Anterior Abdominal Wall: Anatomy

Introduction

Surface landmarks

• Superior border:
  • Xiphoid process Xiphoid process Chest Wall: Anatomy
  • Costal cartilages of the 7th–10th ribs Ribs A set of twelve curved bones which connect to the vertebral column posteriorly, and terminate anteriorly as costal cartilage. Together, they form a protective cage around the internal thoracic organs. Chest Wall: Anatomy
• Middle: Umbilicus is at the midline between the L3 and L4 vertebrae.
• Inferior border:
  • Inguinal ligament Inguinal Ligament Femoral Region and Hernias: Anatomy:
    • Created by the inferior border of the external oblique muscle and its aponeurosis
    • Extends between the anterior superior iliac spine Anterior Superior Iliac Spine Chronic Apophyseal Injury and pubic tubercle
  • Pubic crest and pubic symphysis Pubic Symphysis A slightly movable cartilaginous joint which occurs between the pubic bones. Vagina, Vulva, and Pelvic Floor: Anatomy

Abdominal planes

The abdomen can be divided into 4 quadrants with the transverse and sagittal Sagittal Computed Tomography (CT) planes.

• Transverse (transumbilical) plane: crosses the abdomen at the level of the umbilicus
• Sagittal Sagittal Computed Tomography (CT) (vertical) plane: crosses the body at the level of the umbilicus
• The intersection of these 2 planes defines 4 quadrants:
  • RUQ
  • LUQ
  • RLQ
  • LLQ

The abdomen can also be divided into 9 regions using the following planes:

• Midclavicular planes: vertical planes extending from the midclavicular lines to the midinguinal points
• Upper horizontal (subcostal) plane: inferior to the costal margin at the level of L3
• Lower horizontal (transtubercular) plane: courses between the 2 tubercles of the iliac crest at the level of L5
• The planes define 9 regions:
  • On the left and right sides (superior to inferior):
    • Hypochondrium
    • Lateral abdominal region
    • Inguinal region
  • Centrally (superior to inferior):
    • Epigastric region
    • Umbilical region Umbilical Region Surgical Anatomy of the Abdomen
    • Pubic region or hypogastrium

Abdominal Wall Muscles

Layers of the abdominal wall Abdominal wall The outer margins of the abdomen, extending from the osteocartilaginous thoracic cage to the pelvis. Though its major part is muscular, the abdominal wall consists of at least seven layers: the skin, subcutaneous fat, deep fascia; abdominal muscles, transversalis fascia, extraperitoneal fat, and the parietal peritoneum. Surgical Anatomy of the Abdomen

The layers of the anterior abdominal wall Abdominal wall The outer margins of the abdomen, extending from the osteocartilaginous thoracic cage to the pelvis. Though its major part is muscular, the abdominal wall consists of at least seven layers: the skin, subcutaneous fat, deep fascia; abdominal muscles, transversalis fascia, extraperitoneal fat, and the parietal peritoneum. Surgical Anatomy of the Abdomen from superficial to deep are:

• Skin Skin The skin, also referred to as the integumentary system, is the largest organ of the body. The skin is primarily composed of the epidermis (outer layer) and dermis (deep layer). The epidermis is primarily composed of keratinocytes that undergo rapid turnover, while the dermis contains dense layers of connective tissue. Skin: Structure and Functions
• Superficial fascia Fascia Layers of connective tissue of variable thickness. The superficial fascia is found immediately below the skin; the deep fascia invests muscles, nerves, and other organs. Cellulitis:
  • External layer of adipose tissue Adipose tissue Adipose tissue is a specialized type of connective tissue that has both structural and highly complex metabolic functions, including energy storage, glucose homeostasis, and a multitude of endocrine capabilities. There are three types of adipose tissue, white adipose tissue, brown adipose tissue, and beige or “brite” adipose tissue, which is a transitional form. Adipose Tissue: Histology (Camper fascia Fascia Layers of connective tissue of variable thickness. The superficial fascia is found immediately below the skin; the deep fascia invests muscles, nerves, and other organs. Cellulitis):
    • Contains superficial epigastric veins Veins Veins are tubular collections of cells, which transport deoxygenated blood and waste from the capillary beds back to the heart. Veins are classified into 3 types: small veins/venules, medium veins, and large veins. Each type contains 3 primary layers: tunica intima, tunica media, and tunica adventitia. Veins: Histology that drain the anterior abdominal wall Abdominal wall The outer margins of the abdomen, extending from the osteocartilaginous thoracic cage to the pelvis. Though its major part is muscular, the abdominal wall consists of at least seven layers: the skin, subcutaneous fat, deep fascia; abdominal muscles, transversalis fascia, extraperitoneal fat, and the parietal peritoneum. Surgical Anatomy of the Abdomen
    • Superficial epigastric veins Veins Veins are tubular collections of cells, which transport deoxygenated blood and waste from the capillary beds back to the heart. Veins are classified into 3 types: small veins/venules, medium veins, and large veins. Each type contains 3 primary layers: tunica intima, tunica media, and tunica adventitia. Veins: Histology drain into the femoral and paraumbilical veins Veins Veins are tubular collections of cells, which transport deoxygenated blood and waste from the capillary beds back to the heart. Veins are classified into 3 types: small veins/venules, medium veins, and large veins. Each type contains 3 primary layers: tunica intima, tunica media, and tunica adventitia. Veins: Histology.
  • Internal layer of dense connective tissue Dense connective tissue Connective Tissue: Histology (Scarpa fascia Fascia Layers of connective tissue of variable thickness. The superficial fascia is found immediately below the skin; the deep fascia invests muscles, nerves, and other organs. Cellulitis)
• Muscles:
  • Lateral abdominal muscles:
    • External oblique
    • Internal oblique
    • Transversus abdominis
  • Anterior abdominal muscles:
    • Rectus abdominis
    • Pyramidalis muscle
• Transversalis fascia Fascia Layers of connective tissue of variable thickness. The superficial fascia is found immediately below the skin; the deep fascia invests muscles, nerves, and other organs. Cellulitis
• Extraperitoneal fat
• Peritoneum Peritoneum The peritoneum is a serous membrane lining the abdominopelvic cavity. This lining is formed by connective tissue and originates from the mesoderm. The membrane lines both the abdominal walls (as parietal peritoneum) and all of the visceral organs (as visceral peritoneum). Peritoneum: Anatomy

Lateral abdominal muscles

External oblique:

• Origin: outer surface of ribs Ribs A set of twelve curved bones which connect to the vertebral column posteriorly, and terminate anteriorly as costal cartilage. Together, they form a protective cage around the internal thoracic organs. Chest Wall: Anatomy 5–12
• Insertion: linea alba (rectus sheath), pubic tubercle, and iliac crest
• Nerve supply:
  • Intercostal nerves (T7–T11)
  • Subcostal nerve (T12)
  • Iliohypogastric nerve
• Action:
  • Flexes and rotates the trunk
  • Compresses and supports the internal viscera
  • Assists with expiration Expiration Ventilation: Mechanics of Breathing

Internal oblique:

• Origin: anterior iliac crest, thoracolumbar fascia Thoracolumbar fascia Posterior Abdominal Wall: Anatomy, and lateral 3rd of the inguinal ligament Inguinal Ligament Femoral Region and Hernias: Anatomy
• Insertion: inferior borders of ribs Ribs A set of twelve curved bones which connect to the vertebral column posteriorly, and terminate anteriorly as costal cartilage. Together, they form a protective cage around the internal thoracic organs. Chest Wall: Anatomy 10–12 and linea alba (rectus sheath)
• Nerve supply:
  • Intercostal nerves (T7–T11)
  • Subcostal nerve (T12)
  • Iliohypogastric nerve
• Action:
  • Flexes and rotates the trunk
  • Compresses and supports internal viscera
  • Assists with expiration Expiration Ventilation: Mechanics of Breathing

Transversus abdominis:

• Deepest of the 3 lateral abdominal muscles
• Fibers run horizontally.
• Transversalis fascia Fascia Layers of connective tissue of variable thickness. The superficial fascia is found immediately below the skin; the deep fascia invests muscles, nerves, and other organs. Cellulitis lies underneath the transversus abdominis.
• Origin: inner surface of costal cartilages of ribs Ribs A set of twelve curved bones which connect to the vertebral column posteriorly, and terminate anteriorly as costal cartilage. Together, they form a protective cage around the internal thoracic organs. Chest Wall: Anatomy 7–12, iliac crest, thoracolumbar fascia Thoracolumbar fascia Posterior Abdominal Wall: Anatomy, and lateral 3rd of the inguinal ligament Inguinal Ligament Femoral Region and Hernias: Anatomy
• Insertion: linea alba (rectus sheath)
• Nerve supply:
  • Intercostal nerves (T7–T11)
  • Subcostal nerve (T12)
• Action:
  • Flexes and rotates the trunk
  • Compresses and supports internal viscera
  • Assists with expiration Expiration Ventilation: Mechanics of Breathing

Anterior abdominal muscles

Rectus abdominis:

• Pair of long, straight muscles running vertically
• Left and right parts are separated by the central linea alba.
• Each muscle consists of 4 parts separated by 3 bands of tendon → tendinous intersections
• Origin: pubic symphysis Pubic Symphysis A slightly movable cartilaginous joint which occurs between the pubic bones. Vagina, Vulva, and Pelvic Floor: Anatomy and crest
• Insertion: xiphoid process Xiphoid process Chest Wall: Anatomy and costal cartilage Cartilage Cartilage is a type of connective tissue derived from embryonic mesenchyme that is responsible for structural support, resilience, and the smoothness of physical actions. Perichondrium (connective tissue membrane surrounding cartilage) compensates for the absence of vasculature in cartilage by providing nutrition and support. Cartilage: Histology of ribs Ribs A set of twelve curved bones which connect to the vertebral column posteriorly, and terminate anteriorly as costal cartilage. Together, they form a protective cage around the internal thoracic organs. Chest Wall: Anatomy 5–7
• Nerve supply:
  • Intercostal nerves (T7–T11)
  • Subcostal nerve (T12)
• Action:
  • Flexes trunk
  • Compresses internal viscera
  • Assists with expiration Expiration Ventilation: Mechanics of Breathing
• Enveloped by the rectus abdominis sheath:
  • Created by the aponeurosis of the 3 lateral abdominal muscles
  • Above the arcuate line, the rectus abdominis is enclosed within the sheath.
  • Below the arcuate line, the sheath is entirely anterior to the muscle, placing the muscle in direct contact with the transversalis fascia Fascia Layers of connective tissue of variable thickness. The superficial fascia is found immediately below the skin; the deep fascia invests muscles, nerves, and other organs. Cellulitis.

Pyramidalis muscle:

• Small muscle contained within the rectus abdominis sheath
• May be absent in 20% of the population
• Origin: pubic symphysis Pubic Symphysis A slightly movable cartilaginous joint which occurs between the pubic bones. Vagina, Vulva, and Pelvic Floor: Anatomy and pubic crest
• Insertion: linea alba
• Nerve supply: subcostal nerve (T12)
• Action: tenses linea alba

Inguinal Canal

The inguinal canals are bilateral canals in the lower lateral anterior abdominal wall Abdominal wall The outer margins of the abdomen, extending from the osteocartilaginous thoracic cage to the pelvis. Though its major part is muscular, the abdominal wall consists of at least seven layers: the skin, subcutaneous fat, deep fascia; abdominal muscles, transversalis fascia, extraperitoneal fat, and the parietal peritoneum. Surgical Anatomy of the Abdomen that run obliquely and superolaterally to inferomedially. Each inguinal canal Inguinal canal The tunnel in the lower anterior abdominal wall through which the spermatic cord, in the male; round ligament, in the female; nerves; and vessels pass. Its internal end is at the deep inguinal ring and its external end is at the superficial inguinal ring. Inguinal Canal: Anatomy and Hernias has 4 walls and 2 openings (inguinal rings), 1 at each end.

• Anterior wall is formed by the external oblique aponeurosis.
• Posterior wall is formed by:
  • Tendon of the internal oblique muscle
  • Tendon of the transverse abdominis muscle
  • Transversalis fascia Fascia Layers of connective tissue of variable thickness. The superficial fascia is found immediately below the skin; the deep fascia invests muscles, nerves, and other organs. Cellulitis
• Roof is formed by:
  • Internal oblique muscle
  • Transversus abdominis muscles
• Floor:
  • Formed by the inguinal ligament Inguinal Ligament Femoral Region and Hernias: Anatomy and the aponeurosis of the lower border of the external oblique muscle
  • Extends from the pubic tubercle medially to the anterior superior iliac spine Anterior Superior Iliac Spine Chronic Apophyseal Injury
• Deep inguinal ring Deep inguinal ring Inguinal Canal: Anatomy and Hernias:
  • Origin of the inguinal canal Inguinal canal The tunnel in the lower anterior abdominal wall through which the spermatic cord, in the male; round ligament, in the female; nerves; and vessels pass. Its internal end is at the deep inguinal ring and its external end is at the superficial inguinal ring. Inguinal Canal: Anatomy and Hernias
  • Formed by an opening in the transversalis fascia Fascia Layers of connective tissue of variable thickness. The superficial fascia is found immediately below the skin; the deep fascia invests muscles, nerves, and other organs. Cellulitis
  • Located superior to the inguinal ligament Inguinal Ligament Femoral Region and Hernias: Anatomy halfway between the pubic bone Bone Bone is a compact type of hardened connective tissue composed of bone cells, membranes, an extracellular mineralized matrix, and central bone marrow. The 2 primary types of bone are compact and spongy. Bones: Structure and Types and the anterior superior iliac spine Anterior Superior Iliac Spine Chronic Apophyseal Injury
• Superficial inguinal ring Superficial inguinal ring Inguinal Canal: Anatomy and Hernias:
  • Termination point of the inguinal canal Inguinal canal The tunnel in the lower anterior abdominal wall through which the spermatic cord, in the male; round ligament, in the female; nerves; and vessels pass. Its internal end is at the deep inguinal ring and its external end is at the superficial inguinal ring. Inguinal Canal: Anatomy and Hernias
  • Formed by an opening in the external oblique aponeurosis
  • Located 1 cm superiorly and medially to the pubic tubercle
• Contents of the inguinal canal Inguinal canal The tunnel in the lower anterior abdominal wall through which the spermatic cord, in the male; round ligament, in the female; nerves; and vessels pass. Its internal end is at the deep inguinal ring and its external end is at the superficial inguinal ring. Inguinal Canal: Anatomy and Hernias include:
  • Genital branch of the genitofemoral nerve Genitofemoral nerve Inguinal Canal: Anatomy and Hernias (L1–L2)
  • Ilioinguinal nerve Ilioinguinal nerve Inguinal Canal: Anatomy and Hernias (L1)
  • Spermatic cord Spermatic Cord Either of a pair of tubular structures formed by ductus deferens; arteries; veins; lymphatic vessels; and nerves. The spermatic cord extends from the deep inguinal ring through the inguinal canal to the testis in the scrotum. Testicles: Anatomy in men
  • Round ligament Round ligament A fibromuscular band that attaches to the uterus and then passes along the broad ligament, out through the inguinal ring, and into the labium majus. Uterus, Cervix, and Fallopian Tubes: Anatomy of the uterus Uterus The uterus, cervix, and fallopian tubes are part of the internal female reproductive system. The uterus has a thick wall made of smooth muscle (the myometrium) and an inner mucosal layer (the endometrium). The most inferior portion of the uterus is the cervix, which connects the uterine cavity to the vagina. Uterus, Cervix, and Fallopian Tubes: Anatomy in women

Neurovasculature

Arterial supply

The arteries Arteries Arteries are tubular collections of cells that transport oxygenated blood and nutrients from the heart to the tissues of the body. The blood passes through the arteries in order of decreasing luminal diameter, starting in the largest artery (the aorta) and ending in the small arterioles. Arteries are classified into 3 types: large elastic arteries, medium muscular arteries, and small arteries and arterioles. Arteries: Histology of the anterior abdominal wall Abdominal wall The outer margins of the abdomen, extending from the osteocartilaginous thoracic cage to the pelvis. Though its major part is muscular, the abdominal wall consists of at least seven layers: the skin, subcutaneous fat, deep fascia; abdominal muscles, transversalis fascia, extraperitoneal fat, and the parietal peritoneum. Surgical Anatomy of the Abdomen are divided into superficial and deep layers.

• Superficial layer:
  • Musculophrenic artery:
    • Branch of the internal thoracic artery
    • Supplies the superior anterolateral abdominal wall Abdominal wall The outer margins of the abdomen, extending from the osteocartilaginous thoracic cage to the pelvis. Though its major part is muscular, the abdominal wall consists of at least seven layers: the skin, subcutaneous fat, deep fascia; abdominal muscles, transversalis fascia, extraperitoneal fat, and the parietal peritoneum. Surgical Anatomy of the Abdomen
  • Superficial epigastric artery:
    • Branch of the femoral artery Femoral Artery The main artery of the thigh, a continuation of the external iliac artery. Femoral Region and Hernias: Anatomy
    • Supplies the inferior anterolateral abdominal wall Abdominal wall The outer margins of the abdomen, extending from the osteocartilaginous thoracic cage to the pelvis. Though its major part is muscular, the abdominal wall consists of at least seven layers: the skin, subcutaneous fat, deep fascia; abdominal muscles, transversalis fascia, extraperitoneal fat, and the parietal peritoneum. Surgical Anatomy of the Abdomen
  • Superficial circumflex iliac artery:
    • Branch of the femoral artery Femoral Artery The main artery of the thigh, a continuation of the external iliac artery. Femoral Region and Hernias: Anatomy
    • Supplies the inferior anterolateral abdominal wall Abdominal wall The outer margins of the abdomen, extending from the osteocartilaginous thoracic cage to the pelvis. Though its major part is muscular, the abdominal wall consists of at least seven layers: the skin, subcutaneous fat, deep fascia; abdominal muscles, transversalis fascia, extraperitoneal fat, and the parietal peritoneum. Surgical Anatomy of the Abdomen
• Deep layer:
  • Superior epigastric artery:
    • Direct continuation of the internal thoracic artery
    • Runs inside the rectus sheath behind the rectus muscle
    • Supplies the superior part of the abdominal wall Abdominal wall The outer margins of the abdomen, extending from the osteocartilaginous thoracic cage to the pelvis. Though its major part is muscular, the abdominal wall consists of at least seven layers: the skin, subcutaneous fat, deep fascia; abdominal muscles, transversalis fascia, extraperitoneal fat, and the parietal peritoneum. Surgical Anatomy of the Abdomen
  • Inferior epigastric artery:
    • Branch of the external iliac artery
    • Courses through the rectus sheath and anastomoses with the superior epigastric artery
    • Supplies the inferior part of the abdominal wall Abdominal wall The outer margins of the abdomen, extending from the osteocartilaginous thoracic cage to the pelvis. Though its major part is muscular, the abdominal wall consists of at least seven layers: the skin, subcutaneous fat, deep fascia; abdominal muscles, transversalis fascia, extraperitoneal fat, and the parietal peritoneum. Surgical Anatomy of the Abdomen
  • The 10th and 11th intercostal arteries Arteries Arteries are tubular collections of cells that transport oxygenated blood and nutrients from the heart to the tissues of the body. The blood passes through the arteries in order of decreasing luminal diameter, starting in the largest artery (the aorta) and ending in the small arterioles. Arteries are classified into 3 types: large elastic arteries, medium muscular arteries, and small arteries and arterioles. Arteries: Histology and the subcostal artery supply the lateral abdominal wall Abdominal wall The outer margins of the abdomen, extending from the osteocartilaginous thoracic cage to the pelvis. Though its major part is muscular, the abdominal wall consists of at least seven layers: the skin, subcutaneous fat, deep fascia; abdominal muscles, transversalis fascia, extraperitoneal fat, and the parietal peritoneum. Surgical Anatomy of the Abdomen.

Venous drainage

• Venous drainage follows the arteries Arteries Arteries are tubular collections of cells that transport oxygenated blood and nutrients from the heart to the tissues of the body. The blood passes through the arteries in order of decreasing luminal diameter, starting in the largest artery (the aorta) and ending in the small arterioles. Arteries are classified into 3 types: large elastic arteries, medium muscular arteries, and small arteries and arterioles. Arteries: Histology of the same name.
• The superficial veins Veins Veins are tubular collections of cells, which transport deoxygenated blood and waste from the capillary beds back to the heart. Veins are classified into 3 types: small veins/venules, medium veins, and large veins. Each type contains 3 primary layers: tunica intima, tunica media, and tunica adventitia. Veins: Histology around the umbilicus anastomose with the deep veins Veins Veins are tubular collections of cells, which transport deoxygenated blood and waste from the capillary beds back to the heart. Veins are classified into 3 types: small veins/venules, medium veins, and large veins. Each type contains 3 primary layers: tunica intima, tunica media, and tunica adventitia. Veins: Histology through the paraumbilical veins Veins Veins are tubular collections of cells, which transport deoxygenated blood and waste from the capillary beds back to the heart. Veins are classified into 3 types: small veins/venules, medium veins, and large veins. Each type contains 3 primary layers: tunica intima, tunica media, and tunica adventitia. Veins: Histology.

Innervation

• The skin Skin The skin, also referred to as the integumentary system, is the largest organ of the body. The skin is primarily composed of the epidermis (outer layer) and dermis (deep layer). The epidermis is primarily composed of keratinocytes that undergo rapid turnover, while the dermis contains dense layers of connective tissue. Skin: Structure and Functions, abdominal muscles, and peritoneum Peritoneum The peritoneum is a serous membrane lining the abdominopelvic cavity. This lining is formed by connective tissue and originates from the mesoderm. The membrane lines both the abdominal walls (as parietal peritoneum) and all of the visceral organs (as visceral peritoneum). Peritoneum: Anatomy are innervated by:
  • Thoracoabdominal nerves (T7–T11) that run within the internal oblique and transversus abdominis muscle layers
  • Subcostal nerve (T12)
  • Iliohypogastric nerve (L1)
  • Ilioinguinal nerve Ilioinguinal nerve Inguinal Canal: Anatomy and Hernias (L1)
• Sensory Sensory Neurons which conduct nerve impulses to the central nervous system. Nervous System: Histology distribution:
  • Series of transverse dermatomal Dermatomal Dermatologic Examination bands from T7 to L1
  • Skin Skin The skin, also referred to as the integumentary system, is the largest organ of the body. The skin is primarily composed of the epidermis (outer layer) and dermis (deep layer). The epidermis is primarily composed of keratinocytes that undergo rapid turnover, while the dermis contains dense layers of connective tissue. Skin: Structure and Functions around the umbilicus is innervated by T10.

Clinical Relevance

• Inguinal hernias Inguinal Hernias An abdominal hernia with an external bulge in the groin region. It can be classified by the location of herniation. Indirect inguinal hernias occur through the internal inguinal ring. Direct inguinal hernias occur through defects in the abdominal wall (transversalis fascia) in Hesselbach’s triangle. The former type is commonly seen in children and young adults; the latter in adults. Inguinal Canal: Anatomy and Hernias: The superficial and deep inguinal rings represent 2 weak points in the abdominal wall Abdominal wall The outer margins of the abdomen, extending from the osteocartilaginous thoracic cage to the pelvis. Though its major part is muscular, the abdominal wall consists of at least seven layers: the skin, subcutaneous fat, deep fascia; abdominal muscles, transversalis fascia, extraperitoneal fat, and the parietal peritoneum. Surgical Anatomy of the Abdomen and create a pathway for inguinal hernias Inguinal Hernias An abdominal hernia with an external bulge in the groin region. It can be classified by the location of herniation. Indirect inguinal hernias occur through the internal inguinal ring. Direct inguinal hernias occur through defects in the abdominal wall (transversalis fascia) in Hesselbach’s triangle. The former type is commonly seen in children and young adults; the latter in adults. Inguinal Canal: Anatomy and Hernias. Several risk factors have been implicated in the development of inguinal hernias Inguinal Hernias An abdominal hernia with an external bulge in the groin region. It can be classified by the location of herniation. Indirect inguinal hernias occur through the internal inguinal ring. Direct inguinal hernias occur through defects in the abdominal wall (transversalis fascia) in Hesselbach’s triangle. The former type is commonly seen in children and young adults; the latter in adults. Inguinal Canal: Anatomy and Hernias, including obesity Obesity Obesity is a condition associated with excess body weight, specifically with the deposition of excessive adipose tissue. Obesity is considered a global epidemic. Major influences come from the western diet and sedentary lifestyles, but the exact mechanisms likely include a mixture of genetic and environmental factors. Obesity, pregnancy Pregnancy The status during which female mammals carry their developing young (embryos or fetuses) in utero before birth, beginning from fertilization to birth. Pregnancy: Diagnosis, Physiology, and Care, and aging. Affected individuals will present with a burning sensation or dull ache at the groin Groin The external junctural region between the lower part of the abdomen and the thigh. Male Genitourinary Examination, and a mass Mass Three-dimensional lesion that occupies a space within the breast Imaging of the Breast that may fluctuate in size based on time of the day and preceding activity. Classically, coughing or straining leads to the appearance of the hernia Hernia Protrusion of tissue, structure, or part of an organ through the bone, muscular tissue, or the membrane by which it is normally contained. Hernia may involve tissues such as the abdominal wall or the respiratory diaphragm. Hernias may be internal, external, congenital, or acquired. Abdominal Hernias. Treatment is surgical and usually performed on an outpatient basis with excellent results.
• Caput medusae: a sign of portal hypertension that manifests by the appearance of dilated superficial epigastric veins radiating from the umbilicus. The name caput medusae (Latin for “head of Medusa”) originates from the apparent similarity to Medusa’s head, who, according to Greek Mythology, had venomous snakes instead of hair. Treatment is geared toward controlling portal hypertension Portal hypertension Portal hypertension is increased pressure in the portal venous system. This increased pressure can lead to splanchnic vasodilation, collateral blood flow through portosystemic anastomoses, and increased hydrostatic pressure. There are a number of etiologies, including cirrhosis, right-sided congestive heart failure, schistosomiasis, portal vein thrombosis, hepatitis, and Budd-Chiari syndrome. Portal Hypertension.
• Cullen sign: hemorrhagic discoloration and edema Edema Edema is a condition in which excess serous fluid accumulates in the body cavity or interstitial space of connective tissues. Edema is a symptom observed in several medical conditions. It can be categorized into 2 types, namely, peripheral (in the extremities) and internal (in an organ or body cavity). Edema of the skin Skin The skin, also referred to as the integumentary system, is the largest organ of the body. The skin is primarily composed of the epidermis (outer layer) and dermis (deep layer). The epidermis is primarily composed of keratinocytes that undergo rapid turnover, while the dermis contains dense layers of connective tissue. Skin: Structure and Functions around the umbilicus. A similar finding involving the flank is called Grey Turner sign. Both signs are due to intraperitoneal Intraperitoneal Peritoneum: Anatomy hemorrhage due to acute hemorrhagic pancreatitis Pancreatitis Inflammation of the pancreas. Pancreatitis is classified as acute unless there are computed tomographic or endoscopic retrograde cholangiopancreatographic findings of chronic pancreatitis. The two most common forms of acute pancreatitis are alcoholic pancreatitis and gallstone pancreatitis. Acute Pancreatitis, intra-abdominal trauma, or conditions that lead to hemorrhage into the abdominal cavity. Discoloration of the skin Skin The skin, also referred to as the integumentary system, is the largest organ of the body. The skin is primarily composed of the epidermis (outer layer) and dermis (deep layer). The epidermis is primarily composed of keratinocytes that undergo rapid turnover, while the dermis contains dense layers of connective tissue. Skin: Structure and Functions is due to blood collection in the subcutaneous fascial planes.