1.
PARTONE-ANTERIOR
Txt & Atlas

2.
Hi Future Doctors  <3
This work took from my time and effort to improve my review method.
As you know already, its really hard to open your Anatomy book + atlas + dictionary especially
when you have only little time to finish a certain topic , especially when Your First language is not English.
So I made this reviewer which is combined of all the three things I mentioned earlier
So here it is now between your hands , I hope this will help you like how it helped me
In return , all I need from you is your prayers for me and family ^_^
Thank you and God bless you
,,
In this version I followed the BRS Anatomy 7e txt but the pictures was from different sources
the sources were : Atlas of Human Anatomy, 6e – Netter | Grays Anatomy for Students 2e | McMinn's Seventh 7e |
Clinically Oriented Anatomy - Moore 7e | And other pictures from google (sorry i wasnt able to get the exact site)
please inform me if there is any suggestions or notes or errors in this file
Here is my personal email address, feel free to contact me
[ iamsami.md@gmail.com ]
"Learning Medicine without understanding Can be torture,
But with clear concepts it become Fun and pleasure”

3.
PART ONE - ANTERIOR

4.
I. ABDOMEN P184
- Is divided topographically by
two transverse (horizontal ) and
two longitudinal (vertical ) planes into nine regions:
• Right and left hypochondriac, |6,3|
• epigastric, |1|
• right and left lumbar, |8,5|
• umbilical, |9|
• right and left inguinal (iliac), |7,4|
• hypogastric (pubic). |2|
-Is also divided by vertical and horizontal planes
through the umbilicus into four quadrants:
• right and left upper quadrants,
• right and left lower quadrants.

5.
The umbilicus lies at the level of the intervertebral disk
between the third and fourth lumbar vertebrae.
Its region is innervated by the 10th thoracic nerve.
L3
L4

6.
II. MUSCLES OF THE ANTERIOR ABDOMINAL WALL (Table 5-1) P185

7.
III. FASCIAE AND LIGAMENTS OF THE ANTERIOR ABDOMINAL WALL P185
- Are organized into
• superficial (tela subcutanea)
• deep layers.
The superficial layer has two layers;
• the superficial fatty layer (Camper’s fascia),
• the deep membranous layer (Scarpa’s fascia)

8.
A. Superficial Fascia
B. Deep Fascia
C. Linea Alba
D. Linea Semilunaris
E. Linea Semicircularis (Arcuate Line)
F. Lacunar Ligament (Gimbernat’s Ligament)
G. Pectineal (Cooper’s) Ligament
H. Inguinal Ligament (Poupart’s Ligament)
I. Iliopectineal Arcus or Ligament
J. Reflected Inguinal Ligament
K. Falx Inguinalis (Conjoint Tendon)
L. Rectus Sheath

9.
1. Superficial (Fatty) Layer of the Superficial Fascia (Camper’s Fascia)
■ Continues over the inguinal ligament to merge with the superficial fascia of the thigh.
■ Continues over the pubis and perineum as the superficial layer of the (superficial perineal fascia.)
A : Superficial Fascia

10.
2. Deep (Membranous) Layer of the Superficial Fascia (Scarpa’s Fascia)
■ Is attached to the fascia lata just below the inguinal ligament.
■ Continues over the pubis and perineum as the membranous layer (Colles’s fascia)
of the superficial perineal fascia.

11.
■ Continues over the penis as the superficial fascia of the penis and
over the scrotum as the tunica dartos, which contains smooth muscle.
■ May contain extravasated urine between this fascia and the deep fascia of the abdomen,
resulting from rupture of the spongy urethra .

12.
■ Covers the muscles and continues
over the spermatic cord at the superficial
inguinal ring as the
external spermatic fascia.
■ Continues over the penis as the deep
fascia of the penis (Buck’s fascia)
and over the pubis and perineum as the
deep perineal fascia.
B: Deep Fascia

13.
■ Is a tendinous median raphe between the two rectus abdominis muscles, formed by the
fusion of the aponeuroses of the external oblique, internal oblique, and transverse abdominal muscles.
■ Extends from the xiphoid process to the pubic symphysis and,
in pregnancy, it becomes a pigmented vertical line (linea nigra),
probably due to hormone stimulation to produce more melanin.
C: Linea Alba
Aponeurosis: a sheet of pearly-white fibrous tissue
that takes the place of a tendon in sheetlike muscles
having a wide area of attachment.

14.
■ Is a curved line along the lateral border of the rectus abdominis.
D: Linea Semilunaris

15.
■ Is a crescent-shaped line marking the inferior limit of the posterior layer of the rectus sheath
just below the level of the iliac crest.
E. Linea Semicircularis (Arcuate Line)

16.
■ Represents the medial triangular expansion of the
inguinal ligament to the pectineal line of the pubis.
■ Forms the medial border of the femoral ring
and the floor of the inguinal canal.
F. Lacunar Ligament (Gimbernat’s Ligament)

17.
■ Is a strong fibrous band that extends laterally from the
lacunar ligament along the pectineal line of the pubis.
G. Pectineal (Cooper’s) Ligament

18.
■ Is the folded lower border of the aponeurosis of the
external oblique muscle, extending between the
anterior superior iliac spine and the pubic tubercle.
■ Forms the floor (inferior wall) of the inguinal canal.
H. Inguinal Ligament (Poupart’s Ligament)

19.
■ Is a fascial partition that separates the
muscular (lateral) and vascular (medial) lacunae
deep to the inguinal ligament.
1. The muscular lacuna transmits the
iliopsoas muscle.
2. The vascular lacuna transmits the
femoral sheath and its contents, including
the femoral vessels, a femoral branch of the
Genitofemoral nerve, and the femoral canal.
I. Iliopectineal Arcus or Ligament

20.
■ Is formed by fibers derived from the medial portion of the inguinal ligament and lacunar ligament
and runs upward over the conjoint tendon to end at the linea alba.
J. Reflected Inguinal Ligament

21.
■ Is formed by the aponeuroses of the
internal oblique and transverse muscles
of the abdomen and is inserted into the
pubic tubercle and crest.
■ Strengthens the posterior wall of the
medial half of the inguinal canal.
K. Falx Inguinalis (Conjoint Tendon)

22.
■ Is formed by fusion of the aponeuroses of the external oblique, internal oblique, and transverse muscles
of the abdomen.
■ Encloses the rectus abdominis and
Sometimes the pyramidal muscle.
■ Also contains the :
superior and inferior epigastric vessels
and the ventral primary rami of thoracic nerves 7 to 12.
L. Rectus Sheath

23.
1. Anterior Layer of the Rectus Sheath
a. Above the arcuate line: aponeuroses of the external and internal oblique muscles.
b. Below the arcuate line: aponeuroses of the
external oblique, internal oblique, and transverse muscles.
2. Posterior Layer of the Rectus Sheath
a. Above the arcuate line: aponeuroses of the
internal oblique and transverse muscles.
b. Below the arcuate line: rectus abdominis is in
contact with the transversalis fascia

24.
IV. INGUINAL REGION P187
A. Inguinal (Hesselbach’s) Triangle
B. Inguinal Rings
C. Inguinal Canal

25.
■ Is an area of potential weakness and hence is a common site of a direct inguinal hernia.
Left side of the body Right side of the body
A. Inguinal (Hesselbach’s) Triangle

26.
■ Is bounded :
medially by the linea semilunaris (lateral edge of the rectus abdominis),
laterally by the inferior epigastric vessels,
and interiorly by the inguinal ligament.

27.
1. Superficial Inguinal Ring
■ Is a triangular opening in the aponeurosis of the external oblique muscle
that lies just lateral to the pubic tubercle.
2. Deep Inguinal Ring
■ Lies in the transversalis fascia,
just lateral to the inferior epigastric vessels.
B. Inguinal Rings

28.
■ Begins at the deep inguinal ring and terminates at the superficial ring.
C. Inguinal Canal

29.
■ Transmits the spermatic cord (male) or the round ligament of the uterus (female)
and the genital branch of the genitofemoral nerve,
both of which also run through the deep inguinal ring and the inguinal canal.
An indirect inguinal hernia (if present) also passes through this canal.
Although the ilioinguinal nerve runs through part of the inguinal canal and the superficial inguinal ring,
it does not pass through the deep inguinal ring.

30.
1. Anterior wall:
aponeuroses of the external oblique and
internal oblique muscles.
2. Posterior wall:
aponeurosis of the transverse abdominal
muscle and transversalis fascia.
3. Superior wall (roof):
arching fibers of the internal oblique
and transverse muscles.
4. Inferior wall (floor):
inguinal and lacunar ligaments.

31.
V. SPERMATIC CORD, SCROTUM, AND TESTIS P189
A. Spermatic Cord
B. Fetal Structures
C. Scrotum
D. Testes

32.
V. SPERMATIC CORD, SCROTUM, AND TESTIS P189
A. Spermatic Cord
■ Is composed of the:
• ductus deferens; (testicular, cremasteric),
• deferential arteries;
• ampiniform plexus of testicular veins;
• genital branch of the genitofemoral and cremasteric nerves
and the testicular sympathetic plexus;
• lymph vessels.
[These are all conjoined by loose connective tissue.]

33.
■ Has several fasciae:
1. External spermatic fascia,
derived from the aponeurosis of the
external oblique muscle.
2. Cremasteric fascia
(cremaster muscle and fascia),
originating in the internal oblique muscle.
3. Internal spermatic fascia,
derived from the transversalis fascia.

34.
B. Fetal Structures
1. Processus Vaginalis Testis
2. Tunica Vaginalis
3. Gubernaculum Testis

35.
1. Processus Vaginalis Testis
■ Is a peritoneal diverticulum * in the fetus that evaginates into a developing scrotum and forms the
visceral and parietal layers of the tunica vaginalis testis.
■ Normally closes before birth or shortly thereafter and loses its connection with the peritoneal cavity.
■ May result in a congenital ** “indirect inguinal hernia if it persists.”
■ May cause fluid accumulation “hydrocele processus vaginalis” if it is occluded.
•a peritoneal diverticulum in the embryonic lower anterior abdominal wall that traverses the inguinal canal; in the male it
forms the tunica vaginalis testis and normally loses its connection with the peritoneal cavity; a persistent processus
vaginalis in the female is known as the canal of Nuck.
** congenital : (especially of a disease or physical abnormality) present from birth.

36.
2. Tunica Vaginalis
■ Is a double serous membrane, a peritoneal sac that
covers the front and sides of the testis and epididymis.
■ Is derived from the abdominal peritoneum and forms
the innermost layer of the scrotum.

37.
3. Gubernaculum Testis
■ Is the fetal ligament that connects the bottom of the fetal testis to the developing scrotum.
■ Appears to be important in testicular descent (pulls the testis down as it migrates).
■ Is homologous to the ovarian ligament and the round ligament of the uterus.

38.
C. Scrotum
■ Consists of a thin pigmented skin and dartos fascia,
a layer of smooth muscle fibers; when contracted,
it wrinkles to regulate the temperature.

39.
■ Is innervated by genital branch of the genitofemoral,
anterior scrotal branch of the ilioinguinal,
posterior scrotal branch of the perineal,
and perineal branch of the posterior femoral cutaneous nerves.

40.
■ Receives blood from
anterior scrotal branches of the external pudendal artery
and posterior scrotal branches of the internal pudendal artery
and drains lymph initially into the
superficial inguinal nodes.

41.
D. Testes
Are surrounded by the tunica vaginalis in the scrotum and
produce :
sperm in the seminiferous tubules
and testosterone by interstitial (Leydig) cells.
■ Are innervated by the autonomic nerves,
drain lymph into the deep inguinal nodes and to the lumbar and preaortic nodes,
receive blood from the testicular arteries arising from the aorta,
and drain venous blood by testicular veins,
which empty into the inferior vena cava (IVC) on the right |and| the renal vein on the left.

42.
VI. INNER SURFACE OF THE ANTERIOR ABDOMINAL WALL P189
A. Supravesical Fossa
B. Medial Inguinal Fossa
C. Lateral Inguinal Fossa
D. Umbilical Folds or Ligaments
1. Median Umbilical Ligament or Fold
2. Medial Umbilical Ligament or Fold
3. Lateral Umbilical Fold
E. Transversalis Fascia

43.
A. Supravesical Fossa
■ Is a depression on the
anterior abdominal wall
between the
median and
medial umbilical folds
of the peritoneum.

44.
B. Medial Inguinal Fossa
■ Is a depression on the anterior abdominal wall
between the medial and lateral umbilical
folds of the peritoneum.
It lies lateral to the supravesical fossa.
■ Is the fossa where most direct
inguinal hernias* occur.
An inguinal hernia occurs when soft tissue protrudes
through a weak point in the abdominal muscles.

45.
C. Lateral Inguinal Fossa
■ Is a depression on the
anterior abdominal wall,
lateral to the lateral umbilical fold
of the peritoneum.

46.
D. Umbilical Folds or Ligaments
1. Median Umbilical Ligament or Fold
2. Medial Umbilical Ligament or Fold
3. Lateral Umbilical Fold

47.
1. Median Umbilical Ligament or Fold
■ Is a fibrous cord, the remnant of the obliterated urachus *,
which forms a median umbilical fold of the peritoneum.
■ Lies between the transversalis fascia and the peritoneum
and extends from the apex of the bladder to the umbilicus.
* Urachus: A canal that connects the urinary bladder to the
umbilicus (bellybutton) during fetal development. The urachus is
normally obliterated, so it is usually a solid cord. Failure for the urachus
to fill in leaves it open. The telltale sign of an open urachus is leakage of
urine through the umbilicus. An open urachus is a malformation and
needs to be surgically corrected.

48.
2. Medial Umbilical Ligament or Fold
■ Is a fibrous cord, the remnant of the
obliterated umbilical artery, which forms a medial
umbilical fold and extends from
the side of the bladder to the umbilicus.

49.
3. Lateral Umbilical Fold
■ Is a fold of the peritoneum that covers
inferior epigastric vessels and extends from the
medial side of the deep inguinal ring to the arcuate line.

50.
E. Transversalis Fascia
■ Is the lining fascia of the entire abdominopelvic cavity between the
parietal peritoneum and the inner surface of the abdominal muscles.
■ Continues with the diaphragmatic, psoas, iliac, pelvic, and quadratus lumborum fasciae.

51.
■ Forms the deep inguinal ring and gives rise to the femoral sheath and the internal spermatic fascia.
■ Is directly in contact with the rectus abdominis below the arcuate line.

52.
VII. NERVES OF THE ANTERIOR ABDOMINAL WALL P191
A. Subcostal Nerve
B. Iliohypogastric Nerve
C. Ilioinguinal Nerve

53.
A. Subcostal Nerve
■ Is the ventral ramus of the 12th thoracic nerve and
innervates the muscles of the anterior abdominal wall.
■ Has a lateral cutaneous branch that
innervates the skin of the side of the hip.

54.
B. Iliohypogastric Nerve
■ Arises from the first lumbar nerve and
innervates the internal oblique and transverse muscles of the abdomen.
■ Divides into a
* lateral cutaneous branch
to supply the skin of the
lateral side of the buttocks
and an * anterior cutaneous branch
to supply the skin above the pubis.

55.
C. Ilioinguinal Nerve
■ Arises from the first lumbar nerve, pierces the internal oblique muscle near the deep inguinal ring,
and accompanies the spermatic cord through the inguinal canal and then through the
superficial inguinal ring.
■ Innervates the
internal oblique and
transverse muscles.
■ Gives rise to a femoral branch, which innervates
the upper and medial parts of the
anterior thigh, and the
anterior scrotal nerve, which innervates the
skin of the root of the penis
(or the skin of the mons pubis) and the
anterior part of the scrotum
(or the labium majus).

56.
VIII. LYMPHATIC DRAINAGE OF THE ANTERIOR ABDOMINAL WALL P191
A. Lymphatics in the Region Above the Umbilicus
B. Lymphatics in the Region Below the Umbilicus
C. Superficial Inguinal Lymph Nodes

57.
A. Lymphatics in the Region Above the Umbilicus
■ Drain into the axillary lymph nodes.
B. Lymphatics in the Region Below the Umbilicus
■ Drain into the superficial inguinal nodes.
C. Superficial Inguinal Lymph Nodes
■ Receive lymph from the lower abdominal wall, buttocks, penis, scrotum,
labium majus, and the lower parts of the vagina and anal canal.
Their efferent vessels primarily enter the external iliac nodes
and, ultimately, the lumbar (aortic) nodes.

58.
IX. BLOOD VESSELS OF THE ANTERIOR ABDOMINAL WALL P191
A. Superior Epigastric Artery
B. Inferior Epigastric Artery
C. Deep Circumflex Iliac Artery
D. Superficial Epigastric Arteries
E. Superficial Circumflex Iliac Artery
F. Superficial (External) Pudendal Arteries
G. Thoracoepigastric Veins

59.
A. Superior Epigastric Artery
■ Arises from the internal thoracic artery,
enters the rectus sheath, and descends on the
Posterior surface of the rectus abdominis.
■ Anastomoses * with the
inferior epigastric artery within the rectus abdominis.
* Anastomosis : A cross-connection between adjacent channels, tubes,
fibers, or other parts of a network.

60.
B. Inferior Epigastric Artery
■ Arises from the external iliac artery above the inguinal ligament,
enters the rectus sheath, and ascends between the
rectus abdominis and the posterior layer of the rectus sheath.
■ Anastomoses with the
superior epigastric artery, providing collateral circulation
Between the subclavian and external iliac arteries.

61.
■ Gives rise to the cremasteric artery,
which accompanies the spermatic cord.

62.
C. Deep Circumflex Iliac Artery
■ Arises from the external iliac artery and
runs laterally along the inguinal ligament and the iliac crest
between the transverse and internal oblique muscles.
■ Forms an ascending branch
that anastomoses with the
musculophrenic artery.

63.
D. Superficial Epigastric Arteries
■ Arise from the femoral artery and
run superiorly toward the umbilicus over the inguinal ligament.
■ Anastomose with branches of the
inferior epigastric artery.

64.
E. Superficial Circumflex Iliac Artery
■ Arises from the femoral artery and
runs laterally upward, parallel to the inguinal ligament.
■ Anastomoses with the
deep circumflex iliac and lateral femoral circumflex arteries.
Parallel lines

65.
F. Superficial (External) Pudendal Arteries
■ Arise from the femoral artery, pierce the cribriform fascia, and run medially
to supply the skin above the pubis.
“The external pudendal arteries consist of a
superficial vessel and a deep vessel,
which originate in the femoral artery in the thigh.
They course medially to enter the perineum
anteriorly and supply related skin of the penis and
scrotum or the clitoris and labia majora.”
- Grays Anatomy 2e

66.
A. Superior Epigastric Artery

67.
G. Thoracoepigastric Veins
■ Are longitudinal venous connections between the
lateral thoracic vein and the superficial epigastric vein.
■ Provide a collateral * route for venous return
if a caval or portal ** obstruction occurs.
* Collateral : Acollateral is a subordinate or accessory part.
A collateral is also a side branch, as of a blood vessel or nerve.
** Caval system : the Inferior vena cava returns blood to the heart from the lower limb,
pelvis, and abdomen.
Portal system : portal vein carries used blood from GI Tract to the liver.

68.
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