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General Surgery
Abdominal Wall and Hernias Embryogenesis, Surgical Anatomy
Built from Skandalakis' Surgical Anatomy: The Embryologic and Anatomic Basis of Modern Surgery
What’s inside
10 sections · 128 slides
Overview
- Scope of this topic
- Terminology: aponeurosis versus fascia
Embryogenesis of the anterior abdominal wall
- Normal development of the ventral body wall
- Direction of midline closure
- Competing accounts of closure and the limits of embryology
- The two developmental necessities of the inguinofemoral region
- Development of the inguinal canal
- Superficial ring and Scarpa's fascia relative to the pubic tubercle
- Formation of the femoral canal
- Structures forming or bordering the femoral canal
- Formation of the femoral sheath
- Iliopsoas fascia and the fascia lata
- Iliopubic tract and femoral sheath: shared derivation
- Contents and function of the femoral canal
- Is femoral hernia congenital or acquired
- Proposed mechanisms for a femoral hernial sac
- Crural septum and the femoral canal exit
Congenital anomalies of the anterior body wall
- Reading the table of anterior body wall anomalies
- Anomalies of the Anterior Body Wall
- Anomalies of the Anterior Body Wall (continued)
Surgical anatomy of the anterolateral wall
- Divisions of the anterior abdominal wall
- Fibre orientation and the choice of incision
- Transversus abdominis muscle and aponeurosis
- Bilaminar aponeuroses: the Askar and Rizk revision
- Transverse sections through the anterior abdominal wall
- External oblique muscle: attachments and orientation
- External oblique muscle and aponeurosis
- External oblique fascia: the innominate fascia of Gallaudet
- External oblique aponeurosis and its touchdown point
- Touchdown point of the external oblique aponeurosis
- Inferior edge of the external oblique aponeurosis
- The superficial inguinal ring and its crura
- Internal oblique muscle: attachments and cremaster
- Internal oblique muscle and its arch
- Disputed relations of the internal oblique in the inguinal region
- Internal oblique aponeurosis and the linea alba
- Transversus abdominis: course of the fibres
- Relationship of the transversus arch to the deep ring
- Iliopubic tract: composition and course
- Why the inguinal ligament is invisible from within
- Boundaries of the femoral ring from within
- Transversus abdominis as the critical layer
- Conjoined area of the inguinal region
- Muscles of the Abdominal Wall: origin and insertion
- Muscles of the Abdominal Wall: origin and insertion (continued)
- Muscles of the Abdominal Wall: origin and insertion (continued)
- Muscles of the Abdominal Wall: action, nerve supply and notes
- Muscles of the Abdominal Wall: action, nerve supply and notes (continued)
- Muscles of the Abdominal Wall: action, nerve supply and notes (continued)
The middle portion: rectus abdominis, sheath and linea alba
- Rectus abdominis: attachments and tendinous intersections
- Function of the tendinous intersections
- Rectus sheath above and below the arcuate line
- Rectus abdominis muscle and rectus sheath
- Superior extent of the rectus sheath
- Actions of the rectus and the oblique muscles
- Pyramidalis and the midline landmark
- Blood supply of the rectus abdominis
- Linea alba: structure and decussation
- Extent and attachments of the linea alba
- Diastasis of the rectus muscles by age
- The linea alba in incisional practice
The umbilical area
- Embryologic formation of the umbilicus
- Structures in the umbilical cord
- Structures Associated with the Umbilical Cord and Umbilicus
- Posterior surface of the newborn anterior abdominal wall with the cord attached
- Structures traversing the umbilical ring
- Sagittal section through the normal umbilicus
- Sagittal section through a small umbilical hernia
- Variations in the umbilical ring and umbilical fascia
- Topographic relations of the umbilicus
Transversalis fascia and peritoneum
- Extent of the transversalis fascia
- Continuities of the transversalis fascia
- The deficient posterior inguinal wall
- Cross section of a weak posterior inguinal canal wall
- The peritoneum as the innermost layer
- Upper three-fourths and lower one-fourth of the abdominal wall compared
Blood supply of the anterior abdominal wall
- Why the surgeon must know the wall's blood supply
- Superficial arteries of the lower abdominal wall
- Superficial arteries of the inguinal region
- Deep arteries between transversus and internal oblique
- Deep circumflex iliac artery and the internal oblique flap
- Superior and inferior epigastric arteries
- Anastomosis between the epigastric arteries
- Vessels supplying the anterior abdominal wall
- Perforators and the placement of incisions and trocars
- Primary vascular territories of the anterior abdominal wall
- Venous drainage of the anterior abdominal wall
Lymphatic drainage and innervation
- Lymphatic drainage of the anterior abdominal wall
- Probable lymphatic drainage of the anterior abdominal wall
- Segmental innervation of the anterior abdominal wall
- Course of the anterior rami of the segmental nerves
- Variation in segmental innervation and consequences of nerve section
- Referred groin pain of neural origin
Surgical considerations and synthesis
- Fascial planes and the spread of extravasated fluid
- Anatomical basis of herniation of the anterior wall
- Anatomical rules for planning an abdominal incision
- Key figures to remember
- Summary of the surgical anatomy
- Anatomic and Surgical History of the Abdominal Wall and Hernias
- Anatomic and Surgical History of the Abdominal Wall and Hernias (continued)
- Anatomic and Surgical History of the Abdominal Wall and Hernias (continued)
- Anatomic and Surgical History of the Abdominal Wall and Hernias (continued)
- Anatomic and Surgical History of the Abdominal Wall and Hernias (continued)
- Anatomic and Surgical History of the Abdominal Wall and Hernias (continued)
- Anatomic and Surgical History of the Abdominal Wall and Hernias (continued)
- Anatomic and Surgical History of the Abdominal Wall and Hernias (continued)
- Anatomic and Surgical History of the Abdominal Wall and Hernias (continued)
- Anatomic and Surgical History of the Abdominal Wall and Hernias (continued)
- Anatomic and Surgical History of the Abdominal Wall and Hernias (continued)
- Anatomic and Surgical History of the Abdominal Wall and Hernias (continued)
- Anatomic and Surgical History of the Abdominal Wall and Hernias (continued)
- Anatomic and Surgical History of the Abdominal Wall and Hernias (continued)
- Anatomic and Surgical History of the Abdominal Wall and Hernias (continued)
- Anatomic and Surgical History of the Abdominal Wall and Hernias (continued)
- Anatomic and Surgical History of the Abdominal Wall and Hernias (continued)
- Authors cited in the text
- Further authors cited in the text
- Skandalakis' Surgical Anatomy: The Embryologic and Anatomic Basis of Modern Surgery
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