Antero-Lateral Abdominal Wall E-learning

7/31/2019 Antero-Lateral Abdominal Wall E-learning

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Antero-Lateral Abdominal Wall


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Abdominal Wall

Skin Fascia Muscle Special fascia (Transversalis)

Anterior

Lateral (Rt. & Lf.)

Posterior

Ant & Lat walls boundary is:

Linea Semilunaris

Muscle fascia & nerves arecontinuous within ant. & lat.Walls

Antero-lateral abdominal wall


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Linea Semilunaris


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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


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Fascia of Abdominal Wall

Superficialfatty layer (Campers fascia)membranous (Scarpas fascia)

Deep

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

Transversalis

continuous with endothoracicfascia in the thorax

Extra peritoneal fat


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Linea Semilunaris & Linea Alba

Alba

Semi

Semilunaris

Alba


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Layers of Abdominal Wall


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Muscles 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


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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 tobecome: Inguinal Ligament


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Inguinal Ligament & Superficial Ring


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Inguinal Lig.: Thickened backward reflection of the inferior border

of external oblique aponeurosis that extends from anterior superior

iliac spine to pubic tubercle


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

Structure passing through:

Spermatic cord in male or ? In female


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Internal Oblique Muscle

Main Origin:

lumbar fascia

ant. 2/3 of iliac crest??

Insertion

lower 3 ribs

xiphoid process

Linea alba

symphysis pubis



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Transversus Abdominis

Runs horizontally

Main origin ??

Main Insertion:Linea alba



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Rectus Abdominis

Long strap like muscle

Extends vertically over ant. Wall

4 Fleshy parts run between3 tendinous intersections:

xiphoid

umbilicus

halfway between ?

Enclosed by rectus sheath

(deep fascia)


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Pyramidalis

NOT always present

Base from pubis

Apex inserted into linea alba

Anterior to rectus abdominis

& within Rectus sheath

Function ??


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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 ???


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Exception

At level of ant. sup. Iliac spine

(midway between umbilicus and ?)

All aponeuroses go anterior

NO posterior part

- Rectus abdominis become lined bytransversalis fascia

The infero-posterior disappearance ismarked by: arcuate line


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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)

2 4 - 6


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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?)


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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

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Antero-Lateral Abdominal Wall E-learning