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1、1,Abdominal wall,山东大学医学院 解剖教研室 李振华,2,Anterior wall,Layers ( from superficial to deep) Skin Superficial fascia Anterolateral muscles Transversalis fascia 腹横筋膜 Extraperitoneal fascia 腹膜下筋膜 Parietal peritoneum 壁腹膜,3,Superficial fasciadivisions below umbilicus Superficial fatty layer (Campers) Membranou
2、s layer (Scarpas),4,Muscles of abdomen,Anterolateral group Obliquus externus absominis 腹外斜肌 Oblequus enternus abdominis腹内斜肌 Transversus abdominis腹横肌 Rectus abdominis 腹直肌,5,Posterior group Quadiatus lumborum 腰方肌 Psoas major 腰大肌,6,Obliquus externus absominis 腹外斜肌,General direction of fibers: downward,
3、 forward and medially (run down and inward) Structures Inguinal ligament 腹股沟韧带 Lacunar ligament 腔隙韧带 Superficial inguinal ring 腹股沟浅环 triangular-shaped defect in aponeurosis of obliquus externus abdominis above pubic tubercle,7,8,Obliquus internus abdominis 腹内斜肌,Deep to obliquus externus abdominis Ge
4、neral direction of fibres: upwards, forwards and medially,9,Transversels abdominis 腹横肌,Deep to obliquus internus,10,Inguinal falx 腹股沟镰: arch over spermatic cord, inserted with transverses abdominis fiber into medial part of pecten of pubis Cremaster 提睾肌: around the spermatic cord and testis,11,Rectu
5、s abdominis 腹直肌,Position: lie on to either of midline Origin: pubic crest and symphysis Insertion: xiphoid and 5th-7th costal cartilages Has 3-4 tendinous intersections 腱划 linea semiluaris 半月线,12,Similar functions for above four pairs of muscles,Support and compress the abdominal viscera Increase in
6、tra-abdominal pressure, aid in expulsive efforts-vomiting, coughing, sneezing, defecation, urination and childbirth. Depress ribs, assist in (the act of force(4)expiration. Flex, lateral flex, and rotate vertebral column,13,Sheath of rectus abdominis 腹直肌鞘,Ant layerformed by fusion of aponeurosis of
7、obliquus externus abdominis and anterior leaf of aponeurosis of obliquus internus abdominis Post layer Formed by fusion of posterion leaf of aponeurosis of obliquus internus abdominis and aponeurosis of transverses abdominis Absent in about 4-5cm below the umbilicus, where aponeuroses of all three m
8、uscles form anterior layer the lower free border named arcuate line Below this line rectus abdominis in contact with transverse fascia,14,Linea alba 白线 tendinous raphe between right and left recti from xiphoid to pubic symphysis.,15,Inguinal region 腹股沟区,Boundaries Inguinal ligament Lateral margin of
9、 rectus abdominis A horizontal line stretching from anterior iliac spine to laeral margin of rectus abdominis,16,Descent of testes,Seven-week embryo showing the testis before its descent from the dorsal abdominal wall,17,Fetus at 28 week the testis passing through the inguinal canal,18,Newborn,19,In
10、guinal canal 腹股沟管,Position: oblique passage, 4cm long, located 1.5cm above medial half of inguinal lig.,20,Boundaries Ant wall Aponeurosis of obliquus externus abdominis Obliquus internus abdominis (lateral third of wall),21,Post wall Transverse fascia Inguinal flax medially Roofarched lower fibers
11、of obliquus internus and transversua abdominis Flooringuinal lig,22,Two openings Superficial inguinal ring 腹股沟浅环 Deep inguinal ring 腹股沟深环 defect in transverse fascia 1.5cm above midpoint of inguinal ligament,23,Structures passing through the inguinal canal Spermatic cord 精索 and ilioinguinal nerve髂腹股
12、沟神经 in males Round ligament of uterus 子宫圆韧带and ilioinguinal nerve髂腹股沟神经 in females,24,Inguinal Triangle (of Hesselbach) 腹股沟三角,Boundaries Inguinal ligament inferiorly Lateral border of rectus abdominis medially Inferior epigastric artery laterally,25,Indirect inguinal heinia and direcet inguinal hein
13、ia,26,Superficial vessels and cutaneous nerves,Arteries Superficial epigastric a. Superficial iliac circumflex a. Veins Thoracoepigastric v. Superficial epigastric v. Cutaneous nerves Anterior and lateral cutaneous n. of lower six thoracic Iliohypogastric n. (first lumb nerves),27,Deep vessels and n
14、erves,Arteres Superior and inferior epigastric arteris Lower posterior intercostal a. Subcostal a. Four lumbar a.,28,Nerves Iliohypogastric n. 髂腹下神经 Arises from lubar plexus Passes forward in the interval between obliquus internus and tranversus abdominis Pieces obliquus internus abdominis 2.5 cm me
15、dial to anterior superior iliac spine Pieces aponeurosis of obliquus externus abdominisabout 2.5 cm above superficial inguinal ring Ilioinguinal n. 髂腹股沟神经 Runs parallel with iliohypogastric n. at a lower level Enters inguinal canal and emerges through superficial inguinal ring Genitofemoral n. 生殖股神经
16、,29,Layer ?,30,Abdomen 2,山东大学医学院 解剖教研室 李振华,31,Abdominal aorta 腹主动脉,Continuation of thoracic aorta at aortic hiatus of diaphragm in front of T12 Terminates at lower border of L4 vertebra by dividing into right and left common iliac arteries,32,Parietal branches Inferior phrenic a. 膈下动脉(one pair) Lumbar a. 腰动脉(four pairs of arteries that supply the posterior abdominal wall) Median sacral a. 骶正中动脉,33,Visceral branches Paired branches Middle suprarenal artery 肾上腺中动脉 Re
