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Intertubercular Plane

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Presentation on theme: "Intertubercular Plane"— Presentation transcript:

1

2 Intertubercular Plane
Midclavicular Line Epigastric Hypo- Chondrial Hypo- Chondrial Transpyloric Plane ( Subcostal Plane ) R9 – L1 Umblical Lumbar Lumbar Intertubercular Plane L5 Iliac Hypogastric Or Suprapubic Iliac

3

4 Superficial fascia Deep Fascia Superficial Deep Camper’s FASCIA
Membranous layer Scarpa’s Fascia Colle’s Fascia Deep Fascia

5 Lymph drainage

6 Serratus ant. Latissimus dorsi

7 2)Internal abdominal oblique

8 3)Transversl abdominal

9

10

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12 Action of Muscle Supports of abdominal contents Compresses abdominal
Assists in flexing and rotation of trunk Defecation Partuition Vomiting Expiration -Tenses the lina alba

13 Inguinal Canal 4 cm Spermatic Cord Round Lig. Deep Inguinal ring
Superficial Inguinal ring Spermatic Cord Round Lig.

14

15 Inguinal Herniae a) Indirect

16 Inguinal Herniae b) Direct

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18 Peritoneal Cavity

19 Peritoneum Tunica Serosa -Parietal -Visceral Peritoneal Cavity
( Coelum ) Extraperitoneal Tissue Retroperitoneal

20 Nerve Supply -Phrenic nerve -Intercostal and Lumbar nerve
-Obturator Nerve

21 Ventral Mesentery

22 Stomach

23

24 Lienorenal Ligament

25 Peritoneal Compartments
-Supracolic -Infracolic

26 Transverse Mesocolon

27 Supracolic -Gastrophernic Lig. -Greater omentum -Lesser omentum

28 Greater omentum

29 Gastrocolic lig.

30 Lesser omentum -Hepatogastric Lig. -Hepatoduodenal Lig.
Winslow foramen

31 Winslow foramen -Ant: Lesser omentum ( Triad ) -INF: Duodenum
-Sup: Caudate process -Post: IVC

32 Lesser sac ( Bursa omentalis )
-Stomach Bed

33 Lesser sac ( Bursa omentalis )
-Stomach Bed

34 Hepatorenal Pouch ( Morison )

35

36 Mesentery

37 Infarcolic

38

39 Root of Mesentery

40 Root of Mesentery

41 Root of Mesentery

42 Psoas Major Psoas Minor Quadratus lumborum

43 Quadratus lumborum

44 Genitofemoral n.

45 Laparoscopy

46 Abdominal Esofhagus T10 Ostium Cardiacum T11 (R7)

47 Abdominal Esofhagus Post.

48 Abdominal Esofhagus Post. Left subphrenic a.

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50 Stomach Gaster Ostium cardiacum T11 (R7) Ostium Pyloric L1 (1.25 cm)
Consrtiction Prepyloric vein ( mayo)

51

52 Fundus Body Pars pylorica

53 Coeliac Trunk 1-Left Gastric a. 2-Common Hepatic a. 3-Splenic a.

54 Lesser sac ( Bursa omentalis )
-Stomach Bed

55 Autonomic nerve

56 Ant. Vagal Trunk More from left vagus nerve
-Greater ant. Gastric nerve Gastric branches -Pyloric br. -Hepatic br. -Celiac br.

57 Post. Vagal Trunk More from right vagus nerve
-Greater post. Gastric nerve Gastric branches -Celiac br.

58

59 Duodenum Sup. Part (5 cm) Bulbus Duodenal Cap
2) Descending part (8-10 cm) 3) Horizontal part (10 cm) 4) Ascending part (2.5 cm)

60 Duodenum Sup. Part Duodenal cap

61 Duodenum 1)Sup. Part Post:

62 Duodenum 1)Sup. Part Post: Gastrodeodenal a. Common bile duct
Portal vein

63 Duodenum 2)Descending Part Post:

64 Duodenum 2)Descending Part Post: Right kidney I.V.C

65

66 Vater

67 Duodenum 3)Transverses Part Post: Aortic + I.V.C

68 Duodenum 3)Transverses Part Post: Aortic + I.V.C

69

70 Small Intestine Ileum Diverticulum ilei 60-80 cm from Ileocecal valve
3-5 cm length Stomach or pancreas ectopic tissue

71 Large Intestine -Cecum -Appendix -Ascending colon -Transverses colon -Descending colon -Sigmoid (pelvic) -Rectum

72 Large Intestine Right colic flexure Left colic flexure

73 - 3 + 2 +++ Meso Tenia haustra Epiploic appendices Cecum Vermiform
appendix Ascending Colon Transverse Colon Descending colon Sigmoid colon 2 +++ Rectum

74 Ileocecal Valve -Frenulum Med. and Lat.

75 Appendix vermiform Meso -Position Medial of cecum Retrocolic
Retrocecal Pelvic (31%) Preileal Postileal 65% 5%

76 Lumbar Plexus

77 Ascending Colon 15 cm

78 Ascending Colon

79 Descending Colon 25 cm

80 Descending Colon Post:

81 Descending Colon Post:

82 Sup. Mesenteric a. -L1

83 Sup. Mesenteric a.

84 Sup. Mesenteric a. 1-Inf. Pancreaticoduodenal a.
2-jejunal and ileal a. 3-Iliocolic a. 4-Right Colic a. 5-Middle Colic a.

85 Inf. Mesenteric a. 1-Left Colic a. 2-Sigmoid a. 3-Sup.Rectal a.

86 Marginal a.

87 Spleen v. + Sup. Mesenteric vein Portal Vein

88 Abdominal Esophagus

89 Portal Hypertension Esophageal varicel

90 Caput Meduza

91 Spleen (Lien) Surface: Border: -Diaphragmatic -Visceral Gastric Renal
Colic Border: -Sup. -Inf.

92 Spleen (Lien) Helium

93 Pancreas Ant: -Root of Mesocolon -Sup. Mesenteric a. and v.
-Stomach bed

94 Pancreas Post:

95 Pancreas Post: -I.V.C -Aorta -Treitz lig. -Right renal vein
-Left renal -Left suprarenal -Diaphragm cruse -Sup. Mesenteric a. and v. -Portal vein -Common bile duct

96 Surface: -Diaphragmatic (Sup.) -Post. -Visceral (Inf.)

97 Diaphragmatic (Sup.): -falciform lig Round lig.

98 Visceral (Inf.) Surface:
-Porta hepatis (H)

99 Visceral (Inf.) Surface:
-Porta hepatis (H) Sulcus for Teres lig. ( Left umbilical vein) Sulcus for Venosum lig. Gallbladder I.V.C

100 Lobe Anatomy and Physiology -Right Ant. Post. -Left Medial Lateral

101 Lobe Anatomy and Physiology -Right Ant. Post. -Left Medial Lateral

102 Right and Left Hepatic ducts
Common Hepatic Duct Cystic Duct Common Bile Duct (Choledocus)

103 Gallbladder -30-50 cc -Fundus -Body -Infundibulum (Hartmann’s Pouch)
-Neck (Spiral Valve of Heister)

104 Suprarenal Gland

105 Suprarenal Gland

106 Suprarenal Gland Artery
-Sup. Suprarenal a. -Middle Suprarenal a. -Inf. Suprarenal a. Suprarenal Gland Vein -Right ….. I.V.C -Left …….. left Renal Vein

107 Kidney

108 Renal Fascia (Gerota)

109

110 Kidney Ant:

111 Abdominal Aorta Common Iliac a. -Coeliac Trunk -Sup. Mesentric a.
-Inf. Mesentric a. -Inf. phrenic a. -Renal a. -Gonadal a. -Middle Supra renal a. -Lumbar a. -Median sacral a. Common Iliac a.

112 I.V.C L5-T8

113 I.V.C Ant: Right Common Iliac a. Part 3 of duodenum Root of Mesentery
Gonoadal a. Pancreas Part 1 of Duodenum Winslow Foramen Liver

114 ANATOMY PELVIS

115 Pelvis : - Hip - Sacrum - Coccygeus

116 Pelvis Joint

117 HIP Surface: -Lateral Acetabulum Obturator Foramen

118 HIP Surface: -Lateral Acetabulum Obturator Foramen

119 HIP Surface: Obturator Foramen Male: Female:

120 HIP Obturator Foramen Obturator memberane Obturator Canal Nerve Artery Vein NAV

121 Hip: Border 1-Superior Iliac crest Ant. Sup. Iliac Spine: ASIS
Post. Sup. Iliac Spine

122 Hip: Border 3-Anterior -ASIS -Ant. Inf. Iliac Spine
-IlioPectinal Eminence -Pectinal Surface -Pubic Tubercle -Pubic Crest

123 Hip: Border 4-Posterior -Post. Sup. Iliac. Spine
-Post. Inf. Iliac. Spine -Greater sciatic Notch -Ischial spine -Lesser Sciatic Notch -Ischial Tuberosity

124 Hip: Border 4-Posterior -Greater sciatic Notch -Lesser Sciatic Notch
Sacrotuberous Lig. Sacrospinous Lig. -Greater sciatic Foramen -Lesser Sciatic Foramen

125 Sacrum Surface: -Post. (Dorsal) Median sacral crest Spinous Tubercle Sacral Hiatus Sacral Cornu Intermediate sacral Crest Dorsal Sacral Foramen Lateral Sacral Crest

126 Pelvis Types -Gynaecoid 41% -Android 33% -Platypelloid 2%
-Anthropoid 24%

127

128 Pelvic Muscles Pelvic Walls: Pelvic Floor: Piriformis
Obturator internus Pelvic Floor: Levator Ani Coccygeus

129 Pelvic Diaphragm

130 Peritoneum Female: Male: Rectoutrine Pouch Utrovesical pouch
Rectovesical pouch

131 Bladder

132 Bladder -Apex -Base -Superior Surface -Inferior lateral Surface -Neck
(Posterior Surface) -Superior Surface -Inferior lateral Surface -Neck

133 Bladder Peritoneum Female: Male: Rectoutrine Pouch Utrovesical pouch
Rectovesical pouch

134 Bladder Neck Male Female

135 Bladder Detrusor Muscle Rugae Trigone Interureteric Crest
(Bar of Muscle) (Bells Muscle) Internal Meatus

136 Ureter -Pelvic Male

137 Male Genital Organs -Scrotum -Testis -Epidydimis -Ductus Deferens
-Seminal Vesicle -Prostate

138 Scrotum Nerve Supply -Ilioinguinal L1 -Genitofemoral L1 -Perineal S3
-Post. Femoral Cutaneous S2

139 Scrotum Septum

140 Testis

141 Testicular a.

142 Testicular Vein

143 Prostate -False Prostatic Capsule -Prostatic Venous Plexus
-True Prostatic Capsule Glands + Fibromuscular Stroma

144 Prostate Lobe -Ant. -Middle -Post. -Lat.

145 Uterine Tube (Fallopian) -10 cm -Infundibulum Fimbriae -Ampulla
-Isthmus -Interstitial

146 Uterus -8x5x2.5 -Fundus -Body -Cervix

147 Uterus Cervix -Supravaginal -Vaginal -Internal Os. -External Os.
-Fornix Ant. Post. Lat.

148 Uterus -Anteflexion -170ْْ

149 Uterus -Anteversion -90ْْ

150 Uterus -Transverse Cervical ig. Cardinal Lig. -Pubocervical Lig.
-Sacrocervical Lig.

151 Uterus -Perituneum

152

153 Uterus Perituneum Brod Lig. -Mesovarium

154 Rectum -12-13cm -S3 -Rectal Valves (Houston)

155

156 Anal Canal -4 cm -Anal Columns 10 -Anal Valves -Anal Sinus
-Pectinal Line

157 Anal Sphincter -Internal Upper ¾ -External Pudendal n. -Inf. Rectal n.
Lower 3/4 Subcutaneous Superficial Deep Pudendal n. -Inf. Rectal n.

158 -Obliterated Umblical a. -Sup. Vesical a. -Inf. Vesical a.
Pelvic Vessels Internal Iliac a. Ant. Division Male -Obliterated Umblical a. -Sup. Vesical a. -Inf. Vesical a. -Middle Rectal a. -Obturator a. -Inf. Gluteal a. -Int. Pudendal a. Female -Vaginal a. -Uterine a. -Int. Pudendal a

159 Perineum

160 Perineum Urogenital Region -Skin -Superficial fascia Fats (Campers)
Membranous (Colles) -Superficial Perineal Space -Perineal Membrane -Deep Perineal Space Deep Superficial Skin

161


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