Research Results For 'Abdominal Wall'

ABDOMINAL CAVITY

The abdominal cavity extends from the lower border of the ribs to the pelvis. The abdominal wall is made up of muscle, layers of connective tissue, and fat and is lined by a thin double layered membrane called the periosteum. The abdominal cavity contains all of the organs of the digestive system and the genitourinary system.
Research Abdominal Cavity

ABDOMINAL WALL

Several sets of muscles support and propel the torso. The abdominal wall muscles help transfer force between the upper and lower body, and they also protect the delicate internal organs. Their most important function is to support the back. The muscles of the torso extend in several directions. They help maintain posture and aid the spinal muscles when bending, twisting, and other movements.
Research Abdominal Wall

AMNIOCENTESIS

Amniocentesis is a medical procedure sometimes performed during pregnancy to help determine the health and maturity of an unborn baby. It involves the withdrawal and study of a small amount of the amniotic fluid that surrounds the foetus in the mother's uterus. Laboratory tests on the fluid, which contains cells shed by the foetus, enable detection of many serious disorders that may affect the foetus. Such disorders include Down's syndrome and spina bifida. Amniocentesis involves little risk to either the mother or the foetus.
Amniocentesis is mostly performed around the 16th week of pregnancy on 'at risk' mothers. These include those more than 35 years of age and those with genetic disorders in the family. If tests reveal serious abnormality, likely to cause death or pronounced handicap, the parents may choose to end the pregnancy. Otherwise, doctors can plan ahead for early treatment, either in the womb or at birth. If there is some medical reason for delivering a baby before it is due to be born, amniocentesis may be performed later in pregnancy. In this case, tests show whether the baby is likely to survive outside the womb. An obstetrician performs amniocentesis with the aid of ultrasound which enables the obstetrician to monitor the position of the foetus while inserting a long hollow needle through the mother's abdominal wall and into the uterus. The obstetrician then withdraws a small amount of amniotic fluid, which is sent away for testing.
Research Amniocentesis

APPENDIX

The appendix is sometimes referred to as the 'abdominal tonsil' because it is composed largely of lymphoid tissue and is very susceptible to infection. It varies greatly in size, the average length being 75 mm. Normally it is a hollow tube lined with mucous membrane, with a muscle wall similar to that of the caecum with which it communicates. Its tip may hang down over the brim of the pelvis to make contact with the bladder, the rectum, or in the female with the ovary, uterine tube or uterus. It may on the other hand, turn upwards behind the caecum pointing out towards the groin-the retro-caecal position. It may lie on the front of the caecum immediately under the anterior abdominal wall.
Research Appendix

COLOSTOMY

Colostomy is the operation of opening into the colon, or lower portion of the intestine. This procedure is one of the most important in abdominal surgery. It is sometimes necessary as a life- saving measure. It may be temporary or permanent as an artificial anus in the radical treatment of rectal cancer. Because of its appearance, its inconvenience and the very thought of an artificial opening in the abdominal wall a great deal of care is necessary to allay the anxieties of patients and their relatives when colostomy is necessary.

In some cases of acute intestinal obstruction the surgeon explores the abdomen and finds perhaps a large mass in the region of the pelvic colon or rectum that cannot be removed. An emergency colostomy is then performed in the transverse colon with the immediate purpose of saving life and with the further objective of providing temporary drainage should the growth be removable at a later date. In some such cases, when at first sight the primary cause of the obstruction seems beyond any possibility of surgical removal, after several weeks of colostomy drainage the infection subsides and the affected portion of bowel may then be removed. Colostomy may be necessary as a preliminary to other operations involving removal of the large bowel. Such an occasion arises if diverticulitis has produced vesico-colic fistula (between the colon and bladder). In some cases of severe incontinence due to abnormality or injury to the anus, a left iliac colostomy enables the patient to be free of the terrible inconvenience of perpetual soiling in the perineum. Injuries or abnormalities of the spinal cord produce paralysis of the anal sphincter mechanism and sometimes colostomy is essential. Congenital absence of the rectum or anus requires an emergency colostomy within a day or so of birth.

There are two main forms of colostomy. First is the loop colostomy which has two limbs. The opening is at the apex of the loop and the bowel has not been divided completely across. A variation of the loop colostomy is the double- barrel form in which the two limbs of the loop are separated by a piece of skinrafter complete division. This is also described as a defunctioning colostomy as it prevents the spill of faeces from the proximal to the distal loop. A second variety is the spur colostomy where a spur is formed by suturing the two ends together for several centimeters inside the abdomen. This is of particular value if the colostomy is temporary as the spur can be destroyed by a crushing clamp without risk of peritonitis or perforation since the limbs have become sealed together. When the spur breaks down, the artificial opening on the surface shrinks and sinks back below the skin level. The aim is that this should close spontaneously without further operation. The third type is the terminal colostomy in which the distal portion of bowel is removed completely or in the case of excision of rectum the lower end is closed to form a blind end. In grave emergencies the simplest form of colostomy is performed in which a loop of colon is brought out through the abdominal wall, where it is held by the insertion of a glass rod passed through a small hole in the mesentery. The ends of the glass rod are connected by a loop of rubber tubing which forms a 'bucket handle' . The abdominal wall is closed around the protrusion of the colostomy. Exteriorisation is another way of performing a colostomy. If a growth is present in a part of the bowel which can be brought readily through the abdominal wall (e.g. transverse or pelvic colon) the affected loop containing the growth is left outside and the peritoneum, muscles and skin are closed around the base of the loop where the two limbs converge. The loop of colon containing the growth is then removed, leaving two open ends of
el which can later be joined by crushing the spur between them. This operation avoids the handling of growth or unprepared bowel while the peritoneal cavity is open and so diminishes the risk of peritonitis. A formal operation for closure is required if a spur has not been made.

At the end of the operation a small incision is usually made in the apex of the loop to allow the immediate discharge of gas and faecal material which is collected as cleanly as possible before the patient leaves the theatre. A dressing of petroleum jelly gauze or tulle gras is applied on the exposed bowel. The skin incision may be sealed with Whitehead's varnish and a pad of cellulose tissue and wool is bandaged lightly over the opening. For fear of contaminating the abdominal wound before the peritoneal cavity has become sealed, the former practice was to leave the colostomy unopened for 48 hours. The initial opening may be enlarged by the surgeon two or three days after the colostomy has been raised. The bowel is usually divided (without anaesthetic) by an electric cautery which seals the blood vessels and prevents bleeding from the very vascular mucous membrane and muscle wall of the bowel. A method of draining the colostomy is by the use of Paul's tube. This is an angled wide glass tube which is inserted through a hole in the colostomy loop. It is tied in position in the same way as the caecostomy catheter and connected to a bedside jar with wide, thin, latex tubing.
Research Colostomy

DIAPHRAGM

The diaphragm is the primary muscle responsible for respiration. Connected to the abdominal wall, the lumbar vertebra, the lower ribs, the sternum, and the pericardium of the heart by tendinous tissue, the thin diaphragm creates a partition between the thoracic and abdominal cavity. The
diaphragm forms a domed structure, and when the diaphragm muscle contracts, it lowers to a more flattened arrangement. This flattening causes a vacuum in the thoracic cavity and pressure in the abdominal cavity. The vacuum is filled by the expanding lung tissue and inhaled air. The pressure on the lower viscera are helpful in childbirth and in pushing fecal matter through the lower intestinal tract for expulsion. When the diaphragm relaxes to its domed structure, the air is exhaled and the lungs contract. Though the intercostal and abdominal muscles are also used in respiration, during sleep, it is primarily due to contractions of the diaphragm. The diaphragm is supplied by the inferior and superior phrenic arteries and the musculophrenic artery. It is innervated phrenic nerve.
Research Diaphragm

ENDOSCOPY

Endoscopy is the examination of internal parts of the body using special instruments known as endoscopes. The simplest method of instrumental examination is that employed for the anal canal and rectum. A 'speculum' (proctoscope) which is in fact a simple tube with a handle, is introduced through the anal canal and the surgeon examines the rectal wall through the tube. To facilitate the introduction of the instrument, there is a shaped conical stopper which is known as the 'obturator.' This same principle of a shaped introducer is used on many instruments which have an open tubular end. Sigmoidoscopy is the examination of the upper regions of the rectum and the sigmoid or pelvic colon with a longer tubular speculum. Because the folds of mucous membrane fall against the end of the instrument and obstruct the view, air inflation is used for the introduction of the sigmoidoscope so that the lumen of the bowel is distended. The surgeon inserts the instrument under direct vision, inspecting the wall of the bowel as far as 25 cm. from the anus.

The oesophagoscope is a similar instrument passed down the oesophagus through the mouth, thus enabling the surgeon to inspect the whole length of the gullet. The inside of the stomach is examined by the gastroscope, using air inflation. Through a very small incision in the abdominal wall the surgeon may introduce another viewing instrument, the peritoneoscope, and with this he may inspect the inside of the peritoneal cavity and obtain infonnation to enable him to reach a decision without open operation. In order to separate the coils of intestine from one another and allow the satisfactory inspection of the viscera, the peritoneal cavity is inflated with air through a separate cannula. Endoscopic instruments, except for the simpler forms of proctoscope, carry their own miniature lamps which draw electric current either from a battery or the mains through a transformer to reduce the voltage. The bladder and urethra are inspected with the cytoscope and urethroscope. The urinary tract is distended with water instead of air for the inspection, but air
inflation is sometimes used for the lower part of the urethra. Various forms of speculum are used for the vagina and these are usually illuminated by direct light, although some forms carry a lamp of their own. Operations for the removal of tissue for microscopic examination (biopsy) are performed through some of the tubular instruments, and for this purpose there are special long forceps and diathermy electrodes. Examinations carried out with endoscopic instruments may be made with local or general anaesthesia and in the case of the rectum and colon, without anaesthesia.
Research Endoscopy

ILIOINGUINAL NERVES

The ilioinguinal nerves branch off of the spinal cord at the first lumbar vertebra. They extend down the abdominal wall to the groin, external genitals, and the upper thigh.
Research Ilioinguinal Nerves

INGUINAL LYMPH NODES

The network of lymph vessels in the lower body passes lymph into the bean-sized inguinal nodes deep in the groin. The inguinal lymph nodes can be grouped as superficial and deep. The deep
inguinal lymph nodes are situated near the femoral artery and vein. They receive lymph from the lower limbs, external genitalia, and lower anterior abdominal wall. The superficial
inguinal lymph nodes can be found along the greater saphenous vein. The receive lymph from the external genitalia, and the superficial parts of the lower limbs.
Research Inguinal Lymph Nodes

INTERNAL OBLIQUE

The internal oblique (obliquus internus abdominis) is a small, thin, deep muscle of the abdomen. It runs diagonally opposite underneath the external oblique. It has a quadrilateral form originating from the hip bone (crest of the ilium), and extending to the cartilage of the lower ribs (the tenth, elenenth, and twelfth ribs). It is innervated by the lower thoracic nerves and supplied the intercostal and lumbar arteries. This muscle protects a weak point in the abdominal wall and works with the external oblique to help twist the torso.
Research Internal Oblique

	The Probert Encyclopaedia was designed, edited and programed by Matt and Leela Probert ©1993 - 2009 The Probert Encyclopaedia Southampton, United Kingdom