introduction abdomen-dr.gosai

ABDOMENABDOMENPlanes, Divisions and Planes, Divisions and

Arrangement of Arrangement of StructuresStructures

Dr.B.B.Gosai Dr.B.B.Gosai

IntroductionIntroduction

Learning Objectives:Learning Objectives:

At the end of this lecture At the end of this lecture student should be able to:student should be able to:– Explain Planes and divisions of Explain Planes and divisions of

abdomenabdomen– Arrangement of structures (Skeleton, Arrangement of structures (Skeleton,

Muscles, Vessels and organs) in the Muscles, Vessels and organs) in the abdominal cavityabdominal cavity

AbdomenAbdomen Lower half of trunk Lower half of trunk

below the diaphragmbelow the diaphragm Divided in to two Divided in to two

parts:parts: Abdomen Proper: Abdomen Proper:

From Diaphragm to From Diaphragm to Pelvic brim (Pelvic Pelvic brim (Pelvic inlet)inlet)

Pelvis: Below the Pelvis: Below the pelvic brim (Pelvic pelvic brim (Pelvic inlet)inlet)

Planes for Demarcation of Abdominal Planes for Demarcation of Abdominal RegionRegion

indicated by a line encircling the body midway between the suprasternal notch and the symphysis pubis (or midway between the umbilicus and inferior end of the sternal body or a hand's breadth below the xiphisternal joint); it intersects the first lumbar vertebral body near its lower border and meets the costal margins at the tips of the ninth costal cartilages.Passes through Pylorus of stomach.

corresponds to a line round the trunk level with the iliac tubercles ; it cuts the front of the fifth lumbar vertebral body near its upper border.

Horizontal planesTranstubercular plane

Transpyloric plane (of Addision)

A third horizontal plane, often used in abdominal topography, the subcostal plane, corresponds to a line level with the lowest limits of the tenth costal cartilages. It cuts the front of the third lumbar vertebral body nears its upper border. It often replaces the transpyloric plane in descriptions of abdominal regions.

Subcostal plane

On the body's posterior surface a transverse line between the highest points on the iliac crests and level with the fourth lumbar vertebral spinous process delineates a supracristal plane.

Supracristal plane

Right and left lateral planes:

indicated on the surface by vertical lines through points midway between the anterior superior iliac spines and the symphysis pubis (these lines are also called 'mid-clavicular' or 'mammary' lines).

Vertical planes

Planes for Demarcation of Abdominal RegionPlanes for Demarcation of Abdominal Region

Division of Abdomen in to Nine Division of Abdomen in to Nine QuadrantsQuadrants

Abdomen is divided into nine Regions by Abdomen is divided into nine Regions by Two Horizontal and Two Vertical Planes.Two Horizontal and Two Vertical Planes.

Planes used for demarcation are:Planes used for demarcation are:– Horizontal planes : Transpyloric plane and Horizontal planes : Transpyloric plane and

Transtubercular planes Transtubercular planes – Vertical Planes : Right and left Lateral planesVertical Planes : Right and left Lateral planes

Three regions on Right and Left sides Three regions on Right and Left sides each and Three regions in the central each and Three regions in the central part.part.

L

L

Abdominal QuadrantsAbdominal Quadrants

Abdominal QuadrantsAbdominal Quadrants

Regions of AbdomenRegions of Abdomen

Right Hypochondriac regionRight Hypochondriac region: Lateral to : Lateral to right lateral plane and above right lateral plane and above transpyloric plane.transpyloric plane.

Right Lumbar regionRight Lumbar region: Lateral to right : Lateral to right lateral plane, below transpyloric plane lateral plane, below transpyloric plane and above transtubercular plane.and above transtubercular plane.

Right Iliac regionRight Iliac region: Lateral to right lateral : Lateral to right lateral plane and below transtubercular plane.plane and below transtubercular plane.

Regions of AbdomenRegions of Abdomen

Left Hypochondriac regionLeft Hypochondriac region: Lateral to : Lateral to left lateral plane and above transpyloric left lateral plane and above transpyloric plane.plane.

Left Lumbar regionLeft Lumbar region: Lateral to left : Lateral to left lateral plane, below transpyloric plane lateral plane, below transpyloric plane and above transtubercular plane.and above transtubercular plane.

Left Iliac regionLeft Iliac region: Lateral to left lateral : Lateral to left lateral plane and below transtubercular plane.plane and below transtubercular plane.

Regions of AbdomenRegions of Abdomen

Epigastric regionEpigastric region: Medial to right and : Medial to right and left lateral planes and above left lateral planes and above transpyloric plane.transpyloric plane.

Umbilical regionUmbilical region: Medial to right and : Medial to right and left lateral planes, below transpyloric left lateral planes, below transpyloric plane and above transtubercular plane.plane and above transtubercular plane.

Hypogastric regionHypogastric region: Medial to right and : Medial to right and left lateral planes and below left lateral planes and below transtubercular plane.transtubercular plane.

Arrangement of Arrangement of Structures in Structures in

AbdomenAbdomen

Skeleton of AbdomenSkeleton of Abdomen

Posterior Abdominal WallPosterior Abdominal Wall

Muscles: Muscles: – DiaphragmDiaphragm– Psoas MajorPsoas Major– Quadratus Quadratus

lumborumlumborum– Transversus Transversus

AbdominisAbdominis– IliacusIliacus

Posterior Abdominal WallPosterior Abdominal Wall Main Vessels:Main Vessels:

– Abdomonal Aorta Abdomonal Aorta and its branchesand its branches

– Inferior vena cava Inferior vena cava and its tributariesand its tributaries

Nerves:Nerves:– Subcostal nerveSubcostal nerve– Ilioinguinal and Ilioinguinal and

Iliohypogastric Iliohypogastric nervesnerves

– Femoral nervesFemoral nerves– Genitofemoral Genitofemoral

nervesnerves– Obturator nervesObturator nerves– Sympathetic chainSympathetic chain

Posterior Abdominal WallPosterior Abdominal Wall

Organs:Organs:– Kidneys and ureterKidneys and ureter– Suprarenal glandsSuprarenal glands– PancreasPancreas– DuodenumDuodenum

Disposition of Abdominal Disposition of Abdominal OrgansOrgans

Disposition in AbdomenDisposition in Abdomen

Liver and gall Liver and gall bladderbladder

StomachStomach SpleenSpleen Greater and lesser Greater and lesser

omentumomentum

Disposition in AbdomenDisposition in Abdomen

Small intestine and Small intestine and its parts: Jejunum its parts: Jejunum and Ileumand Ileum

Disposition in AbdomenDisposition in Abdomen

Large intestine and Large intestine and its parts: its parts:

Cecum and appendixCecum and appendix Ascending colon, Ascending colon,

Transverse colon Transverse colon and descending and descending coloncolon

Pelvic colon Pelvic colon RectumRectum

ReferencesReferences

Clinical Anatomy by Richard Snell (8Clinical Anatomy by Richard Snell (8thth Edition)Edition)

Gray’s Anatomy (40Gray’s Anatomy (40thth Edition) Edition)

……..Thanks…....Thanks…..