Anatomy of the Abdomen and its Contents

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Layers of abdominal wall:

• Skin, superficial fascia, external oblique, internal oblique, transversus abdominis, transversalis fascia, extraperitoneal, parietal peritoneum.

Skin and musculature of anterior abdominal wall:

Innervation:

• Ventral primary rami of lower 6 thoracic spinal nerves + iliohypogastric + ilioinguinal branches of ventral primary rami of L1.

Arterial:

• Superior epigastric branch of internal thoracic artery; inferior epigastric and deep circumflex iliac branches of external iliac artery.

Venous:

• Anterior (superficial epigastric vein); superior (lateral thoracic veins); inferiorly (great saphenous vein).

Contents of inguinal canal:

Female:

+ Round ligament and ilioinguinal nerve.

Male:

+ Spermatic chord and ilioinguinal nerve;

Spermatic chord:

• Contains the spermatic fascia, testicular artery, pampiniform venous plexus, and the vas deferens (ductus deferens).

Inguinal hernias:

Direct:

+ Through posterior wall of inguinal canal; more common in older men.

Indirect:

+ Through deep inguinal ring, courses through inguinal canal.

Hypertrophic Pyloric Stenosis:

Projectile vomiting; muscularis externa hypertropied.

Extrahepatic Biliary Atresia:

Biliary ducts blocked; jaundice; white stools; dark urine.

Duodenal Atresia:

Blocked duodenum; polyhydraminos; bile-containing vomitus; distended stomach.

Omphalocele:

Midgut look lies external to abdomen; shiny sac at base of umbilical cord.

Ileal (Meckel) diverticulum:

Remnant of vitelline duct persists; ulceration; asymptomatic.

Liver:

Arterial:

• Portal vein and hepatic artery.

Venous:

• Inferior vena cava.

Pancreas:

Arterial:

• Head (superior and inferior pancreaticoduodenal arteries); body and tail (splenic artery).

Venous:

• Inferior vena cava (?).

Spleen:

Arterial:

• Splenic artery.

Venous:

• Splenic vein.

Kidney:

Arterial:

• Renal arteries (interlobar arteries, arcuate arteries, interlobular arteries, afferent arterioles).

Venous:

• Left and right renal veins.

Lymphatic:

• Lumbar nodes.

Innervation:

• Sympathetic (splanchnic nerves / renal plexus).

Bladder:

Arterial:

• Internal iliac arteries.

Venous:

• Intenal iliac veins.

Lymphatic:

• External and internal iliac nodes.

Innervation:

• Parasympathetic (S2, S3, S4); sympathetic (T11 to L2).

Abdominal vasculature:

Arterial:

• Abdominal aorta; common site for aneurysm.

Venous:

• Inferior vena cava.

Additional Notes:

• 5-HIAA: serotonin.

• VMA: norepinephrine.

• Two types of nephrons: cortical nephrons and juxtamedullary nephrons.

• Stress incontinence in women (urine leakage during coughing or sneezing): weak musculus levator ani.

• Parasympathetic supply of pelvic organs and blood vessels of erectile tissue of penis and clitoris: pelvic splanchnic nerves.

• Dislocated hip: inability to abduct the thigh.

• Pap smear: dysplasia or other abnormalities detected in cervix.

Additional Reading:

Histology and Cytology

1. Cell Components
2. Nervous Tissue
3. Muscle Tissue
4. Lymphoid Tissue
5. Integument
6. Respiratory System
7. Gastrointestinal System
8. Renal/Urinary System
9. Male Reproductive System
10. Female Reproductive System

Gross Anatomy

1. Back and Nervous System
2. Thorax
3. Abdomen, Pelvis, and Perineum
4. Upper Limb
5. Lower Limb
6. Head and Neck
7. Chest Wall
8. Shoulder

Anatomy Videos

1. Video of Musculoskeletal Examination in a Clinical Setting
1. Video of HEENT Examination in a Clinical Setting

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