Muscles of the Trunk and Abdominal Wall · inguinal ligament part of external oblique aponorosis ....

44
Muscles of the Trunk and Abdominal Wall

Transcript of Muscles of the Trunk and Abdominal Wall · inguinal ligament part of external oblique aponorosis ....

Page 1: Muscles of the Trunk and Abdominal Wall · inguinal ligament part of external oblique aponorosis . intercostal nerves pass in the intercostal spaces when they reach the costal margin

Muscles of the Trunk and Abdominal Wall

mohammad
Sticky Note
Aseel AL-Twaijer & Wael Abu anzeh
Page 2: Muscles of the Trunk and Abdominal Wall · inguinal ligament part of external oblique aponorosis . intercostal nerves pass in the intercostal spaces when they reach the costal margin

Lecture Objectives

• List the muscles involved in respiration within the chest (respiratory and non‐respiratory).

• List the abdominal wall muscles.• Describe the attachments of the above mentioned muscles and their nerve supply.

• Discuss the chest and the abdominal wall muscles and their functions and enervation.

• Describe the rectus sheath and the aponeurosis contents.• Define the inguinal region and inguinal ligament.• Describe the inguinal canal.

Page 3: Muscles of the Trunk and Abdominal Wall · inguinal ligament part of external oblique aponorosis . intercostal nerves pass in the intercostal spaces when they reach the costal margin

Muscles of the Thorax that Assist in Breathing

Aseel.J.T
Sticky Note
the action of a muscle is different from the movement of a muscle on a region of the body because in the physiological situation it dosen't occur. there's no muscle that works by itself unless we apply electrical current to the muscle and see it's action . but instead we say that group of muscles work together on a joint to make a specific movement. most of the time the action of a muscle is same as the movement it makes but sometimes it's completely the opposite.
Aseel.J.T
Sticky Note
the work of muscles is coordinated like muscle a (50% of it's capacity) then b then c... coordinated muscle movement occur by innervation usually group of muscle innervated by one nerve.
Aseel.J.T
Sticky Note
the site of the muscle affect it's movement if it's located anteriorly the movement is anteriorly if it's posterior then it's movement is posteriorly.
Page 4: Muscles of the Trunk and Abdominal Wall · inguinal ligament part of external oblique aponorosis . intercostal nerves pass in the intercostal spaces when they reach the costal margin

Muscles of the Thorax that Assist in Breathing

• Respiratory muscles alter the size of the thoracic cavity which affects the pressure in the lungs, and that determines whether we inhale or exhale.

• The diaphragm is the most important respiratory muscle.• Other important respiratory muscles include the external and internal intercostal muscles.

• There are also a number of accessory muscles useful in forced breathing.

Aseel.J.T
Sticky Note
muscles that assist breathing it's major function is to increase the size of the thoracic cavity
Aseel.J.T
Sticky Note
Diaphragm assist inspiration.
Aseel.J.T
Sticky Note
the orientation of ribs is posterior-anterior-downward when they're elevated the thoracic cavity increases in size
Page 5: Muscles of the Trunk and Abdominal Wall · inguinal ligament part of external oblique aponorosis . intercostal nerves pass in the intercostal spaces when they reach the costal margin

Muscles Used in Breathing• Breathing requires a change in  size of the thorax 

• During inspiration, thoracic cavity increases in size• external intercostal lift the ribs • diaphragm contracts & dome is flattened 

• During expiration, thoracic cavity decreases in size• internal intercostal mm used in forced expiration

• Diaphragm is innervated by phrenic nerve (C3‐C5) but intercostals innervated by thoracic spinal nerves (T2‐T12)

Page 6: Muscles of the Trunk and Abdominal Wall · inguinal ligament part of external oblique aponorosis . intercostal nerves pass in the intercostal spaces when they reach the costal margin

Intercostal Spaces

• Between successive ribs• Contain the intercostal mm.

• External , internal, and innermost intercostal mm.

• Neurovascular bundle run superficial to the innermost intercostal m.• Arranged from superior to inferior as vein, artery , and nerve

Aseel.J.T
Sticky Note
orientation is : downward -forward the upper rib is the origin the lower rib is insertion
Aseel.J.T
Sticky Note
orientation is : downward-backward the lower rib is origin the upper rib is insertion
Aseel.J.T
Sticky Note
Page 7: Muscles of the Trunk and Abdominal Wall · inguinal ligament part of external oblique aponorosis . intercostal nerves pass in the intercostal spaces when they reach the costal margin

Intercostal Muscles

Nerve supply: intercostal nerves• Three layers

• External intercostal• Orientation• Anterior (external) intercostal membrane• Helps in inspiration

• Internal intercostal• Orientation• Posterior (internal) intercostal membrane• Helps in expiration

• Innermost intercostal• Cross more than one intercostal spaces• Attached to the endothoracic fascia internally• Attached to parietal pleura

• Divided into three parts• Works with the internal intercostal

Page 8: Muscles of the Trunk and Abdominal Wall · inguinal ligament part of external oblique aponorosis . intercostal nerves pass in the intercostal spaces when they reach the costal margin

Accessory Muscles of Respiration• Transversus thoracis

• Help in expiration• Pectoralis major, pectoralis minor, serratus anterior, scalene mm.• May help in inspiration

Aseel.J.T
Sticky Note
internally attaches the costal cartilages and sternum so it assist expiration.
Page 9: Muscles of the Trunk and Abdominal Wall · inguinal ligament part of external oblique aponorosis . intercostal nerves pass in the intercostal spaces when they reach the costal margin

Accessory Muscles of Respiration• Levator costarum

• Between the transverse processes and the ribs 

• Nerve supply: posterior rami of thoracic spinal nerves

• Help in inspiration• Serratus posterior superior m.• Deep to rhomboids• Nerve supply: 1‐4 intercostalnerves

• Help in inspiration• Serratus posterior inferior m.

• Deep to latissmus dorsi• Nerve supply: last 4 intercostalnerves

• Help in expiration

Aseel.J.T
Sticky Note
in general the origin of the muscle is more medial and the insertion is more lateral.
Page 10: Muscles of the Trunk and Abdominal Wall · inguinal ligament part of external oblique aponorosis . intercostal nerves pass in the intercostal spaces when they reach the costal margin
Page 11: Muscles of the Trunk and Abdominal Wall · inguinal ligament part of external oblique aponorosis . intercostal nerves pass in the intercostal spaces when they reach the costal margin

Abdominal Wall• Parts

• Anterolateral wall• Parts 

• Anterior wall• Left & right lateral walls

• Boundaries• Superiorly – costal margin• Inferiorly – iliac crest, inguinal lig., 

pubic symphysis• Content

• Musculoaponeurotic wall

• Posterior wall

Aseel.J.T
Sticky Note
lateral walls of the dome of diagram is part of the abdominal walls.
Aseel.J.T
Sticky Note
iliac crest determine the superior border of the false pelvis which is part of the abdomen
Page 12: Muscles of the Trunk and Abdominal Wall · inguinal ligament part of external oblique aponorosis . intercostal nerves pass in the intercostal spaces when they reach the costal margin

Anterolateral Abdominal Wall: Content

• Skin• Umbilicus 

• Superficial fascia• Superficial fatty (fascia of Camper)• Deep membranous (Scarpa’s fascia)

• Deep fascia• Muscles• Fascia transversalis(endoabdominal fascia)

• Extraperitoneal fat• Parietal peritoneum

Aseel.J.T
Sticky Note
tough membrane . ends inferiorly with the inguinal ligament.
Aseel.J.T
Sticky Note
muscles of the abdominal wall are surrounded by deep fascia
Aseel.J.T
Sticky Note
form part of the posterior wall of inguinal canal
Aseel.J.T
Sticky Note
the insertion of the three muscles in the mid line so they work(contract) together at the same time
Aseel.J.T
Sticky Note
abdominal muscles when contracted they increase the pressure in the abdominal cavity so they help in all evacuation precesses( defecation,urination,childbirth)
Page 13: Muscles of the Trunk and Abdominal Wall · inguinal ligament part of external oblique aponorosis . intercostal nerves pass in the intercostal spaces when they reach the costal margin

Fascia of abdominal wall• Superficial fascia

• Superficial fatty (fascia of Camper)• Continuous with the rest of the superficial fascia  

• Deep membranous (Scarpa’s fascia)• Disappears laterally & superiorly• Continuous with the fascia lata on the lower limb

• Form a tubular sheath at the penis• At perineum (Colles’ fascia) attached to the pubic arch (anteriorly) & the perineal body & membrane (posteriorly)

Page 14: Muscles of the Trunk and Abdominal Wall · inguinal ligament part of external oblique aponorosis . intercostal nerves pass in the intercostal spaces when they reach the costal margin

Fascia of abdominal wall

• Deep fascia• Covers the muscles

• Fascia transversalis• Lines transversalis m., diaphragm, & iliacus m.

• Anterior wall of femoral sheath• Replace the posterior wall of the rectus sheath below the arcuate line

• Form part of the posterior wall of the inguinal canal

Page 15: Muscles of the Trunk and Abdominal Wall · inguinal ligament part of external oblique aponorosis . intercostal nerves pass in the intercostal spaces when they reach the costal margin

Muscles of the Abdomen 

Page 16: Muscles of the Trunk and Abdominal Wall · inguinal ligament part of external oblique aponorosis . intercostal nerves pass in the intercostal spaces when they reach the costal margin

Muscles of the Abdomen 

• The anterolateral abdominal wall includes the external oblique, internal oblique, and transversus abdominis muscles.• The muscle fascicles of each layer extend in a different direction, conferring considerable protection to the abdominal viscera.

• The muscles of the anterior abdominal wall flex and rotate the vertebral column.• Contraction of the abdominal muscles when the vertebral column is fixed decreases the volume of the abdominal and thoracic cavities and increases the intra‐abdominal pressure which aids in defecation, urination and child birth.

• The aponeuroses of these 3 muscles form the rectus sheaths which enclose the rectus abdominis muscles.• The sheaths form the linea alba, a connective tissue band extending from the xiphoid process to the pubic symphysis.

Aseel.J.T
Sticky Note
rotation by lateral muscles so only if one side of the muscles is contracting this can happen if the two sides contract it dosen't happen
Page 17: Muscles of the Trunk and Abdominal Wall · inguinal ligament part of external oblique aponorosis . intercostal nerves pass in the intercostal spaces when they reach the costal margin

Muscles of Anterolateral Abdominal Wall

• External oblique m.• Inguinal ligament

• Internal oblique m.• Cremaster m.

Neurovascular plane• Transversus abdominis m.

Aseel.J.T
Sticky Note
neurovascular plane between between interal oblique and transversus abdominis
Page 18: Muscles of the Trunk and Abdominal Wall · inguinal ligament part of external oblique aponorosis . intercostal nerves pass in the intercostal spaces when they reach the costal margin

Muscles of Anterolateral Abdominal Wall

• Conjoint tendon• Lower medial part of the internal oblique & trnsversus mm.

• Attached to the pubic crest & pectineal line

• Part of the posterior wall of the inguinal canal

alanwar
Sticky Note
is the inferior insertion for both internal and transversus abdominis
Page 19: Muscles of the Trunk and Abdominal Wall · inguinal ligament part of external oblique aponorosis . intercostal nerves pass in the intercostal spaces when they reach the costal margin

Muscles of anterolateral abdominal wall

• Rectus abdominis m.• Tendinous intersections

• 1st – at xiphoid process• 3rd – at umbilicus• 2nd – in between 

Attached firmly to the anterior wall of the rectus sheath (but not to the posterior wall)

• Pyramidalis m.• Absent in 20%

Page 20: Muscles of the Trunk and Abdominal Wall · inguinal ligament part of external oblique aponorosis . intercostal nerves pass in the intercostal spaces when they reach the costal margin
Aseel.J.T
Sticky Note
posteriorly
alanwar
Sticky Note
inguinal ligament part of external oblique aponorosis
alanwar
Sticky Note
intercostal nerves pass in the intercostal spaces when they reach the costal margin they cross over and move into the abdomen because the nerves pass in the same orientation as in the intercostal spaces.
alanwar
Sticky Note
intercostal nerves / subcostal nerves / 7-12 thoracic iliohypogastric / ilioinguinal nerves/ are part of the lumber plexus .
ASEEL.J.T
Sticky Note
medial part of the rib cage
Page 21: Muscles of the Trunk and Abdominal Wall · inguinal ligament part of external oblique aponorosis . intercostal nerves pass in the intercostal spaces when they reach the costal margin

Rectus Sheath• Aponeuroses of the lateral abdominal mm.

• Anterior wall • Posterior wall

• Enclose the rectus abdominis m. & pyramidalis m.

alanwar
Sticky Note
fusion of lateral muscles aponeurosis the aponeurosis of the internal external transversus will insert in linea alba so it'll cross the rectus muscle **the aponeurosis of the external oblique with half of the internal oblique will cross over anteriorly . and half the internal oblique with the transversus will cross posteriorly. the rectus sheath IS FOUND SUPERIORLY but at some point all the aponeurosis will shift anteriorly so the posterior part of the rectus in this region wont be covered by the rectus sheath.
Page 22: Muscles of the Trunk and Abdominal Wall · inguinal ligament part of external oblique aponorosis . intercostal nerves pass in the intercostal spaces when they reach the costal margin

Rectus Sheath

• Content• Muscles

• rectus abdominis m.  • pyramidalis m.

• Blood vessels• Superior and inferior epigastric vessels

• Nerves (abdominal part of  T7‐T12)

• Lymphatic vessels 

Page 23: Muscles of the Trunk and Abdominal Wall · inguinal ligament part of external oblique aponorosis . intercostal nerves pass in the intercostal spaces when they reach the costal margin

Rectus Sheath• Associated lines

• Linea alba• Linea semilunaris

• From 9th rib to pubic tubercle• Arcuate line 

• At level of ASIS

Page 24: Muscles of the Trunk and Abdominal Wall · inguinal ligament part of external oblique aponorosis . intercostal nerves pass in the intercostal spaces when they reach the costal margin

Rectus Sheath: Walls• Anterior wall

• Above costal margin• Ext. oblique 

• Above arcuate line• Ext. oblique & anterior layer of Int. oblique

• Below Arcuate line• Aponeurosis of all mm.

• Posterior wall• Above costal margin

• Replaced by thoracic wall• Above arcuate line

• Posterior layer of Int. oblique & transversus

• Below arcuate line• Replaced by fascia transversalis

Page 25: Muscles of the Trunk and Abdominal Wall · inguinal ligament part of external oblique aponorosis . intercostal nerves pass in the intercostal spaces when they reach the costal margin
Page 26: Muscles of the Trunk and Abdominal Wall · inguinal ligament part of external oblique aponorosis . intercostal nerves pass in the intercostal spaces when they reach the costal margin

Inguinal Ligament• Lower border of external oblique’s aponeurosis

• Attachment of fascia lata• Between ASIS and pubic tubercle• Lower limb neurovascular bundle (femoral sheath) passes deep to it  

• Continue medially as the lacunar ligament• Femoral ring (medial part)• Continue with the pectinealligament

Page 27: Muscles of the Trunk and Abdominal Wall · inguinal ligament part of external oblique aponorosis . intercostal nerves pass in the intercostal spaces when they reach the costal margin

Inguinal Canal

• Oblique canal in the lower border of the anterior abdominal wall

• Above the inguinal ligament• 4 cm long• In males: connection between testes and abdomen (spermatic cord)

• In female: between uterus and labia majora (round ligament)

alanwar
Sticky Note
passes toward anterosuperior iliac spine and iliac tubercle this forms the lower point of the anterior wall .
Aseel.J.T
Sticky Note
very important because above it is the abdomen and below it the femoral region
alanwar
Sticky Note
the bridging of the inguinal ligament on the hipbone anteriorly forms a space this space is the entrance for the femoral region (the connection between the pelvis and the femoral region).
alanwar
Sticky Note
the scrotum of the testes is outside the pelvic cavity so in order to deliver the spermatic cord, nerves,blood vessels to them . they pass through the inguinal canal.
Page 28: Muscles of the Trunk and Abdominal Wall · inguinal ligament part of external oblique aponorosis . intercostal nerves pass in the intercostal spaces when they reach the costal margin

Inguinal Canal

Deep inguinal ring• Lateral opening to the abdomen through the transversalis fascia

• Oval in shape• Relations

• Inguinal ligament• Inferior epigastric artery

• Internal spermatic fasciaSuperficial inguinal ring

• Medial opening in the ext. oblique aponeurosis

• Triangular in shape• External spermatic fascia

ASEEL.J.T
Sticky Note
external opening toward the scrotum.
ASEEL.J.T
Sticky Note
above the inguinal ligament.
ASEEL.J.T
Sticky Note
above the inguinal ligament connection with the scrotum below the inguinal ligament connection with the femoral sheath
Page 29: Muscles of the Trunk and Abdominal Wall · inguinal ligament part of external oblique aponorosis . intercostal nerves pass in the intercostal spaces when they reach the costal margin

Inguinal Canal: Walls

• Anterior wall• External oblique aponeurosis

• Posterior wall• Conjoint tendon (medially)• Transversalis fascia (laterally)

• Roof • Fibers from int. oblique & transversus mm.

• Floor• Inguinal ligament

ASEEL.J.T
Sticky Note
superiorly is the crossing over of the internal external transversus muscles
ASEEL.J.T
Sticky Note
weakest fascia
Page 30: Muscles of the Trunk and Abdominal Wall · inguinal ligament part of external oblique aponorosis . intercostal nerves pass in the intercostal spaces when they reach the costal margin

Posterior Abdominal Wall

• Lumber vertebrae & their IVD

• Muscles• Somatic & autonomic nerves• Aorta, IVC, & their branches• Lymphatics

Page 31: Muscles of the Trunk and Abdominal Wall · inguinal ligament part of external oblique aponorosis . intercostal nerves pass in the intercostal spaces when they reach the costal margin

Muscles of Posterior Abdominal Wall• Psoas major

• Thick , long muscle• Lateral to vertebral column• Medial arcuate lig.

• Thickening of psoas fascia• Lumber plexus runs posterior and through it

• Quadratus lumborum• Posteriolateral to psoas major• Lateral arcuate lig.

• Thickening of lumbar fascia • Posterior to the lumber plexus

• Iliacus• Lateral to psoas major• Iliopsoas m.

• Transversus abdominis• Diaphragm 

ASEEL.J.T
Sticky Note
psoas major unite with iliacus to form the iliopsoas muscle.
ASEEL.J.T
Sticky Note
insert in the iliac crest
Page 32: Muscles of the Trunk and Abdominal Wall · inguinal ligament part of external oblique aponorosis . intercostal nerves pass in the intercostal spaces when they reach the costal margin
Page 33: Muscles of the Trunk and Abdominal Wall · inguinal ligament part of external oblique aponorosis . intercostal nerves pass in the intercostal spaces when they reach the costal margin

Vertebral ColumnMuscles

Page 34: Muscles of the Trunk and Abdominal Wall · inguinal ligament part of external oblique aponorosis . intercostal nerves pass in the intercostal spaces when they reach the costal margin

Extrinsic Back Muscles

• Superficial layerAxioappendicular mm.• Trapezius m.• Latissimus dorsi m.• Levator scapulae m.• Rhomboids mm.

• Intermediate layerRespiratory muscles• Serratus posterior superior m.

• Deep to rhomboids• Nerve supply: 1‐4 intercostal

nerves• Serratus posterior inferior m.

• Deep to latissmus dorsi• Nerve supply: last 4 intercostal

nerves

Page 35: Muscles of the Trunk and Abdominal Wall · inguinal ligament part of external oblique aponorosis . intercostal nerves pass in the intercostal spaces when they reach the costal margin
Page 36: Muscles of the Trunk and Abdominal Wall · inguinal ligament part of external oblique aponorosis . intercostal nerves pass in the intercostal spaces when they reach the costal margin
Page 37: Muscles of the Trunk and Abdominal Wall · inguinal ligament part of external oblique aponorosis . intercostal nerves pass in the intercostal spaces when they reach the costal margin

Intrinsic (Deep) Back Muscles

• Nerve supply: posterior ramiof spinal nerves

• Control movements of vertebral column and maintain posture

• Three layers• Superficial• Intermediate • Deep 

mohammad
Sticky Note
The spinal nerves once they exit the intervertebral space them branch in to: Anterior / ventral rami (which innervates most of the body be making plexuses like the brachial or cervical plexus) Posterior /dorsal rami (which innervates only the medial back muscles)
Page 38: Muscles of the Trunk and Abdominal Wall · inguinal ligament part of external oblique aponorosis . intercostal nerves pass in the intercostal spaces when they reach the costal margin

Intrinsic (Deep) Back Muscles

• Superficial layer• Splenius mm.

• Splenius cervicis m.• Splenius capitis m.

extend the head and neck, and laterally flex and rotate the head

Splenius cervicis

mohammad
Sticky Note
capitis: refers to the head cervicis: : refers to the neck
Page 39: Muscles of the Trunk and Abdominal Wall · inguinal ligament part of external oblique aponorosis . intercostal nerves pass in the intercostal spaces when they reach the costal margin
Page 40: Muscles of the Trunk and Abdominal Wall · inguinal ligament part of external oblique aponorosis . intercostal nerves pass in the intercostal spaces when they reach the costal margin

Intrinsic (Deep) Back Muscles

• Intermediate layer• Errector spinae mm.

• Iliocostalis (lateral column)• Longissimus (intermediate column)

• Spinalis (medial column)Run longitudinallyMajor extensor of the vertebral column

mohammad
Sticky Note
Errector spinae: very important muscle that helps in maintain the posture of the body
Page 41: Muscles of the Trunk and Abdominal Wall · inguinal ligament part of external oblique aponorosis . intercostal nerves pass in the intercostal spaces when they reach the costal margin
Page 42: Muscles of the Trunk and Abdominal Wall · inguinal ligament part of external oblique aponorosis . intercostal nerves pass in the intercostal spaces when they reach the costal margin
Page 43: Muscles of the Trunk and Abdominal Wall · inguinal ligament part of external oblique aponorosis . intercostal nerves pass in the intercostal spaces when they reach the costal margin

Intrinsic (Deep) Back Muscles

• Deep layer• Transversospinalis muscle group

Run from transverse process to spine of vertebrae above

Help rotate and extend vertebrae• Semispinalis

• Semispinalis capitis, thoracis, and cervicis

• Multifidus• Rotators

• Deepest mm.: Interspinales, intertransversarii, levatorscostarum

mohammad
Sticky Note
Transversospinalis muscle group runs from the transverse process (laterally) toward the spinous processs of the more superior vertebrae ( medially) so one side contract it will rotate the other side .
mohammad
Sticky Note
Semispinalis will cross about 5-6 vertebrae, Multifidus will cross 2-4 vertebrae and the Rotators will cross maybe one or two vertebrae only
Page 44: Muscles of the Trunk and Abdominal Wall · inguinal ligament part of external oblique aponorosis . intercostal nerves pass in the intercostal spaces when they reach the costal margin

Costal Presentation

Costal Presentation

Costal Delights of Turkey

Costal Delights of Turkey

Costal healthy living[1]

Costal healthy living[1]

Costal community

Costal community

Costal erossion

Costal erossion

The Costal Plains

The Costal Plains

Intercostal Space

Intercostal Space

the costal margin, a fourth just reached the costal margn, and the

the costal margin, a fourth just reached the costal margn, and the

costal issues

costal issues

Intercostal Artery Laceration Following Thoracentesis

Intercostal Artery Laceration Following Thoracentesis

Costal Zone Act

Costal Zone Act

Inguinal canaldoctor2017.jumedicine.com/.../sites/7/2019/01/3-inguinal_canal.pdf · •Enters the inguinal canal through the deep inguinal ring lateral to ... Inguinal Hernia ...

Inguinal canaldoctor2017.jumedicine.com/.../sites/7/2019/01/3-inguinal_canal.pdf · •Enters the inguinal canal through the deep inguinal ring lateral to ... Inguinal Hernia ...

Parasternal intercostal nerve block in cardiac surgery ... · bupivacaine and placebo in various surgeries (e.g. hemorrhoidectomy, bunionectomy, inguinal hernia repair, total knee

Parasternal intercostal nerve block in cardiac surgery ... · bupivacaine and placebo in various surgeries (e.g. hemorrhoidectomy, bunionectomy, inguinal hernia repair, total knee

intercostal drainage

intercostal drainage

Intercostal Spaces - Avinash.ppt - Government Medical … lectures/Anatomy/Intercostal... · 2014-07-07 · Intercostal Spaces • Eleven (11) intercostal spaces on each side •

Intercostal Spaces - Avinash.ppt - Government Medical … lectures/Anatomy/Intercostal... · 2014-07-07 · Intercostal Spaces • Eleven (11) intercostal spaces on each side •

ANATOMY OF INTERCOSTAL SPACES

ANATOMY OF INTERCOSTAL SPACES

Costal plains

Costal plains

Intercostal Spaces

Intercostal Spaces

LIVER DISEASE Dr.Mohmmadzadeh. Anatomy Largest solid organ of body Weight : 1.5 kg From the nipple line in 4th intercostal down to the costal margin Falciform.

LIVER DISEASE Dr.Mohmmadzadeh. Anatomy Largest solid organ of body Weight : 1.5 kg From the nipple line in 4th intercostal down to the costal margin Falciform.

Costal Erosion:

Costal Erosion: