The Abdomen

Dr ABDULLAHI NOUR DAACAD

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Outline
• Introduction and basic Anatomy of the abdomen
• Surface Anatomy Of Abdomen
• The Abdominal wall
 Structure of the Anterior Abdominal Wall
Skin
Superficial Fascia
Deep Fascia
Muscles of the Anterior Abdominal Wall
Neurovasculature of Anterolateral Abdominal Wall
Extraperitoneal Fat
Parietal Peritoneum

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Outline
Structure of the Posterior Abdominal Wall
Lumbar Vertebrae
Twelfth Pair of Ribs
Ilium
Muscles of the Posterior Abdominal Wall
Fascial Lining of the Abdominal Walls

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Outline
• The Abdominal cavity
Esophagus
Stomach
Small intestine
Liver
Gallbladder
Large intestine
Pancreas
Spleen
Kidney
Other important anatomical structures of abdomen

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The abdomen is the region of the trunk that
lies between the diaphragm above and the
inlet of the pelvis below

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Surface anatomy of the abdomen

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 Surface Anatomy
• The abdominal cavity contains numerous organs – many of
which can be palpated through the abdominal wall, or their
position can be visualised by surface markings.
• The umbilicus is the most visible structure of the
abdominal wall, and is the scar of the site of attachment of
the umbilical cord.
• The abdomen is a large area, and so it split into nine
regions – these are useful clinically for describing the
location of pain, location of viscera and describing surgical
procedures. The nine regions are formed by two horizontal
and two vertical planes :
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 Surface Anatomy: Abdominal reference
planes, regions and Quadrants

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Right hypochondria region Epigastric region Left hypochondriac region
Right lobe of the liver L.lobe of the liver
Gallbladder L.Lobe of the liver Fundus of the stomach
R.Colic flexure Stomach Tail of the pancreas
R.Kidney Duodenum Spleen
Head & body of pancreas L.Kidney

Right lateral region Umblical region Left lateral region

Ascending colon Transverse colon Descending colon
Ileum Duodenum Jejunum
Lower part of R.kidney Jejunum Lower part of L.kidney
ileum

Right inguinal region Pubic region Left inguinal region

Cecum Urinary bladder Sigmoid colon
Appendix uterus ileum
Ileocecal valve

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 Surface
Anatomy:
Abdominal
reference planes

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 Abdominal Surgical Incisions

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Abdominal
Surgical Incisions

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 • Anterior abdominal wall
Surface Anatomy extends from costal margin
to inferior boundaries:
• Iliac crest
• Anterior superior iliac spine
• Inguinal ligament
• Pubic crest
• Superior boundary
• Diaphragm
• Central landmark
• Umbilicus
• Linea alba (white line)
• Tendinous line
• Extends from xiphoid process
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Structure of the Anterior Abdominal Wall
The anterior abdominal wall is made up of skin,
superficial fascia, deep fascia, muscles, extraperitoneal
fascia, and parietal peritoneum.
key functions of abdominal wall include:
• Forms a firm, flexible wall which keeps the abdominal
viscera in the abdominal cavity.
• Protects the abdominal viscera from injury.
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Cont.……
• Maintains the anatomical position of abdominal
viscera against gravity.
• Assists in forceful expiration by pushing the
abdominal viscera upwards.
• Involved in any action (coughing, vomiting) that
increases intra-abdominal pressure.

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Skin
• The skin is loosely attached to the underlying
structures except at the umbilicus, where it is tethered
to the scar tissue.

• The umbilicus is a scar representing the site of

attachment of the umbilical cord in the fetus; it is
situated in the linea alba
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Blood Supply
• Arteries

• The skin near the midline is supplied by branches of the superior and
the inferior epigastric arteries. The skin of the flanks is supplied by
branches of the intercostal, the lumbar, and the deep circumflex
iliac arteries.

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Cont.….

• In addition, the skin in the inguinal region is supplied by the

superficial epigastric, the superficial circumflex iliac, and the

superficial external pudendal arteries, branches of the

femoral artery.

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Veins
• The venous drainage passes above mainly into
the axillary vein via the lateral thoracic vein and
below into the femoral vein via the superficial
epigastric and the great saphenous veins

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 Nerve Supply
• The cutaneous nerve supply to the anterior abdominal wall

is derived from the anterior rami of the lower six thoracic

and the first lumbar nerves.

• The thoracic nerves are the lower five intercostal and the

subcostal nerves; the first lumbar nerve is represented by the

iliohypogastric and the ilioinguinal nerves.

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• The dermatome of T7 is located in the epigastrium over the xiphoid

process. The dermatome of T10 includes the umbilicus, and that of

L1 lies just above the inguinal ligament and the symphysis pubis. The

dermatomes and distribution of cutaneous nerves are shown in Figure

4-16 below

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Superficial Fascia
• The superficial fascia consists of fatty connective tissue. 
• The composition of this layer depends on its location:
• Above the umbilicus – a single sheet of connective tissue. It is
continuous with the superficial fascia in other regions of the body.
• Below the umbilicus – divided into two layers; the fatty
superficial layer (Camper’s fascia) and the membranous deep
layer (Scarpa’s fascia):
• Fuses with the deep fascia of the thigh
• Continues in the perineum as (colles fascia)
• The superficial vessels and nerves run between these two layers of fascia.

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Deep Fascia

• The deep fascia in the anterior abdominal wall is merely

a thin layer of connective tissue covering the muscles; it

lies immediately deep to the membranous layer of

superficial fascia
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