The Anatomy of the Inguinal Region

Views:
 
     
 

Presentation Description

No description available.

Comments

Presentation Transcript

The Anatomy of the Inguinal Region:

The Anatomy of the Inguinal Region ELTON F. GBOLLIE YEAR III A.M DOGLIOTTI COLLEGE OF MEDICINE JANUARY 13, 2012

Layers of the Anterior Abdominal Wall:

Layers of the Anterior Abdominal Wall The layers of the abdominal wall include (superficial to deep) 1) Skin 2) Camper’s fascia (fatty) 3) Scarpa’s fascia (membranous) 4) Deep fascia 5) External oblique 6) Internal oblique 7) Transverse abdominis 8) Transversalis fascia 9) Extraperitoneal fat 10) Parietal peritoneum

Muscles of the Anterior Abdominal Wall:

Muscles of the Anterior Abdominal Wall The three flat muscles (external and internal oblique, and transversalis ) of the anterolateral abdominal wall compress and support the abdominal viscera, and also flex and rotate the trunk. External Oblique External oblique is the most superficial of the three flat muscles. It arises from the middle and lower 5th – 12th ribs and passes inferomedially to insert into the linea alba, pubic tubercle and the iliac crest. It is innervated by the thoracoabdominal nerves and the subcostal nerve. Internal Oblique Internal oblique has fibres arising from the inguinal ligament and iliac crest that fan out from the anterior superior iliac spine to insert into the linea alba, conjoint tendon and the lower 3 ribs. It is innervated by the thoracoabdominal and lumbar nerves. Transversalis Transversalis is the deepest of the flat abdominal muscles that arises from the costal cartilages, iliac crest and inguinal ligament. The fibres run transversomedially to insert into the linea alba, pubic crest and conjoint tendon. It is innervated by the thoracoabdominal and lumbar nerves.

Muscles of the anterolateral abdominal wall:

Muscles of the anterolateral abdominal wall External oblique muscle Internal oblique muscle Transverse abdominal muscle

Muscles of the Anterior Abdominal Wall cont’d:

Muscles of the Anterior Abdominal Wall cont’d The two vertical muscles are: Rectus Abdominus Rectus abdominus arises from the pubic symphysis and pubic crest, and inserts into the xiphoid process and costal cartilages. It is supplied by thoracoabdominal nerves, and flexes the trunk and also compresses and supports abdominal viscera. Pyramidalis Pyramidalis arises from the pubic crest and inserts into the linea alba. Its function is to tense the linea alba.

Muscles of the anterolateral abdominal wall :

Muscles of the anterolateral abdominal wall

The Rectus Sheath:

The Rectus Sheath The rectus sheath consists of fascia and thickenings of fascia ( aponeurosis ) of the anterior abdominal wall muscles. The layers include: 1) Anterior layer – fascia of external and internal oblique 2) Posterior layer – fascia of internal oblique and transversalis The inferior fourth of the posterior layer is deficient of internal oblique fascia, and is demarcated by the arcuate line. The linea alba is a midline fibrous band in the middle of this sheath.

Rectus sheath :

Rectus sheath Rectus abdominis m Aponeurosis Transverse abdominis m. Internal oblique m. External oblique m.

Inguinal Canal :

Inguinal Canal The inguinal canal is a space just superior to the inguinal ligament that carries the spermatic cord (male) or round ligament of the uterus (female), and the ilioinguinal nerve. Its boundaries are: 1) Anterior wall – aponeurosis of external oblique 2) Posterior wall – transversalis fascia and the conjoint tendon 3) Roof – internal oblique and transverse abdominus 4) Floor – inguinal ligament (superior surface ) The two openings of the canal are the deep inguinal ring (entrance) and the superficial inguinal ring (exit). The deep (internal) ring is an opening of the transversalis fascia superior to the midpoint of the inguinal ligament and lateral to the inferior epigastric artery. The superficial (external) ring is an opening of external oblique superolateral to the pubic tubercle.

Inguinal Canal :

Inguinal Canal Location Inferior part of the anterolateral abdominal wall

Inguinal Canal :

Inguinal Canal Superficial ring Anterior wall

PowerPoint Presentation:

Transverse Abdominal Fascia abdominal inguinal ring (deep inguinal ring

Hesselbach’s Triangle:

Hesselbach’s Triangle Hesselbach’s (Inguinal) Triangle is an important structure as it is the site for direct hernias. The triangle has the following borders: 1) Medial border of rectus abdominus (medially) 2) Inguinal ligament (inferiorly) 3) Inferior epigastric vessels(laterally)

Spermatic Cord :

Spermatic Cord The spermatic cord begins at the deep inguinal ring (inferior to the epigastric vessels) and passes into the inguinal canal, exiting at the superficial inguinal ring and ends in the scrotum at the testes. The spermatic cord is covered by: 1) Internal spermatic fascia (derived from transversalis fascia) 2) Cremasteric fascia (derived from internal oblique) 3) External spermatic fascia (derived from external oblique) The spermatic cord contains: 1) Ductus deferens (and its artery) 2) Testicular artery 3) Cremasteric artery 4) Panpiniform plexus 5) Genital branch of the genitofemoral nerve 6) Sympathetic nerve fibres 7) Lymphatic vessels

A Brief Mention of Hernias:

A Brief Mention of Hernias Hernias are abnormal outpouchings of the abdominal contents (such as the small intestine) from the cavity in which they belong. There are two main types of hernias that occur at the inguinal region. Indirect Hernias (congenital) These are the most common inguinal hernias, and are outpouchings lateral to the inferior epigastric vessels. Abdominal contents enter the deep inguinal ring via a hernial sac (a congenital abnormality – a persistent processus vaginalis ). The hernia then passes the full length of the inguinal canal to exit through the superficial ring and enters the scrotum. Direct Hernias (acquired) Direct hernias occurs lateral to the epigastric vessels. They do not protrude through any ring, but through an area of weakness in the posterior wall of the inguinal canal; this area is likely to be Hesselbach’s Triangle. The hernia is often parallel to the spermatic cord, but almost never enters the scrotum.

Inguinal hernia results because pressure finds weak spot at inguinal canal:

Inguinal hernia results because pressure finds weak spot at inguinal canal

REFERENCE:

REFERENCE www.Revisedmedicine.com www.google.com

authorStream Live Help