above arcuate e
below arcuate line
The muscles of anterolateral abdominal walls
Summary
yer of rectus sheath Rectus abdominis
yer of rectus sheath Transversus abdominis Internal oblique m. External oblique m. Aponeurosis of External oblique m. Tendinous intersections
Skin incisions and dissection
The cadaver is in supine position incision 1 from the xiphoid process to the public symphysis. Incision 2 from the xiphoid process to the post.axillary line along the costal arch. Incision 3 from umblicus to post. axillary line. incision 4 from the lower end of the median incision along the inguinal lig.to the post axillary line.
Formed by fusion of aponeurosis of external oblique m. and ant. leaf of aponeurosis of internal oblique m.
Posterior layer
Formed by fusion of post. leaf of aponeurosis of internal oblique m. and aponeurosis of transversus abdominis
above arcuate line below arcuate line
Rectus sheath -Cross section above arcuate line
1
2
3
4
5
6 7 8 9 10 1112
13 14 15
Rectus sheath-Cross section below acuate line
Abdominal region-nine regions
(By 2-transverse lines & 2-vertical lines)
1 Right hypochondriac region 2 Epigastric region 3 Left hypochondriac region 4 Right lateral (lumbar) region 5 Umbilical region 6 Left lateral (lumbar) region 7 Right iliac (inguinal) region 8 Hypogastric (pubic) region 9 Left iliac (inguinal) region
Right upper quadrant(RUQ)
RUQ LUQ
Right lower quadrant（RLQ） RLQ LLQ
left upper quadrant（LUQ）
Left lower quadrant（LLQ）
Anterolateral abdominal wall
1
Fatty layer Membranous layer
Bony landmark of the abdomen
Organs in the abdomen
Ant.view
Post.view
Surface anatomy of the abdomen
1 xiphoid process 2 costal margin 3 tip of ninth costal cartilage 4 tendinous intersections 5 umblicus 6 iliac crest 7 ant.sup.iliac spine 8 linea semilunaris 9 linea alba 10 inguinal lig. 11 pubic tubercle 12 pubic crest 13 pubic symphysis
F-layer M-layer
Layers,vessels,muscles &nerves of the abdomen
Superficial blood vessels & nerves of anterolateral abdomental wall
Blood vessels and nerve of antrolateral abdominal wall
Regional Anatomy
Abdomen-part one Anterolateral abdominal wall
1
Boundaries of the abdomen
Boundaries
Superiorly－ xiphoid process,costal arch,11th and 12th ribs,vertebra T12
Dissection of Inguinal region
Boundaries
Inferiorly:Inguinal lig. Medially:Lat.margin of
rectus abdominis Superiorly:A horizontal line stretching from ant.iliac spine to lat.margin of rectus abdominis
lower part.
The lateral border is called semilunar line. 3-4 tendinous intersections.
Tendinous intersections
Semilunar line
Rectus Sheath
Anterior layer
A-at the level of the lowerest point of costal arch B-at the level of both anterior superior iliac spine
Quadrants of abdomen (four regions)
According two vertical lines cross the navel
2
3
Layers (from sup.)
4 5
1. Skin 2. Superficial fascia-two layers 3. Anterolateral muscles(3+1)
6
4. Transverse fascia
5. Extraperitoneal fascia
6. Parietal peritoneum
Ant.branches of lower 6 pairs of thoracic nn. are located in between int.oblique m. & transversus abdominis. The lower part of ant. abdominal wall is supplied by iliohypogastric and ilioingunal nn.
Muscles of anterolateral abdominal wall
Anterolateral group External oblique m. internal oblique m. Transversus abdominis Rectus abdominis
Rectus abdominis
above arcuate line
below arcuate line
Attention:below arcuate line,no posterior layer of rectus sheath
Linea alba
It is a tendinous raphe between right & left rectus abdominis from xiphoid to pubic symphysis, it is the fusion of the aponeurosis of left and right three flat muscles,superiorly wide and inferiorly narrow.
Transversus abdominis Internal oblique m. External oblique m.
Tendinous part
Muscular part
External oblique muscle
1 2 Note the poneurosis (1) and superficial inguinal ring (2)
Anterolateral abdominal wall
Superficial fascia
divisions below umbilicus
Fatty layer (Camper’s fascia)
continuous with the superficial fascia over the rest of the body.
Inguinal canal
An oblique cleft or passage. Lie above to medial half of inguinal lig. 4-5cm long in adult. in between muscles,aponeurosis & fascia, Passing structures: Spermatic cord in male; Round lig.of uterus in female