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1、Abdomen 腹部,Boundaries of the abdomen,Boundaries Superiorly xiphoid process, lower border of costal arch, 11th and 12th ribs, vertebra T12 Inferiorlysuperior border of pubic symphysis, pubic crest, pubic tubercle, fold of inguinal canal, anterior superior iliac spine, iliac crest, spinous process of
2、L5,The abdominal regions 腹部分区 Nine regions,R. hypochondriac region 右季肋区,Epigastric region 腹上区,L. hypochondriac region 左季肋区,R. lateral regions 右外区,Umbilical region 脐区,L. lateral regions 左外侧区,R. inguinal region右腹股沟区,L. inguinal region 左腹股沟区,Pubic region 耻区,The abdominal regions 腹部分区 Four quadrants,Lef
3、t upper quadrants,right upper quadrants,right lower quadrants,Left lower quadrants,Landmarks of abdomen,Xiphoid process 剑突 Costal arch 肋弓 Anterior superior iliac spine 髂前上棘 Iliac crest 髂嵴 Pubic symphysis 耻骨联合 Pubic tubercle 耻骨结节 Umbiicus 脐 at the level of L3 L4 Linea alba 白线 Linea semilunaris 半月线,La
4、ndmarks and surface anatomy,Xiphoid process Costal arch Anterior superior iliac spine Iliac crest Superior border of pubic symphysis Pubic tubercle,Landmarks and surface anatomy,Linea alba Rectus abdominis Tendinous intersections Linea semilunaris Umbilicus: at the level of L3 L4 Inguinal ligament,A
5、nterolateral abdominal wall,Layers ( from superficial to deep) Skin Superficial fascia Anterolateral muscles Transversalic fascia 腹横筋膜 Extraperitoneal fascia 腹膜下筋膜 Parietal peritoneum 壁腹膜,Anterolateral abdominal wall,Superficial fascia divisions below umbilicus Fatty layer (Campers fascia) continuou
6、s with the superficial fascia over the rest of the body. Membranous layer (Scarpas fascia) passes over the inguinal ligament to fuse the deep fascia of the thigh (fascia lata) approximately one fingerbreadth below the inguinal ligament. In the midline, it is not attached to the pubis but instead fro
7、m a tubular sheath for the penis (clitoris). In the perineum, it is attaches on each side to the margins of the pubic arch and is know as Colles fascia.,Superficial vessels and cutaneous nerves,Arteries Superficial epigastric a. Superficial iliac circumflex a. Veins Thoracoepigastric v. Superficial
8、epigastric v. Cutaneous nerves Anterior and lateral cutaneous n. of lower six thoracic Iliohypogastric n. (first lumb nerves),Superficial vessels and cutaneous nerves,Lymph drainge Superficial lymph vessels above the level of the umbilicus grain upward into the pectoral Ln. The vessels below this le
9、vel drain downward into the superficial inguinal Ln.,Anterolateral Muscles,Obliquus externus abdominis 腹外斜肌 Obliquus internus abdominis 腹内斜肌 Transversus abdominis 腹横肌 Rectus abdominis 腹直肌,Obliquus externus absominis 腹外斜肌,General direction of fibers: downward, forward and medially (run down and inwar
10、d) Originfrom outer surface of lower eight ribs Insertion Posterior fibers extens vertically sownward to anterior half of iliac crest Remainder extend down and medially into a broad aponeurosis, which: Meets its fellow at linea alba by crossing anterior to rectus abdomins,Obliquus externus absominis
11、 腹外斜肌,Attaches to anterior superior iliac spine and pubic tubercle to form a free lower border ( the inguinal ligament 腹股沟韧带) between these two points Inguinal ligament 腹股沟韧带 Lower free border of aponeurosis of obliquus externus abdominis between anterior superior iliac spine and pubic tubercle Supe
12、rficial inguinal ring 腹股沟管浅环 triangular-shaped defect in aponeurosis of obliquus externus abdominis above pubic tubercle Lacunar ligament 腔隙韧带 Extention of inguinal ligament curving downward and posteriorly from pubic tubercle Pectineal ligament (Coopers) 耻骨梳韧带 Continuation of fibers of lacunar ligm
13、ent along the pectineal line,Superficial inguinal ring 腹股沟浅环,Obliquus internus abdominis 腹内斜肌,Deep to obliquus externus abdominis Origin Lateral 2/3 of inguinal ligament Anterior 2/3 of iliac crest Thoracolumbar facia Insertion Extension of most fibers upwards and medially To lower four ribs and cos
14、tal catilages Into broad aponurosis, which splits into anterior and posterior leaves to enclose rectus abdominis, meeting at linea alba Fibers from inguinal ligamentarch over spermatic cord, inserted with transversus abdominis fibers into pubic crest and adjacent pectineal line to form inguinal falx
15、 腹股沟镰 Derivation of cremaster muscle and facia,Transversus abdominis 腹横肌,Deep to obliquus internus General direction of fibers: run horizontally forward Origin Lateral 1/3 of inguinal ligament Anterior 2/3 of iliac crest Thoracolumbar facia Lower six ribs and costal cartilages Insertion Most fibersr
16、un horizontally into a broad aponurosis, most of which passes posterior to rectus abdominis and meets its fellow at the linea alba,Transversus abdominis 腹横肌,Inguinal falx 腹股沟镰 Formed by insertion of obliquus internus abdominis and transversus abdominis fibers into pubic crest and adjacent pectineal line Strengthens abdominal wall posterior to superficial ring Cremaster 提睾肌 Dirived from the lower fibers of the obliquus internus abdominis and transversus abdominis Around the spermatic cord and testis,
