L3
Skin
L5
Superficial Fascia
3 flat muscles and 1 strap-like muscle
Parietal Peritoneum
Extraperitoneal fat
L3 - L4
Right Hypochondriac, Epigastric, Left Hypochondriac, Right Lumbar, Umbilical, Left Lumbar, Right Inguinal, Hypogastric/Pubic, Left Inguinal
Duodenum (2nd-4th), Pancreas, Ascending/descending colon, Middle rectum
Deep fascia
Muscles
Transversalis fascia
A hematocele is caused by the accumulation of blood, resulting from the rupture of testicular blood vessels after trauma.
The superficial inguinal ring.
Indirect inguinal hernia.
4 paired muscles
It is used for placing prostheses, such as Gore-Tex mesh, when repairing inguinal hernias.
Midway between the umbilicus and pubic crest.
Testicular veins (pampiniform plexus)
The inferior rectum.
A hydrocele is the accumulation of serous fluid, usually from the persistence of the processus vaginalis. It is diagnosed with a positive transillumination test.
A varicocele results from dilatations of the tributaries of the testicular vein.
A varicocele results from dilatations of tributaries of the testicular vein.
Immediately inferior to the Hepatoduodenal ligament.
Stomach
1st duodenum
An organ with no peritoneal covering at all, such as the inferior rectum.
A crescent-shaped line marking the inferior limit of the posterior layer of the rectus sheath, located midway between the umbilicus and pubic crest.
Testicular artery, cremasteric artery, artery of vas deferens
Vas deferens, processus vaginalis
Inguinal ligament
Direct inguinal hernia.
Rectus sheath
In the abdomino-pelvic cavity.
Camper's fascia merges with the superficial fascia of the thigh and the superficial layer of the perineal fascia.
Tunica vaginalis
Superficial to the inguinal ligament.
No, there are no organs in the peritoneal cavity.
Genital branch of the genitofemoral nerve
It provides a continuous arterial circle along the inner border of the colon, ensuring blood supply.
The omentum connects the stomach with other viscera and is often referred to as the 'abdominal policemen'.
Hepatoduodenal ligament, Portal vein, Hepatic artery, Bile duct.
Liver cirrhosis is the late stage of progressive hepatic fibrosis characterized by distortion of the hepatic architecture and the formation of regenerative nodules.
Portal hypertension develops when there is resistance to portal blood flow and is aggravated by increased portal collateral blood flow; it often develops in the setting of cirrhosis, schistosomiasis, or extrahepatic portal vein thrombosis.
They strengthen the abdominal wall and decrease the risk of protrusion of viscera.
Kidney, Ureter, Urinary bladder, Uterus, Fallopian tube, Aorta, IVC, Suprarenal glands
Linea semilunaris
Pancreas, Ureter, Kidney, Inferior vena cava, Duodenum, Ascending Colon, Descending Colon, Abdominal Aorta, Suprarenal gland
Testicular lymph vessels
A spermatocele is a retention cyst containing sperm that develops in the head of the epididymis.
Serratus anterior and latissimus dorsi
Aponeurosis
Within the abdominal cavity and continues into the pelvic cavity.
Through the uterine tubes, uterine cavity, and vagina.
Left Colic, Sigmoid, Superior Rectal
It is outside, external, or posterior to the parietal peritoneum and partially covered with peritoneum, usually on one surface.
The mesentery supports hollow viscera to the body wall and provides a means for neurovascular communication between the organ and the body wall.
2cm below umbilicus in the midline (through the linea alba) and 5cm superior and medial to the anterior superior iliac spines on either side (in update 3cm).
4 layers
The two layers are the Fatty Layer (Camper's fascia) and the Membranous Layer (Scarpa's fascia).
The deep fascia continues over the penis as the deep fascia (Buck's fascia) and perineum as deep perineal fascia.
Left gastric vein, right gastric vein, cystic veins, posterior superior pancreaticoduodenal vein
The superior rectum.
Indirect and direct.
A thin layer of peritoneal fluid that keeps the surfaces moist and lubricates, enabling the viscera to move over each other without friction.
A spermatocele is a retention cyst containing sperm that develops in the head of the epididymis.
Stroking the skin of the superior and medial thigh
Epiploic Foramen
Greater curvature and transverse colon
Esophagus
Skin → Superficial fascia → Deep fascia → Linea alba → Transversalis fascia → Extraperitoneal fat → Parietal peritoneum.
External oblique → Internal oblique → Transversus abdominis → Transversalis fascia → Extraperitoneal fat → Parietal peritoneum.
Right gastroduodenal artery, superior anterior pancreaticoduodenal artery
Right branch of the proper hepatic artery
Lesser Sac or Omental Bursa
C6 vertebra
Ventral rami of the lower six thoracic nerves and First Lumbar nerve (T7 - T12 + L1).
None
The middle rectum.
It extends from the xiphoid process to the pubic symphysis.
Obliquely downward and medially
A hematocele is caused by the accumulation of blood, resulting from the rupture of testicular blood vessels after trauma.
Lateral – Indirect, Medial – Direct (M.D.).
Conjoint tendon
L3
Superior mesenteric, Splenic, Inferior mesenteric, Left/Right gastric, Paraumbilical
The mesentery is a 2-layered extension of the visceral peritoneum that supports hollow viscera to the body wall and provides a means for neurovascular communication between the organ and the body wall.
The left gastric artery.
The portal vein and the anterior wall of the inferior vena cava (IVC)
Thyroid, Parathyroid glands, Tympanic cavity, Trachea, bronchi, lungs, liver, gallbladder, pancreas
Superior part of the Duodenum.
SAD PUCKER
The deep fascia covers the muscles.
Transversus abdominis
Dartos muscle
Superior mesenteric vein and splenic vein
A tendinous median raphe between the two rectus abdominis muscles, formed by the fusion of the aponeuroses of the external oblique, internal oblique, and transversus abdominis muscles.
A potential space between the parietal and visceral layers of the peritoneum.
Upward and medial
Into the Superficial Inguinal nodes.
Femoral branch of the genitofemoral nerve
Collateral circulation may develop by way of anastomoses between the pancreaticoduodenal branches of SMA and gastroduodenal.
Left gastric artery, splenic artery, common hepatic artery
Pharynx, Esophagus, Stomach, Proximal duodenum (2nd part)
Pain may be referred in the shoulder.
Superior Mesenteric Artery
Short gastrics, left gastroepiploic vessels
Superior rectum
Greater and lesser sacs on the left
Lesser curvature of the stomach, duodenum, and proximal part of the duodenum to the liver
The Gimbernat lacunar ligament forms when fibers attach to the superior pubic ramus lateral to the pubic tubercle.
Cooper's ligament is formed by the most lateral fibers of the inguinal ligament that continue to run along the pectin pubis.
Through the anterior abdominal wall lateral to inferior epigastric vessels, entering the deep inguinal ring and appearing at the superficial ring.
Pyramidalis
None
Nine
External oblique
Internal oblique
Into the External iliac nodes and ultimately to the Lumbar nodes.
Genital branch of the genitofemoral nerve
Portal hypertension
Gastroepiploic arteries
Inferior Vena Cava (IVC).
Caudate lobe of the liver.
Jejunum and ileum
Gastrophrenic, Gastrosplenic, Gastrocolic
Carries food and water but no digestion and absorption
Femoral artery
Superior recess and Inferior recess
Internal thoracic vein
External iliac vein
External iliac vein
Femoral vein
A pulsating mass at the midline.
Through the posterior wall and medial to inferior epigastric vessels.
The left gastric artery.
No, they never enter the scrotum.
The transversalis fascia and the conjoint tendon (inguinal falx).
The deep fascia continues over the spermatic cord as the External spermatic fascia.
Skin
Rectus abdominis
External Spermatic Fascia
Cremaster muscle
Internal Spermatic Fascia
Autonomic nerves, genital branch of genitofemoral nerve
A hydrocele is the accumulation of serous fluid, usually from persistence of processus vaginalis, and it is diagnosed with a positive transillumination test.
L1 spinal nerve
Visceral peritoneum.
The splenic artery.
Yes, viscera with mesentery are mobile.
Dorsal mesentery
Greater omentum
Greater curvature of the stomach and proximal part of the duodenum
Internal thoracic artery
2 layers
Palmar erythema, spider angioma, icterus, hepatomegaly, splenomegaly, skin excoriations, signs of hyperestrogenemia (gynecomastia, testicular atrophy, loss of male-pattern hair distribution).
Behind the trachea
Esophageal hiatus of the diaphragm
T10
Ileo-colic artery
Left gastric artery and inferior phrenic arteries
Children and young adults.
Lateral to inferior epigastric vessels.
Inferior phrenic, Lumbar
The splenic artery.
Elderly.
Into the Axillary Lymph nodes.
Yes, the peritoneal cavity is completely closed in males.
Superficial Inguinal lymph nodes.
Porta-caval shunts
Left gastric artery
Branches to the spleen, branches to the body and tail of the pancreas, short gastric branches, left gastro-omental artery
Common hepatic artery
The complications of portal hypertension include variceal hemorrhage and ascites.
Dorsal mesentery
L1
Pancreas (except tail)
Right Colic artery
Colon (ascending & descending)
Kidneys
Esophagus
Just proximal to the bifurcation of the aorta at the level of L4 vertebra.
Anastomoses between the tributaries of systemic veins, such as the thoraco-epigastric vein
The Portal triad consists of the Portal vein (lying posterior), the Common bile duct (lying anterior and to the right), and the Hepatic artery (lying anterior and to the left).
The gastroduodenal artery.
The deep inguinal ring (hole in fascia transversalis) and the superficial inguinal ring (hole in external oblique aponeurosis).
The falciform ligament is a derivative of the ventral mesentery.
Rectus abdominis, Pyramidalis, Superior epigastric vessels, Inferior epigastric vessels, Lower 5 intercostal and subcostal vessels & nerves (T7-T12)
The Pringle maneuver involves compressing the hepatoduodenal ligament manually or with a vascular clamp in the omental foramen to control bleeding from the hepatic inflow source.
Pelvic space
The hepatogastric ligament connects the liver to the lesser curvature of the stomach.
The rectovesical pouch is a peritoneal fold between the rectum and urinary bladder in males. It is the most dependent space in the peritoneal cavity.
Descending colon
Approximately 4 weeks after passing through the inguinal canal.
Level T10
Left gastric artery and inferior phrenic arteries
Stomach, liver, spleen.
It connects the Greater sac to the Lesser sac (Omental bursa).
Celiac trunk
The gastroduodenal artery.
The splenic vein
The clinical manifestations of portal hypertension include splenomegaly, abdominal wall collateral circulation, and thrombocytopenia.
Cecum and appendix, transverse colon, sigmoid colon
Suprarenal gland (adrenals)
Posterior to the stomach and lesser omentum
Inferior Pancreaticoduodenal artery
Middle Colic artery
Symptoms include sharp, localized pain, rebound tenderness, and guarding.
Peritoneum and layers of the spermatic cord.
Ascites is the accumulation of fluid in the peritoneal cavity due to peritonitis from congestion of the venous drainage of the abdomen.
Paracentesis is the surgical puncture of the peritoneal cavity for aspiration or drainage of fluid.
Suprarenal, Renal, Gonadal
The hepatoduodenal ligament conducts the Portal triad.
Hepatic artery
Pain may be referred to the shoulder.
The aponeurosis of the external oblique muscle (EOM).
Inferior VENA CAVA
The hepatoduodenal ligament contains the portal triad: proper hepatic artery, portal vein, and common bile duct.
Anterior: Free border of the lesser omentum (hepatoduodenal ligament), Posterior: Inferior vena cava, Superior: Caudate lobe of the liver, Inferior: 1st part of the duodenum
Connects the spleen to the fundus of the stomach and contains the short gastric artery.
The medial umbilical fold overlies the medial umbilical ligament, and the lateral umbilical fold overlies the inferior epigastric vessels.
Connects the spleen to the diaphragm.
The parietal peritoneum lines the walls of the abdominal and pelvic cavities.
The peritoneum suspends the organs within the peritoneal cavity, fixes some organs within the abdominal cavity, helps peritoneal covering of the intestine stick together in infection, and secretes peritoneal fluid for the gliding of mobile viscera over one another.
Subdiaphragmatic parietal peritoneum.
Abdominal policemen
Proximal duodenum to right half (upper 2/3) of transverse colon
Inferior Mesenteric Artery
Left half (lower 1/3) of transverse colon to upper part of anus
Duodenum (2nd & 3rd part)
Ascites, edema, encephalopathy, coagulopathy, esophageal varices.
Ureters
The proximal part of the second part of the duodenum is supplied by the foregut.
The distal part of the second part of the duodenum is supplied by the midgut.
The upper 2/3 or right side of the transverse colon is supplied by the midgut.
Rectum (middle)
Celiac artery
The internal surface of the abdomino-pelvic wall.
In the abdominopelvic cavity.
C3-C5 dermatomes over the shoulder.
Pain is poorly localized.
Foramen of Winslow
Supports the appendix and contains the appendiceal artery.
The hepatoduodenal ligament borders the omental foramen, which connects the greater and lesser sacs.
Rectus abdominis, External Oblique, Internal Oblique, Transversus abdominis
SUPERIOR MESENTERIC VEIN
The hepatogastric ligament is a derivative of the ventral mesentery.
Phrenic nerve.
External surfaces of ribs 5–12
Linea alba, pubic tubercle, anterior half of iliac crest
Compresses and supports abdominal viscera, flexes and rotates trunk
The Lateral Abdominal veins of the Inferior Vena Cava are the inferior phrenic and lumbar veins.
Ventral rami of six inferior thoracic and first lumbar nerves
Superior and inferior epigastric arteries
Iliolumbar ligament, internal lip of iliac crest
Greater curvature and spleen
Esophagus
The boundaries of the inguinal triangle are the inferior epigastric artery (superior and lateral), the inguinal ligament/Poupart ligament (inferior and lateral), and the rectus abdominis (medial).
Abdominal aorta / IVC
Urinary bladder
Hepatoduodenal ligament and Hepatogastric ligament
Femoral artery
IVC, Cisterna chyli
Intercostal and subcostal arteries
Inferior epigastric and Deep circumflex arteries
Celiac, Superior mesenteric, Inferior mesenteric
Ligaments are 2 layered and connect viscera to each other or to the body wall.
Collateral circulation may develop in the head of the pancreas by way of anastomoses between the pancreaticoduodenal branches of SMA and gastroduodenal.
Organs/viscera.
Pain is generally localized.
The falciform ligament contains the ligamentum teres hepatis (a derivative of the fetal umbilical vein) and patent paraumbilical veins.
The same blood and lymphatic vasculature and same visceral nerve supply as the organs it covers.
The spermatic cord.
Superior MESENTERIC VEIN
Greater omentum
No, there is no posterior layer of the rectus sheath below the arcuate line.
The hepatogastric ligament contains the gastric vessels.
INFERIOR MESENTERIC VEIN
The recto-uterine pouch is located between the rectum and uterus in females. It is more dependent than the vesico-uterine pouch.
The vesico-uterine pouch is a peritoneal fold located between the bladder and uterus in females.
Connects the spleen to the splenic flexure of the colon.
Autonomic afferent nerves.
The Inferior Vena Cava pierces the diaphragm at the level of the 8th Thoracic vertebra.
Superior and inferior epigastric and deep circumflex iliac arteries
Ventral rami of six inferior thoracic nerves
Pectineal line, iliopectineal eminence
Greater Sac
From the diaphragm to the pelvis
External iliac artery
The inguinal region is significant because it is where structures exit and enter the abdominal cavity, making it a potential site for herniation.
Greater omentum
Spleen
Portal vein → liver → hepatic vein → IVC
Portal hypertension.
Gynecomastia, testicular atrophy, loss of male-pattern hair distribution.
Splenic artery and vein, tail of pancreas
Pancreas, splenic vein, left renal vein, 3rd part duodenum, mesentery, nodes, autonomic plexus, lesser sac, stomach, omentum, small bowel
The lower 1/3 or left side of the transverse colon is supplied by the hindgut.
The upper part of the anal canal is supplied by the hindgut.
Common iliac, Median sacral
Gastroduodenal artery
Parallel and immediately above the inguinal ligament.
Branches of the superior mesenteric artery and tributaries of the superior mesenteric vein.
Right and Left Subphrenic spaces
LEFT RENAL VEIN
Superiorly: Respiratory Diaphragm; Inferiorly: Levator Ani and Coccygeus Muscles (Pelvic Diaphragm)
SPLENIC VEIN
The median umbilical fold covers the median umbilical ligament.
The hepatogastric ligament may be cut during surgery to access the lower sac.
The Inferior Vena Cava ascends on the RIGHT side of the Aorta.
Inferior borders of ribs 10–12, linea alba, pubis via conjoint tendon
Linea alba with aponeurosis of internal oblique, pubic crest, and pecten pubis via conjoint tendon
Femoral nerve
Iliohypogastric nerve
Liver, biliary tree
External iliac artery
It is caused by an enlarged gastrointestinal structure or by the escape of fluid, resulting in sharp, localized pain over the affected area.
Musculophrenic and Superior epigastric arteries
It can lead to the formation of an abscess in the subphrenic recess.
Jejunal-Ileal arteries
Superficial circumflex and Superficial epigastric arteries
Femoral vein
The lower part of the anal canal is derived from the ectoderm.
Arteries supplying GI structures are single and branch anteriorly, whereas arteries supplying non-GI structures are paired and branch laterally and posteriorly.
Medial to inferior epigastric vessels.
Stretching.
The transverse colon and the middle colic vessels.
Falciform ligament
Transversus abdominis (TA) aponeurosis and internal oblique (IO) aponeurosis
It acts as an 'abdominal policeman' and hangs down like an apron in front of the coils of the small intestine, folded back on itself to be attached to the transverse colon.
Hepatoduodenal ligament, hepatogastric ligament, hepatoesophageal ligament
Two-layered folds of peritoneum connecting and supporting parts of intestines to the posterior abdominal wall, containing the neurovascular structures that supply the organs it supports.
Celiac lymph node
The greater omentum stores a large amount of fat in the peritoneal ligaments and acts as the policemen of the abdomen to prevent the spread of infection.
2nd, 3rd, 4th duodenum, ascending colon, descending colon, rectum (middle 1/3), pancreas (head and body).
Superior 2/3 iliac fossa, ala of sacrum, anterior sacro-iliac ligaments
Linea alba
Vertebral margins of T12 – L1 vertebrae, corresponding intervertebral disc
Iliolumbar artery
Permits free movement of the stomach on adjacent structures
Sympathetic chain
Spleen to left pararenal space
Azygos veins, para-aortic nodes, coeliac ganglia
Dorsal mesentery
T12-L4 vertebrae, left lumbar veins
Yes, they can enter the scrotum.
Splenic artery
Weak abdominal wall.
The same blood and lymphatic vasculature and same somatic nerve supply as the region of the wall it lines.
Greater peritoneal cavity/sac
The inguinal ligament.
External oblique (EO) aponeurosis and internal oblique (IO) aponeurosis
Attaches the superior surface of the liver to the inferior surface of the diaphragm and demarcates the bare area of the liver.
Connects the liver beneath the surface of the diaphragm.
By the 28th week (7th month).
The hepatogastric ligament separates the greater and lesser sacs on the right.
The median umbilical ligament is a remnant of the urachus, and the medial umbilical ligament is a remnant of the obliterated umbilical arteries.
Ventral rami of six inferior thoracic nerves
Because the peritoneal cavity in females communicates with the exterior through the uterine tube/fallopian tubes, uterus, and vagina.
The veins of origin of the Inferior Vena Cava are the right and left common iliac veins and the median sacral vein.
Pubic symphysis, pubic crest
Body of pubis
Acting superiorly with iliacus, flexes hip; acting inferiorly, flexes vertebral column laterally; used to balance trunk in sitting position; acting inferiorly with iliacus, flexes trunk
Medial half of inferior border of 12th rib, tips of Lumbar transverse processes
Cardiac orifice
Patent processus vaginalis.
Left and right gastric lymph nodes → celiac lymph nodes → cisterna chyli
T12
Parietal peritoneum and visceral peritoneum.
Only by external spermatic fascia.
Pressure, pain, heat, and cold.
The falciform ligament connects the liver to the anterior abdominal wall.
Behind the lesser omentum and stomach, in front of the posterior abdominal wall and pancreas (head and body)
Supports the sigmoid colon and contains the sigmoid vessels.
The round ligament of the uterus.
By the 12th week.
Pain, pressure, temperature, and touch.
Approximately 3 days.
The four small pockets of the duodenal recess are the superior duodenal recess, inferior duodenal recess, paraduodenal recess, and retroduodenal recess.
Stretch and tearing.
Peritoneal/ascitic fluid.
The Anterior Visceral veins of the Inferior Vena Cava are the right and left hepatic veins.
Ventral rami of six inferior thoracic and first lumbar nerves
Deep circumflex iliac and inferior epigastric arteries
Iliac branches of iliolumbar artery
Inferior epigastric artery
Touch, heat, and cold.
The internal oblique (IO) and transversus abdominis (TA) muscles.
Inferior VENA CAVA
Between the right lobe of the liver, right kidney, and right colic flexure
The ilioinguinal nerve.
The mesentery of the jejunum and ileum
Posteriorly: Lumbar vertebra, Sacrum; Posterolaterally: Quadratus lumborum, Psoas major & psoas minor, Illiacus
Lesser curvature of the stomach, duodenum, and esophagus to the liver
Lower 6 thoracic nerves (T7 - T12) and 1st lumbar nerve (L1).
1.5 - 2.5 cm
Obturator nerve.
The visceral peritoneum covers the organs inside the abdominal cavity.
Vagus and sympathetic nerves
Kidney, ureters, urinary bladder, suprarenal gland, abdominal aorta, inferior vena cava, renal and gonadal vessels.
Compresses and supports abdominal viscera
Flexes hip and stabilizes hip joint; acts with psoas major
Lumbar branch of iliolumbar artery
The hepatoduodenal ligament connects the liver to the duodenum.
Common bile duct, hepatic artery, portal vein
Connects the liver to the anterior abdominal wall.
Aponeurosis of external oblique (EO), internal oblique (IO), and transversus abdominis (TA)
Ascending colon
Connects the spleen to the left kidney.
The three small pockets of the cecal recess are the superior ileocecal recess, inferior ileocecal recess, and avascular retrocecal recess.
The intersigmoid recess is situated at the apex of the inverted V-shaped root of the sigmoid mesocolon, with its mouth opening downward.
Superior and inferior epigastric arteries
The Lateral Visceral veins of the Inferior Vena Cava are the right suprarenal, right and left renal, and right gonadal veins.
Inferior rectum.
Lesser trochanter of femur and shaft inferior to it, and to psoas major tendon
Ventral rami of first four lumbar nerves
Ventral rami of first lumbar nerve
The Inferior Vena Cava is formed by the union of 2 Common Iliac veins behind the right Common Iliac artery at the level of the 5th Lumbar vertebra.
In surgery, the peritoneal cavity is divided into mesocolic spaces, which are separated by the transverse colon and transverse mesocolon into the supra-mesocolic compartment and infra-mesocolic compartment.
Thoracolumbar fascia, anterior 2/3 of iliac crest, lateral half of inguinal ligament
Compresses and supports abdominal viscera, flexes and rotates trunk
Xiphoid process, costal cartilages 5–7
Transverse processes of Lumbar vertebrae, sides of bodies of T12 – L5 vertebrae, intervening intervertebral discs
Lumbar branches of iliolumbar artery
Ventral rami of T12 and first four lumbar nerves
Internal surfaces of costal cartilages 7–12, thoracolumbar fascia, iliac crest, lateral third of inguinal ligament
Flexes trunk, compresses abdominal viscera
Lesser trochanter of femur
Tenses linea alba
Flexes pelvis on vertebral column
Extends and laterally flexes vertebral column, fixes 12th rib during inspiration
