Antero-Lateral Abdominal Wall

Abdominal 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

Linea Semilunaris

Antero-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 (Campers fascia) membranous (Scarpas fascia) Deep enclosing the muscles (muscle fascia) fuse in 2 lines (semilunaris & alba) Transversalis continuous with endothoracic fascia in the thorax Extra peritoneal fat

Linea Semilunaris & Linea Alba

Semi

Alba

Semilunaris
Alba

Layers of Abdominal Wall

Muscles of Antero-Lateral Wall

Read Table 4-1 in Your Textbook

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

External Oblique
From: outer surfaces of lower ribs (??) Inferomedially Inserted to: Linea alba Pubic crest & tubercle Ant. of iliac crest Inferior free border is thickened to become: Inguinal Ligament

Inguinal Ligament & Superficial Ring

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 Muscle

Read Table 4-1 in Your Textbook

Main Origin: lumbar fascia ant. 2/3 of iliac crest ?? Insertion lower 3 ribs xiphoid process Linea alba symphysis pubis

Transversus Abdominis
Runs horizontally Main origin ?? Main Insertion: Linea alba

Read Table 4-1 in Your Textbook

Rectus 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)

Pyramidalis
NOT always present Base from pubis Apex inserted into linea alba Anterior to rectus abdominis & within Rectus sheath Function ??

Rectus 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 + of internal oblique - Post. to rectus abdominis transversus + of internal oblique Merges in midline as ???

Exception
At level of ant. sup. Iliac spine (midway between umbilicus and ?) 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 Sheath

2 muscles ??
4 bld. Vessels
Sup. & Inf. epigastric arteries Sup. & Inf. epigastric veins

6 nerves
T7 T11 intercostals (5 nerves) Subcostal n. (T12)

24-6

Blood Vessels of Abdominal Wall

Superior epigastric a. continuation of ?? posterior to rectus abdominis m.
Inferior epigastric a. from external iliac artery Route & location ? 10th & 11th Post. intercostals & Subcostal a. (12th) Lumbar arteries (between which layers?) Deep Circumflex iliac (origin?)

Nerves of Abdominal Wall

Lower intercostal nerves:
T7 T11

Subcostal n.
T12

1st lumbar nerve:

2 divisions: iliohypogastric n. ilioinguinal n. does NOT enter the rectus sheath