Inguinal Canal
Deep inguinal ring (Internal):
entrance to the canal
above the middle of inguinal ligament
O val opening in transversalis fascia
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Superficial inguinal ring:
Triangular exit
Due to defect in ???
Lateral & Medial (margins) Borders crura
Crura: attachment site for external fasciacovering the spermatic cord
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Walls of the canalWalls of the canal
Anterior:External oblique aponeurosis
reinforced on lat. 1/3 by:Internal oblique aponeuroses.
Posterior:Transversalis fascia
Reinforced medially by:Insertion of int. oblique &transversus m. ( Conjoint tendon )
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Conjoint TendonConjoint Tendon
Merging of internal oblique aponeurosis & transversus abdominisaponeurosis to share a common insertion into pubic crest
Locatedposteromedial to
superficial ring
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Walls of Inguinal CanalWalls of Inguinal CanalRoof (superior wall):
arching fibers of Internal oblique m. & Transversus m.
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Walls of Inguinal CanalWalls of Inguinal Canal
Floor (inferior wall):Inguinal Ligament& Lacunar lig.
Lacunar Lig.:medial continuation of inguinal
ligament
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Lacunar Lig.: a small part of inguinal ligament fibers that reflectedfrom pubic tubercle & attach to the pubic ramus
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M - muscles
A aponeuroses
L - ligaments
T - transversalis/Tendon
Sup
Ant Post
Inf
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Spermatic CordSpermatic Cord
Contents
Ductus (vas) deferens
Testicular arterya. to vas deferensCremasteric a.
Testicular Vein (pampiniform plexus)
Autonomic nerve fibersGenital branch of genitofemoral n.(to cremaster muscle)
Lymphatic vessels
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Cremaster MuscleCremaster Muscle
Extension from lower part of internal oblique m.
Pass with spermatic cord to thescrotum
Fxn.In cold environment:
elevates testis superiorly
In warm environment:relaxes & testis descend in the
scrotum
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Inguinal HerniaInguinal Hernia
Hernia = L, ruptureProtrusion of abdominal organs to outside through abdominal
wall weakness
Diaphragmatic hernia:usually in esophageal opening-sliding or paraesophageal
Inguinal hernia: (in inguinal region)Indirect ( through inguinal canal )Direct
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Indirect HerniaIndirect Hernia
75% of inguinal hernias are indirect
Part of the intestine pass through thecanal
Commonly enters the scrotum
20x males thanfemales
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Direct HerniaDirect Hernia
Usually medial to inf. epigastric a.
In Inguinal triangle area:
inf. epig. A.rectus abdominisinguinal lig.
Forms an inguinal sac by
transversalis fascia
Does not enter the scrotum
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Surface AnatomySurface Anatomy
9 regions classification
Subcostal plane:lowest costal margin,10 cc, L3
Transtubercular plane:iliac tuberclesw hat vertebral level?
Midclavicular planes:mid clavicle
mid inguinal lig.
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9 Regions
Rt. & Lf. Hypochondriac
Rt. & Lf. Lumbar
Rt. & Lf. Inguinal
Epigastric
Umbilical
Hypogastric (pubic)
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4 Regions classification
Transumbilical plane
IV disc L3-L 4
Midsagittal line
symphesis menti
symphesis pubis