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ABDOMEN

dr. Nurlis Mahmud

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Regio abdomen

Epigastric region
RH or epigastrium LH

RL LL

Umbilical region

RI Hypogastric region
or hypogastrium LI

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M. Rectus Abdominis Aponeurosis M.Obl.Abd.Ext

Aponeurosis M.Obl.Abd.Int

Cutis
Fascia camperi
Fascia superfisialis
Fascia scarpae
Aponeurosis M. M.Obl.Abd.Ext
Transversus Peritoneum M.Obl.Abd.Int
Abdominis
M.Transversus Abdominis

Peritoneum

Extra Peritoneal fat Fascia transversa

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Dinding Abdomen INSCRIPTIONES
TENDINAE

PROCESSUS
XIPHOIDEUS

VESICA FELLEA

LINEA
LINEA ALBA
SEMILUNARIS

GARIS MONROE
UMBILICUS
SIAS LINEA ARCUATA

LIGAMENTUM
M. RECTUS
INGUINALE
ABDOMINIS
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 Mc. Burneys point on
Spinoumbilical line

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DINDING DORSOLAT ABDOMEN
1. M. OBL. ABD. EXTERNUS
2. M. OBL. ABD. INTERNUS
3. M. TRANSVERSUS ABDOMINIS
4. M. QUADRATUS LUMBORUM
5. M. ILIOPSOAS
6. COLL. VERTEBRALIS
7. M. SACROSPINALIS

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 VASCULARISASI DINDING
PERUT
1. AA. INTERCOSTALES
2. AA. LUMBALES
3. A. EPIGASTRICA SUPERFICIALIS
A. CIRCUMFL.ILIUM.SPF
4. A. EPIGASTRICA INFERIOR
A. CIRCUMFL.ILIUM.PRF
5. A. EPIGASTRICA SUP.

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Arteries of the Anterolateral Abdominal Wall

Artery Origin Course Distribution

Rectus abdominis
Superior Internal thoracic Descends in rectus sheath
superior part
epigastric artery deep to rectus abdominis
abdominal wall
Rectus abdominis and
Runs superior and enters
Inferior medial part of
rectus sheath; runs deep
Epigastric anterolateral
to rectus abdominis
abdominal wall
External iliac artery
Runs on deep aspect of Iliacus muscle and
Deep circumflex anterior abdominal wall, inferior part of
iliac parallel to inguinal anterolateral
ligament abdominal wall

Suoerficial Subcutaneus tissue

circumflex iliac Runs in superficial fascia and skin over inferior
along inguinal ligament part of anterolateral
Femoral artery abdominal wall
Subcutaneus tissue
Superficial Runs in superficial fascia
and skin over
Epigastric toward umbilicus
suprapubic region
 INNERVASI DINDING PERUT
1. NN. INTERCOSTALES
2. N. ILIOHYPOGASTRICUS
3. N. ILIOINGUINALIS
4. N. GENITOFEMORALIS

N. SPERMATICUS EXT
N. LUMBOINGIONALIS

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Nerves of the Anteriolateral Abdominal Wall

Nerve Origin Course Distribution
Anterior abdominal
Run between 2nd and
Thoraco abdominal Continuation of lower muscle and overlying
3rd layers of
(T7-T11) intercostal nerves skin; periphery of
abdominal muscle
diaphragm
Lowest slip of
external oblique
Ventral ramus of 12th Runs along inferior
Subcostal muscle and skin over
thoracic nerve border of 12th rib
anterior superior iliac
spine and hip
Pierces transverse Skin of hypogastric
Chiefly from ventral abdominal muscle; region and over iliac
Iliohypogastric (L1) ramus of 1st lumbar branches pierce crest; internal oblique
nerve external oblique and trasverse
aponeurosis abdominal

Skin of scrotum or
Passes between 2 nd
labium majus, mons
and 3rd layers of pubis, and adjacent
Ventral ramus of 1st
Ilioinguinal (L1) abdominal muscles medial aspect of
lumbar nerve
and passes through thigh; internal oblique
inguinal canal and transverse
abdominal
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Corresponding Layers of the Anterior Abdominal Wall,

Spermatic Cord, and Scrotum
Layers of Anterior Scrotum and Covering of Covering of Spermatic
Abdominal Wall Testis Cord
Skin Skin
Scrotum (and scrolal
Subcutaneous tissue or Superficial (dartos) fascia septum)
superficial fascia and dartos muscle
External oblique External spermatic fascia External spermatic fascia
aponeurosis
Internal oblique muscle Cremaster muscle Cremaster muscle
Fascia of both superficial Cremasteric fascia Cremasteric fascia
and deep surface of the
internal oblique muscle
Transverse abdominal
muscle
Transversalis fascia Internal spermatic fascia Internal spermatic fascia
Extraperitoneal fat
Peritoneum Tunica vaginalis Obliterated processus
vaginalis
 CANALIS INGUINALIS
Batas :
DINDING VENTRAL : FASCIA SPF / APON.M.OBL.ABD.EXT

DINDING DORSAL : PERITONEUM / FASCIA TRANSVERSA

DINDING CRANIAL : M.OBL.ABD.INT / M.TRANSV.ABD

DINDING CAUDAL : LIG. INGUINALE

ISI : FUNICULUS SPERMATICUS (LAKI-LAKI)

LIG. TERES UTERI (WANITA)

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 FUNICULUS SPERMATICUS
ISI :
1. A. dan VV. DEFERENTIALES
2. A. SPERMATICA INTERNA
3. PLEXUS PAMPINIFORMIS
4. PLEXUS NERVOSUS
DEFERENTIALES ET SPERMATICUS
5. DUCTUS DEFERENS

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 HERNIA
INGUINALES

EPIGASTRICA

LUMBALIS

FEMORALIS

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 HERNIA INGUINALES
1. INDIRECTA : CONGENITAL
: ASQUISITA
: Lateral dari vasa epigastrica inf

2. DIRECTA : ASQUISITA
: Medial dari vasa epigastrica inf

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 Hernia inguinalis indirecta
1. Paling sering terjadi di antara semua
hernia abdominalis
2. Meninggalkan cavum abd lateral dr a/v
epigastrica inf
3. Mempunyai kantung hernia yg dibentuk
proc.vag.perit
4. Melalui canalis inguinalis
5. Keluar melalui annulus inguinalis spf
6. Umumnya masuk ke dalam scrotum
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Indirect
inguinal
hernia

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 Hernia inguinalis directa
1. Medial dari A. epigastrica inf
2. Menonjol di daerah yg relatif lemah di dinding post.
C.I
3. Mempunyai kantung hernia yg dibentuk fascia
transversa
4. Terletak di luar proc. Vaginalis
5. Tidak memasuki C.I biasanya medial dr ann.ing.spf
6. Menonjol melalui trigonum inguinale (Hesselbach)
7. Tidak pernah memasuki scrotum

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Direct inguinal Hernia

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