Topic 215. Topographo- Anatomical Regions OF THE Abdomen PDF

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TOPIC 215. TOPOGRAPHO-ANATOMICAL REGIONS OF THE ABDOMEN ANTEROLATERAL ABDOMINAL WALL → muscular aponeurotic formation limited by the abdominal wall from the anterior and lateral sides. 1. BORDERS - Superior o Costal arches of both sides o Xiphoid process - Inferior o Iliac crest o Anterior superior iliac spines o Inguinal ligaments or inguinal folds o Pubic symphysis o Pubic tubercle - Lateral – continuation of the midaxillary lines (Lesgaft’s lines) 2. ORIENTATION LINES - HORIZONTAL ORIENTATION LINES o SUPERIOR HORIZONTAL LINE (linea costarum, linea bicostalis)  Joins the lowest portions of the costal arches  Area superior to it is the EPIGASTRIUM o INFERIOR HORIZONTAL LINE (linea spinarum, linea bispinalis)  Joins the anterior superior iliac spines  Area inferior to it is the HIPOGASTRIUM *Area between these 2 lines is the MESOGASTRIUM -

VERTICAL ORIENTATION LINES o RIGHT MIDCLAVICULAR LINE (linea clavicularis media, linea mamillaris dextra)  Joins the middle point of the right clavicle to the middle point of the right inguinal ligament. o LEFT MIDCLAVICULAR LINE (linea clavicularis media, linea mamillaris sinistra)  Joins the middle point of the left clavicle to the middle point of the left inguinal ligament 3. REGIONS The abdomen is divided into 9 regions by the orientation lines: o RIGHT HYPOCHONDRIAC REGION (regio hypochondriaca dextra) o PROPER EPIGASTRIC REGION (regio epigástrica propia) o LEFT HYPOCHONDRIAC REGION (regio hypochondriaca sinistra) o RIGHT LATERAL ABDOMINAL REGION (regio abdominalis lateralis dextra) o UMBILICAL REGION (regio umbilicalis) o LEFT LATERAL ABDOMINAL REGION (regio abdominalis lateralis sinistra) o RIGHT INGUINAL (ILIOINGUINAL) REGION (regio ilioinguinalis dextra) o HYPOGASTRIC (SUPRAPUBIC) REGION (regio suprapubicalis) o LEFT INGUINAL (ILIOINGUINAL) REGION (regio ilioinguinalis sinistra) 4. QUADRANTS The abdomen is divided into 4 quadrants by the STERNAL LINE (linea sternalis) corresponding to the WHITE LINE (línea alba abdominis) and TRANSUMBILICAL LINE (linea transumbilicalis) crossing the umbilicus: o RIGHT UPPER QUADRANT o LEFT UPPER QUADRANT

o RIGHT LOWER QUADRANT o LEFT LOWER QUADRANT 5. PROJECTION OF ORGANS ON THE ABDOMEN (holotopy of the abdominal organs) - RIGHT HYPOCHONDRIAC REGION o Right lobe of the liver o Gall bladder o Superior pole of the right kidney o Right suprarenal gland o Right colic flexure of the large intestine - PROPER EPIGASTRIC REGION o Left lobe of the liver o Stomach o Body of the pancreas o Superior part of the duodenum o Inferior vena cava o Abdominal aorta o Coeliac trunk o Coeliac plexus o Lesser omentum - LEFT HYPOCHONDRIAC REGION o Part of the stomach o Left colic flexure of the large intestine o Spleen o Superior pole of the left kidney o Left suprarenal gland o Tail of the pancreas - RIGHT LATERAL ABDOMINAL REGION o Ascending colon o Right kidney (except superior pole) o Right ureter o Loops of the small intestine - UMBILICAL REGION o Duodenum (except superior part) o Head of the pancreas o Transverse colon o Loops of small intestine o Inferior vena cava - LEFT LATERAL ABDOMINAL REGION o Descending colon o Left kidney (except superior pole) o Left ureter o Loops of the small intestine - RIGHT INGUINAL REGION o Caecum o Vermiform appendix o Right ureter o Right external iliac artery and vein - HYPOGASTRIC REGION o Distal part of the sigmoid colon

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Supraampular part of the rectum Abdominal part of the ureter Distended urinary bladder Uterus (after the 1st trimester)

LEFT INGUINAL REGION o Sigmoid colon o Left ureter o Left external iliac artery and vein

UMBILICAL REGION AND WHITE LINE -

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UMBILICAL RING (annulus umbilicalis) o Located in the umbilical region o Weak place because it consists of 3 layers only:  SKIN  ENDOABDOMINAL FASCIA  PERITONEUM o Muscle is absent in this region → contributes to the common occurrence of umbilical hernias. WHITE LINE (linea alba) o Formed by the fusion of the aponeurosis of the broad muscles of the abdominal wall o Muscle is absent here o It is wider in the upper part of the abdomen o It is narrower in the lower part of the abdomen o If the loops of aponeurotic fibers are wide in this region → herniation may occur....