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D R M A RYA M A L A M K H A N
M B B S , F C P S
S 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
• Anatomical landmarks
• Anatomical planes
• Quadrants and regions
• 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.
13. Pubic symphysis.
THE ANATOMICAL PLANES
HORIZONTAL PLANES
XIPHISTERNAL
PLANE=T9
SUBCOSTAL
PLANE=L3
SUPRACRISTAL
PLANE= L4
TRANSTUBERCULAR
PLANE=L5
INTERSPINOUS
PLANE
VERTICAL PLANES
Midline
Two Paramedian Planes
(Mid Clavicular Line/ Mammary Line)
THE QUADRANTS AND REGIONS
DERMATOMES
VENOUS AND NERVE SUPPLY
LYMPHATIC SUPPY
FASCIAL LAYERS
LAYERS OF ABDOMINAL WALL
THE EXTERNAL OBLIQUE MUSCLE
THE INTERNAL OBLIQUE MUSCLE
THE TRANSVERSUS ABDOMINIS
THE RECTUS ABDOMINIS MUSCLE
THE RECTUS SHEATH
THE INGUINAL CANAL
THE INGUINAL LIGAMENT
THE SPERMATIC CORD
Three 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 artery
Three veins:
Pampiniform plexus and testicular vein
Cremasteric vein
Deferential vein
Three nerves:
Genital branch of genitofemoral nerve
Ilioinguinal nerve
Sympathetic nerves (testicular plexus)
Lymphatics
HASSELBACH’S TRIANGLE
THE NERVES OF INGUINAL REGION
THE FEMORAL CANAL
THE FEMORAL HERNIA
THE ABBERANT OBTURATOR ARTEY
THE ABDOMINAL WALL FROM INSIDE
SPACE OF BOGROS AND RETRO-PUBIC
SPACE OF RETZIUS
LAPAROSCOPIC ANATOMY
LAPAROSCOPIC ANATOMY
LAPAROSCOPIC ANATOMY
THE TRIANGLE OF DOOM
THE TRIANGLE OF PAIN
THE CIRCLE OF DEATH
Presentation

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