This document provides an overview of the anatomy of the abdominal wall muscles and incisions used to access the upper genitourinary organs. It describes the origins, insertions and actions of the external oblique, internal oblique, transversus abdominis, rectus abdominis, and pyramidalis muscles. It also discusses flank, anterior, and thoracoabdominal incisions including the 11th rib, subcostal, bilateral subcostal, and midline incisions. The Gibson incision for renal transplantation is also summarized.
This document provides an overview of surgical incisions and abdominal wall anatomy relevant to urological surgery. It describes the layers of the abdominal wall including skin, fascia and muscles. It then classifies and describes various incision types for accessing the urinary system including flank, anterior abdominal, thoracoabdominal and midline incisions. Key abdominal wall muscles like the rectus abdominis and their innervation are also defined.
Anterior abdominal wall , Rectus sheath and Inguinal.pptxJudeChinecherem
In this detailed lecture note, we embark on a comprehensive journey through the complex and crucial anatomy of the abdominal wall. The abdominal wall is not just a physical barrier; it is a dynamic structure with multiple layers, muscles, and intricate structures that play a fundamental role in protecting our internal organs, providing support, and enabling various bodily functions.
We will delve deep into the layers of the abdominal wall, understanding the significance of each component - from the outermost skin to the innermost peritoneum. Through detailed illustrations, diagrams, and explanations, you will gain a profound insight into the anatomical intricacies of this region.
Moreover, this lecture note provides valuable insights into the clinical relevance of the abdominal wall. Learn about common medical conditions and surgical procedures related to the abdominal wall, including hernias, trauma, and abdominal wall reconstruction. Whether you are a medical student, healthcare professional, or simply intrigued by the wonders of the human body, this resource will enrich your knowledge and understanding of this vital anatomical structure.
Join us on this educational journey as we unravel the mysteries of the abdominal wall, exploring its anatomy, functions, and clinical significance. Whether you're studying medicine, pursuing a career in healthcare, or just eager to expand your knowledge, this lecture note is a valuable resource for anyone interested in the fascinating world of human anatomy."
The document summarizes the anatomy of the anterior abdominal wall and groin region. It describes the layers that make up the abdominal wall from superficial to deep, including the skin, superficial fascia, deep fascia, muscles and rectus sheath. It discusses the contents and boundaries of the inguinal canal. It also outlines the structures contained within the femoral triangle in the groin, including the femoral artery and vein, nerves, and lymph nodes.
The abdominal wall has several layers including skin, superficial fascia, muscles and fascia. The superficial fascia below the umbilicus divides into two layers: Camper's fascia and Scarpa's fascia. The muscles of the abdominal wall include three flat muscles on each side (external oblique, internal oblique, transversus abdominis) and two vertical muscles near the midline (rectus abdominis). The aponeuroses of the flat muscles come together to form the rectus sheath surrounding the rectus abdominis muscle. Below the arcuate line, the posterior wall of the rectus sheath is deficient.
This document discusses the anatomy of the anterior abdominal wall. It covers the embryology of the abdominal wall muscles and structures like the umbilicus and inguinal region. It then discusses the layers of the anterior abdominal wall, muscles, fascia, blood supply, lymphatics and nerve supply. It also covers hernias that can occur in the abdominal wall and types of abdominal incisions.
This document summarizes the surgical anatomy of the inguinal canal. It describes the internal and external inguinal rings and boundaries of the canal. It discusses inguinal hernias, including types of indirect and direct hernias. The document also summarizes laparoscopic views of the posterior wall and peritoneal reflections, identifying structures like the inferior epigastric artery, internal ring, and cord structures. Potential spaces in the region are described along with ligaments like the iliopubic tract. Dangerous areas for dissection are identified, including the triangle of doom and corona mortis.
The document provides information about anatomy of the abdomen and pelvis including:
1. It describes the boundaries and layers of the abdominal wall including the muscles and fascia.
2. It discusses the inguinal region and types of hernias that can occur there.
3. It explains the peritoneum, mesenteries, and retroperitoneal organs.
This document provides an overview of surgical incisions and abdominal wall anatomy relevant to urological surgery. It describes the layers of the abdominal wall including skin, fascia and muscles. It then classifies and describes various incision types for accessing the urinary system including flank, anterior abdominal, thoracoabdominal and midline incisions. Key abdominal wall muscles like the rectus abdominis and their innervation are also defined.
Anterior abdominal wall , Rectus sheath and Inguinal.pptxJudeChinecherem
In this detailed lecture note, we embark on a comprehensive journey through the complex and crucial anatomy of the abdominal wall. The abdominal wall is not just a physical barrier; it is a dynamic structure with multiple layers, muscles, and intricate structures that play a fundamental role in protecting our internal organs, providing support, and enabling various bodily functions.
We will delve deep into the layers of the abdominal wall, understanding the significance of each component - from the outermost skin to the innermost peritoneum. Through detailed illustrations, diagrams, and explanations, you will gain a profound insight into the anatomical intricacies of this region.
Moreover, this lecture note provides valuable insights into the clinical relevance of the abdominal wall. Learn about common medical conditions and surgical procedures related to the abdominal wall, including hernias, trauma, and abdominal wall reconstruction. Whether you are a medical student, healthcare professional, or simply intrigued by the wonders of the human body, this resource will enrich your knowledge and understanding of this vital anatomical structure.
Join us on this educational journey as we unravel the mysteries of the abdominal wall, exploring its anatomy, functions, and clinical significance. Whether you're studying medicine, pursuing a career in healthcare, or just eager to expand your knowledge, this lecture note is a valuable resource for anyone interested in the fascinating world of human anatomy."
The document summarizes the anatomy of the anterior abdominal wall and groin region. It describes the layers that make up the abdominal wall from superficial to deep, including the skin, superficial fascia, deep fascia, muscles and rectus sheath. It discusses the contents and boundaries of the inguinal canal. It also outlines the structures contained within the femoral triangle in the groin, including the femoral artery and vein, nerves, and lymph nodes.
The abdominal wall has several layers including skin, superficial fascia, muscles and fascia. The superficial fascia below the umbilicus divides into two layers: Camper's fascia and Scarpa's fascia. The muscles of the abdominal wall include three flat muscles on each side (external oblique, internal oblique, transversus abdominis) and two vertical muscles near the midline (rectus abdominis). The aponeuroses of the flat muscles come together to form the rectus sheath surrounding the rectus abdominis muscle. Below the arcuate line, the posterior wall of the rectus sheath is deficient.
This document discusses the anatomy of the anterior abdominal wall. It covers the embryology of the abdominal wall muscles and structures like the umbilicus and inguinal region. It then discusses the layers of the anterior abdominal wall, muscles, fascia, blood supply, lymphatics and nerve supply. It also covers hernias that can occur in the abdominal wall and types of abdominal incisions.
This document summarizes the surgical anatomy of the inguinal canal. It describes the internal and external inguinal rings and boundaries of the canal. It discusses inguinal hernias, including types of indirect and direct hernias. The document also summarizes laparoscopic views of the posterior wall and peritoneal reflections, identifying structures like the inferior epigastric artery, internal ring, and cord structures. Potential spaces in the region are described along with ligaments like the iliopubic tract. Dangerous areas for dissection are identified, including the triangle of doom and corona mortis.
The document provides information about anatomy of the abdomen and pelvis including:
1. It describes the boundaries and layers of the abdominal wall including the muscles and fascia.
2. It discusses the inguinal region and types of hernias that can occur there.
3. It explains the peritoneum, mesenteries, and retroperitoneal organs.
The anterior abdominal wall has two layers - lateral and medial. The lateral layer consists of skin, subcutaneous tissue, and three muscles - external oblique, internal oblique, and transversus abdominis. The medial layer consists of skin, fascia, the rectus sheath enclosing the rectus abdominis muscle, and peritoneum.
The inguinal canal transmits the spermatic cord in males and round ligament in females. It has openings called the deep and superficial rings. The spermatic cord contains the vas deferens and vessels. A weakness in the abdominal wall makes the inguinal region prone to hernias, where abdominal contents can protrude through the ingu
The neck muscles are divided into 4 layers. The first layer includes the trapezius and latissimus dorsi muscles. The second layer includes the splenius, levator scapulae, rhomboideus major and minor, and serratus posterior superior and inferior muscles. The third layer is the erector spinae muscle. The fourth layer includes the multifidus, rotatores, interspinales, intertransversii and sub occipital muscles. The back muscles are divided into 3 groups: superficial muscles around the shoulder, intermediate muscles for respiration, and deep muscles of the vertebral column.
The document discusses the anatomy of the anterolateral abdominal wall. It describes the five muscles that make up the anterolateral wall - the external oblique, internal oblique, transversus abdominis, rectus abdominis, and pyramidalis. It details the structure, function and innervation of these muscles. The document also discusses the blood supply, lymphatic drainage and applied clinical considerations like different types of hernias related to weaknesses in the abdominal wall.
The document provides an overview of the anatomy of the spine. It discusses the conceptual overview including the functions and components of the spine. It describes the regional anatomy including the intervertebral discs, ligaments, muscles and fascia of the back. It also discusses the blood supply, lymph drainage and surface anatomy as it relates to the spine. Key features include the long vertebral column and short spinal cord, as well as the intervertebral foramina and spinal nerves.
The document summarizes the layers of muscles in the back and neck. It divides the muscles into 4 layers - the first layer includes the trapezius and latissimus dorsi muscles, the second layer includes muscles like the levator scapulae and rhomboideus, the third layer is the erector spinae muscles, and the fourth layer includes small muscles like the multifidus. It also describes the blood supply and innervation of the back muscles and provides details on the origin, insertion, nerve supply and action of some key muscles like the trapezius, latissimus dorsi and erector spinae.
Laparoscopic Rectopexy (LRP) is a surgical technique used to treat persistent rectal prolapse in children. The authors present their experience using LRP at their hospital in Egypt. LRP involves mobilizing the rectum laparoscopically and attaching it to the sacrum using sutures or mesh to provide support. The document discusses the anatomy of the rectum and pelvic floor muscles. It also covers patient presentation, investigations, and surgical management options for rectal prolapse in both adults and children.
The axilla is a pyramid-shaped space between the upper arm and chest that contains nerves, blood vessels, and lymph nodes. It provides an important passageway from the neck to the upper limb. The axilla contains the brachial plexus nerve network, axillary artery and vein, and lymph nodes that drain the upper limb and breast. The pectoralis minor muscle crosses the axillary contents and divides the axillary artery into three parts.
The document summarizes the anatomy of the abdominal wall. It describes the layers from the outer skin to the inner lining, including the three flat sheet muscles and rectus abdominis muscle. It also details the divisions of the abdominal regions and covers the nerve supply and functions of the abdominal wall muscles.
The document describes the anatomy of the shoulder region. It discusses the bones that make up the shoulder girdle, including the clavicle and scapula. It then describes the major muscles of the shoulder girdle, including the deltoid, supraspinatus, infraspinatus, teres minor, teres major, and subscapularis muscles. It provides details on the origins, insertions, nerve supplies and actions of these muscles. It also discusses the rotator cuff and its role in stabilizing the shoulder joint. Finally, it outlines some important neurovascular structures in the shoulder region, including the suprascapular nerve and axillary nerve.
The femoral triangle contains important structures in the upper thigh. It has boundaries of the inguinal ligament superiorly, the sartorius muscle laterally, and the adductor longus muscle medially. The floor contains muscles that aid in hip adduction. The femoral nerve provides sensation and motor function, and the femoral artery and vein are also located here, with the artery giving off deep branches. The structures of the femoral triangle are clinically relevant to conditions like varicose veins, hernias, and addressing muscle spasticity in cerebral palsy.
The document provides detailed information about the anatomy of the axilla region. It discusses the boundaries, contents, neurovasculature and lymph nodes of the axilla. The key points are:
The axilla is bounded superiorly by the clavicle, first rib and scapula. It contains the axillary vessels (artery and vein), brachial plexus nerves, lymph nodes and loose connective tissue. The axillary artery divides into three parts based on its relationship to the pectoralis minor muscle and gives off six branches. The axillary vein receives tributaries that parallel the arterial branches. The axillary nerve originates from the brachial plexus and innervates the deltoid
The diaphragm develops from four sources in the embryo and matures to become a dome-shaped musculofibrous sheet that separates the thoracic and abdominal cavities. It has a central tendon to which muscular fibers attach and is the primary muscle of respiration. During inspiration, it contracts to flatten and lower, increasing the vertical space in the thorax. It has openings that allow structures like the esophagus, inferior vena cava and aorta to pass between the thorax and abdomen. The phrenic nerves provide motor innervation and allow the diaphragm to contract during breathing.
The document describes the anatomy of the anterior abdominal wall. It is divided into nine quadrants and contains skin, superficial fascia with fatty and membranous layers, deep fascia, three muscle layers (external oblique, internal oblique, transversus abdominis), rectus abdominis muscles, pyramidalis muscle, extraperitoneal fascia, and parietal peritoneum from external to internal. Key nerves are branches of thoracic and lumbar nerves, and arteries include the superior and inferior epigastric arteries. Lymphatic drainage is to axillary nodes above the umbilicus and inguinal nodes below.
The document describes the anatomy of the anterior thigh. It discusses the fascia lata, cutaneous nerves, and muscles in the anterior compartment, including the quadriceps femoris and sartorius. It also describes the femoral triangle and its contents, including the femoral nerve, artery, and vein.
The rectum is the lower part of the large intestine extending from the sigmoid colon to the anal canal. It is around 5 inches long and located in the pelvis in front of the sacrum and coccyx. It has two flexures that follow the curves of the sacrum and coccyx. The upper third is covered in peritoneum while the lower third has no peritoneal covering. It is supplied by branches of the inferior mesenteric artery and drains into internal iliac and inferior mesenteric lymph nodes. A thorough understanding of rectal anatomy is important for surgical management of rectal conditions and cancer.
The perineum is the region between the thighs and behind the genitals. It is divided into an anterior urogenital triangle and a posterior anal triangle by an imaginary line between the ischial tuberosities. The pelvic outlet forms the inferior boundary and consists of the pubic arch anteriorly and sciatic notches posteriorly. The perineum contains the anus, ischiorectal fossae in the anal region, and male or female genitals in the urogenital region. It has three spaces - subcutaneous, superficial, and deep perineal pouches. The urethral sphincter mechanism surrounds the membranous urethra in males and middle/lower u
ANATOMY OF THE FEMALE REPRODUCTIVE SYSTEM.docGichanaElvis
The document provides an in-depth overview of the anatomy of the female reproductive system and pelvis. It describes the layers of the anterior abdominal wall, including the skin, superficial and deep fascia, musculo-aponeurotic layer, fascia transversalis, properitoneal adipose layer, and parietal peritoneum. It then discusses the bones of the pelvis, outlining the pelvic inlet and outlet, planes and diameters, and different types of pelves. The key differences between the female and male pelvis are also summarized.
The document summarizes the surgical anatomy of the inguinal canal. It describes the layers of the anterior abdominal wall and how they contribute to the structures of the groin. It details the internal and external oblique muscles and how their aponeuroses form the inguinal ligament, lacunar ligament and other structures. It explains the anatomy of the inguinal canal, including the superficial and deep inguinal rings, and contents of the spermatic cord in males that passes through the canal.
This document describes the ilioinguinal surgical approach. It involves making a skin incision from above the pubic symphysis to the iliac crest. The external oblique muscle is released to expose the internal iliac fossa. The femoral vessels and nerves are mobilized by releasing muscles from the inguinal ligament. This provides three windows of exposure - the internal iliac fossa, pelvic brim, and a limited view between the rectus muscle and spermatic cord. The approach is used for fractures of the anterior pelvic wall and columns.
The pelvis is formed by bones and muscles. The back wall is formed by the sacrum and piriformis muscle, the side walls are the obturator internus muscles, and the front wall is the symphysis pubis. The floor is formed by the levator ani and coccygeus muscles covering the sacrospinous ligaments. The pelvic diaphragm consists of the levator ani muscles and coccygeus muscle. It contains openings for the urethra, vagina, and anal canal. The pelvic viscera are supported by connective tissues like the cardinal and uterosacral ligaments.
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
The anterior abdominal wall has two layers - lateral and medial. The lateral layer consists of skin, subcutaneous tissue, and three muscles - external oblique, internal oblique, and transversus abdominis. The medial layer consists of skin, fascia, the rectus sheath enclosing the rectus abdominis muscle, and peritoneum.
The inguinal canal transmits the spermatic cord in males and round ligament in females. It has openings called the deep and superficial rings. The spermatic cord contains the vas deferens and vessels. A weakness in the abdominal wall makes the inguinal region prone to hernias, where abdominal contents can protrude through the ingu
The neck muscles are divided into 4 layers. The first layer includes the trapezius and latissimus dorsi muscles. The second layer includes the splenius, levator scapulae, rhomboideus major and minor, and serratus posterior superior and inferior muscles. The third layer is the erector spinae muscle. The fourth layer includes the multifidus, rotatores, interspinales, intertransversii and sub occipital muscles. The back muscles are divided into 3 groups: superficial muscles around the shoulder, intermediate muscles for respiration, and deep muscles of the vertebral column.
The document discusses the anatomy of the anterolateral abdominal wall. It describes the five muscles that make up the anterolateral wall - the external oblique, internal oblique, transversus abdominis, rectus abdominis, and pyramidalis. It details the structure, function and innervation of these muscles. The document also discusses the blood supply, lymphatic drainage and applied clinical considerations like different types of hernias related to weaknesses in the abdominal wall.
The document provides an overview of the anatomy of the spine. It discusses the conceptual overview including the functions and components of the spine. It describes the regional anatomy including the intervertebral discs, ligaments, muscles and fascia of the back. It also discusses the blood supply, lymph drainage and surface anatomy as it relates to the spine. Key features include the long vertebral column and short spinal cord, as well as the intervertebral foramina and spinal nerves.
The document summarizes the layers of muscles in the back and neck. It divides the muscles into 4 layers - the first layer includes the trapezius and latissimus dorsi muscles, the second layer includes muscles like the levator scapulae and rhomboideus, the third layer is the erector spinae muscles, and the fourth layer includes small muscles like the multifidus. It also describes the blood supply and innervation of the back muscles and provides details on the origin, insertion, nerve supply and action of some key muscles like the trapezius, latissimus dorsi and erector spinae.
Laparoscopic Rectopexy (LRP) is a surgical technique used to treat persistent rectal prolapse in children. The authors present their experience using LRP at their hospital in Egypt. LRP involves mobilizing the rectum laparoscopically and attaching it to the sacrum using sutures or mesh to provide support. The document discusses the anatomy of the rectum and pelvic floor muscles. It also covers patient presentation, investigations, and surgical management options for rectal prolapse in both adults and children.
The axilla is a pyramid-shaped space between the upper arm and chest that contains nerves, blood vessels, and lymph nodes. It provides an important passageway from the neck to the upper limb. The axilla contains the brachial plexus nerve network, axillary artery and vein, and lymph nodes that drain the upper limb and breast. The pectoralis minor muscle crosses the axillary contents and divides the axillary artery into three parts.
The document summarizes the anatomy of the abdominal wall. It describes the layers from the outer skin to the inner lining, including the three flat sheet muscles and rectus abdominis muscle. It also details the divisions of the abdominal regions and covers the nerve supply and functions of the abdominal wall muscles.
The document describes the anatomy of the shoulder region. It discusses the bones that make up the shoulder girdle, including the clavicle and scapula. It then describes the major muscles of the shoulder girdle, including the deltoid, supraspinatus, infraspinatus, teres minor, teres major, and subscapularis muscles. It provides details on the origins, insertions, nerve supplies and actions of these muscles. It also discusses the rotator cuff and its role in stabilizing the shoulder joint. Finally, it outlines some important neurovascular structures in the shoulder region, including the suprascapular nerve and axillary nerve.
The femoral triangle contains important structures in the upper thigh. It has boundaries of the inguinal ligament superiorly, the sartorius muscle laterally, and the adductor longus muscle medially. The floor contains muscles that aid in hip adduction. The femoral nerve provides sensation and motor function, and the femoral artery and vein are also located here, with the artery giving off deep branches. The structures of the femoral triangle are clinically relevant to conditions like varicose veins, hernias, and addressing muscle spasticity in cerebral palsy.
The document provides detailed information about the anatomy of the axilla region. It discusses the boundaries, contents, neurovasculature and lymph nodes of the axilla. The key points are:
The axilla is bounded superiorly by the clavicle, first rib and scapula. It contains the axillary vessels (artery and vein), brachial plexus nerves, lymph nodes and loose connective tissue. The axillary artery divides into three parts based on its relationship to the pectoralis minor muscle and gives off six branches. The axillary vein receives tributaries that parallel the arterial branches. The axillary nerve originates from the brachial plexus and innervates the deltoid
The diaphragm develops from four sources in the embryo and matures to become a dome-shaped musculofibrous sheet that separates the thoracic and abdominal cavities. It has a central tendon to which muscular fibers attach and is the primary muscle of respiration. During inspiration, it contracts to flatten and lower, increasing the vertical space in the thorax. It has openings that allow structures like the esophagus, inferior vena cava and aorta to pass between the thorax and abdomen. The phrenic nerves provide motor innervation and allow the diaphragm to contract during breathing.
The document describes the anatomy of the anterior abdominal wall. It is divided into nine quadrants and contains skin, superficial fascia with fatty and membranous layers, deep fascia, three muscle layers (external oblique, internal oblique, transversus abdominis), rectus abdominis muscles, pyramidalis muscle, extraperitoneal fascia, and parietal peritoneum from external to internal. Key nerves are branches of thoracic and lumbar nerves, and arteries include the superior and inferior epigastric arteries. Lymphatic drainage is to axillary nodes above the umbilicus and inguinal nodes below.
The document describes the anatomy of the anterior thigh. It discusses the fascia lata, cutaneous nerves, and muscles in the anterior compartment, including the quadriceps femoris and sartorius. It also describes the femoral triangle and its contents, including the femoral nerve, artery, and vein.
The rectum is the lower part of the large intestine extending from the sigmoid colon to the anal canal. It is around 5 inches long and located in the pelvis in front of the sacrum and coccyx. It has two flexures that follow the curves of the sacrum and coccyx. The upper third is covered in peritoneum while the lower third has no peritoneal covering. It is supplied by branches of the inferior mesenteric artery and drains into internal iliac and inferior mesenteric lymph nodes. A thorough understanding of rectal anatomy is important for surgical management of rectal conditions and cancer.
The perineum is the region between the thighs and behind the genitals. It is divided into an anterior urogenital triangle and a posterior anal triangle by an imaginary line between the ischial tuberosities. The pelvic outlet forms the inferior boundary and consists of the pubic arch anteriorly and sciatic notches posteriorly. The perineum contains the anus, ischiorectal fossae in the anal region, and male or female genitals in the urogenital region. It has three spaces - subcutaneous, superficial, and deep perineal pouches. The urethral sphincter mechanism surrounds the membranous urethra in males and middle/lower u
ANATOMY OF THE FEMALE REPRODUCTIVE SYSTEM.docGichanaElvis
The document provides an in-depth overview of the anatomy of the female reproductive system and pelvis. It describes the layers of the anterior abdominal wall, including the skin, superficial and deep fascia, musculo-aponeurotic layer, fascia transversalis, properitoneal adipose layer, and parietal peritoneum. It then discusses the bones of the pelvis, outlining the pelvic inlet and outlet, planes and diameters, and different types of pelves. The key differences between the female and male pelvis are also summarized.
The document summarizes the surgical anatomy of the inguinal canal. It describes the layers of the anterior abdominal wall and how they contribute to the structures of the groin. It details the internal and external oblique muscles and how their aponeuroses form the inguinal ligament, lacunar ligament and other structures. It explains the anatomy of the inguinal canal, including the superficial and deep inguinal rings, and contents of the spermatic cord in males that passes through the canal.
This document describes the ilioinguinal surgical approach. It involves making a skin incision from above the pubic symphysis to the iliac crest. The external oblique muscle is released to expose the internal iliac fossa. The femoral vessels and nerves are mobilized by releasing muscles from the inguinal ligament. This provides three windows of exposure - the internal iliac fossa, pelvic brim, and a limited view between the rectus muscle and spermatic cord. The approach is used for fractures of the anterior pelvic wall and columns.
The pelvis is formed by bones and muscles. The back wall is formed by the sacrum and piriformis muscle, the side walls are the obturator internus muscles, and the front wall is the symphysis pubis. The floor is formed by the levator ani and coccygeus muscles covering the sacrospinous ligaments. The pelvic diaphragm consists of the levator ani muscles and coccygeus muscle. It contains openings for the urethra, vagina, and anal canal. The pelvic viscera are supported by connective tissues like the cardinal and uterosacral ligaments.
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
2. Anatomical background
Superficial Abdominal Muscles :
A) ) Lateral Group
External oblique muscle
Internal oblique muscle
Transversus abdominis
B) Medial Group :
• Rectus abdominis
• Pyramidalis
3. A) Lateral group :
External Oblique Muscle
The external oblique muscle arises by eight slips from
the external surfaces of the fifth through twelfth ribs.
Its five upper slips interdigitate with the origins of
serratus anterior, its three lower slips with the origins
of latissimus dorsi.
Its posterior fibers descend almost vertically to the
iliac crest, and the adjacent anterior fibers pass
obliquely forward and medially in their downward
course.
4. About a finger width from the lateral border of the
rectus abdominis muscle, the external oblique fibers
terminate in an aponeurosis. The aponeuroses of both
external oblique muscles unite at the linea alba, where
they attach to the pubic symphysis and the adjacent
anterior surfaces of the superior pubic ramus.
5. The portion of the aponeurosis between the anterior
superior iliac spine and the pubic tubercle is thickened
to form a tendinous band, the inguinal ligament.
Just above and medial to the inguinal ligament is the
superficial inguinal ring, bounded by the medial crus,
lateral crus, and intercrural fibers. The latter are
reinforcing fibers of the external oblique aponeurosis.
6. Internal Oblique Muscle
The internal oblique muscle originates from the deep
layer of the lumbodorsal fascia, from the intermediate
line of the iliac crest, from the anterorsuperior iliac
spine, and from the lateral portion of the inguinal
ligament.
Its muscular fibers fan out broadly to their sites of
insertion. The uppermost posterior fibers are inserted
into the inferior borders of the last three ribs. The
intermediate fibers form an aponeurosis at the lateral
border of the rectus abdominis muscle.
7. This aponeurosis splits into an anterior and a posterior
layer that pass around the rectus abdominis to form
the rectus sheath before uniting with the contralateral
aponeurotic fibers at the linea alba.
The posterior rectus sheath terminates about three
finger widths below the umbilicus at the arcuate line.
The lower fibers of the internal oblique are continued
onto the spermatic cord in males to form the cremaster
muscle. In females, a few muscle fibers accompany the
round ligament of the uterus within the inguinal canal.
8. Transversus Abdominis
The deepest of the three lateral abdominal muscles,
the transversus abdominis, arises by six slips from the
internal aspects of the seventh through twelfth costal
cartilages, interdigitating with the slips of the costal
part of the diaphragm. Fibers also arise from the deep
layer of the lumbodorsal fascia, the inner lip of the
iliac crest, and the lateral part of the inguinal
ligament.
9. The transversus abdominis fibers pass in a horizontal
direction and terminate in an aponeurosis along the
laterally convex semilunar line. Above the arcuate line,
this aponeurosis forms the posterior layer of the rectus
sheath.
Below the arcuate line, it unites with the anterior
lamina of the internal oblique aponeurosis and helps
form the anterior layer of the rectus sheath. Each
transverses aponeurosis fuses with its counterpart at
the linea alba.
10. B) Medial group :
rectus abdominis
The rectus abdominis muscle arises by three slips from
the external surfaces of the fifth through seventh
costal cartilages and from the xiphoid process. The
muscle tapers in its straight, descending course,
especially in its lower one-fourth, and inserts by a
short, strong tendon into the pubic crest.
11. The fiber mass of the rectus abdominis is interrupted
by three or more transverse tendinous bands, the
tendinous intersections, which are intimately attached
to the anterior rectus sheath
12. Rectus Sheath.
The rectus sheath that envelops the rectus abdominis
muscle is formed by the aponeuroses of the three lateral
abdominal muscles. It is divided into an anterior layer
(anterior rectus sheath) and a posterior layer (posterior
rectus sheath).
The aponeurosis of the internal oblique muscle splits
into two parts that pass behind and in front of the
rectus abdominis to reach the linea alba.
13. Above the umbilicus, or more precisely above the
arcuate line, the anterior wall of the sheath consists of
the external oblique aponeurosis and, deep to it, the
anterior layer of the internal oblique aponeurosis.
14. Below the level of the arcuate line, the aponeuroses of
all three abdominal muscles pass in front of the rectus
abdominis muscle The posterior layer of the internal
oblique aponeurosis is reinforced above the arcuate
line by the aponeurosis of the transversus abdominis.
Below the arcuate line, the posterior wall of the rectus
sheath is formed entirely by the transversalis fascia.
15. Pyramidalis
The pyramidalis muscle arises broadly from the
superior pubic ramus, anterior to the insertion of the
rectus abdominis. It passes upward, gradually
narrowing as it ascends, to insert on the linea alba. The
pyramidalis is absent in approximately 20% of the
population.
17. Psoas Major
The superficial part of the psoas major arises from the
lateral surfaces of the twelfth thoracic vertebra and the
first four lumbar vertebrae, and its deep part from the
first through fifth costal processes.
lt unites with the fibers of the iliacus muscle and,
enveloped by the iliac fascia, inserts into the lesser
trochanter of the femur as the iliopsoas muscle.
18. The psoas minor is a variant present in fewer than 50%
of individuals. It arises from the twelfth thoracic and
first lumbar vertebrae and is attached to the iliac fascia
and, via the fascia, to the iliopubic eminence.
Iliacus :
The iliacus muscle arises from the iliac fossa and
inserts conjointly with psoas major into the lesser
trochanter of the femur. Their composite, the
iliopsoas, passes through the lacuna musculorum
(muscular compartment) beneath the inguinal
ligament to reach the thigh.
19. Quadratus Lumborum
The quadratus lumborum is a flat muscle that lies
adjacent to the vertebral column and stretches
between the twelfth rib and iliac crest. It consists of
two parts that cannot be completely separated from
each other: a posterior part arising from the iliac crest
and iliolumbar ligament and inserting into the costal
processes of the first through third (or fourth) lumbar
vertebrae and twelfth rib, and an anterior part passing
from the costal processes of the lower three or four
lumbar vertebrae to the last rib.
20. INCISIONS FOR EXPOSURE OF THE
UPPER GENITOURINARY ORGANS
Flank Approaches :
A flank incision offers extraperitoneal access to the
kidney and adjacent structures. However, access to the
hilar structures may be limited, especially in the
presence of large tumors. Experienced surgeons rarely
find this limitation bothersome if exploration of other
intra-abdominal structures is not required.
23. ELEVENTH RIB INCISION (CLASSIC
FLANK)
Although a flank incision can be made through or between
the beds of the lowest three ribs, removal of the 11th rib
usually offers excellent exposure and minimizes risk of
entering the pleura.
The incision begins posteriorly at the angle of the rib and
may extend as far as the border of the rectus abdominus.
The skin and subcutaneous tissues are opened to expose
the latissimus overlying the chosen rib. Transecting the
overlying muscle exposes the periosteum, which can be
incised along the length of the rib using the electrocautery
or scalpel.
24.
25.
26. SUBCOSTAL FLANK INCISION
If there is no need for high exposure, a flank incision
can be made below the 12th rib. This eliminates the
risk of entering the pleural cavity, but is no less painful
than a rib incision. The incision is especially useful in
children.
A formal flank position is used. After marking the tips
of the lower ribs with a surgical pen, it is helpful to
draw the position of the 12th thoracic nerve, also
known as the subcostal nerve. The incision extends
from sacrospinalis muscle posteriorly to the rectus
border anteriorly
27. The skin and subcutaneous tissues are opened to
expose the external abdominal oblique muscle and
latissimus dorsi. Care must be taken opening the
internal oblique in order to avoid damaging the
subcostal nerve, which lies between the internal
abdominal oblique muscle and the underlying
transversalis abdominus.
28. Careful mobilization of the subcostal nerve and vessels
allows them to be retracted either cephalad or caudad.
The lumbodorsal fascia (the fusion of the internal
oblique and transversalis muscle sheaths posteriorly)
is incised to enter the retroperitoneum. Peritoneum is
then swept away from the anterior abdominal wall.
The transversalis fibers are separated bluntly.
29. DORSAL LUMBOTOMY
This incision is used infrequently, but in properly
selected thin patients it offers relatively atraumatic
access to the ureteropelvic junction (UPJ). The incision
is limited by the 12th rib superiorly and the iliac crest
inferiorly, so there is no option to extend it; therefore,
it should be used only when the access needed is
undoubtedly within this narrow window.
30. The incision follows the lateral border of the
paraspinous muscles from the 12th rib to iliac crest.
Rolled sheets support the shoulders with the patient
prone. A small amount of bed extension increases the
distance between the bony limits.
31. After opening the skin and subcutaneous tissues, the
lumbo -dorsal fascia is identified. The medial aspect is
bordered by the paraspinous muscles and quadratus
lumborum.The lateral aspect is bordered by the
latissimus dorsi. Dividing the lumbodorsal fascia
exposes Gerota’s fascia
32.
33. Because the space is small, the incision may be best
visualized with handheld retractors. The UPJ and
upper ureter are easily mobilized through a window in
Gerota’s fascia.
34. Anterior Approaches
Excellent exposure and ready access to the renal hilum
are advantages of intra-abdominal anterior
approaches. Disadvantages include the higher
incidence of ileus and incisional hernia.
35. SUBCOSTAL TRANSPERITONEAL
INCISION
The patient is placed in the supine position with the
bed extended below the lumbar spine. A blanket
elevating the ipsilateral shoulder enhances lateral
extension.
The skin incision is made two fingerbreadths below
the costal margin from the anterior axillary line to
slightly across the midline. The external oblique,
internal oblique, and transversalis muscles are opened
laterally
36. Their fasciae briefly join lateral to the rectus
abdominus muscle. At that point, the rectus fascia
splits anteriorly and posteriorly. In patients without
extensive intra-abdominal scarring, an effective
approach is to enter the peritoneal cavity in the
midline portion of the incision under direct
visualization.
37. Properitoneal fat should be swept off the peritoneum,
which is grasped with tissue forceps and held up to
allow the underlying omentum and small bowel to fall
away prior to cutting between the forceps.
38. Two fingers are placed under the abdominal wall to
protect the underlying small bowel. The abdominal
wall is then opened under direct vision, ligating the
branches of the superior epigastric artery.
The falciform ligament holds the ligamentum teres,
which is the remnant of the umbilical vein. In patients
with adhesion of peritoneal contents to the abdominal
wall, the dissection into the abdomen should be done
with a combination of blunt and sharp dissection.
39.
40. BILATERAL SUBCOSTAL
TRANSPERITONEAL INCISION
Excellent exposure to the upper abdominal cavity and
retroperitoneum is afforded through this incision,
otherwise known as a chevron or “bucket-handle”
incision. The patient’s waist is positioned over the
flexion point of the surgical bed.
Arms may be tucked at the patient’s side, but if the
dissection is planned beyond the anterior axillary line,
they should be placed on arm boards. Table extension
increases exposure as long as caval compression by
stretching is avoided.
41. As with any bilateral incision, care should be taken to
assure the incision is symmetrical with respect to the
midline and to the costal margins. The abdomen is
entered in the same manner as in the unilateral
subcostal transperitoneal incision.
42.
43. THORACOABDOMINAL INCISION
Thoraco abdominal incision offers wide exposure of the
upper abdomen, chest, and retroperitoneum for large
renal, adrenal, or retroperitoneal tumors or when an
ipsilateral lung nodule is to be removed concurrently.
With the patient in the semi-oblique position and the bed
extended, an incision is made through the eighth or ninth
intercostal space extending inferomedially to or across the
midline. It may also be extended caudally along the midline
if needed.
44. The abdominal portion of the incision is opened first
as described above if the finding of metastatic disease
or tumor fixation is likely to terminate the operation.
45.
46. The costal cartilage between the tips of the two ribs on
either side of the incision is then divided with heavy
scissors or rib cutters. Dissection is carried through
the intercostal muscles along the upper border of the
adjacent lower rib in order to avoid the neurovascular
bundle.
The pleura is opened under direct visualization. The
diaphragm is incised With the diaphragm opened, the
liver can be retracted into the thorax to maximize
exposure of the underlying structures.
47.
48. The most versatile abdominal incision is the midline,
as it can be extended in either direction if needed. This
makes it the choice for diagnostic exploratory
laparotomy or trauma. Within the bony limits of the
sternal xyphoid process above and pubis below, there
is flexibility to use the portion needed. If the incision
must extend beyond the umbilicus, we prefer to
encircle it so the incision is not subject to moisture.
Midline Abdominal Incisions
49. The midline is incised through the skin and
subcutaneous tissue to expose the linea alba. This
structure is identified by the decussating fibers
between the bellies of the two recti abdomini.
Although dissection laterally helps identify the linea
alba, excessive mobilization can leave dead space that
can lead to seroma or hematoma and subsequent
wound infection.
50.
51. The linea alba is wider immediately below the
umbilicus than it is nearer the pubis, so it is easier to
enter in this area. Care is taken going through the linea
alba, properitoneal fat, and peritoneum to prevent
inadvertent injury to underlying structures if no
adhesions are present.
52. Gibson’s Incision
Now used mainly for renal transplantation, the Gibson
incision affords relatively atraumatic access to the iliac
fossa and ureter. In the supine position, an incision is
made 2–3 cm medial to the line from the anterior
superior iliac spine to the pubis.
Surgeon preference will dictate whether the incision
parallels that line or curves moderately. Some also
prefer to make a “hockey stick” extension across the
midline about 2 cm above the pubis, which gives more
access to the bladder.
53. The external oblique aponeurosis is exposed. An
incision is made along the lateral border of the rectus
abdominus. If more medial exposure is needed, the
rectus may be transected across its tendinous
attachment to the pubis. The inferior epigastric artery
may be ligated and divided as it passes along the
posterior aspect of the rectus.
54.
55. The transversalis fascia is incised to expose the correct
plane for blunt dissection. The peritoneum and
bladder are swept medially to develop the
extraperitoneal space .
56. Infra umbilical Incision
The incision is begun below the umbilicus but the
peritoneum is not opened after incising the linea alba.
It is easier to find the midline near the umbilicus
because the linea alba is wider at this point.
Identifying the proper plane is often overlooked in
developing the space of Retzius.
57. The first plane encountered after opening the linea
alba is superficial to the transversalis fascia. If this
plane is developed, troublesome venous bleeding may
be encountered and the inferior epigastric vessels may
be injured.
Opening the thin transversalis fascia allows the
relatively avascular plane to be developed by sweeping
two fingers along the posterior pubis.
58.
59. Lower Abdominal Transverse
Incision
Although several variations have been described,
Pfannenstiel’s incision is still the standard for exposure
of the bladder and pelvis. The incision is strong and
cosmetically acceptable.
In most patients, it can be hidden below the pubic
hairline. Although the skin incision is transverse, the
Pfannnenstiel actually functions as a midline incision
in disguise.
60. The patient is positioned similarly to other lower
abdominal incisions unless simultaneous vaginal
incision requires lithotomy. In women, it is ideal to
make the incision just below or at the hairline.
The incision is carried through the skin and
subcutaneous tissues to expose the rectus sheath,
which has only an anterior layer at this level .
61. Inguinal Incision
A skin incision is created 1 or 2 cm above the inguinal
ligament, identified as the line between the anterior
superior iliac spine and the pubic tubercle. Making the
incision above the inguinal (Poupart’s) ligament helps
avoid moisture from the groin crease.
Scarpa’s (and occasionally Camper’s) fascia is
visualized as the dissection is carried to the external
oblique aponeurosis.
62. Care must be taken to identify and control the
superficial epigastric branch of the saphenous vein. It
is helpful to fully define the lower aspect of the
external oblique aponeurosis, where it rolls inward to
form the inguinal ligament. Just above the pubic
tubercle, the aponeurosis separates around the
spermatic cord to form the external inguinal ring.