ANA LAB 4.

01
Anterolateral Abdominal Wall
January 19, 2019

TRANS Lobo, Ongchan, Ortega Danna, Padilla B, Padilla K CORE Garces, Lee, Marcelo, Martinez, Mauricio, Morales, VPAA Natural 09175454982
Ocampo Musni 09054003142
 Structures to be identified:

SURFACE LANDMARKS
● Transpyloric plane ● Umbilicus
● Subcostal plane ● Pubic Symphysis
● Intertubercular plane ● Linea alba
● Interspinous plane ● Xiphoid process
● Transumbilical plane ● Anterior Superior Iliac
Spine (ASIS)

4.01 Anterolateral Abdominal Wall LE 4 TRANS 1

 Surface Landmarks
Abdominal Reference Planes

Transpyloric Plane - extrapolated

midway between the superior borders
of the manubrium of the sternum and
the pubic symphysis (typically the L1
vertebral level)

Subcostal Plane - passing through

the inferior border of the 10th costal
cartilage on each side, cutting across
upper border of L3

Intertubercular Plane - passing

through the iliac tubercles (approx.
5cm posterior to the ASIS on each
side) and the body of the L5 vertebra

Interspinous Plane - passes through

the easily palpated ASIS on each siide

4.01 Anterolateral Abdominal Wall LE 4 TRANS 1

 Surface Landmarks
Abdominal Quadrants
Right Upper Quadrant
(RUQ)
Liver: right lobe
Gallbladder
Stomach: pylorus
Duodenum: parts 1-3
Pancreas: head
Right suprarenal gland
Right kidney
Right colic (hepatic) flexure
Ascending colon: superior part
Transverse colon: right half
Right Lower Quadrant
(RLQ)
Cecum
Appendix
Most of ileum
Ascending colon: inferior part
Right ovary
Right uterine tube
Right ureter: abdominal part
Right spermatic cord: abdominal
part
Uterus (if enlarged)
Urinary bladder (if very full)
4.01 Anterolateral Abdominal Wall
Left Upper Quadrant Transumbilical Plane - passing
(LUQ) through the umbilicus or navel (and
typically the intervertebral [IV] disc
Liver: left lobe
Spleen between L3 and L4 vertebrae),
Stomach dividing it into upper and lower halves
Jejunum and proximal ileum
Pancreas: body and tail
Left kidney
Left suprarenal gland
Left colic (splenic) flexure
Transverse colon: left half
Descending colon: superior part
Left Lower Quadrant
(LLQ)
Sigmoid colon
Descending colon: inferior part
Left ovary
Left uterine tube
Left ureter: abdominal part
Left spermatic cord: abdominal
part
Uterus (if enlarged)
Urinary bladder (if very full)
LE 4 TRANS 1
 Surface Landmarks
Umbilicus - or navel at the level of L3 vertebra or level
of T10 dermatome
Pubic Symphysis - is a unique joint consisting of a
fibrocartilaginous disc sandwiched between the articular
surfaces of the pubic bones.
Linea Alba - extends from the xiphoid process to the
pubic symphysis
4.01 Anterolateral Abdominal Wall
Xiphoid Process - the smallest and most variable part of the
sternum, is thin and elongated, and at the level of T10
vertebra
Anterior Superior Iliac Spine (ASIS) - the long curved and
thickened superior border of the ala of the ilium
LE 4 TRANS 1
 Structures to be identified:

Nine (9) Regions of the

Abdomen
● Epigastric ● Right & Left Lateral
● Umbilical ● Right & Left Hypochondriac
● Pubic ● Right & Left Inguinal

4.01 Anterolateral Abdominal Wall LE 4 TRANS 1

 Surface Landmarks
9 Abdominal Regions

- used to describe the location of

abdominal organs, pains, or
pathologies

Abdominal Regions

RH Right Hypochondrium
RL Right Lumbar/Lateral/Flank
RI Right Inguinal
E Epigastric
U Umbilical
P Pubic
LH Left Hypochondrium
LL Left Lumbar/Lateral/Flank
LI Left Inguinal

4.01 Anterolateral Abdominal Wall LE 4 TRANS 1

RIGHT
LEFT
HYPOCHONDRIAC
EPIGASTRIC HYPOCHONDRIAC
REGION
REGION REGION

RIGHT LUMBAR/ LEFT LUMBAR/

LATERAL/ UMBILICAL LATERAL/FLANK
FLANK REGION REGION REGION

RIGHT LEFT
INGUINAL PUBIC INGUINAL
REGION REGION REGION
 Structures to be identified:

ANTEROLATERAL ABDOMINAL WALL

and RECTUS SHEATH
● Ca e Fa cia ● Rectus Sheath
● Sca a Fa cia ● Rectus Abdominis Muscle
● External Oblique Muscle & ● Tendinous Intersections
Aponeurosis ● Pyramidalis Muscle
● Internal Oblique Muscle & ● Linea Semilunaris
Aponeurosis ● Arcuate Line
● Transversus Abdominis ● Superior Epigastric Arteries &
Muscle Veins
● Transversalis Fascia ● Inferior Epigastric Arteries &
● Peritoneum Veins

4.01 Anterolateral Abdominal Wall LE 4 TRANS 1

 Ca e Fa cia (S e ficial Fa La e )
Sca a Fa cia (Dee Me b a La e )

- Found inferior to the umbilicus

- Reinforced by many elastic and
collagen fibers
- Camper’s Fascia is continuous over
the inguinal ligament with the
superficial fascia of thigh
- Scarpa’s Fascia is continuous with
the superficial fascia of the back
and thorax

4.01 Anterolateral Abdominal Wall LE 4 TRANS 1

 External Oblique Muscle and Aponeurosis

Origin: External surfaces of 5th - 12th ribs

Insertion: Linea alba (anteriorly) , Pubic tubercle
(inferomedially and aponeurotic ), and anterior
half of iliac crest
Action: Compresses and supports abdominal
viscera; flexes and rotates trunk
Innervation: Thoraco-abdominal nerves (T7-T11
spinal nerves) and Subcostal (T12) Nerve
Notes:
- Muscle fiber direction: Inferomedial
- Continues as External Spermatic Fascia that External Oblique
Aponeurosis
covers spermatic cord

4.01 Anterolateral Abdominal Wall LE 4 TRANS 1

 Internal Oblique Muscle and Aponeurosis

Origin Thoracol mbar fascia anterior of

iliac crest (inferiorly), connective tissue in
lateral 3rd deep to the inguinal ligament
Insertion: Inferior borders of 10th - 12th
ribs, linea alba, and pecten pubis
Action: Compresses and supports abdominal
Internal Oblique
viscera; flexes and rotates trunk
Innervation: Thoraco-abdominal nerves (T6-
T12) and first lumbar nerves

Notes:
Internal Oblique
- Muscle fiber direction: Aponeurosis
above iliac crest: Superomedially
below iliac crest: Transversely

4.01 Anterolateral Abdominal Wall LE 4 TRANS 1

 Transversus Abdominis and Transversalis Fascia

Origin: Internal surfaces of the 7th to 12th costal

cartilages, iliac crest, thoracolumbar fascia
Insertion: Linea alba with aponeurosis of internal
oblique, pubic crest, and pecten pubis via conjoint
tendon
Action: Compresses and supports abdominal
viscera
Innervation: Thoraco-abdominal nerves (T6-T12)
and first lumbar nerves

Notes:
The portion lining the deep surface of the
transversus abdominis muscles and its
aponeurosis is the transversalis fascia

4.01 Anterolateral Abdominal Wall LE 4 TRANS 1

 Peritoneum: Parietal Peritoneum & Visceral Peritoneum

Peritoneum
- continuous, glistening and slippery
transparent serous membrane
- It lines the abdominopelvic cavity
and invests the viscera

Parietal Peritoneum
- It is sensitive to pressure, pain,
heat, cold, and laceration
- Internal to the transversalis fascia

Visceral Peritoneum
- Insensitive to pressure, pain, heat,
cold, and laceration
- Stimulated primarily by stretching Parietal Peritoneum
and chemical irritation

4.01 Anterolateral Abdominal Wall LE 4 TRANS 1

 Peritoneum: Lesser Omentum and Greater Omentum
Lesser
omentum

Greater omentum

Lesser Omentum Greater Omentum

- much smaller, double - layered
peritoneal fold
- It connects the lesser curvature
of the stomach and the proximal
part of duodenum to the inferior
surface of the liver
- prominent, large, apron-like,
four- layered peritoneal fold
- located from greater curvature of
stomach and the proximal part of
duodenum

4.01 Anterolateral Abdominal Wall LE 4 TRANS 1

 Rectus Sheath and Linea Semilunaris

Rectus Sheath
Anterior Layer of Rectus Sheath
- aponeuroses of the three flat Linea semilunaris Rectus Sheath
muscles pass anterior to the rectus
abdominis to form the anterior layer
- completely aponeurotic

Posterior Layer of Rectus Sheath

- deficient superior to the costal
margin
- not completely aponeurotic, it ends
at the arcuate line

Linea Semilunaris / Spigelian line

- curved tendinous intersection found
on either side of the rectus
abdominis muscle.

4.01 Anterolateral Abdominal Wall LE 4 TRANS 1

 Arcuate Line

Umbilicus

Linea
Semilunaris

- It demarcates the transition Arcuate Line

between the aponeurotic posterior
wall of the sheath covering the
superior three quarters of the rectus
and the transversalis fascia covering
the inferior quarter

- It also marks the entrance of the

inferior epigastric vessels into the
rectus sheath

4.01 Anterolateral Abdominal Wall LE 4 TRANS 1

 Rectus Abdominis and Tendinous Intersections

Origin: Pubic symphysis and pubic crest

Insertion: Xiphoid process and 5th - 7th costal
cartilages
Action: Flexes trunk and compresses abdominal
viscera; stabilizes and controls tilt of pelvis
Innervation: Thoraco-abdominal nerves (anterior
rami of T6-T12 spinal nerves)

Tendinous Intersections
- anchors the rectus abdominis to the anterior
layer of rectus sheath
- When tensed in muscular people, the areas of
muscle between the tendinous intersections
bulge outward

4.01 Anterolateral Abdominal Wall LE 4 TRANS 1

 Pyramidalis muscle

Umbilicus

Pyramidalis

- It is a small triangular muscle that is absent in

approximately 20% of people
- It lies anterior to the inferior part of the rectus
abdominis and attaches to the anterior surface of
pubis and pubic ligament Pyramidalis
- Landmark for median abdominal incision
- Action: Tensor of the Linea Alba

4.01 Anterolateral Abdominal Wall LE 4 TRANS 1

 Superior Epigastric Arteries & Veins

- The superior epigastric artery is the direct

continuation of the internal thoracic artery
- It enters the rectus sheath superiorly through its
posterior layer
- It supplies the superior part of rectus abdominis
- The superior epigastric vein is a tributary of the
and anastamoses with the inferior epigastric
femoral vein and drains into the internal thoracic
artery
vein.
4.01 Anterolateral Abdominal Wall LE 4 TRANS 1
 Inferior Epigastric Arteries & Veins

- The inferior epigastric artery arises from the external

iliac artery just superior to the inguinal ligament
- It runs superiorly in the transversalis fascia to enter
the rectus sheath below the arcuate line
- It enters the lower rectus abdominis and - The inferior epigastric vein is a tributary of the
anastomoses with the superior epigastric artery.
external iliac vein.

4.01 Anterolateral Abdominal Wall LE 4 TRANS 1

 Structures to be identified:

INGUINAL REGION
● External Inguinal Ring ● Inguinal Canal
● Inguinal Ligament ● Conjoint Tendon

Spermatic Cord and Scrotum

● Ilioinguinal Nerve
● Ductus Deferens
● Pampiniform Venous Plexus
● Testes
● Tunica Vaginalis
Female Vulva
● Labia Majora & Minora
● Dartos Muscle
● Spermatic Fascia
● Testicular Artery
● Cremaster Muscle
● Epididymis
● C lle Fa cia
● Round Ligament
of the Uterus

4.01 Anterolateral Abdominal Wall LE 4 TRANS 1

INGUINAL CANAL: MALE

4.01 Anterolateral Abdominal Wall LE 4 TRANS 1

EXTERNAL (SUPERFICIAL)
INGUINAL RING:
- exit of the spermatic cord (males), or the round ligament of
uterus (females) as it emerges from the inguinal canal

INGUINAL LIGAMENT:
INGUINAL
- dense band constituting the most inferior part of the
LIGAMENT
external oblique aponeurosis

INGUINAL CANAL:
- oblique passage directed inferomedially through the lower
part of the anterolateral abdominal wall
- runs parallel and superior to the medial half of the inguinal
ligament
- occupied by the spermatic cord (males) and the round
ligament of uterus (females)

CONJOINT TENDON
- also called the inguinal falx
- found in the lower part of the internal oblique and the
transversus abdominis aponeurosis as it inserts into the pubic
crest and pectineal line
4.01 Anterolateral Abdominal Wall LE 4 TRANS 1
 SPERMATIC
CORD

DUCTUS
DEFERENS

TESTIS
COVERED IN
TUNICA PAMPINIFORM
VAGINALIS PLEXUS
(VISCERAL
EPIDIDYMIS
LAYER)

EPIDIDYMIS

TUNICA VAGINALIS
(PARIETAL LAYER)

4.01 Anterolateral Abdominal Wall LE 4 TRANS 1

 SUPERFICIAL
INGUINAL
ILIO-INGUINAL
RING NERVE:
- branch of L1
SPERMATIC
- innervates the anterior surface
CORD
of the scrotum or labia majora
root of penis or mons pubis, and
small part of the upper
ILIO- anteromedial thigh
INGUINAL
NERVE
DUCTUS DEFERENS:
- also called vas deferens
DUCTUS
- a continuation of the duct of the
DEFERENS
epididymis

TESTICULAR TESTICULAR
ARTERY:
ARTERY

FASCIA - a paired branch of the

WITH
DARTOS
abdominal artery
MUSCLE - supplies the testis
- equivalent to the ovarian artery
in females

4.01 Anterolateral Abdominal Wall LE 4 TRANS 1

 SPERMATIC CORD:
- structure that runs to the testis and suspends the testis in
the scrotum
- coverings:
- internal spermatic fascia
- cremasteric fascia
- external spermatic fascia

SPERMATIC CORD

4.01 Anterolateral Abdominal Wall LE 4 TRANS 1

4.01 Anterolateral Abdominal Wall LE 4 TRANS 1
INGUINAL CANAL: FEMALE

4.01 Anterolateral Abdominal Wall LE 4 TRANS 1

 ROUND
LIGAMENT OF SUPERFICIAL
UTERUS INGUINAL
RING

ROUND
LIGAMENT OF
UTERUS:
- male homologue:
- gubernaculum
- originates at the uterine
horns in the parametrium
and exits the pelvis via the
deep inguinal ring
- passes through the inguinal
canal and continues on to
the labia majora where its
fibers spread and mix with
the tissue of the mons pubis
ILIO-INGUINAL
NERVE

4.01 Anterolateral Abdominal Wall LE 4 TRANS 1

 LABIA
MINORA

LABIA
MAJORA

4.01 Anterolateral Abdominal Wall LE 4 TRANS 1

 4.02 Digestive System [DS-II] (Gross Lab)
February 3, 2019

TRANS Monasterial, Monsalve, Montalban, Morilla CORE Garces, Lee, Marcelo, Martinez, Mauricio, Morales, VPAA Natural
Ocampo 09175454982
Musni 09054003142
 Structures to be identified in this section (Oral cavity,
Pharynx, and Esophagus)
Oral cavity Pharynx
• Oral vestibule • Palatine tonsils
• Lips and vermillion border • Palatopharyngeal arch (fold)
• Teeth and alveolar processes • Oropharyngeal isthmus
• Oral cavity proper • Pharyngeal constrictors
• Frenulum linguae
• Gingivae or gums
• Hard and soft palate Vagus nerve, cervical and thoracic portions
• Salivary glands and openings
• Tongue and its regions and muscles
• Sulcus terminalis

Parts of the pharynx and boundaries

Parts of the esophagus

4.02 Digestive System LE 1 TRANS 1

 Upper GIT: Oral cavity, Pharynx and Esophagus

Blood Supply Innervation Lymphatic

Upper Lip Superior labial artery (branch Superior labial branches of Submandibular nodes
of the facial a.); Infraorbital infraorbital n. (CN V2)
a. (branch of maxillary a)

Lower Lip Inferior labial a. (branch of Inferior labial branches of Lateral: Submandibular
facial artery); Mental a. mental n. (CN V3) nodes
(branch of maxillary a.) Middle: Submental nodes

X.0Y Session Title LE 1 TRANS 1

 Upper GIT: Oral cavity

X.0Y Session Title LE 1 TRANS 1

 Upper GIT: Oral cavity

X.0Y Session Title LE 1 TRANS 1

 Upper GIT: Oral cavity, Pharynx and Esophagus

X.0Y Session Title LE 1 TRANS 1

 Upper GIT: Esophagus

Blood Supply Innervation Lymphatic

Cervical Branches from the Recurrent Laryngeal Paratracheal lymph

inferior thyroid nerves (somatic nodes and inferior
arteries fibers); Cervical deep cervical lymph
sympathetic trunks nodes
(vasomotor nerves)

Thoracic Esophageal arteries; Right and Left vagus Anterior:

branches of bronchial nerves; Left recurrent Paratreacheal nodes
arteries, right laryngeal nerve and Superior and
posterior intercostal Inferor
arteries Tracheobronchial
nodes
Above carina:
Paratracheal and
Tracheobronchial
nodes
Below carina:
Retrocardiac and
Intracardiac group of
nodes to the
paratracheal nodes

Abdominal Left gastric artery Esophageal plexus Left gastric lymph

(from the celiac (parasympathetic: nodes → celiac lymph
trunk); Left inferior vagus trunks, sacral nodes
phrenic artery plexus; sympathetic:
thoracic sympathetic
trunks)

X.0Y Session Title LE 1 TRANS 1

 Structures to be identified in this section
Peritoneal disposition and reflections:
• Greater sac*
• Lesser sac (Omental bursa)*
• Greater omentum
• Right and left paracolic gutters
• Gastrocolic ligament
• Gastrohepatic ligament
• Mesentery
• Mesoappendix*
• Sigmoid mesocolon
• Lesser omentum
• Omental (or epiploic) foramen
• Gastrosplenic ligament
• Lienorenal ligament/ Splenorenal ligament*
• Mesogastrium
• Transverse mesocolon

4.02 Digestive System LE 1 TRANS 1

 Peritoneum
Abdomen

Stomach

Lesser
omentum
Epiploic
foramen
Greater
omentum
 Peritoneum
Abdomen

Liver

Gastrohepatic ligament

Stomach
 Peritoneum
Abdomen

Hepatoduodenal ligament

Duodenum
 Peritoneum
Abdomen Mesentery and sigmoid mesocolon

Mesentery
 Peritoneum
Abdomen Right and left paracolic gutters; transverse mesocolon
 Structures to be identified in this section
STOMACH
PANCREAS
• Cardia
• Parts: head, neck, body, tail
• Fundus
• Splenic artery
• Body
• Main pancreatic duct
• pylorus
• Hepatopancreatic ampulla
• Greater and lesser curvature
• Incisura angularis SPLEEN
• Rugae
• Splenic artery
• Right and left gastric arteries and veins
• Splenorenal ligament

4.02 Digestive System LE 1 TRANS 1

 Stomach
Abdomen Divisions of the Stomach & Blood Supply (Dissection)

Fundus

Body
Left Gastric Artery
Pylorus

Splenic Artery

Gastroduodenal Celiac Trunk

Artery
 Stomach
Abdomen Divisions and other parts/landmarks of the Stomach (Model)

Fundus

Body

Rugae
Pancreatic Esophagus
Duct

Pancreas Greater
Curvature

Cardia
Duodenum
Lesser
Curvature

Pylorus

Anterior view, 90 degree counterclockwise rotation Posterior view

 Spleen
small description of pictures
Abdomen

Spleen
Pancreas

Splenorenal ligament
- Splenic artery & vein
- Tail of Pancreas

Left Kidney

Additional Notes:
Pancreas (tail): always points toward the spleen
Splenorenal ligament: extends between hilum of spleen and anterior
aspect of left kidney; contains splenic vessels and tail of pancreas
 Pancreas
Parts of Pancreas (Dissection)
Abdomen

Head
Tail

Body

Neck
 Pancreas
Parts of Pancreas (Model)
Abdomen
Posterior View

Common Bile Duct

Accessory Pancreatic
Stomach
Duct
Head
Tail

Neck

Body Main pancreatic duct (Wirsung)

 Structures to be identified in this section
Small intestine Vessels
• Duodenum • Superior mesenteric a. and v.
• Jejunum • Inferior mesenteric v.
• Ileum • Aorta
• Inferior vena cava
Large intestine
• Left colic a.
• Cecum • Sigmoid a.
• Vermiform appendix • Superior rectal a.
• Ascending colon • Marginal a.
• Transverse colon
• Descending colon
• Sigmoid colon
• Rectum
• Right and Left colic (hepatic) flexures

4.02 Digestive System LE 1 TRANS 1

 Small intestine: Ileum and Jejunum
Parts of the small intestine
Abdomen

LUQ
Most of the jejunum

RLQ

Most of the Ileum

 Small intestine: Duodenum
Parts of the Duodenum (Model)
Abdomen
Superior part
Posterior View

Descending

Ascending

Inferior (horizontal)
 Duodenum
Parts of the Duodenum (Dissection)
Abdomen

Descending Superior part

part

Ascending part

Inferior
part
 Gross Anatomy: Large intestine
Parts of the Large intestine
Abdomen The large intestine is found on top of the small intestine

Stomach
Left colic hepatic
flexure
Descending colon

Transverse
colon
Right colic hepatic
flexure
Ascending colon

Cecum

Sigmoid Colon
 Gross Anatomy: Large intestine
Parts of the Large intestine
Abdomen The large intestine is found on top of the small intestine

Transverse
Right colic hepatic colon
flexure Left colic hepatic
flexure
Ascending colon
Descending colon

Cecum
 Gross Anatomy: vessels
Abdomen
Middle colic
artery

Drummond marginal a.
Superior mesenteric
a.
Left colic
artery

Iliac a.

Sigmoid a.
 Gross Anatomy: vessels
Abdomen

Inferior mesenteric a.
aorta
Inferior vena cava
Superior
rectal a.
 Gross Anatomy: vessels
Abdomen

(Srivastava, Sharma, &

Saxena, 2013)
 Structures to be identified in this section

LIVER, PORTA HEPATIS, CELIAC TRUNK • PORTA HEPATIS AND CELIAC TRUNK
• Common hepatic artery
• LIVER
• right gastric artery
• Falciform ligament
• Left gastric artery
• Left and right triangular ligaments
• Splenic artery
• Coronary ligament
• Common Bile Duct
• Abdominal esophagus groove/impression
• Hepatic Artery
• Ligamentum Venosum
• Left and Right branches
• Ligamentum teres
• Portal Vein
• Caudate Lobe
• Left and right portal branches
• Quadrate Lobe
• Cystic Artery
• Right Lobe
• Cystic duct
• Left lobe
• Common hepatic ducts
• Groove for inferior vena cava
• Left and right hepatic ducts
• Inferior vena cava
• Bare area of the liver
• Fossa of the gallbladder
• Gallbladder
• Fundus, neck/infundibulum, body

4.02 Digestive System LE 1 TRANS 1

 Gross Anatomy: Liver
Liver Anterior View

Falciform
Ligament

Round
Ligament of
the liver
 Gall Gross Anatomy: Liver
bladder Anterior View

Gallbladder
 Gall Gross Anatomy: Liver
bladder Anterior View

Cystic Duct

Neck/infundibulum

Body
Fundus

Common Bile Duct

 Celiac Gross Anatomy: Liver
Trunk Anterior View

Left hepatic artery

Common hepati
artery
Gallbladder

Right hepatic
artery
Celiac trunk
Hepatic artery
proper

Gastroduodenal Artery

Portal Vein
Celiac Gross Anatomy: Liver
Trunk Anterior View
 Gross Anatomy: Liver
Liver Anterior View
Coronary ligament

Right triangular ligament

Left triangular
ligament
Left lobe
of the liver

Right lobe of the liver

Round ligament
 Gross Anatomy: Liver
Liver Posterior View
Groove for Inferior Vena Cava

caudate lobe Bare area

Left lobe

Right lobe

Porta hepatis Quadrate lobe

Round ligament
Gallbladder
 Gross Anatomy: Liver
Liver Anterior View

Falciform ligament

Left lobe

Right lobe

Gallbladder
 Gross Anatomy: Liver
Liver Posterior View

Quadrate lobe
Bare area

Inferior vena cava

Ligamentum Venosum
Caudate lobe

Esophageal impression

Renal Impression

Porta hepatis
Gallbladder Colic Impression
Ligamentum Teres
 Gross Anatomy: Liver
Liver Inferior View
Hepatic portal vein

Hepatic artery proper

 4.03 Posterior Abdominal Wall

TRANS Gaspar I, Gaw, Go B, Go L, Gomez CORE Garces, Lee, Marcelo, Martinez, Mauricio, Morales, VPAA Natural
Ocampo 09175454982
Musni 09054003142
 Diaphragm
Central Tendon

Right and Left Crura

of Diaphragm
 Posterior
Abdominal
Wall

Quadratus Transverse
Lumborum Muscle Abdominis Muscle

Psoas Major
Abdominal Aorta
Muscle
Median Sacral
Common Iliac
Vessel
Artery
Psoas Minor
Tendon Internal Iliac
Artery

Iliacus Muscle
Abdominal Aorta
Begins at the aortic hiatus
behind the median arcuate
ligament, level of T12
vertebra
Lies left of the median plane
Ends at the level of L4
vertebra as it divides into
right & left common iliac
arteries
Abdominal Aorta
Unpaired ventral branches
Celiac trunk
Superior mesenteric artery
Inferior mesenteric artery

Paired lateral branches

Unpaired
Celiac Trunk (CT)
Branches:
1. Splenic artery (SA)
2. Left Gastric Artery (LGA)
3. Common Hepatic Artery
(CHA)
a. Hepatic Artery Proper
i. Right Hepatic Artery
(RHA)
1. Cystic Artery
(CA)
ii. Left Hepatic Artery
(LHA)
b. Gastroduodenal Artery
(GDA)
Superior Mesenteric Artery
Branches:
1. Ileal arteries
2. Jejunal arteries
3. Ileocolic artery
4. Middle colic artery
5. Right colic artery
Inferior Mesenteric
Artery
Branches:
1. Left Colic Artery
2. Sigmoidal Arteries
3. Superior Rectal Artery
Inferior Vena Cava

Begins at the level of L5

vertebra
Ascends on the right side
of the bodies of L3-L5
vertebrae, right psoas
major, and right of the
aorta
Leaves through the caval
opening and enters
thorax at level of T8
Inferior Vena Cava
Tributaries
Paired visceral branches:
1. Right suprarenal v.
2. Right renal v.
3. Left renal v.
a. Left suprarenal v.
b. Left gonadal v.
4. Right gonadal v.

Paired parietal branches:

1. Inferior phrenic veins
2. 3rd (L3) and 4th (L4) lumbar
veins
3. Common iliac veins
Nerves on Posterior
Abdominal Wall
1. Iliohypogastric n.
2. Ilio-inguinal n.
3. Obturator n.
4. Genitofemoral n.
5. Femoral n.
6. Sympathetic trunk
 Radiology -
Esophagus
1. Aortic impression
2. Bronchus impression
3. Upper esophagus
Radiology - Stomach
and Duodenum
4. Gastric fundus
5. Rugae
6. Pyloric canal
7. Antrum
8. Lesser curvature
10. 1st Duodenum
11. 2nd Duodenum
Radiology - Stomach
and Duodenum
5. Rugae
8. Lesser curvature
9. Greater curvature
11. 1st Duodenum
Radiology - Small
Intestine

10. 1st portion of

duodenum
11. 2nd portion of
duodenum
12. 3rd portion of
duodenum
13. 4th portion of
duodenum
14. Duodenojejunal flexure
15. Jejunum
Radiology - Small
Intestine

1. Duodenum
2. Jejunum
3. Ileum
 Radiology - Large
Intestine
1. Cecum
2. Ascending Colon
3. Hepatic Flexure
4. Transverse colon
5. Splenic Flexure
6. Descending Colon
7. Sigmoid
8. Rectum
9. Ileum
 4.04 Urinary System (Gross Lab)
February 6, 2019

TRANS Guerrero, Guillermo, Gumba, Guy, Hao CORE Garces, Lee, Marcelo, Martinez, Mauricio, Morales, VPAA Natural
Ocampo 09175454982
Musni 09054003142
 Structures to be identified
Kidney
• Minor calyx
• Renal sinus • Renal papilla
• Renal hilum • Renal cortex
• Renal vein • Renal medulla
• Renal artery • Renal column (of Bertin)
• Renal pelvis • Renal pyramid
• Ureter
• Renal capsule
• Major calyx

4.03 Urinary System LE 4 TRANS 3

Urinary Kidney Descending colon
(reflected)
System
T12-L3 Renal hilum
bean shaped
Left kidney
concave medial
margin, convex
lateral margin
retroperitoneal
right is lower than
the left (due to liver)

Abdominal aorta

Inferior mesenteric artery

Urinary Kidney
Renal Coverings
System

Renal Capsule
aka Fibrous/True
Renal Capsule
thin, fibrous
membrane in direct
contact with renal
parenchyma
barrier against
spread of infection

Renal coverings (innermost to outermost):

Renal capsule
Perirenal fat
Renal fascia
Pararenal fat

∗Pararenal fat/Paranephric fat - external to renal fascia;

extraperitoneal fat of the lumbar region that is most
obvious posteriorly.
 Urinary Kidney: Anterior View
Neurovasculature: Renal hilum Renal sinus (space)
System
Blood supply: Renal arteries (from
abdominal aorta)

Venous drainage: Renal veins to IVC

Innervation: Renal hilum

Renal nerve plexus
(abdominopelvic splanchnic
nerves)
Parasympathetic: vagus &
pelvic splanchnic nerves (S2-
S4)
Sympathetic: Lesser & Least
splanchnic nerves (T10-T11),
lumbar nerves (L1-L2)

*All of these enter the renal sinus

through the renal hilum

Ureter
Urinary (L) Kidney: Posterior View
Neurovasculature: Renal hilum
System
Renal artery

Renal vein

Arrangement of structures at renal

hilum (Anterior to Posterior):
Renal Vein
Renal Artery
Renal pelvis Ureter
*VAU

Left renal vein is longer than

right because it is farther from
the IVC

Ureter
 Urinary Kidney: Anterior View
Neurovasculature: Renal hilum
System
Renal sinus (space)
space/deep recess where
renal neurovasculature
enters (exit through renal
hilum)
occupied by a variable Renal hilum
amount of fat (continuous
with perirenal fat
capsule/perinephric fat)
transmits:
renal artery & vein
renal nerves
renal pelvis
Urinary (L) Kidney: Anterior View
System
Renal artery

The ureters pass under the

Renal vein gonadal veins
“water under the bridge”

The Left gonadal vein drains

into the Left renal vein, while
the Right gonadal vein drains
directly into the IVC.
Ureter

Gonadal vein
 Urinary Kidney
Renal Parenchyma
System

Renal Cortex
Cortex = outer region;
Medulla = inner region
1 medullary pyramid and its
surrounding cortex
represents 1 renal lobe Renal Medulla

Renal Pelvis
Renal pyramid
Base: continuous with and
directed towards the cortex Renal Pyramid
Apex: projected inwards to
the renal sinus

Renal Column (of Bertin)

Renal Lobe
Urinary Kidney
Renal Parenchyma
System

Renal Medulla
Apex of renal pyramid [Renal
Papillae] is cupped by the minor
Renal Papillae calyx which arises from the major
calyx
Area cribosa - opening at
renal papillae
Path of urine:
Minor Calyx collecting duct -> papillary
duct -> area cribosa -> minor
calyx -> major calyx -> renal
Major Calyx pelvis -> ureter -> urinary
bladder

Renal Pelvis

Ureter
Urinary KUB Radiograph
Plain film of the abdomen (KUB =
System Kidneys, Ureters, Bladder))

Labels:
1 - Minor calyx
2 - Major calyx
3 - Renal pelvis
4 - Ureter
5 - Urinary bladder
6 - Renal shadow
7 - T12 vertebra
8 - L2 vertebra
 Structures to be identified

• Adrenal (or suprarenal)

gland
• Suprarenal arteries and
veins
• Urinary bladder
• Male urethra

4.03 Urinary System LE 4 TRANS 3

 Urinary (R) Suprarenal/Adrenal Glands
System
Laterality (based on shape):
Right: pyramidal
Left: crescent
Right adrenal
Blood Supply:
gland
Superior suprarenal a. (from Inferior
phrenic a.)
Middle Suprarenal a. (from Renal
Abdominal aorta) Capsule
Inferior Suprarenal a. (from Renal a.)

Venous drainage: Right kidney

Right suprarenal v. -> IVC
Left suprarenal v. -> left renal v. ->
IVC

Innervation: Celiac Plexus and Abdominopelvic

Splanchnic Nerves
Ureter
Additional Info:
Enclosed by renal fascia
Located at the superomedial aspects
of kidney and diaphragm
Urinary Urinary Bladder
System
Urinary Bladder

EMPTY STATE: Tetrahedral boat-shaped, lies within lesser

pelvis
FULL STATE: Ovoid, ascends in the abdominal cavity
ARTERIAL SUPPLY
Internal iliac artery
Superior vesical a. - superolateral/anterosuperior part
Inferior vesical a. (male); vaginal arteries (female)-
fundus & neck
NERVE SUPPLY
Hypogastric plexus (T11-T12): “filling” nerves
sympathetic: relaxes bladder wall, increase internal
urethral sphincter tone*
Pelvic splanchnic nerves & inferior hypogastric nerves (S2-
S4): “emptying” nerves
parasympathetic: contracts bladder wall, relaxes
internal & external urethral sphincter
Urinary Urinary Bladder
System

Rugae = allow stretching of the bladder

Smooth muscle (detrusor muscle) = for
contraction of the bladder upon urinating
Trigone region = triangular region formed by the
openings of the ureters and the internal sphincter
very sensitive to stretching and expansion
Urinary Urinary Bladder
System

Median umbilical ligament = remnant

of the urachus
attaches the apex of the bladder
to the anterior abdominal wall
Fundus = expands freely
Neck = continuous with the urethra
Body = between the apex and the
fundus
Urinary Male Urethra
System From 2021B trans