Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior...
Transcript of Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior...
![Page 1: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/1.jpg)
Author: Oldřich Eliška Subject: General Medicine - Anatomy 1
Charles University in Prague - 1st Faculty of Medicine
Muscles of the thorax, abdomen, inguinal canal
Muscles of the thorax, abdomen, inguinal canal
Institute of Anatomy
![Page 2: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/2.jpg)
Muscles of the chest • thoraco-humeral musclespectoralis major and minorsubclavius m., serratus anterior m.
• proper chest musclesexternal, internal and innermost intecostal mm., subcostal mm., transversus thoracis m.
• diaphragm
![Page 3: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/3.jpg)
pectoralis major and minorInnervation: medial and lateral pectoralnerves
![Page 4: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/4.jpg)
serratus anterior muscle – frommedial margin of scapula to 1st – 9th rib In. Long thoracic nerve – palsy: winging scapula
![Page 5: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/5.jpg)
External, internal and innermost intercostalMuscles
Internal and external intercostal membrane
intercostal nn. Th1 - Th12
![Page 6: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/6.jpg)
Innermost intercostal muscles
![Page 7: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/7.jpg)
Intercostal neurovascular bundle:v. + a. + n. intercostalis (VAN)
Pleural tap – posterior axillary line, 8th intercostal space
YES
NO ! X
![Page 8: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/8.jpg)
Domes of the diaphragm:Right side – 4th intercostal space, left – 5th
RL
The Diaphragm
![Page 9: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/9.jpg)
Sternal, costal, and lumbar part; centrum tendineumForamen venae cavae, hiatus oesophageus,hiatus aorticus
Right and left crus
Medial arcuate ligament(psoatic arcade)
Lateral arcuate ligament(over quadratus lumborum) Inn. by phrenic nerve (C3 – C5)
![Page 10: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/10.jpg)
Lumbocostal and sternocostal trigonum
![Page 11: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/11.jpg)
![Page 12: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/12.jpg)
Diaphragmaticsurfaceof the heart
![Page 13: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/13.jpg)
Fascias of the chestSuperficial pectoral fascia
Clavipectoral fascia – fossa ovalis infraclavicularis
Endothoracic fascia (Sibson’s)
![Page 14: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/14.jpg)
Muscles of the abdomen - inguinal canal.
Surgical approaches to the abdominal cavity.
Vessels and nerves of abdominal wall.
![Page 15: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/15.jpg)
Abdominal fascias• Camper’s fascia• Fascia abdominis subcutanea (Scarpe’s
fascia) – superficial, continues as f. perinei superficialis.
• Fascia abdominis superficialis => fascia spermatica externa
• Fascia transversalis (endoabdominalis) – septum femorale – fascia spermatica interna
![Page 16: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/16.jpg)
fascia abdominis subcutanea
fascia lata femorisfascia superficialis perinei
fascia penis superficialis
transition to tunica dartos
fascia abdominis superficialis
![Page 17: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/17.jpg)
Muscles of the abdomen
ventral – m. rectus abdominis, m. pyramidalis
lateral – m. obliquus abdominis externus et internus,
m. transversus abdominisdorsal – m. quadratus lumborum
![Page 18: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/18.jpg)
m. rectus abdominis, vagina mm. recti abdominism. obliquus abdominis ext.
![Page 19: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/19.jpg)
m. obliquus abdominis internusm. transversus abdominis
![Page 20: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/20.jpg)
m. obliq. abd. internusm. obliq. abd. externus
Muscular corsetCountering theback muscles
![Page 21: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/21.jpg)
Linea semilunaris Linea arcuata (semicircularis)
![Page 22: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/22.jpg)
v. thoracoepigastrica
vv. paraumbilicales
v. epigastrica superficialis
v. circumflexa ilium superficialis
Vessels of theabdominal wall(superficial)
=> cavo-caval anastomoses!
![Page 23: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/23.jpg)
inferior epigastric
superior epigastric
aa. intercostales V - XII
Vessels of theabdominal wall(deep)
internal thoracic a.
![Page 24: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/24.jpg)
Vessels of theabdominal wall(deep)-inside view
=> cavo-caval anastomoses!
![Page 25: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/25.jpg)
Innervation:nn. intercostales 5.-12.
pl. lumbalis:n. subcostalisn. iliohypogastricusn. ilioinguinalis
Head’s zonesof referred pain
diaphragm,gallbladder
stomach
liver, gallbladder
small intestine
large intestine
urinary bladderkidney, testicle
![Page 26: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/26.jpg)
Midline laparotomy- superior- inferior
Transrectal approachPararectal approach
Alternating approach Sprengel-Mc Burney
Subcostal approach
Surgical approaches to the abdominal cavity
![Page 27: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/27.jpg)
ParacentesisPuncture & Drainage
Beware of topography and possible injury to the pleural cavity (recesses)
![Page 28: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/28.jpg)
LaparoscopyNeedle puncture – Veressi needleapplied kapnoperitoneum - CO2
to create some “wiggle room”,air is not used (danger of embolism)
Possible complications:Injury to epigastic vessels,or intestinal loop,Rare but serious: - aortic puncture (possibly lethal)
![Page 29: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/29.jpg)
Equipment for laparoscopic surgery
![Page 30: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/30.jpg)
![Page 31: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/31.jpg)
![Page 32: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/32.jpg)
Advantages of laparoscopy
Early – less pain, faster healing, collaboration, rehabilitaton
Long-term - Preserves integrity of abdominal wall, less scarring, adhesions, hernias in scar
![Page 33: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/33.jpg)
Midline laparotomyPararectal incission
Pararectal incission: what are the pitfalls?
![Page 34: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/34.jpg)
![Page 35: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/35.jpg)
![Page 36: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/36.jpg)
![Page 37: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/37.jpg)
Transrectal incission
![Page 38: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/38.jpg)
Mc Burney (for appendix)
![Page 39: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/39.jpg)
Subcostal incission(liver, gallbladder)
![Page 40: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/40.jpg)
![Page 41: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/41.jpg)
Pfanenstiel (bladder, Ceasarian)
![Page 42: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/42.jpg)
![Page 43: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/43.jpg)
M. quadratus lumborum
![Page 44: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/44.jpg)
Trigonum lumbale (Petiti)crista iliacam. obliquus externus abd. m. latissimus dorsi
Spatium tendineum lumbale-tetragon Krausei12th ribm. seratus post. Inf.m. sacrospinalism. obliquus abd. internus
- hernias (rare)
![Page 45: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/45.jpg)
The inguinal canal:Aponeurosis of the external oblique muscle
![Page 46: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/46.jpg)
The internal oblique
![Page 47: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/47.jpg)
The inguinal canal - cross sections
![Page 48: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/48.jpg)
![Page 49: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/49.jpg)
The inguinal canal:Transversus abdominis muscle
![Page 50: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/50.jpg)
Deep inguinal ringInside view
![Page 51: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/51.jpg)
Inside view of the abdominal wall
![Page 52: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/52.jpg)
Inside view of the umbilical region
![Page 53: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/53.jpg)
Plica umbilicalis mediana (urachus),medialis (a.umbilicalis),lateralis (vasa epigastrica inf.)
Fovea supravesicalis
Fovea inguinalis medialis(trigonum inguinale)
Fovea inguinalis lateralis(anulus ing. prof.)
Inside view of theanterior abdominal wall
![Page 54: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/54.jpg)
Why so many eponymous names?
![Page 55: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/55.jpg)
Hernia supravesicalis – fovea supravesicalis
Hernia inguinalis directa – trigonum inguinale – anulus ing. spfc.
Hernia inguinalis indirecta – anulus ing. prof. – anulus ing. spfc.
Hernia femoralis – septum femorale in lacuna vasorum- fossa iliopectinea –
hiatus saphenusSeminars!
![Page 56: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/56.jpg)
![Page 57: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/57.jpg)
![Page 58: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/58.jpg)
![Page 59: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/59.jpg)
Inguinal region is clinically important.
Let’s review it then once more -
Layer by layer, ligament by ligament:
![Page 60: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/60.jpg)
1st layer – aponeurosis of m.o.a.extLig. inguinale
Anulus inguinalis superficialis
Crus mediale et laterale
Fibrae intercrurales
Lig. reflexum
![Page 61: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/61.jpg)
2nd layer – aponeurosis of m.o.a. int.
M. cremaster
Falx inguinalis
![Page 62: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/62.jpg)
3rd layer – aponeurosis of m. tr.a.
Falx inguinalis
Anulus inguinalis profundus
Trigonum inguinale
Vasa epigastrica inf.
![Page 63: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/63.jpg)
Inside view – deep and superficial ring are distinguished by the inferior epigastric vessels
![Page 64: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/64.jpg)
Peritoneal coveringsPlica umbilicalis mediana (urachus),medialis (a. umbilicalis),lateralis (vasa epigastrica inf.)
Fovea supravesicalis
Fovea inguinalis medialis(trigonum inguinale)
Fovea inguinalis lateralis(anulus ing. prof.)
![Page 65: Institute of Anatomy - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0701.pdf · posterior axillary line, 8th intercostal space YES NO ! X. ... Linea semilunaris Linea arcuata](https://reader031.fdocuments.us/reader031/viewer/2022022806/5cc160e188c99315158bf8b2/html5/thumbnails/65.jpg)
References• Čihák: Anatomie 1, 3• Netter’s Anatomical Atlas• Sobotta: Atlas of Anatomy• Thieme: Anatomischer atlas• Tillmann BN: Atlas der Anatomie.
• The publishers of these books hold thee respective copyright; any unauthorized reproduction of these images is prohibited.