Landmarks of Abdomen
Pubic tubercle: Small bony projection can be felt at medial end of fold of groin Pubic crest: Short bony ridge between pubic tubercle and pubic symphysis Pubic symphysis: Lies in median plane at level of tip of coccyx
Dr. Praveen Kurrey
08-09-2025
Arterial Supply of Abdominal Wall
Anterior cutaneous branches of superior and inferior epigastric arteries Lateral cutaneous branches of posterior intercostal arteries Three superficial branches of femoral artery Superficial external pudendal artery Superficial epigastric artery Superficial circumflex iliac artery Deep circumflex iliac artery (branch of external iliac artery)
Dr. Praveen Kurrey
08-09-2025
Nerves of Abdominal Wall
Supplied by lower six thoracic nerves and first lumbar nerves-PKK
Dr. Praveen Kurrey
08-09-2025
Superficial Fascia Of Abdomen
Fascia of Camper (superficial fatty layer) This layer – continuous with subcutaneous fat of adjoining areas In penis – devoid of fat; in scrotum, replaced by involuntary dartos muscle-PKK
Dr. Praveen Kurrey
08-09-2025
Bony Cavity of Abdomen
Bounded as follows Superiorly by xiphoid process and right and left costal margins Inferiorly by iliac crest, fold of groin, pubic tubercle,pubic crest, and pubic symphysis On each side, extends up to midaxillary line and continues with posterior abdominal wall-PKK
Dr. Praveen Kurrey
08-09-2025
Holdens Line- Abdomen
Holden’s line: Extends 8 cm laterally from pubic tubercle in horizontal plane-PKK
Dr. Praveen Kurrey
08-09-2025
Extravasated Urine Flow- Abdomen
Due to attachment of fascia of Scarpa, extravasated urine in ruptured urethra gets accumulated in superficial perineal pouch in thigh up to Holden’s line and in anterior abdominal wall inferior to umbilicus
Dr. Praveen Kurrey
08-09-2025
Cutaneous Nerves-Abdomen
Supplied by lower six thoracic nerves and first lumbar nerves
Dr. Praveen Kurrey
08-09-2025
Superficial Veins- Abdomen
Above umbilicus: These veins run toward axilla and drain into axillary vein and finally to superior vena cava Below umbilicus: Cutaneous veins run toward groin and drain into great saphenous vein and finally to inferior vena cava Small veins (paraumbilical veins) from umbilicus run along ligamentum teres drain into portal vein
Dr. Praveen Kurrey
08-09-2025
Superficial Lymphatics -Abdomen
axillary and superficial inguinal nodes and follow water-shed line at level of umbilicus as follows -- 1. Above umbilicus, lymphatic vessels run upward to drain into the axillary lymph nodes 2. Below umbilicus, lymphatic vessels run downward to drain into superficial inguinal nodes
Dr. Praveen Kurrey
08-09-2025
Dermatomes- Abdomen
Lower six thoracic nerves (T7–T12) Two lateral intercostal nerves are derived from lower two intercostal nerves (T10, T11) pierce external intercostal muscle Divided into anterior and posterior divisions to supply skin on side of abdomen
Dr. Praveen Kurrey
08-09-2025
External Oblique Muscle -Abdomen
Origin-- Originates by eight fleshy slips from outer surfaces of middle of shafts of lower eight ribs Direction of fibers-- Run downward, forward, and medially (similar to direction of fingers when one keeps hand in Trousers’ pocket)
Dr. Praveen Kurrey
08-09-2025
External and Internal Oblique Muscle
External Oblique-- Insertion Posterior most fibers insert on outer lip of anterior 2/3rd of iliac crest Posterior border of muscle extends from 12th rib to iliac crest Forms anterior boundary of lumbar triangle of petit
Dr. Praveen Kurrey
08-09-2025
Internal Oblique Muscle
Origin-- 1. Lateral 2/3rds of upper surface of inguinal ligament 2. Intermediate area of anterior 2/3rd of iliac crest 3. Thoracolumbar fascia
Dr. Praveen Kurrey
08-09-2025
Transversus Abdominis
Origin-- Lateral 1/3rd of upper surface of inguinal ligament Inner lip of anterior 2/3rd of iliac crest Thoracolumbar fascia Inner surfaces of lower six ribs and their costal cartilages
Dr. Praveen Kurrey
08-09-2025
Rectus and Transversus Abdominis muscle
Rectus Abdominis-- Long, flat strap muscle supports anterior abdominal wall (rectus = straight in Latin) Origin Originates by two tendons or heads Medial head originates from anterior surface of pubic symphysis and anterior pubic ligament Lateral head originates from lateral part of pubic crest Insertion Inserts on horizontal line passing laterally from xiphoid process Intersecting 5th, 6th, and 7th costal cartilages Innervation Ventral primary rami of lower six or seven nerves (T7–T12) Actions Maintains anterior abdominal wall tone during standing Flexion of trunk on pelvis Protects abdominal viscera
Dr. Praveen Kurrey
09-09-2025
Pyramidalis Muscle
Origin-- Front pubic crest and anterior pubic ligament Direction of fibers--Run upward and medially Insertion--Inserts into linea alba, midway between umbilicus and pubic symphysis Innervation--Subcostal nerve (T12) Action--Tenses linea alba
Dr. Praveen Kurrey
09-09-2025
Cremaster Muscle
Origin-- Superficial fibers – originate from middle 1/3rd of upper surface of inguinal ligament Deep fibers – originate from pubic crest and conjoint tendon Insertion Superficial fibers extend along spermatic cord and reach scrotum Superficial and deep fibers – connected with each other around spermatic cord and upper part of scrotum In females, few fibers of cremaster muscle accompany round ligament of uterus, Innervation---Genital branch of genitofemoral nerve (L1–L2) Mostly these fibers carry sympathetic innervation Cremaster muscle – not under voluntary control, Actions--- Pulls testis upward toward superficial inguinal ring helps in closing superficial inguinal ring and controlling temperature of testis
Dr. Praveen Kurrey
09-09-2025
Iliohypogastric and Ilioinguinal Nerve
Iliohypogastric Nerve--Branch of 1st lumbar nerve Close to iliac crest, nerve divides into Lateral branch – pierces external and internal oblique muscle, passes posteriorly to supply skin of gluteal region Anterior branch – pierces internal oblique at 2.5 cm medial to anterior superior iliac spine Pierces external oblique about 3 cm above superficial inguinal ring
Dr. Praveen Kurrey
09-09-2025
Fascia Transversalis
Thin layer of areolar membrane lines deeper surface of transverse abdominis muscle Extent-- Superiorly, continuous with ill-defined subdiaphragmatic fascia Inferiorly -- continuous with fascia iliaca (fascia covering iliacus muscle) Extent Attached to iliac crest, inguinal ligament, pecten pubis, and pubic crest Continuous with pelvic fascia
Dr. Praveen Kurrey
09-09-2025
8 Layers of Anterior Abdominal Wall
Consists of eight layers from superficial to deep as follows Skin Superficial fascia External oblique muscle and aponeurosis Internal oblique muscle and aponeurosis Transverse abdominis muscle and aponeurosis Fascia transversalis Extra peritoneal connective tissue Parietal layer of peritoneum
Dr. Praveen Kurrey
09-09-2025
Muscles of Anterior Abdominal Wall
External oblique Internal oblique Transverse abdominis Rectus abdominis Pyramidalis External oblique, internal oblique, and transverse abdominis – large, broad, flat muscles
Dr. Praveen Kurrey
09-09-2025