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Abdominal Wall Anatomy and Hernias: The Basics
Summary
Join this comprehensive teaching session on Abdominal Wall Anatomy and Hernias led by Ms. Akriti Nanda. Get an in-depth understanding of the anterolateral abdominal wall's structure, its four main layers, and the key roles each layer plays in human anatomy. Explore the diverse muscles of the anterolateral abdominal wall and their significance. The session will also cover various types of hernias, risk factors, manifestations, and unique repair options like the Rives-Stoppa, Recto-rectus, and Transverse Abdominus Release. This informative and interactive program is a must-attend session for all medical professionals looking to enhance their knowledge on this critical aspect of human anatomy.
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Description
Learning objectives
- To understand and identify the four main layers of the anterolateral abdominal wall: Skin, Superficial Fascia, Muscles and Associated Fascia, and Parietal Peritoneum.
- To comprehend the specific function and contribution of each muscular component of the abdominal wall, including the flat muscles (External oblique, Internal oblique, Transversus Abdominus) and the vertical muscles (Rectus Abdominus, Pyramidalis)
- To differentiate a Hernia from Divarification of the Recti and understand the associated risk factors and presentation of each.
- To examine an open appendix procedure and identify each layer encountered during the procedure.
- To comprehend various repair options for different types of hernias, including Umbilical Hernia and Rives-Stoppa, and understand when to involve plastic surgery in the repair process.
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Abdominal Wall Anatomy and Hernias Ms Akriti NandaAnatomy – Abdominal Wall •Forms a firm, yet flexible boundary which keeps the abdominal viscera in the abdominal cavity and assists the viscera in maintaining their anatomical position against gravity. •Protects the abdominal viscera from injury. •Assists in forceful expiration by pushing the abdominal viscera upwards. •Is involved in any action (coughing, vomiting, defecation) that increases intra-abdominal pressureAnatomy The anterolateral abdominal wall consists of four main layers (external to internal): 1. Skin 2. Superficial Fascia 3. Muscles and Associated Fascia 4. Parietal Peritoneum.Anatomy The anterolateral abdominal wall consists of four main layers (external to internal): 1. Skin 2. Superficial Fascia 3. Muscles and Associated Fascia 4. Parietal Peritoneum.Anatomy Superficial Fascia •Above the umbilicus – a single sheet of connective tissue. It is continuous with the superficial fascia in other regions of the body. •Below the umbilicus – divided into two layers; the fatty superficial layer (Camper’s fascia) and the membranous deep layer (Scarpa’s fascia). • The superficial vessels and nerves run between these two layers of fascia.Anatomy The anterolateral abdominal wall consists of four main layers (external to internal): 1. Skin 2. Superficial Fascia 3. Muscles and Associated Fascia 4. Parietal Peritoneum. Anatomy Muscles • 3 flat muscles = laterally • External oblique • Internal oblique • Transversus Abdominus • 2 vertical muscles = midline Anatomy Muscles • 3 flat muscles = laterally • External oblique • Internal oblique • Transversus Abdominus • 2 vertical muscles = midline • Rectus Abdominus • PyramidalisAnatomy Rectus SheathAnatomy Quiz! What layers do you come across when doing an open appendix? • Skin • Campers • Scarpa’s • Anterior sheath • EO • IO • TA • Posterior sheathIncisionsHernias Divarification of the Recti Stretching of the linea alba, resulting in a widening of the gap between the rectus abdominus muscles. Is this a hernia? As there is no defect in the abdominal wall, it is not a hernia. Risk factors for its development include advanced age and multiparity. It often presents with a bulge when sitting up, however no discrete lump or mass is present. As no hernia is present, no surgery is necessary and the mainstay of initial treatment is with physiotherapy to strength the abdominal wall. Any surgical intervention is purely cosmetic (plastics).Repair OptionsRepair Options Umbilical hernia • Suture • Mesh >1cm • LaparoscopicRepair Options Rives-Stoppa Recto-rectusRepair Options Transverse Abdominus ReleasePlastics involvementHuge range!