Osteology
|
| Bone |
Structure |
Description |
Notes |
| os coxae (TG6-3) |
|
one of three bones that form the pelvis |
paired; the os coxae forms the lateral part of the pelvis; it is formed by three fused bones: ischium, ilium & pubis; also known as the innominate bone (Latin, os = bone) |
| pubis (TG6-4) |
|
an angulated bone the forms the anterior part of the pelvis |
one of three bones that form the os coxae: ilium, ischium, pubis; its body forms 1/5 of the acetabulum; its symphyseal surface unites with the pubis of the opposite side to form the pubic symphysis; the superior and inferior pubic rami participate in the formation of the obturator foramen |
|
pubic crest |
ridge on the superior border of the superior ramus |
attachment of rectus abdominis & pyramidalis mm. |
|
pubic tubercle |
process at the lateral end of pubic crest |
attachment point of the medial end of the inguinal ligament |
|
pecten |
ridge on superior surface of the superior pubic ramus |
attachment point of the pectineal ligament |
| ilium (N468, TG3-05, TG3-05, TG6-3) |
|
fan-shaped bone that forms the lateral prominence of the pelvis |
one of three bones that form the os coxae: ilium, ischium, pubis |
|
iliac crest |
arching superior edge of the ilium that forms the rim of the "fan" |
attachment for abdominal wall muscles |
|
iliac tubercle |
roughened area along the outer edge of the iliac crest |
|
|
anterior superior iliac spine |
spine at the anterior end of the iliac crest |
lateral attachment of the inguinal ligament |
|
arcuate line |
ridge running from anteroinferior to posterosuperior on the inner surface of the ilium |
inferior boundary of the iliac fossa; marks the plane of transition from abdominal cavity to pelvic cavity; part of the iliopectineal line (Note: this is obviously not the same arcuate line as is found on the posterior aspect of the rectus sheath) (Latin, arcuate = bowed) |
Muscles
|
| Muscle |
Origin |
Insertion |
Action |
Innervation |
Artery |
Notes |
Image |
| external abdominal oblique (N249, TG5-04, TG5-05, TG5-06B, TG5-06C) |
lower 8 ribs |
linea alba, pubic crest & tubercle, anterior superior iliac spine & anterior half of iliac crest |
flexes and laterally bends the trunk |
intercostal nerves 7-11, subcostal, iliohypogastric and ilioinguinal nerves |
musculophrenic a., superior epigastric a., intercostal aa. 7-11, subcostal a., lumbar aa., superficial circumflex iliac a., deep circumflex iliac a., superficial epigastric a., inferior epigastric a., superficial external pudendal a. |
the inguinal ligament is a specialization of the external abdominal oblique aponeurosis; the external spermatic fascia is the external abdominal oblique muscle's fascia's contribution to the coverings of the testis and spermatic cord |
 |
| internal abdominal oblique
(N250, TG5-04, TG5-05, TG5-06B, TG5-06C) |
thoracolumbar fascia, anterior 2/3 of the iliac crest, lateral 2/3 of the inguinal ligament |
lower 3 or 4 ribs, linea alba, pubic crest and pecten |
flexes and laterally bends the trunk |
intercostal nerves 7-11, subcostal, iliohypogastric and ilioinguinal nerves |
musculophrenic a., superior epigastric a., intercostal aa. 7-11, subcostal a., lumbar aa., superficial circumflex iliac a., deep circumflex iliac a., superficial epigastric a., inferior epigastric a., superficial external pudendal a. |
anterior fibers of internal abdominal oblique course up and medially, perpendicular to the fibers of external abdominal oblique; the cremaster muscle and fascia is the internal abdominal oblique muscle's contribution to the coverings of the testis and spermatic cord |
 |
| transversus abdominis (N251, TG4-08, TG4-09, TG5-05, TG5-06B, TG5-06C) |
lower 6 ribs, thoracolumbar fascia, anterior 3/4 of the iliac crest, lateral 1/3 of inguinal ligament |
linea alba, pubic crest and pecten |
flexes and laterally bends trunk |
intercostal nerves 7-11, subcostal, iliohypogastric and ilioinguinal nerves |
musculophrenic a., superior epigastric a., intercostal aa. 7-11, subcostal a., lumbar aa., superficial circumflex iliac a., deep circumflex iliac a., superficial epigastric a., inferior epigastric a., superficial external pudendal a. |
transversus abdominis muscle does not contribute to the coverings of the spermatic cord and testis; transversalis fascia, the deep fascia that covers the inner surface of the transversus abdominis, forms the internal spermatic fascia |
 |
| rectus abdominis (N250, TG5-05, TG5-06B, TG5-06C) |
pubic crest and symphysis |
xiphoid process of the sternum and costal cartilages 5-7 |
flexes the trunk |
intercostal nerves 7-11 and subcostal nerve |
superior epigastric a. intercostal aa., subcostal a., inferior epigastric a. |
rectus sheath contains rectus abdominis and is formed by the aponeuroses of external and internal oblique and transversus abdominis mm. (Latin, rectus = straight) |
 |
| pyramidalis (TG5-10) |
pubic crest, anterior to rectus abdominis |
linea alba |
draws the linea alba inferiorly |
subcostal nerve |
subcostal a., inferior epigastric a. |
the pyramidalis m. is not always present |
 |
| cremaster (N260,N387,N390, TG5-04, TG5-10B, TG6-31) |
inguinal ligament |
forms thin network of muscle fascicles around the spermatic cord and testis (or around the distal portion of the round ligament of the uterus) |
elevates testis (not well developed in females) |
genital branch of the genitofemoral nerve |
cremasteric a., a branch of the inferior epigastric a. |
the cremaster m. is internal abdominal oblique muscle's contribution to the coverings of the spermatic cord and testis; the cremasteric reflex may be elicited by stroking the medial thigh (where the femoral branch of the genitofemoral n. distributes cutaneously) (Greek, cremaster = a suspender) |
 |
| dartos (TG5-04, TG5-05) |
subcutaneous connective tissue of the scrotum and the penis (or labium majus and clitoris) |
skin of the scrotum and penis (or labium majus and clitoris) |
elevates testis (tenses the skin of the pudendal region in the female) |
postganglionic sympathetic nerve fibers arriving via the ilioinguinal nerve and the posterior scrotal nerve |
cremasteric a., posterior scrotal (labial) a. |
the dartos elevates the testis in response to cold (it is modified arrector pili fibers, or the goose-bump muscles) (Greek, dartos = leather) |
 |
Joints and Ligaments
|
| Joint |
Description |
Significance |
| linea alba (N249,N251,N252A,N252B, TG5-04, TG5-05, TG5-06) |
a midline aponeurotic band that extends from the xiphoid process to the pubic symphysis |
linea alba is formed by intermingling of aponeuroses of external abdominal oblique, internal abdominal oblique, & transversus abdominis; it is used for midline abdominal incisions to avoid major nerves or vessels (Latin, linea alba = white line) |
| inguinal ligament (N250,N251, TG5-04) |
the ligament that connects the anterior superior iliac spine with the pubic tubercle |
the inguinal ligament is a specialization of the inferior border of the external abdominal oblique aponeurosis; it is the site of origin for a part of the internal abdominal oblique muscle and for a part of the transversus abdominis muscle; also known as: Poupart's ligament |
| lacunar ligament (N251,N262, TG5-08D, TG5-09D) |
an extension of the medial end of inguinal ligament which connects the pubic tubercle with the pecten of the pubis |
the lacunar ligament is a flattened portion of the aponeurosis of the external abdominal oblique m. that projects posteriorly from the pubic tubercle; it forms the medial border of the femoral ring and the floor of the inguinal canal at the superficial inguinal ring (Latin, lacuna = a lake or pit) |
| pectineal ligament (N251,N262, TG5-08D, TG5-09D) |
a thickening of fascia on the pecten of the pubis |
the pectineal ligament looks like an extension of the lacunar ligament along the surface of the pectineal line; also known as Cooper's ligament (note: Cooper's ligaments are also found in the breast) |
| pubic symphysis (TG6-04) |
symphysis |
midline joint uniting the pubic bodies (Greek, symphysis = a growing together) |
| falx inguinalis (TG5-08) |
the inferomedial attachment of internal abdominal oblique and transversus abdominis |
also known as: conjoint tendon (Latin, falx = sickle) |
Nerves
|
| Nerve |
Source |
Branches |
Motor |
Sensory |
Notes |
| intercostal n. (N254,N257, TG5-02) |
ventral primary rami of spinal nerves T1-T11 |
lateral & anterior cutaneous brs. |
intercostal muscles; abdominal wall muscles (via T7-T11); muscles of the forearm and hand (via T1) |
skin of the chest and abdomen anterolaterally; skin of the medial side of the upper limb (via T1-T2) |
intercostal n.travels below the posterior intercostal a. in the costal groove |
| subcostal n. (N254,N257, TG5-02) |
ventral primary ramus of T12 |
lateral cutaneous br., anterior cutaneous br. |
muscles of the abdominal wall |
skin of the anterolateral abdominal wall |
the subcostal n. is equivalent to a posterior intercostal n. found at higher thoracic levels |
| iliohypogastric n. (N257,N266, TG5-02, TG5-38) |
lumbar plexus (ventral primary ramus of spinal nerve L1) |
lateral and anterior cutaneous brs. |
muscles of the lower abdominal wall |
skin of the lower abdominal wall, upper hip and upper thigh |
iliohypogastric n. receives a contribution from T12 in approximately 50% of cases |
| ilioinguinal n. (N257,N266, TG5-02, TG5-08, TG5-09, TG5-10, TG5-38) |
lumbar plexus (ventral primary ramus of spinal nerve L1) |
anterior cutaneous br. (also known as: anterior labial/scrotal n.) |
muscles of the lower abdominal wall |
skin of the lower abdominal wall and anterior scrotum/labium majus |
ilioinguinal n. courses through the inguinal canal and superficial inguinal ring |
| genitofemoral (TG5-02, TG5-08) |
lumbar plexus (ventral primary rami of L1-L2) |
genital & femoral brs. |
cremaster m. |
skin of anterior scrotum/labia majora & upper medial thigh |
lies on psoas major in abdomen; genital br. passes through deep inguinal ring & inguinal canal; brushing thigh elicits elevation of testis via cremasteric reflex |
Arteries
|
| Artery |
Source |
Branches |
Supply to |
Notes |
| epigastric, inferior (N25,N253, N255, N260, TG5-05, TG5-07) |
external iliac a. |
cremasteric a. |
lower rectus abdominis m., pyramidalis m., lower abdominal wall |
inferior epigastric a. anastomoses with the superior epigastric a. within the rectus abdominis m. |
| epigastric, superficial (N249, TG5-02) |
femoral a. |
cutaneous brs. |
superficial fascia and skin of the lower abdominal wall |
superficial epigastric a. is one of three superficial arteries that arise from the femoral a. (see also: superficial circumflex iliac a. and superficial external pudendal a.) |
| epigastric, superior (N191, TG4-08, TG5-05) |
internal thoracic a. |
no named branches |
upper rectus abdominis m., upper abdominal wall |
superior epigastric a. is the direct continuation of the internal thoracic a.; it anastomoses with the inferior epigastric a. within the rectus abdominis m. |
| intercostal, posterior (TG4-39) |
highest intercostal (upper 2 intercostal spaces), descending thoracic aorta (3rd-11th intercostal spaces) |
posterior br., spinal br., anterior br., collateral br., lateral cutaneous br. |
intercostal muscles, spinal cord and vertebral column, deep back muscles, skin and superficial fascia overlying the intercostal spaces |
posterior intercostal aa. supply the lateral and posterior portions of the intercostal space; anterior intercostal aa. supply the anterior portions of the intercostal spaces |
| subcostal (TG4-39) |
descending thoracic aorta |
spinal br., collateral br., lateral cutaneous br. |
vertebrae, spinal cord; muscles, skin & fascia of the upper abdominal wall |
subcostal a. is equivalent to a posterior intercostal a., but is named subcostal because it courses inferior to the 12th rib |
| cremasteric (TG6-31) |
inferior epigastric a. |
no named branches |
cremaster m., coverings of the spermatic cord |
cremasteric a. is one of the contents of the spermatic cord; it anastomoses with the testicular artery distally (Latin, cremaster = suspender) |
| testicular (TG6-31) |
abdominal aorta |
ureteric brs. |
testis, epididymis, lower part of the ductus deferens, ureter near its midpoint |
testicular a. is one of the contents of the spermatic cord; the origin of
the testicular a. from the aorta at the L2 vertebral level indicates the embryonic
level of origin of the testis prior to its descent |
Topographic Anatomy
|
| Structure/Space |
Description/Boundaries |
Significance |
| arcuate line (TG5-05, TG5-07) |
anatomical feature on the inner surface of the abdominal wall; a fascial line in the transverse plane approximately 1/2 of the distance from the umbilicus to the pubic symphysis |
arcuate line is the point at which the posterior lamina of the rectus sheath ends and transversalis fascia lines the inner surface of the rectus abdominis m. (Latin, arcuate = bowed) |
| epigastric region (TG5-01) |
an area on the anterior abdominal wall between the midclavicular lines, superior to the transpyloric line |
one of 9 regions of the abdomen |
| hypochondriac region (TG5-01) |
an area on the anterior abdominal wall lateral to the midclavicular line, superior to the transpyloric line |
right and left hypochondriac regions comprise 2 of 9 regions of the abdomen |
| hypogastric region (TG5-01) |
an area on the anterior abdominal wall between the midclavicular lines, inferior to the intertubercular line |
one of 9 regions of the abdomen; also known as: pubic region |
| inguinal region (TG5-01) |
anterior abdominal wall lateral to midclavicular line, inferior to intertubercular line |
right and left inguinal regions comprise 2 of 9 regions of the abdomen; also known as: iliac region |
| intercristal line |
an imaginary line drawn in the horizontal plane at the upper margin of the iliac crests |
intercristal line locates the level of the L4 vertebra; a useful landmark in spinal tap procedure |
| intertubercular line (TG5-01) |
an imaginary line drawn in the horizontal plane at the upper margin of the iliac tubercles |
intertubercular line locates the level of the L5 vertebra; used with midinguinal and transpyloric lines to divide the abdominal wall into 9 regions |
| lumbar region |
an area on the anterior abdominal wall lateral to the midclavicular line, inferior to transpyloric line, superior to intertubercular line |
right and left lumbar regions comprise 2 of 9 regions of the abdomen; also known as: lateral region |
| McBurney's point (TG5-15) |
a point on the anterior abdominal wall which is 1/3 of the distance along a line from the right anterior superior iliac spine to the umbilicus |
McBurney's point is the approximate location of the vermiform appendix; point of tenderness in appendicitis |
| midaxillary line (TG4-01) |
an imaginary vertical line passing through the middle of the axilla |
used as a surface landmark for descriptive purposes |
| midclavicular line (TG4-01, TG5-01) |
an imaginary vertical line passing through the midshaft of the clavicle |
used as a surface landmark for descriptive purposes |
| midinguinal line (TG5-01) |
an imaginary vertical line passing through the midpoint of inguinal ligament |
used with the transpyloric and intertubercular lines to divide the abdomen into 9 regions |
| quadrant, inferior left (TG5-01) |
a region on the anterior abdominal wall defined by the midline and the transumbilical line |
one of 4 abdominal quadrants |
| quadrant, inferior right (TG5-01) |
a region on the anterior abdominal wall defined by the midline and the transumbilical line |
one of 4 abdominal quadrants |
| quadrant, superior left (TG5-01) |
a region on the anterior abdominal wall defined by the midline and the transumbilical line |
one of 4 abdominal quadrants |
| quadrant, superior right (TG5-01) |
a region on the anterior abdominal wall defined by the midline and the transumbilical line |
one of 4 abdominal quadrants |
| semilunar line (TG5-01) |
an anatomical feature of the anterior abdominal wall; the lateral edge of the rectus abdominis m. |
semilunar line is formed by the fused aponeuroses of the abdominal wall mm. at the lateral margin of the rectus sheath |
| transpyloric line (TG5-01) |
an imaginary horizontal line 1/2 of the distance between the jugular notch and the pubic crest |
transpyloric line is used with the midinguinal and intertubercular lines to divide the abdominal wall into 9 regions; the fundus of the gall bladder lies at the intersection of the transpyloric line with the right 9th costal cartilage; the pylorus of the stomach is located at this plane; a horizontal plane through the transpyloric line locates the level of the L1 vertebra |
| transumbilical line (TG5-01) |
an imaginary horizontal line through the umbilicus |
transumbilical line is used with the midline to divide abdomen into 4 quadrants |
| transverse lines |
anatomical features in the anterior abdominal wall; folds in the anterior abdominal wall (usually 3) |
transverse lines are creases that overlie the tendinous intersections in the rectus abdominis m. |
| umbilical region |
a region on the anterior abdominal wall between the midclavicular lines, inferior to the transpyloric line, superior to the intertubercular line |
one of 9 regions of the abdomen |
| umbilicus (TG5-01) |
remnant of the attachment of the umbilical cord to the anterior abdominal wall |
umbilicus marks the approximate level of the L3/L4 intervertebral disc in non-obese individuals (Latin, umbilicus = navel) |
| superficial (external) inguinal ring (N387,N249,N259,N260, TG5-08A, TG5-09A, TG5-10) |
slitlike opening between the diagonal fibers of the aponeurosis of the external oblique, superolateral to the pubic tubercle |
exit from the inguinal canal |
| deep (internal) inguinal ring (TG5-08C, TG5-09C) |
site of an outpouching of the transversalis fascia approx. 1.25 cm superior to the middle of the inguinal ligament and lateral to the inferior epigastric a. |
opening into the inguinal canal |
| inguinal canal (N387,N249,N259,N260, TG5-08A, TG5-09A, TG5-10A, TG5-10B, TG5-11A) |
Anterior - aponeurosis of the ext. oblique; Posterior - transversalis fascia; Roof - fibers of the int. oblique and transverse abdominis; Floor - superior surface of the inguinal ligament |
pathway for the spermatic cord in males and round ligament of the uterus in females |
| inguinal triangle (N259, TG5-07) |
bounded by the rectus abdominis medially, the inferior epigastric vessels laterally, and the inguinal ligament inferiorly |
the weak fascia, where direct hernias occur, is located in the inferior portion of this triangle |
| lateral inguinal fossa (N253,N259, TG5-07) |
shallow depression on the inner aspect of the abdominal wall lateral to the lateral umbilical fold |
an indirect inguinal hernia passes through the anterior abdominal wall in this fossa (Latin, fossa = trench or ditch) |
| lateral umbilical (epigastric) fold |
peritoneal fold overlying the inferior epigastric vessels |
an indirect inguinal hernia passes through the anterior abdominal wall lateral to this fold; a direct inguinal hernia passes through the anterior abdominal wall medial to this fold |
| medial inguinal fossa (N253,N259, TG5-07) |
shallow depression on the inner aspect of the abdominal wall between the medial inguinal fold and the lateral umbilical fold |
a direct inguinal hernia passes through the anterior abdominal wall in this fossa; it passes through a subdivision called the inguinal triangle (Latin, fossa = trench or ditch) |
| medial umbilical fold (N253, TG5-07) |
peritoneal fold overlying the medial umbilical ligament |
medial umbilical ligament is the obliterated umbilical a. |
| median umbilical fold (N253, TG5-07) |
peritoneal fold overlying the median umbilical ligament (remnant of urachus) |
median umbilical ligament is the remnant of the urachus |
| supravesical fossa (N253, N259, TG5-07) |
between the median and medial umbilical folds, formed as the peritoneum reflects from the anterior abdominal wall onto the bladder |
potential sites for rare external supravesical hernias (Latin, fossa = trench or ditch) |
Viscera/Fascia
|
| Organ |
Location |
Description |
Notes |
| thoracolumbar aponeurosis (fascia) (N174, TG1-13) |
extends laterally from the spinous processes and forms a thin covering for the deep muscles in the thoracic region and a strong, thick covering for muscles in the lumbar region |
forms the aponeurotic origin of latissimus dorsi |
(Greek, aponeurosis = a broad, flat nerve; due to the resemblance between nerves & tendons) |
| conjoint tendon (TG5-08D, TG5-09D) |
attached to pubic crest and pecten pubis |
the most inferior, medial tendinous fibers of the internal oblique join with the aponeurotic fibers of the deeper transverse abdominis |
also called the falx Inguinalis |
| ductus deferens (N387, N262, TG5-08C, TG5-08D, TG5-09D, TG5-10B, TG5-10C) |
passes through superficial inguinal ring, inguinal canal & deep ring to reach posteroinferior surface of bladder where it joins with duct of seminal vesicle to form ejaculatory duct |
continuous with tail of epididymis |
(Latin, ductus = to lead + deferens = to carry away) |
| fascia, cremasteric (N260, N387, N390, TG5-08C, TG5-09C, TG5-10B, TG6-31) |
intermediate covering of spermatic cord |
|
derived from internal abdominal oblique muscle (Greek, fascia = a band + cremaster = a suspender) |
| fascia, external spermatic (N260, N387, N390, TG5-08C, TG5-09C, TG5-10B, TG6-31) |
outermost covering of spermatic cord |
|
derived from fascia of external abdominal oblique muscle (Greek fascia = a band) |
| fascia, internal spermatic (N260, N387, N390, TG5-08C, TG5-09C, TG5-10B, TG6-31) |
innermost covering of spermatic cord |
|
derived from transversalis fascia |
| fascia lata (N249, TG3-02) |
deep fascia forming tubular investment of the thigh |
thickened laterally as iliotibial tract/band; connected to femur by lateral & medial intermuscular septa |
Scarpa's fascia attaches to it below inguinal ligament |
| crus, lateral (TG5-08C, TG5-09C) |
lateral border of superficial inguinal ring |
attaches to pubic tubercle |
(Latin, crus = leg) |
| crus, medial (TG5-08C, TG5-09C) |
medial border of superficial inguinal ring |
attaches to pubic crest |
(Latin, crus = leg) |
| parietal peritoneum (N335, N336, TG5-42, N337, TG5-43) |
lines the internal surface of the abdominopelvic wall |
invests organs |
(Latin, parietal = wall) |
| rectus sheath (N249,N251,N252A,N252B, TG5-05, TG5-06, TG5-06) |
tough, aponeurotic, tendinous sheath of the rectus abdominis muscle |
|
(Latin, rectus = straight) |
| round ligament of uterus (N397, TG5-09A, TG5-09C, TG5-09D) |
attaches to inner aspect of labia majora, traverses superficial inguinal ring, inguinal canal & deep inguinal ring to reach lateral surface of uterus below uterine tube |
continuous with ovarian ligament |
a.k.a. ligamentum teres uteri; remnant of gubernaculum (Latin, teres = round) |
| scrotal ligament (TG6-31A) |
band of connective tissue that attaches the inferior end of the testis to the inner aspect of the scrotal sac |
scrotal ligament is the remnant of the gubernaculum testis |
|
| scrotum (TG6-31A) |
sac of hair-covered skin containing the testis |
in the scrotum the fatty and membranous layers of the superficial fascia (as seen in the lower abdominal wall) are fused to form the tunica dartos scroti |
|
| spermatic cord (N387, N262, TG5-08, TG5-08D, TG5-10B, TG5-10C) |
bundle of vessels, nerves and lymphatics ensheathed in tissue layers derived from the abdominal wall; it begins at the deep inguinal ring, passes through the inguinal canal and the superficial ring to reach the testis in the scrotum |
spermatic cord comprises the: ductus deferens, testicular a., pampiniform plexus, deferential a. & v. and genital br. of the genitofemoral n.; coverings of the cord are the: internal spermatic fascia (from the transversalis fascia), cremasteric muscle and fascia (from the internal abdominal oblique), external spermatic fascia (from the external abdominal oblique fascia) |
|
| testis (TG6-32B) |
an endocrine and exocrine gland contained within the scrotum |
testis is the male gonad; its exocrine product is sperm which drain to the head of the epididymis via efferent ductules; its endocrine product is testosterone; the testis migrates into the scrotum shortly before birth; it is tethered to the scrotum inferiorly by the scrotal ligament (a remnant of the gubernaculum) |
|
| tunica dartos scroti (TG6-32B) |
a subcutaneous layer of smooth muscle located in the scrotum |
fatty and membranous layers of the superficial fascia (as seen in the lower abdominal wall) are fused in the scrotum to form the tunica dartos scroti |
(Greek, dartos = leather) |
| tunica vaginalis testis (TG6-32B, TG6-32C) |
a peritoneal sac located anterolateral to the testis |
tunica vaginalis testis has two layers: visceral and parietal; the visceral layer lies on the anterolateral surface of the testis and epididymis; the parietal layer lines the inner surface of the scrotal sac |
(Latin, vagina = sheath) |
| fascia, transversalis (N251,N252,N259, TG5-07) |
lines majority of abdominal wall |
covers the deep surface of the transverse abdominis and its aponeurosis |
right and left sides continuous deep to the linea alba |
| fascia, weak (N251,N252,N259, TG5-07) |
located in the inguinal triangle |
|
hernias can occur here |
| testis (TG6-31) |
an endocrine and exocrine gland contained within the scrotum |
testis is the male gonad; its exocrine product is sperm which drain to the head of the epididymis via efferent ductules; its endocrine product is testosterone; the testis migrates into the scrotum shortly before birth; it is tethered to the scrotum inferiorly by the scrotal ligament (a remnant of the gubernaculum) |
|
Clinical Terms
|
| Term |
Definition |
| appendicitis |
inflammation (and usually infection) of the appendix, a finger-like projection
of the first portion of the colon, that often causes right, lower quadrant
abdominal pain, fever and loss of appetite |
| cholecystitis |
acute or chronic inflammation of the gallbladder; may necessitate a cholecystectomy or
gall bladder removal, which is now usually performed laparoscopically. History may
reveal pain, fever with chills and nausea with vomiting. |
| McBurney's point/incision |
McBurney's point lies 1/3rd superiomedially along the line between the right anterior
superior iliac spine and the umbilicus; this point marks the usual location of the appendix
within the right iliac fossa; McBurney's incision is an oblique incision over this point
inferomedially directed, splitting the fibers of the external oblique aponeurosis; fibers of
internal abdominal oblique and transversus abdominis muscles are then split to gain access to
the appendix |
| median incision |
incisions made through the fibrous tissue of the linea
alba superior and/or inferior to the umbilicus; linea alba usually only
transmits small vessels and nerves, therefore these incisions are relatively
harmless and bloodless; however, in some patients these incisions may be
problematic as they may cut through vascularized fat; also, as it is poorly
vascularized, incisions of the linea alba may result in necrosis if the
incisions are not brought together well; lower median incisions are often
used in female patients to access the female pelvic viscera; median incisions
are generally used for exploratory procedures |
| paramedian incision |
incision through the anterior layer of the rectus sheath which is laterally
retracted, and then through the posterior layer and peritoneum to enter
the peritoneal cavity |
| subcostal incision |
provides access to the gallbladder and biliary tract on the right side
and the spleen on the left; made parallel to the costal margin but at least 2.5
cm inferior to avoid the 7th and 8th thoracic spinal
nerves |
| Pfannenstiel (suprapubic) incision |
incision made at the pubic hairline; horizontal with a
slight downward convexity; used for most gynecological and obstetrical
operations (e.g., for cesarean section and removal of a tubal pregnancy) |
| transpyloric plane |
at the
midpoint between the suprasternal notch and the pubic symphysis, at
the level of the first lumbar vertebra |
| paresthesia |
an abnormal spontaneous sensation such as burning, pricking, and numbness
|
| periumbilical |
around or near the umbilicus |
| emesis |
act of vomiting |
| anorexia |
uncontrolled loss of appetite for food |
| auscultation |
the act of listening for sounds within the body, chiefly for ascertaining
the condition of the lungs, heart, pleura, abdomen and other organs and
for the detection of pregnancy |
| abdominal guarding |
spasm of the anterolateral abdominal muscles and a muscular rigidity usually in response
to intraperitoneal inflammation or irritation |
| rebound tenderness |
when pressure is applied to an area of the abdominal wall and then suddenly removed,
extreme localized pain is felt by the patient usually in response to intraperitoneal
inflammation or irritation |
| gastroenteritis |
an acute inflammation of the lining of the stomach and intestines that can be initiated by
food poisoning due to viral or bacterial infection resulting in nausea (+/- emesis), pain,
and diarrhea (+/- blood) |
| peritonitis |
inflammation of the peritoneum |
| Caesarian/Cesarian section |
an obstetrical procedure in which an infant, instead of being born vaginally,
is surgically removed from the uterus; requires both an incision into
the abdominal wall and the wall of the uterus; done in
ancient civilizations to save babies after the death of a full-term pregnant
mother, hence, the name Caesarian, since it is believed that Caesar was
born by this procedure |
| umbilical hernia |
an abnormal protrusion of abdominal contents into a defect in the umbilical area; common in the newborn, but usually resolves by age two (Latin, hernia = to rupture) |
| direct/indirect inguinal hernia |
protrusion of parietal peritoneum and viscera such as the small intestine, or part of them, through a normal or abnormal opening from the cavity in which they belong. Most hernias are reducible, meaning that they can be returned to their normal place in the abdominal cavity by appropiate manipulation. Approximately 90% of abdominal hernias are in the inguinal region. An indirect (congenital) inguinal hernia, the most common type, leaves the abdominal cavity lateral to the inferior epigastric vessels and enters the deep inguinal ring, enters a hernial sac formed by a persistent processus vaginalis, goes through the entire inguinal canal, exits through the superficial inguinal ring and commonly enters the scrotum. However, a direct inguinal hernia leaves the abdominal cavity medial to the inferior epigastric artery, protrudes through the posterior wall of the inguinal canal at the inguinal triangle, has a hernial sac formed by the transversalis fascia, lies outside the tunica vaginalis, does not traverse the entire inguinal canal, passes through or around the conjoint tendon to reach the superficial inguinal ring, gains a covering of external spermatic fascia, and almost never enters the scrotum (Latin, hernia = to rupture) |
| incisional hernia |
protrusion of omentum (a fold of peritoneum) or an organ through a surgical incision. If the muscular and aponeurotic layers of the abdomen do not heal properly, an incisional hernia can result. Infection, bowel obstruction, and obesity are predisposing factors to incisional hernias (Latin, hernia = to rupture) |
| herniorrhaphy |
surgical repair of a hernia; can be done under local or general anaesthesia; may be performed using a conventional incision or using a fiberoptic laparoscope |
| strangulation, gangrene |
strangulation involves stopping blood flow by constriction or compression; as, a strangulated hernia; gangrene is death of tissue, usually in considerable mass and generally associated with loss of vascular (nutritive) supply and followed by bacterial invasion and putrefaction |
| reduction |
correction of a fracture, dislocation or hernia |
| cremasteric reflex |
elicited by lightly stroking the skin on the medial aspect of the superior part of the thigh with an application stick or tongue depressor; this area of skin is supplied by the femoral branch of the genitofemoral nerve; the elevation of the testes is on the same side as the stroking (Latin, cremaster = suspender) |
| cryptorchidism |
failure of one or both testes to descend into the scrotum; occurs in 3% of full-term and in 30% of pre-mature infants; the importance of this condition is its potential for developing malignancy |
| hydrocele |
an accumulation of serous fluid in a sac-like cavity adjacent to the testis, a swelling due to the accumulation of serous fluid in the tunica vaginalis of the testis or in the spermatic cord (Greek, hydro = water + -cele = hernia) |
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