Anterior Abdominal Wall: Umbilicus o Dermatome: T10 Skin o Stratified squamous epithelium, largest organ of body, protection, most

st superficial layer of anterior abdominal wall External Abdominal Oblique Muscle and Aponeurosis o Most superficial abdominal mm o !: T7-T12 "nternal Abdominal Oblique Muscle and Aponeurosis o # of "O m aponeurosis forms anterior rectus sheath, # forms posterior rectus sheath $abo%e umbilicus& o !: T8-L1 'ectus Abdominus o Straight skeletal mm of abdomen, found inside rectus sheath o (lood supply: superior epigastric a ) inferior epigastric a Anterior and Posterior Rectus S eat o Abo%e arcuate line $*+,*-&: Anterior rectus sheath: E O aponeurosis, # " O aponeurosis .osterior rectus sheath: / A aponeurosis, # " O aponeurosis 0ampers fascia $fatty& o (elow arcuate line $*+,*-&: Anterior rectus sheath: aponeurosis of E O , " O , and / A .osterior rectus sheath: trans%ersalis fascia 0ampers $fatty& ) Scarpas $membranous& fascia Aponeuroses o 0onnecti%e tissue Scarpas fascia o Membranous fascia o !ound onl" belo# umbilicus $arcuate line% 0ampers fascia o 1atty fascia o 1ound abo%e2below umbilicus Tendinous intersection a&a trans'erse inscri(tions /rans%ersus Abdominus o !: T7-L1 Trans'ersalis !ascia o Makes up the posterior rectus sheath below the arcuate line o 0onnecti%e tissue .arietal .eritoneum o 3eepest layer of anterior abdominal wall 4isceral .eritoneum Extraperitoneal 1at Superior and "nferior Epigastric 4essels o Arteries anastomose to supply the rectus abdominus o Parent to su(erior e(i)astric 'essel: internal t oracic arter" *subcla'ian+ o Parent to in,erior e(i)astric e-ternal iliac arter" *iliac a. abdominal aorta+ External iliac artery - branches: /n,erior e(i)astric a.0more medial Dee( circum,le- a.0more lateral Abdominal Aorta o 5 ma6or branches: celiac trunk, SMA, "MA 1eliac Trun& o 2ranc o, abdominal aorta o 3 ma4or branc es: s(lenic a.5 le,t )astric a.5 common e(atic a. $SL1% Su(erior 6esenteric Arter"

o 7 ma6or branches: o middle colic arter" $supplies trans%erse colon&, o RT colic arter" $supplies ascending colon&, o /leocolic a. $supplies ileocecal 6unction&, o intestinal arteries $6e6una2illeal arteries8 supply 6e6unum2ileum& /n,erior 6esenteric Arter" o 5 branches o Le,t colic arter" $supplies descending colon&, o si)moidal a. $supplies sigmoid colon&, and o su(erior rectal a $supplies rectum& 0ommon "liac 4essels o Abdominal aorta bifurcates into - common iliac arteries o 0ommon iliac arteries bifurcate into: external2internal iliac arteries o External iliac artery has - branches: deep circumflex ) inferior epigastric artery $anostomases w2 superior epigastric and supplies rectus abdominus mm & External "liac 4essels o 7-ternal iliac a. as 2 branc es: dee( circum,le- a. 8 in,erior e(i)astric a. o .arent: common iliac artery "nternal "liac 4essels o .arent: common iliac artery "nternal /horacic 4essels o .arent to internal thoracic artery: subcla%ian artery o "nternal thoracic artery bifurcates into: musculophrenic artery $5,7,9 keep the diaphragm ali%e& superior epigastric artery $anostomases w2 inferior epigastric to supply the rectus abdominus mm & Musculophrenic %essels o Musculophrenic a supplies the diaphragm o (ranch of internal thoracic artery :subcla%ian a ; T oracic Dia( ra)m o 3 o(enin)s: Aortic 9iatus: abdominal aorta 7so( a)eal 9iatus: esophagus /n,erior :ena 1a'a !oramen: /:1 Linea alba o Salient ,eature: # ite line o Separates # of anterior abdominal wall from the other *inea semilunaris o Salient ,eature: se(arates obli;ues ,rom rectus abdominus .yramidalis m o <nl" 20 = o, (o(ulation a'e t is abdominal m. 6edian umbilical li)ament o 7mbr"olo)ical ori)in: urac us 6edial umbilical li)aments o 7mbr"olo)ical ori)in: obliterated umbilical arteries Lateral umbilical ,old o 1ontains in,erior e(i)astric 'ein>arter"

/n)uinal 1anal Spermatic cord Arteries found w2in: testicular artery a , artery to ductus, ) cremasteric a 'ound ligament of the uterus External Spermatic fascia "nternal Spermatic fascia 0remasteric muscle and fascia Superficial inguinal ring

 3efect: inguinal hernia 3eep "nguinal ring .ubic /ubercle .ubic Symphysis "nguinal ligament *acunar ligament 0on6ont /endon Stomac o 3 muscle la"ers $su(er,icial to dee(%: lon)itudinal5 circular5 obli;ue mm. o 9istolo)ical ,eature: )astric )lands #> mucus5 (arietal5 c ie,5 and endocrine cells o /nner'ations: Paras"m(at etic: A>P 'a)al n. S"m(at etic: )reater s(lanc nic n. !undus o, t e stomac o Supplied by s ort )astric a. :splenic artery; o *ymphatic drainage: s(lenic nodes (ody $0orpus& of Stomach 0ardiac notch ?reater 1ur'ature o Supplied L>R )astroomental a. .arent of * gastro,omental a : splenic artery .arent of ' gastro,omental a : gastro,duodenal a o Attachment of greater omental to trans%erse colon o *ymphatic drainage: )astro-omental nodes Lesser cur'ature o Supplied by L>R )astric a. Parent to L )astric a.: celiac trun& Parent to R )astric a.: (ro(er e(atic a. o *ymphatic drainage: )astro-omental nodes o Attachment of lesser omental o - ligaments attach to lesser omental: hepatoduodenal ) hepatogastric <astroesophageal 6unction o 0ardiac notch2lower esophageal sphincter Antrum .ylorus P"loric S( incter o Smoot mm. o (etween pylorus and first part of duodenum ?reater <mentum o 1onnecti'e tissue o Attac es )reater cur'ature o, stomac to trans'erse colon *esser Omentum o 1onnecti'e tissue o Attac es t e lesser cur'ature o, stomac to t e li'er and duodenum o - ligaments: hepatoduodenal ligament ) hepatogastric ligaments 'ugae o <astric folds o "ncreases surface area of stomach 2lood Su((l": ?astric arteries $Ri) t and Le,t% o Su((l" lesser cur'ature o, stomac o Parent o, ri) t )astric arter": (ro(er e(atic arter" o Parent o, le,t )astric arter": celiac trun& ?astro-omental $7(i(loic% Ri) t and Le,t o Su((lies t e )reater cur'ature o, stomac o Parent o, ri) t )astro-omental arter": )astroduodenal arter"

o Parent o, le,t )astro-omental arter": s(lenic arter" Short <astric o Supplies fundus of stomach o .arent of short gastric: splenic artery Small /ntestine: Duodenum 9istolo)ical ,eatures: lined #> columnar e(it elium@ )oblet cells5 cr"(ts o, Lieber&u n5 2runnerAs )lands5 Panet cells 7mbr"olo)ical ori)in: o !ore)ut: su(erior $1st% 8 (art o, descendin) $2nd% to t e ma4or duodenal (a(illa o 6id)ut: (art o, descendin) $2nd (art startin) at t e ma4or duodenal (a(illa%5 oriBontal>in,erior $3 rd (art%5 and ascendin) $Ct (art% Superior o 1st (art o Supplied by su(erior (ancreatico-duodenal arter" *1eliac trun&+ .arent of superior pancreatico duodenal artery: gastro,duodenal a :common hepatic a celiac trunk; o 7mbr"olo)ical ori)in: ,ore)ut o Salient ,eature: commonest site o, (e(tic ulcer $(osterior as(ect% 3escending o 2nd (art o Supplied by bot S>/ (ancreatico-duodenal arteries .arent to Superior pancreatico,duodenal artery: gastro,duodenal a :common hepatic artery celiac trunk; .arent to inferior pancreatico,duodenal artery: SMA o /wo different sources: celiac trun& 8 S6A o Embryological origin: ,ore)ut 8 mid)ut o Salient feature: contains ma6or2minor duodenal papilla 6a4or duodenal (a(illa o(ened b": s( incter o, oddi =ori>ontal o "nferior part o 3rd (art o /n,erior (ancreatico-duodenal arter" *S6A+ o 7mbr"olo)ical ori)in: mid)ut Ascending o Ct (art o /n,erior (ancreatico-duodenal arter" *S6A+ o 7mbr"olo)ical ori)in: mid)ut 2lood Su((l": o Superior pancreaticoduodenal and branches .arent: gastro,duodenal a :common hepatic a celiac trunk; o "nferior pancreaticoduodenal and branches .arent: SMA De4unum o 9istolo)ical ,eature: lon) 'illi5 columnar e(it elium5 micro'illi5 central lacteal5 Pe"erAs (atc /leum o 9istolo)ical ,eatures: s ort 'illi5 columnar e(it elium5 micro'illi5 central lacteal5 more common: Pe"erAs (atc 7mbr"lo)ical ori)in o, 4e4unum>ileum: mid)ut /ntestinal arteries su((l" bot 4e4unum>ileum o Parent to intestinal arteries: S6A 2lood Su((l": o "ntestinal arteries $?e6unal and "leal arteries& Lar)e /ntestine $0olon& Salient ,eature: e(i(loic a((enda)es5 austra5 tenia coli 1ecum o Su((lied b" (osterior>anterior cecal arteries *ileocecal a. S6A+ o .arent to cecal a : ileocolic artery o .arent to ileocolic a : SMA Trans'erse colon

Supplied by middle colic a .arent to middle colic a : SMA 7mbr"olo)ical ori)in: Pro-imal $2>3%: mid)ut Distal $1>3%: ind)ut o Salient feature: attached to greater omentum which is also attached to greater cur%ature of stomach Descendin) colon o Su((lied b" le,t colic a. */6A+ o .arent to left colic a : "MA Si)moid colon o Su((lied b" si)moidal a. */6A+ o .arent to sigmoidal a : "MA =austra /eni coli Appendix o Supplied by appendicular artery o Parent to a((endicular arter": ilecolic a. *S6A+ o .arent to ileocolic artery: SMA o *ined by columnar epithelium o Sur,ace mar&in): 6c2urne"As (oint: diagonal line btwn umbilicus and AS"S, -25 away from umbilicus 'ight 0olic $=epatic& 1lexure o 0ontacts the li%er o 0olic impression on li%er *eft 0olic $Splenic& 1lexure o 0lose relationship to spleen o o o

2lood Su((l": Superior Mesenteric4essels o SMA o 9 branches: in,erior (ancreatico-duodenal a.5 intestinal branc es $4e4una>ileul%5 middle colic branc 5 ri) t colic branc 5 ileocolic branc /ntestinal branc o, *S6A; supplies the 6e6unum ) ileum 6iddle colic branc *S6A+ supplies the trans%erse colon Ri) t colic branc *S6A+ supplies the ascending colon /liocolica a. *S6A+ supplies: last of ileum, cecum, ) appendix "MA o 5 branches: left colic branch, sigmoidal branch ) superior rectal branch Le,t colic su((lies */6A+ the descending colon Si)moidal branc */6A+ su((lies t e si)moid colon Su(erior rectal branc */6A+ supplies the rectum Li'er 'ight *obe o 'ight functional li%er o Supplied by right hepatic a *eft *obe o *eft functional li%er o Supplied by left hepatic a 1audate lobe o # part of '/ ) # part of */ functional lobes o Su((lied b" le,t e(atic a. 8 ri) t e(atic a. o Ad4acent to /:1 Euadrate lobe o .art of left functional lobe o Su((lied b" le,t e(atic a. o Ad6acent to gallbladder

'ight and *eft /riangular ligament 0oronary *igament o Attaches thoracic diaphragm Round Li)ament o, li'er o A&a li)amentum teres e(atis o 7mbr"olo)ical ori)in: obliterated le,t umbilical '. !alci,orm li)ament 1ontains # at structure 8 # at is embr"olo)ical ori)inF 0ontains what structure: Li)amentum teres e(atis (ara-umbilical 'eins Li)amentum 'enosum o 7mbr"olo)ical ori)in: ductus 'enosus (are Area o "n close proximity w2 thoracic diaphragm .orta =epatis o 0ontains portal triad: common bile duct, portal %ein, and proper hepatic artery o Separates the caudate lobe from quadrate lobe Ri) t>le,t e(atic duct o Draina)eF Ri) t>le,t e(atic arter" o Ri) t e(atic a. distributes to ri) t ,unctional lobe $ri) t lobe 8 ri) t G o, caudate lobe% o Le,t e(atic a. distributes to le,t ,unctional lobe $le,t lobe5 le,t G o, caudate lobe5 ;uadrate lobe% /n,erior 'ena ca'a o Passes t rou) t e dia( ra)m at # at 'ertebral le'elF T8 2lood Su((l": 0ommon =epatic a is one of 5 ma6or branches off the celiac trunk 0ommon hepatic artery bifurcates: proper hepatic artery ) gastroduodenal a .roper hepatic artery passes through the porta hepatis 2ranc es o, (ro(er e(atic arter": ri) t )astric arter"5 L>R e(atic arteries 1"stic arter" branc es o,, o, ri) t e(atic arter" Portal 'ein ,ormed b" s(lenic 'ein 8 su(erior mesenteric '. =epatic 4eins /m(ressions: 'enal 0olic <astric Suprarenal Esophageal 3uodenal ?allbladder 9istolo)ical ,eature: muscular sac lined #> columnar e(it elium H: )reater s(lanc nic ner'es $TI-J% Re,ers (ain to intrasca(ular re)ion $T7-J% 1undus o Surface marking: tip of ' @th costal cartilage on lateral edge of right rectus abdominus (ody !eck o *eads to cystic duct 2lood Su((l": 0ystic a o .arent of cystic artery: right hepatic artery :proper hepatic artery common hepatic artery; 2iliar"Tree 1ommon bile duct o 3 (arts: 1st t ird abo'e t e duodenum5 2nd t ird be ind t e duodenum5 3rd (art in ead o, (ancreas o Su((lied b" c"stic a.

Parent to c"stic a.: ri) t e(atic a. o 1orms anterior border of the omental foramen o 'uns w2 portal % ) proper heptatic a in the porta hepatis 0ommon =epatic 3uct o ?oins w2 cystic duct to form common bile duct 0ystic duct o ?oins w2 common hepatic duct to form common bile duct o 0omprised of mucosa arranged in spiral ) smooth form 'ight and *eft =epatic 3ucts o ?oin to form common hepatic duct .ancreatic duct $ma6or and minor& o ?oins w2 common bile duct /ogether 6oin at the -nd part of duodenum at the ampulla of %ater $ma6or duodenal papilla A nipple part of the opening& (ile ) pancreatic en>ymes pass through the ampulla of %ater controlled by the the sphincter of oddi

Pancreas =ead o o

Ad6acent to second part of the duodenum Main pancreatic duct of Birsung empties into the -nd part of the duodenum %ia the ampulla of %ater in the head of pancreas o Emptying of the duct controlled by spinchter of odi Uncinate Process o Relations i( #> t ird (art o, t e duodenum !eck (ody /ail o 3amage of tail ma6or problem resulting in release of digesti%e en>ymes which digest the tissues of abdominal ca%ity o 1lose relations i( #>s(leen 2lood Su((l": Superior pancreaticoduodenal o Parent Su(erior P.D. a.: )astroduodenal arter" *common e(atic a. celiac trun&+ /n,erior (ancreaticoduodenal o Parent o, /n,erior P.D. a.: S6A

S(leen Salient ,eature: lar)est sin)le l"m( oid collection5 collects dead R215 su((lied b" s(lenic a. 2 sur,aces: dia( ra)matic 8 'isceral sur,ace 2 (oles: su(erior>in,erior 2 li)aments: linorenal 8 )astros(lenic Lienorenal li)ament 1ontains s(lenic a.>'. ?astros(lenic li)aments 1ontain s ort )astric 'essesl $su((l" ,undus o, stomac % 8 le,t )astromental 'essels $su((l" t e )reater cur'ature o, stomac % 1losel" related to tail o, (ancreas =ilum o 9omolo)ous to t e (orta e(atis o, li'er o S(lenic a.>'. (ass t rou) 2lood Su((l": o Splenic artery o 'uns along the body2tail of pancreas o .arent: celiac trunk /m(ressions: o <astric o 0olic aka splenic flexure of colon o 'enal