D R M U H A M M A D I M R A N K H A NM B B S , F C P S

S E N I O R R E G I S T R A RS U R G I C A L E WA R D

K H Y B E R T E A C H I N G H O S P I TA L

SURGICAL-ANATOMY OF ANTERIOR

ABDOMINAL WALL

POINTS

• Anatomical landmarks• Anatomical planes • Dermatomes • Muscles and rectus sheath• Layers of abdominal wall• Inguinal canal• Femoral canal• Laparoscopic anatomy

LANDMARKS

1. Xiphoid process. 2. Costal margin. 3. Tip of the ninth costal cartilage. 4. Tendinous intersections. 5. Umbilicus. 6. Iliac crest. 7. Anterior superior iliac spine. 8. Linea semilunaris. 9. Linea alba. 10. Inguinal ligament. 11. Pubic tubercule. 12. Pubic crest.

THE ANATOMICAL PLANESHORIZONTAL PLANES

XIPHISTERNAL PLANE=T9SUBCOSTAL PLANE=L3SUPRACRISTAL PLANE= L4 TRANSTUBERCULAR PLANE=L5INTERSPINOUS PLANE VERTICAL PLANES

MidlineTwo Paramedian Planes

(Mid Clavicular Line/ Mammary Line)

DERMATOMES

Bony pelvis

THE SPERMATIC CORDThree fasciae:  External spermatic (from external oblique fascia)  Cremasteric (from internal oblique muscle and fascia)  Internal spermatic (from transversalis fascia)Three arteries:  Testicular artery  Cremasteric artery  Deferential arteryThree veins:  Pampiniform plexus and testicular vein  Cremasteric vein  Deferential veinThree nerves:  Genital branch of genitofemoral nerve  Ilioinguinal nerve  Sympathetic nerves (testicular plexus)Lymphatics

THE FEMORAL HERNIA

LAPAROSCOPIC ANATOMY

LAPAROSCOPIC ANATOMY