Dinding Abdomen Dan Peritoneum

8/19/2019 Dinding Abdomen Dan Peritoneum

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DINDING VENTRO-LATERAL ABDOMENDINDING VENTRO-LATERAL ABDOMEN

&&PERITONEUMPERITONEUM

dr. Subagjo, MS dr. Subagjo, MS


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SUBTOPIK :SUBTOPIK :

1.1. DINDING VENTRO LATERALDINDING VENTRO LATERAL

ABDOMENABDOMEN

2. INNERVASI2. INNERVASI

3. VASCULARISASI3. VASCULARISASI

4. PERITONEUM4. PERITONEUM5. CANALIS INGUINALIS & HERNIA5. CANALIS INGUINALIS & HERNIA


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CAVUM ABDOMENCAVUM ABDOMENABDOMEN :ABDOMEN :

Bagia !"#$#% ia!a"a !'("a) a *+,-i%Bagia !"#$#% ia!a"a !'("a) a *+,-i%

Diig a(/+ :Diig a(/+ :

0 Dia*'"ag/a %%Dia*'"ag/a %%

0 V+!"a, ,a!+"a, *(%!+"i(" Ca-#/ a(/+V+!"a, ,a!+"a, *(%!+"i(" Ca-#/ a(/+

0 Ai!#% *+,-i%Ai!#% *+,-i%

$a-#/ a(/i(*+,-i$#%$a-#/ a(/i(*+,-i$#%

M+/"aa %+"(%#/M+/"aa %+"(%#/

$a-#/ *+"i!(+i$a-#/ *+"i!(+i

$a-#/ a(/ii% *+"i!(+i$a-#/ a(/ii% *+"i!(+i

$a-#/ *+,-i% *+"i!(+i$a-#/ *+,-i% *+"i!(+i

$a-#/ *+,-i% %#*+"i!(+i$a-#/ *+,-i% %#*+"i!(+i


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ISI CAVUM ABDOMINIS :ISI CAVUM ABDOMINIS :

• OLLO! ORGAN :OLLO! ORGAN : 0 ESOPAGUS PARSESOPAGUS PARS

ABDOMINALISABDOMINALIS

0 GASTERGASTER

0 INTESTINUM TENUEINTESTINUM TENUE0 INTESTINUM CRASSUMINTESTINUM CRASSUM

• "ELEN#AR :"ELEN#AR :0 EPAR $ LIVEREPAR $ LIVER

0 PANCREASPANCREAS• #ARINGAN RETICULO#ARINGAN RETICULO

ENDOTELIAL SISTEM :ENDOTELIAL SISTEM : LIEN$LIMPALIEN$LIMPA


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U!# +*+!iga ,iiU!# +*+!iga ,ii ,(a%i,(a%i("ga,+!a +"i("ga,+!a +"i $a-#/ a(/+$a-#/ a(/+

iagi /+6ai "+gi( a!a# 7#a"a!iagi /+6ai "+gi( a!a# 7#a"a!

R+gi(R+gi( (,+' : 2 '("i8(!a, *,a+ (,+' : 2 '("i8(!a, *,a+

2 -+"!i$a, *,a+ .2 -+"!i$a, *,a+ .

9#a"a!9#a"a! (,+' : 1 -+"!i$a, *,a+ (,+' : 1 -+"!i$a, *,a+1 '("i8(!a, *,a+1 '("i8(!a, *,a+


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REGIO *aa CAVUMREGIO *aa CAVUM

ABDOMINISABDOMINIS1.1. H("i8(!a, *,a+% :H("i8(!a, *,a+% :

a)a) Subcostal plane :Subcostal plane : M+,a,#i !+*i aa' $a"!i,ag( $(%!a+M+,a,#i !+*i aa' $a"!i,ag( $(%!a+

1; +)!"a a %ii%!"a1; +)!"a a %ii%!"a

Transpyloric plane :Transpyloric plane :

Biag '("i8(!a, /+,a,#i *+"!+ga'aBiag '("i8(!a, /+,a,#i *+"!+ga'a

iag /+ia ia!a"a i$i%#"a 6#g#,a"i%iag /+ia ia!a"a i$i%#"a 6#g#,a"i%!+*i a!a% %/*%i% *#i%!+*i a!a% %/*%i% *#i%

b)b) Transtubercular plane :Transtubercular plane :

/+,a,#i !#+"$#,#/ $"i%!a i,ia$a/+,a,#i !#+"$#,#/ $"i%!a i,ia$a+)!"a a %ii%!"a a /+/(!(g+)!"a a %ii%!"a a /+/(!(g$("*#% -+"!+"a L5$("*#% -+"!+"a L5

2.2. V+"!i$a, *,a+% :V+"!i$a, *,a+% :

Mid clavicular/mid inguinal planeMid clavicular/mid inguinal planedextra dan sinistradextra dan sinistra

/+,a,#i *+"!+ga'a $,a-i$#,a +/+,a,#i *+"!+ga'a $,a-i$#,a +*+"!+ga'a ig#ia,*+"!+ga'a ig#ia,


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9 REGIO :9 REGIO :

1. REGIO HYPOCHODRIACA1. REGIO HYPOCHODRIACA

DEXTRADEXTRA

2. REGIO EPIGASTRICA2. REGIO EPIGASTRICA

3. REGIO HYPOCHONDRIACA3. REGIO HYPOCHONDRIACA

SINISTRASINISTRA 4. REGIO LUMBALIS DEXTRA 4. REGIO LUMBALIS DEXTRA

5. REGIO UMBILICALIS5. REGIO UMBILICALIS

6. REGIO LUMBALIS SINISTRA6. REGIO LUMBALIS SINISTRA

7. REGIO INGUINALIS7. REGIO INGUINALIS

DEXTRADEXTRA

8. REGIO PUBICA8. REGIO PUBICA

9. REGIO INGUINALIS9. REGIO INGUINALIS

SINISTRASINISTRA


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9UADRANTS *aa CAVUM ABDOMINIS9UADRANTS *aa CAVUM ABDOMINIS

1.1. TRANSUMBILICAL PLANE TRANSUMBILICAL PLANE

Biag '("i8(!a, /+,a,#iBiag '("i8(!a, /+,a,#i#/i,i$#% a i%$#%#/i,i$#% a i%$#%i!+"-+"!+"a,i% ia!a"a -+"!+"ai!+"-+"!+"a,i% ia!a"a -+"!+"aL3 & L4L3 & L4

2.2. MEDIAN PLANE :MEDIAN PLANE :

Biag ,(gi!#ia, /+,a,#i iagBiag ,(gi!#ia, /+,a,#i iag/+ia/+ia

T+"i"i : T+"i"i :

9#a"a! aa a!a% a aa'9#a"a! aa a!a% a aa'

9#a"a! i"i a!a% a aa'9#a"a! i"i a!a% a aa'


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DINDING VENTROLATERAL ABDOMENDINDING VENTROLATERAL ABDOMEN


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LAPISAN DINDING ABDOMENLAPISAN DINDING ABDOMEN1. CUTIS1. CUTIS UMBILICUSUMBILICUS

STRIAE ALBICANS & GRAVIDARUMSTRIAE ALBICANS & GRAVIDARUM

. SU!CUTIS. SU!CUTIS

-- LAMINA SUPERFICIAL LAMINA SUPERFICIAL::


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M. OBLIQUUS EXTERNUS ABDOMINISM. OBLIQUUS EXTERNUS ABDOMINIS

• LINEA ALBALINEA ALBA

• LINEA SEMILUNARISLINEA SEMILUNARIS

• LIG.INGUINALE % POUPARTLIG.INGUINALE % POUPART

• CRURA LATERALISCRURA LATERALIS

• CRURA MEDIALISCRURA MEDIALIS

• 'IBRAE INTERCRURALE'IBRAE INTERCRURALE

• ANULUS INGUINALIS E(T.ANULUS INGUINALIS E(T.

• 'ASCIA SPERMATICA E(T.'ASCIA SPERMATICA E(T.

• TRIGONUM LUMBALISTRIGONUM LUMBALIS


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TRIGONUM LUMBALIS TRIGONUM LUMBALIS


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LIG RE'LE(UM % COLLESI

LIG. LACUNARE

LIG. PECTINEUM


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M. ,!#IUUS I(T*%(US $!+,MI(ISM. ,!#IUUS I(T*%(US $!+,MI(IS

M. CREMASTERM. CREMASTER

'ASCIA CREMASTERICA'ASCIA CREMASTERICA


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M. TRANSVERSUS ABDOMINISM. TRANSVERSUS ABDOMINIS

CON#OINT TENDONCON#OINT TENDON

( FALK APONEUROTICA /( FALK APONEUROTICA /

FALK INGUINALE )FALK INGUINALE )


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OTOT ANTERIOR ABDOMENOTOT ANTERIOR ABDOMEN

1. M. %*CTUS $!+,MI(IS1. M. %*CTUS $!+,MI(IS

INSCRIPTIONES TENDINEIINSCRIPTIONES TENDINEI

RECTUS SHEATHRECTUS SHEATH

. M. 0%$MI+$#IS. M. 0%$MI+$#IS


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VAGINA M. RECTI ABDOMINISVAGINA M. RECTI ABDOMINIS% RECTUS SEAT % RECTUS SEAT

1.1. #$MI($ $(T*%I,%#$MI($ $(T*%I,%

23 ATAS DIBENTUK APONEUROSIS23 ATAS DIBENTUK APONEUROSIS

M. OEAM. OEA

M. OIAM. OIA

13 BA?AH DIBENTUK APONEUROSIS13 BA?AH DIBENTUK APONEUROSIS

M. OEAM. OEAM. OIAM. OIA

M. TAM. TA

.. #$MI($ ,ST*%I,%#$MI($ ,ST*%I,%

23 ATAS DIBENTUK APONEUROSIS23 ATAS DIBENTUK APONEUROSIS

M. OIAM. OIA

M. TAM. TA 13 BA?AH13 BA?AH @@

LINEA ARCUATA/SEMICIRCULARISLINEA ARCUATA/SEMICIRCULARIS

ISI RECTUS SHEATH ISI RECTUS SHEATH


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I((*%$SI :I((*%$SI :

1. INTERCOSTALIS 0 121. INTERCOSTALIS 0 12

2. ILIOH>POGASTRICUS2. ILIOH>POGASTRICUS

3. ILIOINGUINALIS3. ILIOINGUINALIS


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$SCU#$%IS$SI :$SCU#$%IS$SI :

).A$V EPIGASTRICA SUPER'.).A$V EPIGASTRICA SUPER'.

*.A$V CIRCUM'LE(A ILIUM SUPER'*.A$V CIRCUM'LE(A ILIUM SUPER'

+. A$V EPIGASTRICA IN'ERIOR+. A$V EPIGASTRICA IN'ERIOR

,. A$V EPIGASTRICA SUPERIOR,. A$V EPIGASTRICA SUPERIOR

. A$V MUSCULOPRENICA. A$V MUSCULOPRENICA

. A$V LUMBALIS. A$V LUMBALIS

/. A$V INTERCOSTALIS/. A$V INTERCOSTALIS

0. A$V CIRCUM'LE(A ILIUM PRO'.0. A$V CIRCUM'LE(A ILIUM PRO'.


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$#I%$( #IM'$ :$#I%$( #IM'$ :

DIATAS UMBILICUSDIATAS UMBILICUS

LNN.A(ILLARISLNN.A(ILLARIS

DIBAWAHUMBILICUSDIBAWAHUMBILICUS

LNN.SUBINGUINALIS TRACTUS ORI1ONTALIS LNN.SUBINGUINALIS TRACTUS ORI1ONTALIS


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'UNGSI DINDING ABDOMEN:'UNGSI DINDING ABDOMEN:

).). MENGGERA""AN TRUNCUSMENGGERA""AN TRUNCUS*.*. E(PIRASIE(PIRASI+.+. MELINDUNGI VISCERAMELINDUNGI VISCERA

,.,. MENING"AT"AN TE"ANANMENING"AT"AN TE"ANANINTRAABDOMINAL:INTRAABDOMINAL:

DE


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C$($#IS I(UI($#ISC$($#IS I(UI($#ISCELAHCELAH MEMANANG PADA DINDING VENTROLATERAL ABDOMENMEMANANG PADA DINDING VENTROLATERAL ABDOMEN

>ANG BERALAN SERONG >ANG BERALAN SERONG CRANIAL TERHADAP LIG.CRANIAL TERHADAP LIG.

INGUINALEINGUINALE DIANTARADIANTARA ANULUS INGUINALIS INTERNUS ANULUS INGUINALIS INTERNUS

DANDAN ANULUS INGUINALIS EXTERNUS. ANULUS INGUINALIS EXTERNUS.


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!$T$S2!$T$S :!$T$S2!$T$S :

!ENTRAL "!ENTRAL "

M. OBLI9UUS INTERNUS ABD. M. OBLI9UUS INTERNUS ABD. APONEUROSIS M.OBLI9UUS. APONEUROSIS M.OBLI9UUS.

E=TERNUS ABDOMINISE=TERNUS ABDOMINIS

DORSALDORSAL ::


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$(U#US I(UI($#IS$(U#US I(UI($#IS

I(T*%(USI(T*%(US

DIBATASI "DIBATASI "

- M. TRANSVERSUS ABDO-M. TRANSVERSUS ABDO-MINISMINIS

- RE'LE(I 'ASCIA TRANS-RE'LE(I 'ASCIA TRANS-VERSAVERSA

% LIG. INTER'OVEOLARE% LIG. INTER'OVEOLARE

ESSELBAC ESSELBAC


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$(U#US$(U#US

I(UI($#ISI(UI($#IS

*3T*%(US*3T*%(US DIBATASI "DIBATASI "

CRURA LATERALECRURA LATERALE

CRURA MEDIALECRURA MEDIALE


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ISI C$($#IS I(UI($#ISISI C$($#IS I(UI($#IS

::

#$4I2#$4I#$4I2#$4I ::

FUNICULUS SPERMATICUSFUNICULUS SPERMATICUS

N. ILIOINGUNALEN. ILIOINGUNALE

5$(IT$5$(IT$ : :

LIG. TERES UTERILIG. TERES UTERI

N. ILIOINGUINALEN. ILIOINGUINALE


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ERNIA DINDING ABDOMENERNIA DINDING ABDOMEN

• BEN#OLANBEN#OLANABNORMAL PADAABNORMAL PADADINDING ABDOMENDINDING ABDOMEN

2ANG BERISI2ANG BERISIORGAN $ VISCERAORGAN $ VISCERA2ANG DIBUNG"US2ANG DIBUNG"USOLE PERITONEUM OLE PERITONEUM


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MACAM ERNIA DINDING ABDOMENMACAM ERNIA DINDING ABDOMEN

1. HERNIA LINEA ALBA1. HERNIA LINEA ALBA

2. HERNIA UMBILICALIS2. HERNIA UMBILICALIS

3. HERNIA SEMILUNARIS3. HERNIA SEMILUNARIS

4. HERNIA TRIGONUM LUMBALIS4. HERNIA TRIGONUM LUMBALIS

5. HERNIA INGUINALIS5. HERNIA INGUINALIS

SEBAB : LOCUS MINORIS RESISTENTIAE SEBAB : LOCUS MINORIS RESISTENTIAE


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ERNIA INGUINALISERNIA INGUINALIS

). INDIRECTA % "ONGENITAL). INDIRECTA % "ONGENITAL

DESCENSUS TESTICULORUM DESCENSUS TESTICULORUM

PATENT PROCESSUS VAGINALISPATENT PROCESSUS VAGINALISPERITONEIPERITONEI

2DROCELE 2DROCELE

*. DIRECTA % AC3UISITA *. DIRECTA % AC3UISITA

"ELEMAAN DINDING ABDOMEN"ELEMAAN DINDING ABDOMEN

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TE"ANAN INTRAABDOMINALTE"ANAN INTRAABDOMINAL

2 !$TU4 C6%,(IS2 !$TU4 C6%,(IS

2 !6 7 !*(I( %,ST$T2 !6 7 !*(I( %,ST$T60*%T%,'I )60*%T%,'I )

2 !$TU *SIC$ U%I($%I$ / U%*T6%$2 !$TU *SIC$ U%I($%I$ / U%*T6%$


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HERNIOTOMIHERNIOTOMI


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PERITONEUM : - PARIETALISPERITONEUM : - PARIETALIS - VISCERALIS- VISCERALIS

#ENIS ORGAN#ENIS ORGAN !*%+$S$% #U$S *%IT,(*UM!*%+$S$% #U$S *%IT,(*UM


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#ENIS ORGAN #ENIS ORGAN 88 !*%+$S$% #U$S *%IT,(*UM!*%+$S$% #U$S *%IT,(*UM0$( M*(UTU *%MU4$$((0$ :0$( M*(UTU *%MU4$$((0$ :

). ORGAN INTRAPERITONEAL). ORGAN INTRAPERITONEAL

• M5BILEM5BILE

• TANG"AITANG"AI MESO 66MESO 66• RE'LE(IRE'LE(I RADI( 66RADI( 66

*. ORGAN RETROPERITONEAL*. ORGAN RETROPERITONEAL% E(TRAPERITONEAL % E(TRAPERITONEAL

TERFIXIRTERFIXIR Dd DORSALDd DORSAL

T*%MI(,#,I :T*%MI(,#,I :


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T*%MI(,#,I :T*%MI(,#,I :

1.1. PLICAPLICA

PLICA UMBILICALIS MEDIANAPLICA UMBILICALIS MEDIANA

@ PLICA VESICOUMBILICALIS MEDIALIS @ PLICA VESICOUMBILICALIS MEDIALIS

ISI : CHORDA URACHUSISI : CHORDA URACHUSPLICA UMBILICALIS MEDIALISPLICA UMBILICALIS MEDIALIS

@ PLICA VESICOUMBILICALIS LAT.@ PLICA VESICOUMBILICALIS LAT.

ISI : CHORDA A. UMBILICALISISI : CHORDA A. UMBILICALIS

PLICA UMBILICALIS LATERALISPLICA UMBILICALIS LATERALIS

ISI : VASA EPIGASTRICA IN


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CAVUM PERITONEICAVUM PERITONEI

RUANG POTENTIAL ANTARA PERITONEUM PARIETALE & VISCERALERUANG POTENTIAL ANTARA PERITONEUM PARIETALE & VISCERALE

PADA LAKI LAKIPADA LAKI LAKI RUANG TERTUTUPRUANG TERTUTUP

PADA ?ANITAPADA ?ANITA RUANG TERBUKARUANG TERBUKA

TERDIRI DARI :TERDIRI DARI :

1. %*$T*% S$C1. %*$T*% S$C7C$UM *%IT,(*I *(*%$#IS)7C$UM *%IT,(*I *(*%$#IS)

$.$. CA!UM ABDOMINIS PERITONEICA!UM ABDOMINIS PERITONEI

%.%. CA!UM PEL!IS PERITONEICA!UM PEL!IS PERITONEI

2. LESSER SAC & BURSA OMENTALIS '2. LESSER SAC & BURSA OMENTALIS '

',%$M*( *I#,ICUM 7 5I(S#,5I )',%$M*( *I#,ICUM 7 5I(S#,5I )

LUBANG PENGHUBUNG ANTARALUBANG PENGHUBUNG ANTARAGREATER SAC DAN LESSER SACGREATER SAC DAN LESSER SAC


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'ORAMEN EPIPLOICUM % !INSLO!I 'ORAMEN EPIPLOICUM % !INSLO!I

!$T$S2!$T$S :!$T$S2!$T$S :

$(T*%I,% :$(T*%I,% :

OMENTUM MINUSOMENTUM MINUS

( LIG. HEPATODUODENALIS )( LIG. HEPATODUODENALIS )

,ST*%I,% :,ST*%I,% :

V. CAVA INFERIORV. CAVA INFERIOR

SU*%I,% :SU*%I,% :LOBUS CAUDATUS HEPATISLOBUS CAUDATUS HEPATIS

I('*%I,% :I('*%I,% :

PARS CRANIALIS DUODENIPARS CRANIALIS DUODENI

Dinding Abdomen Dan Peritoneum

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