Bony pelvis 骨盆.pptxVIP

Boney pelvis、anterior abdominal wall and soft tissues of the pelvis Bony pelvis 骨盆 Composition: formed by paired innominate bones, sacrum, coccyx, and their articulations Two portions: false pelvis true pelvis Terminal line: formed by promontory of sacrum, arcuate line, pecten of pubis, pubic tubercle, upper border of pubic symphysis Innominate bone Formed by the fusion of the iliac, ischial ,and pubic ossification centers at the acetabulum . Palpable landmarks: Iliac crest 髂嵴 Anterior superior iliac spine 髂前上棘 Posterior superior iliac spine 髂后上棘 Anterior inferior iliac spine 髂前下棘 Posterior inferior iliac spine 髂后下棘 pubic tubercle 耻骨结节 ischial tuberosity 坐骨结节 Bony pelvis Sacrospinous ligament Sacrotuberous ligament Anterior abdominal wall Layers ( from superficial to deep) Skin Superficial fascia muscles Transverse fascia Extraperitoneal fascia Parietal peritoneum Langer lines To minimize scarring,incisions of the anterior abdominal wall and flank should follow langer lines of cleavage. These lines parallel dermal collagen fibers and are oriented along lines of stress. They correspond to the segmental thoracic and lumber nerves. Langer line History: The lines were first discovered in 1861 by Austrian anatomist Karl Langer (1819-1887),[1][2][3] though he cited the surgeon Baron Dupuytren as being the first to recognise the phenomenon. Langer punctured numerous holes at short distances from each other into the skin of a cadaver with a tool that had a circular-shaped tip, similar to an ice pick. He noticed that the resultant punctures in the skin had ellipsoidal shapes. From this testing he observed patterns and was able to determine line directions by the longer axes of the ellipsoidal holes and lines .  Subcutaneous fasciae Superficial fascia Fatty layer (Camper’s fascia) continuous with the superficial fascia over the rest of the body. The superficial circumflex ili