TOPIC 6.

1
ABDOMEN
ABDOMINAL WALL
Abdominal cavity wall boundaries
The superior boundary ie the diaphragm (superior), anterior and posterior walls
(lateral), and the pelvic floor.
 ABDOMEN

ABDOMINAL WALL ABDOMINAL CAVITY

• anterolateral wall • peritoneum
• posterior wall • stomach, duodenum & pancreas
Functions • liver & spleen
• protection • small & large intestine
• muscle attachment • kidneys & adrenal glands
• movement • blood vessels, lymph & nerves
• raising intra-abdominal
Functions
pressure for coughing,
• nutrient absorption
vomiting, farting,
excreting and birthing • excretion
• homeostasis
Bones associated with the abdominal cavity

Lumbar vertebrae
•L1-L5
Sacrum (pelvic cavity)
•5 Fused vertebrae
Coccyx
•3-5 fused bones
ABDOMINAL WALL & CAVITY

Name the sub cavities in

the thoracic cavity
 Muscles of the abdominal wall
• Muscles of the abdominal wall – anterior (3
Flat muscles and 2 vertical muscles)
– 1. External oblique - aponeurosis
– 2. Internal oblique - aponeurosis
– 3. transversus abdominis - aponeurosis
– 4. rectus abdominis
– 5. pyramidalis*
Muscles Human Anterior
External Oblique : action : flexes vertebral column, ipsilateral lateral flexion, contralateral trunk rotation

Origin: lower 8 ribs

insertion: ilium crest / pubis

Muscles Human Anterior
Internal Oblique: action flexes vertebral column, ipsilateral lateral flexion, ipsilateral trunk rotation
 Muscles Human Anterior
Transverse Abdominis
 Summary : MUSCLES OF ANTERO-LATERAL WALL
Muscle Function
External oblique flexes & rotates trunk; compresses & support viscera
Internal oblique flexes & rotates trunk; compresses & support viscera
Transverse abdominal support back; compresses & support viscera
 Anterior Abdominal wall
Rectus abdominis
Anterior Abdominal wall
Anterior Abdominal wall
MUSCLES OF ANTERO-LATERAL WALL
Muscle Function
Rectus abdominis flexes trunk; compresses & support viscera
 Muscles of the posterior abdominal wall

• Posterior abdominal wall muscles

– Psoas major (minor* 60%)
– Iliacus
– Quadratus lumborum
Muscles of the posterior abdominal wall

What is the name

given to the Psoas
major and iliacus
m?

Ans : Iliopsoas m
 MUSCLES OF THE POSTERIOR WALL
Muscle Function
psoas flexes hip (thigh), flexes trunk*, works with iliacus
(iliopsoas)
iliacus flexes hip (thigh), flexes trunk* works with posas
quadratus extends & laterally flexes trunk, fixes rib 12 during
lumborum inspiration
 Trunk flexion
• Trunk flexion – rectus abdominis is the agonist
muscle (the prime mover) – synergist –
external and internal oblique.
• Trunk extension – erector spinae grp of
muscles (3 different muscles) are / is the
agonist muscle, and the abdominal muscles
are the antagonists.
 External / internal oblique
• The external oblique functions to pull the chest
downwards and compress the abdominal cavity, which
increases the intra-abdominal pressure as in a
valsalva maneuver.
• It also performs ipsilateral (same side) side-bending and
contralateral (opposite side) rotation. So the right
external oblique would side bend to the right and rotate
to the left.
• The internal oblique muscle functions similarly except it
rotates ipsilaterally.
• left internal oblique would side bend to the left side and
rotates to the left.
• The term contralateral rotation is used to
describe the motion created by a muscle that
rotates the abdomin to the opposite side from
where it is located —
– in other words, a left-sided external oblique muscle
that rotates the trunk to the right side is
performing contralateral rotation,
– as is a right-sided muscle that rotates the trunk to
the left side
 MUSCLES OF POSTERIOR WALL
Iliopsoas lies near the kidneys, ureters, appendix, sigmoid colon, pancreas,
lumbar lymph nodes & sacroiliac plexus. If these structures are diseased, pain
will occur with movement of iliopsoas
Eg right hip flexion with appendicitis
The pelvic floor structures
• Inguinal ligament
• Blood vessels
• nerves
 INGUINAL REGION
• inguinal ligament (red) – pubic tubercle to ASIS
• inguinal canal (red circle) – medial portion, oblique angled tunnel
• contents are different in male & female (yellow)

inguinal ligament
inguinal canal
 INGUINAL REGION
Male
• spermatic cord – nerves, vessels,
vas deferens
• coverings of spermatic cord
• scrotum
• cremaster muscle
• testis

copyright Internet
 INGUINAL REGION
Female
 round ligament of uterus

Round
ligament

http://anatomy.med.umich.edu/atlas/images/abdo_wall_gifs/a63.gif

http://www.austinmidwifeforum.com/images/pregnant_cutaway.jpg
• How does the contents of the make and
female inguinal canal differ?

Ans :
• in the male it consists of the spermatic cord
• In the female it consists of the round ligament
of the uterus
 VESSELS OF ANTEROLATERAL WALL
Arteries from Veins to Lymph to
• internal thoracic - epigastric  axillary  axillary
• aorta – lumbar arteries  femoral  inguinal
• external iliac – internal iliac
• femoral a
 ABDOMINAL LYMPHATIC DRAINAGE
Lymph drainage from GIT, kidneys & adrenals
 ARTERIES OF POSTERIOR WALL

T12
 ARTERIES OF POSTERIOR WALL
Abdominal Aorta
Distribution Artery Level
Alimentary tract  Celiac T12
(unpaired)  Superior mesenteric L1
 Inferior mesenteric L3
Urogenital &  Suprarenal L1
endocrine glands  Renal L1
(paired)  Gonadal L2
Diaphragm & body  Subcostal* L2
wall (paired &  Inferior phrenic T12
segmental)  Lumbar L1-L4
Lower Limb (paired)  Common iliac L4
Unpaired and paired blood vessels
Inferior phrenic a
Celiac T

Middle suprarenal a

Superior mesenteric a
Renal a
Lumbar a 1-4
Gonadal a
inferiorior mesenteric a

Median sacral s
 NERVES OF ANTEROLATERAL WALL
Nerve Innervation
5-11 intercostal (T5-11) supply anterior abdominal wall
as well as thoracic
subcostal (T12) lower anterior abdominal wall
iliohypogastric & ilioinguinal (L1) inguinal region
 NERVE SUPPLY OF ANTERIOR & LATERAL BODY WALL

Nerve Supply
1st intercostal (T1) joins brachial plexus

2nd intercostal (T2) b ranches to brachial plexus

& supplies floor of axilla and
part of arm

3-6 intercostal (T3-5) typical distribution within their

intercostal space

7-11 intercostal (T7-11) supply anterior abdominal wall

as well as thoracic

subcostal (T12) lower anterior abdominal wall

iliohypogastric, inguinal region

& ilioinguinal (L1)
 NERVES OF POSTERIOR WALL
Spinal Nerves (somatic)
• Subcostal nerve from
anterior rami of T12
• Lumbar plexus from
anterior rami of L1-L4
(sup branch L4)
• Lumbosacral trunk from
anterior rami of L4 (inf
branch) & L5
 NERVES OF POSTERIOR WALL

LUMBAR PLEXUS (L1-L4)

(NB: lower limb)

iloinguinal & iliohypogastric

(L1), supplies abdominal
muscles and skin of abdomen,
inguinal & pubic regions

genitofemoral (L1-2),
supplies genital and upper
thigh region

•lateral cutaneous nerve of

thigh (L2-3), supplies skin of
anterolateral thigh
 NERVES OF POSTERIOR WALL
LUMBAR PLEXUS (L1-L4)
(NB: lower limb)

•lumbosacral trunk L4 &

L5 joins sacral plexus in
pelvis

•femoral nerve (L2-4),

under inguinal ligament,
supplies flexors of hip and
extensors of leg &
associated skin regions

•obturator (L2-4), through

obturator foramen,
supplies adductors of thigh
and associated skin regions