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RegionalAnatomy1Abdomen-partoneAnterolateralabdominalwallBoundariesoftheabdomenBoundariesSuperiorly－xiphoidprocess,costalarch,11thand12thribs,vertebraT12Inferiorly－spinousprocessofL5;iliaccrest;ant.sup.iliacspine;inguinallig;pubictubercle;pubiccrest;sup.borderofpubicsymphysisActually:thevolumeofabdominalcavityismorethanthatoftheabdomen.BonylandmarkoftheabdomenOrgansintheabdomenAnt.viewPost.view1xiphoidprocess2costalmargin3tipofninthcostalcartilage4tendinousintersections5umblicus6iliaccrest7ant.sup.iliacspine8lineasemilunaris9lineaalba10inguinallig.11pubictubercle12pubiccrest13pubicsymphysisSurfaceanatomyoftheabdomenAbdominalregion-nineregions1Righthypochondriacregion2Epigastricregion3Lefthypochondriacregion4Rightlateral(lumbar)region5Umbilicalregion6Leftlateral(lumbar)region7Rightiliac(inguinal)region8Hypogastric(pubic)region9Leftiliac(inguinal)region(By2-transverselines&2-verticallines)A-atthelevelofthelowerestpointofcostalarchB-atthelevelofbothanteriorsuperioriliacspineRightupperquadrant(RUQ)Rightlowerquadrant（RLQ）leftupperquadrant（LUQ）Leftlowerquadrant（LLQ）LUQRUQRLQLLQQuadrantsofabdomen(fourregions)AccordingtwoverticallinescrossthenavelAnterolateralabdominalwallLayers(fromsup.)1.Skin2.Superficialfascia-twolayers3.Anterolateralmuscles(3+1)4.Transversefascia5.Extraperitonealfascia6.Parietalperitoneum123456FattylayerMembranouslayerAnterolateralabdominalwallSuperficialfasciadivisionsbelowumbilicusFattylayer(Camper’sfascia)continuouswiththesuperficialfasciaovertherestofthebody.Membranouslayer(Scarpa’sfascia)passesovertheinguinallig.tofusethedeepfasciaofthethigh(fascialata)approximatelyonefingerbreadthbelowtheinguinalligament.Inthemidline,itisattachedtolineaalba.Inferiorly,itiscontinuouswithsup.perinealfascia(Colles’fascia).F-layerM-layerLayers,vessels,muscles&nervesoftheabdomenSuperficialbloodvessels&nervesofanterolateralabdomentalwallBloodvesselsandnerveofantrolateralabdominalwallAnt.branchesoflower6pairsofthoracicnn.arelocatedinbetweenint.obliquem.&transversusabdominis.Thelowerpartofant.abdominalwallissuppliedbyiliohypogastricandilioingunalnn.MusclesofanterolateralabdominalwallAnterolateralgroupExternalobliquem.internalobliquem.TransversusabdominisRectusabdominisExternalobliquem.RectusabdominisTransversusabdominisInternalobliquem.ExternalobliquemuscleNotetheponeurosis(1)andsuperficialinguinalring(2)MuscularpartTendinouspart21Internalobliquem.腹内斜肌MuscularpartTendinouspartTransversusabdominisTheincisionabouttherectusabdominisLocation:bothsidesofant.medianline.upperpartiswiderthanthatoflowerpart.Thelateralborderiscalledsemilunarline.3-4tendinousintersections.SemilunarlineTendinousintersectionsAnteriorlayerFormedbyfusionofaponeurosisofexternalobliquem.andant.leafofaponeurosisofinternalobliquem.PosteriorlayerFormedbyfusionofpost.leafofaponeurosisofinternalobliquem.andaponeurosisoftransversusabdominisAbsentinabout4-5cmbelowtheumbilicus,whereaponeurosesofallthreemusclesformant.layerthelowerfreebordernamedarcuatelineBelowthislinerectusabdominisincontactwithtransversefasciaRectusSheathbelowarcuatelineabovearcuatelineRectussheath-Crosssectionabovearcuateline123456789101112131415Rectussheath-CrosssectionbelowacuatelineabovearcuatelinebelowarcuatelineAttention:belowarcuateline,noposteriorlayerofrectussheathLineaalbaabovearcuatelinebelowarcuate...