By Prof. Saeed Makarem

ByByProf. Saeed MakaremProf. Saeed Makarem

Layers of the Anterior Abdominal Wall

1- Skin.1- Skin. 2- Superficial fascia:2- Superficial fascia: a- Superficial fatty layer, (Camper’s fascia) a- Superficial fatty layer, (Camper’s fascia) b- Deep membranous layer, (Scarpa’s fascia)b- Deep membranous layer, (Scarpa’s fascia) No Deep Fascia in the anterior abdominal wall

3- External oblique muscle.3- External oblique muscle. 4- Internal oblique muscle.4- Internal oblique muscle. 5- Transversus abdominis muscle.5- Transversus abdominis muscle. 6- Fascia Transversalis6- Fascia Transversalis.. 7- Extraperitoneal fatty Tissue.7- Extraperitoneal fatty Tissue. 8- Peritoneum.8- Peritoneum.

Prof. Saeed MakaremProf. Saeed Makarem

Layers of anterolateralLayers of anterolateral abdominal wallabdominal wall

1- Skin.1- Skin.2- Superficial fascia:2- Superficial fascia: a- Superficial fatty layera- Superficial fatty layer (Camper’s fascia).(Camper’s fascia). b- Deep membranousb- Deep membranous (Scarp’s fascia).(Scarp’s fascia).4- Muscular layers: (External & 4- Muscular layers: (External &

internal oblique and internal oblique and transversus abdominis.transversus abdominis.

5- Fascia transversalis.5- Fascia transversalis.6- Extra peritoneal fatty tissue. 6- Extra peritoneal fatty tissue.

(Space of (Space of Bogros).Bogros).7- Parietal peritoneum.7- Parietal peritoneum. Prof. Saeed MakaremProf. Saeed Makarem

Prof. Saeed MakaremProf. Saeed Makarem

External Oblique External Oblique Origin:Origin: outer surface of the outer surface of the

lower 8 ribs.lower 8 ribs. (by 8 fleshy digitations which (by 8 fleshy digitations which

interdigitate with serratus interdigitate with serratus anterior and latissimus dorsi.anterior and latissimus dorsi.

Insertion:Insertion: Xiphoid process, Xiphoid process, Linea alba, Pubic crest, Linea alba, Pubic crest, Pubic tubercle, ASIS. & Pubic tubercle, ASIS. & anterior ½ of the outer lip of anterior ½ of the outer lip of the iliac crest.the iliac crest.

Direction of its fibers : Direction of its fibers : Downward, Forward, and Downward, Forward, and Medially.Medially.

Prof. Saeed MakaremProf. Saeed Makarem

Prof. Saeed MakaremProf. Saeed Makarem

Superficial Superficial inguinal ringinguinal ring

Lacunar Ligament

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superficial inguinal ringsuperficial inguinal ring

Prof. Saeed MakaremProf. Saeed Makarem

Prof. Saeed MakaremProf. Saeed Makarem

Prof. Saeed MakaremProf. Saeed Makarem

Internal ObliqueInternal Oblique OriginOrigin: lateral 2/3 of the

inguinal ligament, anterior 2/3 of iliac crest, and lumbar fascia.

InsertionInsertion: : Lower border of lower 3 ribs and their costal cartilages, xiphoid process, linea alba, symphysis pubis, pubic crest and pectineal line.

Direction of its Fibers: upward forward and medially (at right angle with the fibers of the angle with the fibers of the external oblique).external oblique).

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Transversus AbdominisTransversus Abdominis OriginOrigin:: Lateral 1/3 of Lateral 1/3 of

inguinal ligament, anterior inguinal ligament, anterior 2/3 of inner lip of iliac 2/3 of inner lip of iliac crest, lumber fascia and crest, lumber fascia and lower 6 costal cartilages.lower 6 costal cartilages.

InsertionInsertion:: Xiphoid Xiphoid Process, Linea alba, Process, Linea alba, symphysis pubi,s Pubic symphysis pubi,s Pubic crest, and Pectineal line.crest, and Pectineal line.

Direction of its fibersDirection of its fibers: : Horizontally.Horizontally.

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Prof. Saeed MakaremProf. Saeed Makarem

Rectus AbdominisRectus AbdominisOrigin:Origin: By 2 heads from pubic crest, By 2 heads from pubic crest,

pubic tubercle and front of pubic tubercle and front of symphysis pubis.symphysis pubis.

Insertion: Into 5Into 5thth,6,6thth,and 7,and 7thth costal costal

cartilages and xiphoid process.cartilages and xiphoid process. It is a strap muscle that It is a strap muscle that

extend along the whole length of extend along the whole length of the anterior abdominal wall.the anterior abdominal wall.

It shows a transverse tendinous It shows a transverse tendinous intersection.intersection.

It is enveloped in the It is enveloped in the rectus rectus sheath.sheath.

Prof. Saeed MakaremProf. Saeed Makarem

Prof. Saeed MakaremProf. Saeed Makarem

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Contents of the Contents of the Rectus SheathRectus Sheath

2 Muscles2 Muscles:: Rectus Abdominis & Rectus Abdominis &

Pyramidalis.Pyramidalis.

2 Vessels 2 Vessels : : Superior & inferior Superior & inferior

epigastric vessels.epigastric vessels.2 verves2 verves: : Lower 5 intercostal & Lower 5 intercostal &

Subcostal nervesSubcostal nervesLymph VesselsLymph Vessels.. Prof. Saeed MakaremProf. Saeed Makarem

Prof. Saeed MakaremProf. Saeed Makarem

Prof. Saeed MakaremProf. Saeed Makarem