Abdominal Wall

Abdominal Wall

1. Muscles

   • superficial
     • External oblique
       • insertion: ASIS, public tubercle, and linea alba
       • lguinal ligament
         • double infolding of external oblique
   • Intemediate
     • internal oblique
       • insertion:Linea alba, pectineal line (via conjoint tendon), and ribs.
       • 2/3 the way down from ASIS
   • deep
     • transversus abdominus
       • Insertion: Xiphoid process, linea alba, pubic crest and pecten pubis via conjoint tendon
       • 1/3 way down from ASIS
     • anterior: rectus abdominis (abs)
       • enclosed by aponeuroses
         • tendinous intersection
         • rectus sheath
           • formed by apon. of ext. obl, intern. obl., & trans. abd.
           • Inferior to ASIS
             • anterior: all 3 muscles (ext & int ob. & transversus abdominis) no posterior
           • Superior to ASIS
             • Anterior Composed of external oblique, 1/2 internal oblique; posterior: other 1/2 ofinternal oblique and transversus abdominis
   • Actions
     • support & compress viscera
     • flex vertebral column with bilateral contraction
     • lateral flexion of vertebral column w/ unilateral contraction
     • rotation of trunk when internal abdominal oblique and contralateral external abdominal oblique contract simultaneous (turns to side of internal abdominal oblique).
   • Attachment Vocab
   • Transversalis Fascia
     • internal layer of deep investing fascia of abd. wall mm.

2. Iguinal Canal

   • oblique passage thru the abdominal wall allowing the spermatic cord and the female round ligament to exit the abdominal cavity
     • passage of testis into the scrotum
   • iguinal hernia
     • direct
       • weakness in the abdominal wall in the region of the inguinal triangle
         • emerges medial to the inferior epigastric artery
     • indirect
       • deep inguinal ring, inguinal canal, and superficial inguinal ring
       • follows sperm. cord
     • Iguinal
       • male; old/young
         • above & medial to pubic tubercle
     • femoral
       • female
         • below & lateral to pubic tubercle
           • below iguinal ligament (weak area)
     • Iguinal triangle
       • borders: laterally epigastric a. ; medially inf. border if rectus abdominis; inferior iguinal ligament
   • deep iguinal ring
     • internal entrance in the transversalis fascia
     • located deep side of abd wall lateral to inferior epigastric a.
   • Superficial Iguinal ring
     • iguinal ligament
       • inferior free border of external oblique aponeurosis attaching bet. ASIS and pubic tubercle
         • ext. oblique apon. splits
           • lateral crus
             • passes to pubic tubercle
           • medial crus
             • passes to pubic symphysis
           • intracrural fibers make triangle look ring like
       • lacunar ligment
         • attaches iguinal ligament to pectineal line
     • exit of iguinal canal
   • boundaries
     • Roof
       • int abd ob
       • trans abd
     • anterior wall
       • ext abd. ob.
     • posterior wall
       • transversalis fascia & conjonined tendon
     • floor
       • iguinal ligament
       • lacunar ligament
   • deficiency in 3 muscles
   • Spermatic cord
     • supporting element for testis in scrotum; covered by layers from abd. region
     • Contents: ductus deferens, testicular artery, pampiniform plexus of veins, genital branch of genitofemoral nerve (supplies cremaster), lymph vessels. Tunica vaginalis: peritoneal extension covering the testes on its anterior and lateral sides.

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