Antero-Lateral Abdominal WallAntero-Lateral Abdominal Wall

Abdominal WallAbdominal Wall

Skin Fascia Muscle Special fascia (Transversalis)

Anterior

Lateral (Rt. & Lf.)

Posterior

Ant & Lat walls boundary is:

Linea Semilunaris

Muscle fascia & nerves are continuous within ant. & lat. Walls

Antero-lateral abdominal wall

a curved ridge formed by the lateral margin of rectus abdominis muscle

Site of fusion of deep fascia

9th CC to pubic tubercle

Linea Semilunaris

Antero-Lateral WallAntero-Lateral Wall

Boundaries:

Superior

Xiphoid process

& costal margin

(7th-10th CC)

Inferior

Inguinal Ligament:

C.T. ligament extends from

ant. sup. iliac spine pubic tubercle

Fascia of Abdominal Wall• Superficial

fatty layer (Camper’s fascia)membranous (Scarpa’s fascia)

• Deep enclosing the muscles (muscle fascia)fuse in 2 lines (semilunaris & alba)

• Transversaliscontinuous with endothoracicfascia in the thorax

• Extra peritoneal fat

Layers of Abdominal WallLayers of Abdominal Wall

Muscles of Antero-Lateral WallMuscles of Antero-Lateral Wall

5 muscles

3 lateral: (flat broad m)

Named by layer & fibers direction

external oblique

internal oblique

transversus abdominis

2 anterior: (vertical m)

Named by shape

Rectus Abdominis

Pyramidalis

Read Table 4-1 in Your Textbook

External ObliqueExternal Oblique

From:

outer surfaces of lower 8 ribs

Inferomedially

Inserted to:

Linea alba

Pubic crest & tubercle

Ant. ½ of iliac crest

Inferior free border is thickened to become: Inguinal Ligament

Inguinal Lig.: Thickened backward reflection of the inferior border

of external oblique aponeurosis that extends from anterior superior

iliac spine to pubic tubercle

Superficial Inguinal Ring: a triangular split (opening) in the aponeurosis of external oblique muscle, above pubic crest & medial to inguinal lig.

Structure passing through:

Spermatic cord in male or ? In female

Internal Oblique MuscleInternal Oblique Muscle

• Main Origin:

lumbar fascia

ant. 2/3 of iliac crest

lateral 2/3 of inguinal lig

• Insertion

lower 3 ribs

xiphoid process

Linea alba

symphysis pubis

Read Table 4-1 in Your Textbook

Transversus AbdominisTransversus Abdominis

• Runs horizontally

• Main origin ??

• Main Insertion:

Linea alba

Read Table 4-1 in Your Textbook

Rectus AbdominisRectus Abdominis

Long strap like muscle

Extends vertically over ant. Wall

4 Fleshy parts run between

3 tendinous intersections:

xiphoid

umbilicus

halfway between ?

Enclosed by rectus sheath

(deep fascia)

PyramidalisPyramidalis

• NOT always present

• Base from pubis

• Apex inserted into linea alba

• Anterior to rectus abdominis& within Rectus sheath

Rectus SheathRectus Sheath

Long fibrous sheath that is formed by

The three lat. Muscles aponeuroses

Starts from linea semilunaris

in both sides

Splits into 2 parts:

- Ant. to rectus abdominis

ext. oblique + ½ of internal oblique

- Post. to rectus abdominis

transversus + ½ of internal oblique

Merges in midline as ???

ExceptionException

At level of ant. sup. Iliac spine

All aponeuroses go anterior

NO posterior part

- Rectus abdominis become lined by transversalis fascia

The infero-posterior disappearance is marked by: arcuate line

Contents of Rectus SheathContents of Rectus Sheath

• 2 muscles ??

• 4 bld. VesselsSup. & Inf. epigastric arteries

Sup. & Inf. epigastric veins

• 6 nervesT7 –T11 intercostals (5 nerves)

Subcostal n. (T12)

2 – 4 - 6

Blood Vessels of Abdominal WallBlood Vessels of Abdominal Wall

• Superior epigastric a.

continuation of ??

posterior to rectus abdominis m.

• Inferior epigastric a.

from external iliac artery

upward and medially

• 10th & 11th Post. intercostals & Subcostal a. (12th)

• Lumbar arteries:

• Deep Circumflex iliac: branch of ext. iliac a.

Nerves of Abdominal WallNerves of Abdominal Wall

• Lower intercostal nerves:T7 – T11

• Subcostal n.T12

• 1st lumbar nerve:

does NOT enter the rectus sheath

2 divisions:

iliohypogastric n.

ilioinguinal n.