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Toronto Notes 2019
Basic Anatomy Review
General Surgery and Thoracic Surgery GS3
Transversus abdominis muscle Internal oblique muscle External oblique aponeurosis
Peritoneum Preperitoneal fat
Inferior epigastric artery
Inferior epigastric vein
Transversalis fascia Deep inguinal ring Membranous layer of superficial fascia (Scarpa’s fascia)
Fatty layer of superficial fascia (Camper’s fascia)
Superficial inguinal ring
Tunica vaginalis
Testis
Internal spermatic fascia Cremaster muscle
External spermatic fascia
Colle’s superficial perineal fascia Dartos muscle
Skin of scrotum
Figure 2. Continuity of the abdominal wall with layers of the scrotum and spermatic cord
External oblique muscle Internal oblique muscle Aponeurosis of internal oblique muscle Aponeurosis of external oblique muscle (cut edge) Cremaster muscle Spermatic cord
Skin
Superficial fascia
(Camper’s + Scarpa’s fascia) External oblique
Internal oblique
Transversus abdominis Transversalis fascia Preperitoneal fat
Peritoneum
Skin
Superficial fascia External oblique Internal oblique Transversus abdominis Transversalis fascia Preperitoneal fat Peritoneum
Above arcuate line
Below arcuate line
Rectus abdominis
Inferior epigastric artery
Figure 3. Midline cross-section of abdominal wall
4 1
3 2 7
8
Celiac trunk (1)
5
12 13
6
10 15
9
i) Common hepatic artery (2) • Hepatic proper (3)
– Left hepatic artery (4)
– Right hepatic artery (5) • Right gastric artery (7)
• Gastroduodenal artery (8)
ii) Left gastric artery (6) iii) Splenic artery (9)
Superior mesenteric artery (10)
i) Right colic artery (12) ii) Middle colic artery (11)
iii) Ileocolic artery (13)
iv) Ileal and jejunal branches (14)
Inferior mesenteric artery (15)
i) Left colic artery (16)
ii) Sigmoid arteries (17)
ii) Superior rectal artery (18)
11
16
14
17
18
Figure 4. Arterial blood supply to the GI tract
© Frances Yeung 2005 © Bryce Hough © Leanne Chan 2011