Blood supply of the abdomen

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Presentation transcript:

Blood supply of the abdomen Dr Idara

Nerve Supply of Anterior Abdominal Wall Muscles The oblique and transversus abdominis muscles are supplied by the lower six thoracic nerves and the iliohypogastric and ilioinguinal nerves (L1). The rectus muscle is supplied by the lower six thoracic nerves . The pyramidalis is supplied by the 12th thoracic nerve.

Dermatomes of the anterolateral abdominal wall Nerves T7 to T9 supply the skin from the xiphoid process to just above the umbilicus. T10 supplies the skin around the umbilicus. T11, T12, and L1 supply the skin from just below the umbilicus to, and including, the pubic region.

Superior and inferior epigastric arteries. The superior and inferior epigastric arteries both enter the rectus sheath. They are posterior to the rectus abdominis muscle throughout their course, and anastomose with each other

Superficial veins of the anterior abdominal wall The superficial veins form a network that radiates out from the umbilicus. Above, the network is drained into the axillary vein via the lateral thoracic vein . Below, into the femoral vein via the superficial epigastric and great saphenous veins. A few small veins, the paraumbilical veins, connect the network through the umbilicus and along the ligamentum teres to the portal vein. This forms an important portal systemic venous anastomosis

Caval Obstruction If the superior or inferior vena cava is obstructed, the venous blood causes distention of the veins running from the anterior chest wall to the thigh. The lateral thoracic vein anastomoses with the superficial epigastric vein, a tributary of the great saphenous vein of the leg. In these circumstances, a tortuous varicose vein may extend from the axilla to the lower abdomen.

Portal Vein Obstruction In cases of portal vein obstruction , the superficial veins around the umbilicus and the paraumbilical veins become grossly distended. The distended subcutaneous veins radiate out from the umbilicus, producing in severe cases the clinical picture referred to as caput medusae.

Euphorbia caput-medusae The species name "caput-medusae" is Latin for "Medusa's Head", in reference to the Greek mythological monster who had snakes for hair.

Lymph Drainage of the Anterior Abdominal Wall Superficial lymphatics above the umbilicus pass in a superior direction to the axillary nodes, while drainage below the umbilicus passes in an inferior direction to the superficial inguinal nodes.

Lymph drainage of the skin of the anterior and posterior abdominal walls

References Clinically oriented anatomy by Keith L. moore, Arthur F. Daley, Anne M. Agur 6th Edition