Definitions: Abductor canal: is conduit located in middle third of anterior medial side of the thigh through which blood vessels from triangle pass to enter the posterior aspect of the leg and it’s bounded by
Upper opening: it’s formed by the apex of femoral triangle
Lower opening: it’s formed by adductor tendinous oppeing
Anterior wall: it’s formed by sartorius and Adductor lamina
Lateral Wall: it’s formed by vastus medialis
Posterior Wall: It’s formed by adductor longus and adductor magmus
Content6s:
1. medial muscular branch of femoral nerve 2. Saphanous nerve and its anterior to the femoral 2. Femoral vein which is posterior to the femoral artery
Femoral triangle: Is a triangular are located the upper one third of anteromedial region of thigh and bounded by the following borders
Superior border: formed by inguinal ligament lateral boder: formed by medial border of the sartorius
Medial border: formed by medial border of adductor longus.
Anterior border(the roof) formed by Skin, Superficial fascia and fascia lata
Poserior border( the floor): formed by adductor longus , pectinus and iliopsoas from medial to lateral
Contents: 5Fs: 1-femoral Nerve, femoral artery(lateral) 3- femoral vein( intermediate) 4- femoral canal (medial). 5- femoral lymph nodes and fatty tissue.
Femoral sheath:
Formation: formed by the continuous part of transverse fascia and iliac fascia which enclose the upper part of the femoral vessels
It’s divided into three parts by two longtudinal fibrous septa
Lateral part: it’s occupied by femoral artery. Intermediate part: occupied by femoral vein
Middle part: occupied by femoral canal
Contents:1. Femoral Artery which divides into 1. Superficial epigastric artery 2- superficial iliac circumflec artery , external pudendal artery and deep femoral artey
2- Femoral vein and femoral canal.
Humeromuscular triangle: it is formed by the triceps brachii and the groove of radial nerve of humerus
Contents: it contains 1-Radial nerve 2-the deep brachial artery and vein.
Tarsal tunnel: is a fibrous sheath which begins anterior to the metocarpophalangeal joints and extend to the digitalophalangeal and formed by fibrous arches and cruciate ligaments attached posteriorly to the margins of phalanges and planater ligaments associated with the metatarsophalangeals and interphalangeal joints . It is passed by flexor digitorum longus, flexor digitorum brevis, and flexor halucis longus.
Inguinal triangle: (hasselbach triangle): it is a triangular area which is located deep structures of anterolateral abdominal wall and bounded by three borders which are:
Lateral border: formed by Inferior epigastric artery. Medial border: formed by lateral boder of rectus abdominis.. Inferior boder: formed the inguinal ligament.
Clinical significance: Direct inguinal hernia emerges form here.

Stomach bed: Organs which lie the posterior of the stomach that are: omental bursa, left suprarenal gland, left kidney, pancreas, spleen, tranverse colon and its mesocolon.
Carotid sheath: it’s formed by the cervical fascia which surounds the common carotid artery, internal jagular vein, internal carotid artery and vagus nerve in the cervical region.
Cystic triangle(Calot triangle): it’s a triangular space which is formed by the cystic duct , common hepatic duct and inferior surface of the liver. Cystic artery passes it
Perineum: is a diamond shaped region of inferior orifice of pelvis, it includes all of the soft tissues between the pubis symphysis and the cocyx.
Omentum bursa: is the space behind the stomach and lesser omentum and bounded by:
Anterior: Lesser omentum, peritoneun and posterior wall of stoamch and gastrocolic ligament.
Posterior: formed by transverse colon with its mesocolon and the peritoneum which covers the anterior face of pancreas, left kidney and left suprarenal gland.
Superior wall; is formed by the peritoneum which covers the inferior surface of caudate lobe of liver and the diaphragm.
Inferior wall: is formed by the connection of lower end of the anterior two layers and the posterior two layers of greater omentum.
Right wall: is formed by omental foramen.. Left wall: is formed by spleen,gastrosplenic ligament and splenorenal ligament.
Transverse pericardial sinus is a transversely running passage within the pericardial cavity between these two groups of vessels and the reflections of serous pericardium around them.
Oblique pericardial sinus is a wide pocket-like recess in the pericardial cavity posterior to the base (posterior aspect) of the heart, formed by the left atrium. It is bounded laterally by the pericardial reflections surrounding the pulmonary veins and IVC and posteriorly by the pericardium overlying the anterior aspect of the esophagus.
Suspensory ligament of the breast: it is a fibrous connective tissue that form the fibrous septa which seperates the lobes of the mammary gland, the septa are well developed and extended from the skin to the deep fascia.
Clavicpectoral fascia: it is a srtong fibrous sheath posterior to pectoralis major and occupies the interval between pectoralis minor, subclaviuos and the corocoid process of the scapula. It is pierced by cephalic vein, thoracoacromial artery and vein, and lateral pectoral nerve.
Superficial perineal space: is a complete closed compartment..its inferior border is formed by perineal fascia and its superior border is formed perineal membrane.
Thyroid suspensory ligament: is formed by a false capsule on the medial of the lateral lobes on behind the isthmus of the thyroid gland to connect with the laryngeal cartilage and ring of the trachea.
Dangerous triangle of the face: it is atriangular area which is located between the root of the nose and two oral angles. The facial vein is located in this triangle, and the infection of this region can easily envade to the cranial cavity through the communicating ways of facial vein.
Lacuna Vasorum: there is a space which is located between the inguinal ligament and hip bone, it is divided into two spaces ( the lacuna musculorum and lacuna vasorum) by ileopectineal arch which arises from the inguinal ligament and inserts into ileopubic eminence.
Triangle of arterial duct: is the area located anterior to the left side of aortic arch. And is bounded by
Anterior: left phrenic nerve. Posteriorly: left vagus nerve. Inferior: left pulmonary artey.
Contents: arterial ligament. Left recurrent laryngeal nerve and superficial cardiac plexus.
Pretracheal space: It is a space which is located between the pretracheal fascia and cervical part of the trachea.
Prevertebral space: it is a space which is located between the cervical vertebra and the prevertebral fascia.
Suspensort ligament of the duodenum: it is afibro mascular band which is located in the right superior deep layer of superior duodenal fold. It suspends and supports the duodenojejunum flexure.
Inferior lumbar triangle: is the triangle formed by ,medially: latissmus dorsi muscle.laterally: by external abdomial oblique muscle. Inferiorly: by iliac crest and the floor is formed by internal abdominal oblique muscle
Pterion: is the junction where the frontal, parietal , sphenoid , and temporal bones are in close proximity. The clinical sequences of a skull fructure in this area can be very serious.
Scalene fissure is a triangular hiatus found in the neck. * Anteriorly: Scalenus anterior * Posteriorly: Scalenus posterior * Caudally: Clavicle
Carrying angle of the elbow: When the arm is extended, with the palm facing forward or up, the bones of the humerus and forearm are not perfectly aligned. The deviation from a straight line occurs in the direction of the thumb, and is referred to as the “carrying angle”). carpal tunnel:is the osseofibrous passageway deep to the flexor retinaculum between the tubercles of the scaphoid and trapezoid bones on the lateral side and the pisiform and the hook of the hamate on the medial side. transmits the Tendons of Flexor digitorum profundus, flexor digitorum superficialis, flexor pollicus longus and the median nerve.
Omental foramen: is a short, vertical slit, 3cm height in adults an opening situated posterior to the free edge of the lesser omentum (hepatoduodenal ligament) * Superior－caudate lobe of liver * Inferior－superior part of duodenum * Anterior－hepatodudenal ligament * Posterior－peritoneum covering the inferior vena cava
Scarper’s fascia: is a deep membranous layer which lies immediately superficial to the apponeurosis of the oblique externus abdominis
Malleolar canal: is the canal formed by the thickened fascia of flexor retinaculum together with the medial malleolus and calcaneal tuberosity. There are three fibrous septa that arise from the flexor retinaculum and divides the malleolar canal into four ossiofibrous canals.In which Their contents from anterior to posterior are: 1st canal- contain the tendon of tibialis posterior. 2nd canal contain the tendon of flexor digitorum longus. 3rd canal: contain posterior tibial artey and vein and tibial nerve. 4th canal: contains the tendon of flexor hallucus longus.

Essay question
1: stomach * Location: most part of stomach is located in the left hypochondric region and small part is located in the epigastric region . * Parts : stomach is divided in to cardiac , fundus ,body and pylorus * Relations : anteriorwall : at the right side it close to the left half of liver Left upper part it close to the diaphgram and left lower part it close to the anterior abdominal wall . posterior wall : it is close to the omental bursa , left suprarenal gland, left kidney ,pancreas, spleen, transverse colon and its messo colon. * Blood supply: (A) The arteries that suply the stomach arise from celiac trunk and its brach; * The left gastric artery: branch of celiac trunk * The right gastric aretery : branch of proper hepatic artery * Left gastro epiploic artery: branch of splenic artery * Right gastroepiploic artery:branch of gastroduodenal artery * Shert gastric aretery: branch of splenic artery * Posterior gastric artery: branch of splenic artery (B) the most gastric veins accompanied to with the corresponding arteries and at last drian to hepatic portal vein ; * The left gastric vein: drain to hepatic portal vein or splenic * The right gastric vein : drain to proper hepatic vein * Left gastro epiploic vein: drain to splenic vein * Right gastroepiploic vein:drain to superior messenteric vein * Shert gastric vein: drain to splenic vein * Posterior gastric vein: drain to splenic vein. * Lymphatic drainage: the lymphatic vessels of stomach drain to the lymph nodes which are arranged around the the lasser carvature and greater carvature of stomach and every group of lymph nodes arrange along the corresponding arteries ; * Lymph from the area near the lesser carvature drain to right and left gastric lymphnodes . * Lymph from the area near the greater carvature drain to the following lumph node (a)rigt part drain to right gastroepiploic and then infrapyloric lymph node
(b)left part drain to left gastroepiploic lymphnode and then splenic lymph node. * Lymph from the area near the cardiac orifice drain to cardiac lymp node * Lymph from the fudus of stomach drain to splenic lymph node * Lymph from the pyloric part drain to superior and in ferior pyloric lymph node. And all of the eefferents from the above lymph nodes lastly drain to celiac lymph node . 2) appendix: * Location : is worm like diverticulum that lies right iliac fossa by which its base attached to the posterio medial wall of the cecum and its orifice is situated just 2cm below the ileocecal orifice . * Features : appendix has messoappendix formed by two layers of peritoneum located between lower part of messentary and appendix ,
Mc burney’spoint is the point that lies at the junction of the lateral third and meddle third of the line joining the umblicus to the right anterior iliac spine . * Blood suply: * Appendicular artery suplies the appendix which is branch of lower division of ileocecal artery and come to the appendix trough messo appendix * Veins of the appendix is accompanied with the corresponding arteries and drain to ileocecal vein and then to superior messentaric vein and then to hepatic vein. * To find appendix during operation the three colic bands of cecum acts as land mark * During the opartion the passing layers are the skin ,superfiscialfascia,mascularlayers,transverse fascia, supperitoneal fascia, pariatal peritoneum then appendix . 3) Uterus: * Loctation: it is located in the central part of the pelvis between urinary bladder and rectum with in the postion of the anteversion and anteflection. * parts: the uterus canbe divided in to four parts which are fundus located below the pelvic cavity .body ,isthmus and cervix in which located above the level of ischial spine and canbe further subdivided into supravagina and vaginal part * relation: anterior: vesicouterine pouch,uppersurface and fundus of urinary bladder posterior: rectouterine pouch and rectum inferior:cervix of the uterus that connected with the upper end of vagina lateral:braod ligament of uterus ,ovaries,uterine tube and uterine artery * blood vessels : * uterine artery which is branch of internal iliac artery gives off branches and supply uterus ,uterine tube ,ovary and vagina. * Veins of the uterus arise from uterine venous plexus and vaginal venous plexus to form the uterine vein and drain into internal ilaic vein . * Lymphatic drainage : lymph from the fundus and upper part of the body drain to common iliac lymph node and lumbar lymph node along the ovarian vessels and small parts of these lymph drain to super ficial inguinal lymph node along roung ligament of uterus . and lymph from the lower part of the body of uterus and cervix drain into internal iliac lymph node along the uterine vessels and small parts of these lymph nodes drain to sacral lymph nodes along the uterosacral ligament. 4) pelvic wall: it consist of the bony pelvis whicha consist of the sacrum coccyx ,right and left hip bones and corresponding joints, ligaments and acrtilages and pelvis fascia it has four walls which are anterior posterior and two lateral walls and inferiorly which connect each other at the base of pelvis to form the pelvis diaphgram formed by levatorani, coccygeus and superior and inferior of pelvis diaphgram. Pelvis canbe divided into greater and lesser pelvis . 5) popliteal fossa : diamond shaped fossa located the posterior side of the knee joints bounded by superiolaterally : biceps femoris muscle superiomedially: semitendinosus muscl and semimembranosus muscle inferio medial : medial head of gastrocnemius muscle inferiolatarelly: lateral gastrocnemius muscle theBase: popliteal surface of femur, articular capsule of knee joint ,oblique popliteal ligament Popliteus and its fascia
Contents of popiteal fossa From superficial to the deep * common fibular N. * tibial N. * popliteal V. * popliteal A. * popliteal lymph node superficial group around the termination of the small saphenous Vein and deep group around the popliteal vessels 6) cubital fossa is traingular area located on the anterior aspects of elbow joint bounded by
Superiorly:an imaginary line connecting the medial and lateral epicondyles.
Medially:the pronator teres.
Laterally: the brachioradialis.
Contents cubital fossa: tendon of biceps brachialis
The brachial artery:
Radial and ulnar arteries
The median nerve 7) Axillary fossa is pramydal space located under the shoulder joint that is bounded by
Anterior wall: the pectoralis major, clavipectoral fascia, subclavius and the pectoralis minor.
Posterior wall: the subscapularis, teres major, and latissmus dorsi muscles.
Lateral wall: the medial surface of upper part of the humerus, covered by the coracobrachialis muscle.
Medial wall: by the upper ribs and intercostal muscles, covered by the serratus anterior muscle thebase: the axillary fascia and skin
Contents of axillary fossa are * Infra clavicular part of brachial plexus and its branches * Axillary artery and its branches * Axillary vein and its tributaries * The axillary lymph node and * Loose arleolar tisue 8) ischiorectalfossa: is wedged shaped space * Location: it is situated one on each side of the anal canal below the pelvic diaphragm, its base directed downwards towards the surface and ita apex directed upwards. * Boundaries: it has one apex , four walls ,and one base * Medial wall: formed by sphincter ani externus, levator ani and coccygeus with inferior pelvic fascia covering these muscles * Lateral Wall: formed by the ischial tuberosity and obturator internus and its fascia. * Anterior Wall: formed by superficial transverse perineal muscle and posterior border of urigenital diaphragm * Posterior Wall: formed by inferior border of gluteus maximus and sacrotuberous ligament * Apex: formed by the line wheere the obturator fascia meets the inferior fascia of the pelvic diaphragm * Base: formed by the skin lateral to the anus * Contents: * Fatty tissue, blood vessels, internal pudendal vessels ,pudendal nerve, and external genital organs 9)Carotid triangle: The carotid triangle is a vascular area bounded by the superior belly of the omohyoid, the posterior belly of the digastric, and the anterior border of the SCM.
Contents
* The internal jugular vein and its tributeries * The common carotid artery and its branches, external carotid artery , * The vagus nerve, accssory nerve and the hypoglossal nerve. 10) Frontoparietoccipital region: * Soft tissue layers : SCALP 11) The anterolateral abdominal wall is composed of four pairs of flat, sheetlike muscles. These muscles support and protect the organs of the abdominal cavity and aid in breathing. They are : * External oblique abdominis is attached to the external surfaces and inferior borders of the lower eight ribs. * Internal oblique abdominis lies deep to external oblique. Its fibers arise from the lateral two-thirds of the inguinal ligament, the iliac crest, and the thoracolumbar fascia. * Transversus abdominis is the deepest of the lateral abdominal muscles. It is attached to the inguinal ligament, the anterior segment of the iliac crest, the thoracolumbar fascia, and the internal aspects of the lower six costal cartilages. * Rectus abdominis is a long, strap-like muscle. It is widest in the upper abdomen and lies just to the side of the midline. Rectus abdominis arises from the crest of the pubis and symphysis pubis. Superiorly, rectus abdominis is inserted upward into the anterior surface of xiphoid process and costal cartilages of 5th to 7th ribs. 12) The lymphatic drainage of the breast : Most lymph (>75%), especially from the lateral breast quadrants, drains to the axillary lymph nodes, initially to the pectoral nodes for the most part. However, some lymph may drain directly to other axillary nodes or even to interpectoral, deltopectoral, supraclavicular, or inferior deep cervical nodes And most of the remaining lymph, particularly from the medial breast quadrants, drains to the parasternal lymph nodes or to the opposite breast, whereas lymph from the inferior quadrants may pass deeply to abdominal lymph nodes (inferior phrenic lymph nodes).
13) Thyroid gland surgery: Passing layers from superficial to deep are : Skin, Superficial fascia, Superficial layer of cervical fascia, infrahyoid muscles, and peritracheal fascia.
Superior Thyroid artey: must be ligated at the thyroid when conducting a thyroidectomy. If the artery is severed, but not ligated, it will bleed profusely. In order to gain control of the bleeding the surgeon may need to extend the original incision laterally to gain access to its origin from the external carotid artery and ligate it there. 14) A direct inguinal hernia protrudes through a weakened area in the transversalis fascia near the medial inguinal fossa within an anatomic region known as the inguinal or Hesselbach's triangle, Direct inguinal hernias are the same in men and women.
The indirect hernia emerges from the lateral inguinal fossa, it descends along the spermatic cord in males from the deep internal ring or the round ligament in females..
15) Femoral hernia occur just below the inguinal ligament, when abdominal contents pass through a naturally occurring weakness called the femoral canal. Femoral hernia is a relatively uncommon type, accounting for only 3% of all hernias. While femoral hernia can occur in both males and females, almost all of them develop in women because of the wider bone structure of the female pelvis.Femoral hernia are more common in adults than in children
16) according to the relations of the head of pancreas in cancer patients: it is like to expand and invade the descending part of the duodenum. The mass may extend into the neck of the pancreas and can block the pancreatic duct.posteriorly the mass may have invade the portal veinous confluence of the splenic and superior messentric vein producing series of gastric splenic and small bowel varices

17) Kidney :
Position: the kidney is located in the retroperitoneal space and beside the vertebral column
Relations of the kidney * Superior: suprarenal gland * Inframedial: Renal pelvis continues with ureter * Medial: Right kidney: inferior vena ceva and right sympathetic trunk which is behind the inferior vena ceva * Medial: Left kidney: Adominal aorta, left sympathetic trunk * Anterior : Right kidney: right lobe of liver, right colic flexure, descending part of duodenum * Left kidney: posterior wall of stomach,pancrease, coils of jejunum and left colic flexure. * Posterior: Above the 12th rib: the kidney is seperated from the pleural cavityby the diaphragm and below the 12th rib from medial to lateral there are psoas major with genitofemoal nerve which is anterior to the psoas maor……

18) During obstruction of the trachea or tracheostomy :To avoid complications during a tracheostomy, the following anatomical relationships are important: * The inferior thyroid veins arise from a venous plexus on the thyroid gland and descend anterior to the trachea. * A small thyroid ima artery is present in approximately 10% of people; it ascends from the brachiocephalic trunk or the arch of the aorta to the isthmus of the thyroid gland. * The left brachiocephalic vein, jugular venous arch, and pleurae may be encountered, particularly in infants and children.The thymus covers the inferior part of the trachea in infants and children.