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Zhen Yu Liu 3rd Year Notes

Gastro Anatomy
[1] Abdominal Cavity

 Space bounded by the abdominal walls,

diaphragm and pelvis
o Anteriorly: musculo-aponeurotic
abdominal walls
o Superiorly: separated superiorly
up to the 4th intercostal by the
o Inferiorly: plane of the superior
pelvic aperture


 Two horizontal planes: subcostal (passing through the inferior border of 10th
costal) and transtubercular (passing through iliac tubercles and L5)
 Two vertical planes: passing through the midpoints of the clavicles

[2] Anterolateral Abdominal Wall

 Superficial fatty layer of subQ tissue (camper fascia) + deep
membranous layer
 3 muscle layers (external oblique, internal oblique and transversus
abdominis from external to internal) covered by investing fascia
 Deep endo-abdominal fascia overlying deep extraperitoneal fat and
parietal peritoneum lining the abdominal cavity
Zhen Yu Liu 3rd Year Notes

 Aponeuroses of the EO, IO and TA form the rectus sheath which encloses the rectus abdominis, this aponeuroses fuses
again at the midline forming the linea alba extending from the xiphoid process to the linea alba
Zhen Yu Liu 3rd Year Notes
Rectus Abdominis

 Throughout the transversus abdominis their exist tendinous intersections at the level of the xiphoid process and the
umbilicus and a point half way between (or 2 points between depending on the person)
o Superior to the arcuate line (point between umbilicus and pubic symphysis, approx. 1/3) the rectus abdominis is
sheathed within the rectus sheath (formed anteriorly of the anterior/posterior lamina of the EO & the anterior
lamina of the IO)
o Below the arcuate line the aponeurosis of the EO, IO and TA run anterior to the rectus abdominis with only the
transversalis fascia and peritoneum deep to the RA

Anterior Peritoneal Folds

 Median umbilical fold: extends from the

apex of the urinary bladder to the umbilicus
(covers the median umbilical ligament)
 Medial umbilical folds, lateral to the median
umbilical folds (covers the umbilical
 Lateral umbilical folds (covers the inferior
epigastric vessels)
 Supravesical fossae lie between the median
and medial umbilical folds (rises and falls
with bladder level)
 Medial inguinal fossae between the medial
and lateral umbilical folds direct hernia
occurs here
 Lateral inguinal fossae contains the lateral
umbilical folds indirect hernia occurs here
Zhen Yu Liu 3rd Year Notes
Surface Anatomy

 Linea alba: midline, subcutaneous

aponeurosis of EO, IO, and TA, runs
from xiphoid to pubic symphysis
 Semilunar lines demarcate the
lateral borders of the rectus
abdominis and the rectus sheath

Nerves and Arteries

Zhen Yu Liu 3rd Year Notes

 Superior epigastric (continuation of the internal thoracic artery) enters the rectus sheath superiorly from the posterior layer
and anastomoses with inferior epigastric (arises from external iliac artery)

Veins and Lymphatics

 Venous drainage supplied by anastomosis of the

axillary and superficial epigastric vein, creating the thoraco-
epigastric vein
 Superficial lymphatic vessels drain into the axillary
lymph nodes and superficial inguinal lymph nodes
Zhen Yu Liu 3rd Year Notes

[3] Inguinal Region

 Site where structures enter and exit the abdominal cavity (site of herniation, 86% of which occurs in males due to
spermatic cord exit)
 Extends from ASIS to pubic tubercle