ABDOMEN

The abdomen is the part of the trunk between the thorax and
the pelvis
Located between the diaphragm and the pelvic inlet.
Separated from the thoracic cavity by the thoracic
diaphragm.
Continuous inferiorly with the pelvic cavity.
Under cover of the thoracic cage superiorly.
Supported and partially protected inferiorly by the greater
pelvis.
Enclosed anterolaterally by multi-layered,
musculoaponeurotic, abdominal walls.
The location of most digestive organs, parts of the urogenital
system (kidneys and most of the ureters), and the spleen.
 Abdominal Wall
Although the abdominal wall is continuous,
it is subdivided into the anterior wall, right
and left lateral walls (flanks), and posterior
wall
The wall is musculoaponeurotic, except for
the posterior wall, which includes the
lumbar vertebral column.
Because the boundary between the anterior
and the lateral walls is indefinite, the term
anterolateral abdominal wall is often used
 The anterolateral abdominal wall extends from the
thoracic cage to the pelvis
The anterolateral abdominal wall is bounded
superiorly by the cartilages of the 7-10th ribs and
the xiphoid process of the sternum and inferiorly
by the inguinal ligament and the superior margins of
the anterolateral aspects of the pelvic girdle (iliac
crests, pubic crests, and pubic symphysis
The wall consists of skin and subcutaneous tissue
(superficial fascia) composed mainly of fat, muscles
and their aponeuroses and deep fascia,
extraperitoneal fat, and parietal peritoneum
 Muscles of the Anterolateral Abdominal Wall

There are five (bilaterally paired)

muscles in the anterolateral
abdominal wall
the external oblique,
internal oblique,
transverse abdominal
rectus abdominis
pyramidalis
 Nerves of the Anterolateral
Abdominal Wall

The skin and muscles of the anterolateral

abdominal wall are supplied mainly by the
following nerves:
Thoracoabdominal nerves: T7-11
Lateral (thoracic) cutaneous branches: of the
thoracic spinal nerves T7-T9 or T10.
Subcostal nerve: the large anterior ramus of
spinal nerve T12.
Iliohypogastric and ilioinguinal nerves: terminal
branches of the anterior ramus of spinal nerve
L1.
 the anterior abdominal cutaneous branches
of thoracoabdominal nerve(s):
T7-T9 supply the skin superior to the
umbilicus.
T10 innervates the skin around the
umbilicus.
T11, plus the cutaneous branches of the
subcostal (T12), iliohypogastric, and
ilioinguinal (L1), supply the skin inferior to
the umbilicus.
 Vessels of the Anterolateral
Abdominal Wall

The primary blood vessels (arteries and veins) of the

anterolateral abdominal wall are the
Superior epigastric vessels and branches of the
musculophrenic vessels from the internal thoracic
vessels.
Inferior epigastric and deep circumflex iliac vessels
from the external iliac vessels.
Superficial circumflex iliac and superficial epigastric
vessels from the femoral artery and greater
saphenous vein, respectively.
Posterior intercostal vessels of the 11th intercostal
space and the anterior branches of subcostal vessels
 Peritoneum and Peritoneal Cavity

It lines the abdominopelvic cavity and invests

the viscera .
The peritoneum consists of two continuous
layers: the parietal peritoneum, which lines
the internal surface of the abdominopelvic wall,
and the visceral peritoneum, which invests
viscera such as the stomach and intestines.
Both layers of peritoneum consist of
mesothelium, a layer of simple squamous
epithelial cells.
 The parietal peritoneum is served by
the same blood and lymphatic
vasculature and the same somatic
nerve supply as is the region of the
wall it lines.
the peritoneum lining the interior of
the body wall is sensitive to pressure,
pain, heat and cold, and laceration.
Pain from the parietal peritoneum is
generally well localized.
 The visceral peritoneum and the organs it covers
are served by the same blood and lymphatic
vasculature and visceral nerve supply.
The visceral peritoneum is insensitive to touch,
heat and cold, and laceration;
It is stimulated primarily by stretching and
chemical irritation.
The pain produced is poorly localized, being
referred to the dermatomes of the spinal ganglia
providing the sensory fibers, particularly to
midline portions of these dermatomes.
 An omentum is a double-layered extension or fold of
peritoneum that passes from the stomach and proximal
part of the duodenum to adjacent organs in the abdominal
cavity
The greater omentum is a prominent peritoneal fold that
hangs down like an apron from the greater curvature of the
stomach and the proximal part of the duodenum. After
descending, it folds back and attaches to the anterior
surface of the transverse colon and its mesentery.
The lesser omentum connects the lesser curvature of the
stomach and the proximal part of the duodenum to the
liver
A peritoneal ligament consists of a double layer of
peritoneum that connects an organ with another organ or
to the abdominal wall.
 The liver is connected to the:
Anterior abdominal wall by the
falciform ligament
Stomach by the hepatogastric
ligament, the membranous portion of
the lesser omentum.
Duodenum by the hepatoduodenal
ligament, the thickened free edge of
the lesser omentum,
 The posterior abdominal
wall
The posterior abdominal wall is mainly composed of
the:
Five lumbar vertebrae and associated IV discs (centrally).
Posterior abdominal wall muscles, including the psoas,
quadratus lumborum, iliacus, transverse abdominal, and
oblique muscles (laterally).
Diaphragm, which contributes to the superior part of the
posterior wall.
Fascia, including the thoracolumbar fascia.
Lumbar plexus, composed of the anterior rami of lumbar
spinal nerves.
Fat, nerves, vessels (e.g., aorta and IVC), and lymph
nodes.
Diaphragma
 The posterior abdominal wall (Figs. 2.75 and 2.76) is mainly
composed of the:
Five lumbar vertebrae and associated IV discs (centrally).
Posterior abdominal wall muscles, including the psoas,
quadratus lumborum, iliacus, transverse abdominal, and
oblique muscles (laterally).
Diaphragm, which contributes to the superior part of the
posterior wall.
Fascia, including the thoracolumbar fascia.
Lumbar plexus, composed of the anterior rami of lumbar
spinal nerves.
Fat, nerves, vessels (e.g., aorta and IVC), and lymph nodes.
If observing the
 Abdominal Viscera
The principal viscera of the abdomen
are the terminal part of the
esophagus and the stomach,
intestines, spleen, pancreas, liver,
gallbladder, kidneys, and suprarenal
(adrenal) glands