By Raftery, Delbridge, Douglas
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Additional resources for Basic Science for the MRCS. A revision guide for surgical trainees
13 The male perineum viewed from below. On the right side the muscles have been removed to display the crus and bulb of the penis. 14 The female perineum. On the right side the muscles have been removed to display the bulb of the vestibule and Bartholin’s glands. l l Superficial transverse perineal muscle running transversely from the perineal body to the ischial ramus. The same muscles are present in the female but are less well developed (Fig. 14). Perineal body l l l Fibromuscular nodule lying in the midline between anterior and posterior perineum.
51). e. the lesser omentum. This then separates to enclose the stomach, reforming again on the greater curvature, and then loops downwards again, turning upwards and attaching to the length of the transverse colon, forming the greater omentum (Fig. 8). The lower leaf of the greater omentum continues upwards, enclosing the transverse colon as the transverse mesocolon. At the base of the transverse mesocolon the double layer divides again. The upper leaf passes over the abdominal wall and upwards to reflect onto the liver.
Linea alba virtually bloodless. 27 28 SECTION ONE l ANATOMY Structures encountered: n skin n subcutaneous fat n superficial fascia (two layers in lower abdomen) n linea alba n extraperitoneal fat n peritoneum. n Subcostal (Kocher’s) l l l l Right side (cholecystectomy), left side (elective splenectomy), both sides connected (kidneys: anterior approach). 5 cm below and parallel to costal margin extending laterally to lateral border of rectus or further. Structures encountered: n skin n subcutaneous fat n superficial fascia n anterior rectus sheath n rectus abdominis n posterior rectus sheath n extraperitoneal fat n peritoneum.