PHT 611 Stab Wound Layers + Derivative Structures

Parasternal in area of ribs1-6, btw ribs

- Skin
- Superficial fascia
- Deep fascia that covers muscle
- Pectoralis major (too medial for minor)
- External intercostal membrane (superficial)
- Internal intercostal muscle (deep layer 1)
- Neurovascular plane
- Transversus thoracis muscle (not innermost muscles bc too medial)
- Endothoracic fascia (holds parietal to body wall)
- Parietal plaura
- Visceral pleura
- Lung

Lateral stab wound, midaxillary

- Skin

- Superficial fascia

- Deep fascia

- Serratus anterior

- Maybe external intercostal muscles

- Internal intercostal muscles

- Neurovascular plane/space

- Innermost intercostal muscles

- Endothoracic fascia

- Parietal plaura

- Visceral pleura

- Lung

Paravertebral, just beside spine, low but within level of lung

• Skin

- Superficial layer of thoracolumbar fascia

- Erector spinae muscles

- Transversospinalis mucles - semispinalis, multifidus, roatores

- Middle layer of thoracolumbar fascia

- If little more lateral, into quadratus lumborum muscle

- Anterior layer of thoracolumbar fascia

- Not even to thoracic cage yet! Why getting hit on back is better

- External intercostal muscles

- Internal intercostal membrane

- Neurovascular plane

- Subcostal muscles (counterprt to transvere thoracic)

- Endothoracic fascia

- Parietal pleura

- Visceral pleura

Lungs (tuxedo tails)

Anterior abdomen

- Skin

- Superficial fascia

○ Single fatty layer

○ If below umbilicus, called Campers Fascia

○ Also go through Scarpas fascia - more membranous, if below umbilicus, deeper superficial layer

○ Just superficial if above

- Deep fascia (same again)

- Muscles: rectus amdominus if just lateral to umbilicus

○ If more posterior/lateral, through external oblique, internal oblique, transverse abdominus

○ If true lateral or posteriro lateral - external/internal oblique, thoracolumbar fascia

1. External oblique

2. Internal oblique

3. Neurovascular plane

4. Transversus abdominis

5. Transversalis fascia

6. Extra peritoneal fascia

7. Parietal peritoneum

8. Visceral peritoneum

9. Organ (liver, gallbladder, spleen)

Paraumbilical above umbilicus

- Skin

- Superficial fascia - fatty layer

- Deep fascia

- Anterior rectus sheath - specifically

○ Ex oblique aponeurosis

○ Internal oblique aponeurosis

- Rectus abdominis muscle

- Posterior rectus sheath

○ Internal oblique aponurosis AGAIN because it split!!

○ Transversus abdominus aponeurosis

- Transversalis fascia

- Extraperitoneal fascia

- Parietal peritoneum

Visceral peritineum

Paraumbilical below umbilicus

- Skin

- Superficial fascia - 2 layers below umbilicus!!

○ Fatty campers facia

○ Membranous scarpas fascia

- Deep fascia layer

- Anteiror rectus sheath

○ External oblique apon

○ Interna oblique apon

○ Transversus abdominus apon

- Rectus abdominis muscle itself

- Transversalis fascia

- Extraperitoneal fascia

- Parietal peritoneum

Visceral peritoneum

foramen ovale becomes

fossa ovalis

Ductus arteriosus becomes

Ligamentum arteriosum

Ductus veniosus becomes

ligamentum veniosum, hepatic portal vein to round ligament of liver

Ventral mesentary/primitive gut becomes

falciform ligament

Urachus becomes

Median umbilical ligament in fold

umbilical arteries become

Medial umbilical ligaments in folds

Umbilical vein becomes

Round ligament of liver

Spermatachord in womem becomes

round ligament of uterus