Anterior abdominal wall and inguinal region

Regional classification

Abdominal cavity can be divided into the abdominal proper and pelvic cavity by a plane which lies at the superior aperture or brim of the bony pelvis.

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Superficial anatomy of anterior abdominal wall

Umbilicus Linea transversae: mark position of underlying tendinous intersections of reclusive abdominis muscle. Linea semilunares (outer) Linea alba (midline)

Layers of anterior abdominal wall

Camper’s fascia Scarpa’s fascia Muscles and muscular fascia Transversalis fascia Extra peritoneal fat Peritoneum

Muscles and muscular fascia

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Rectus Sheath

 

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Caption: : Composition:the rectus abdominis muscle is enclosed in a sheath consisting of anterior and posterior laminae. A cresent-shaped arcuate line is formed when an abrupt trasition is made from a posterior lamina consisting of aponeurotic tissue to simple transveralis fascia.

Blood supply and innervation

Arteries Segmentally arranged (lower posterior intercostals, subcostal, lumbar arteries). longitudinal channel superior epigastric (terminal branch of internal thoracic artery) inferior epigastric (branch of the external iliac artery) the above two arteries form am important anastamosis which connects the subclavian artery above to the external iliac artery below.

Nerves innervated by intercostal and subcostal nerves (T7-T12), iliohypogastric nerve (L1) and ilioinguinal nerve (L1) Dermatomes epigastric region (T6, T7, T8) Umbilicus (T10)***** Above pubis (T12) Inguinal Region (L1)

Inguinal Region

Inguinal ligament This is the inferior edge of the external oblique aponerurosis extending from the anterior superior iliac spine to the pubic tubercle. Superficial inguinal ring medial crus lateral crus intercrural fibers Concept of inguinal canal and deep inguinal ring 3 board model

3 Board Model (binary/octet-stream)

inguinal hernia

direct vs. indirect inguinal hernia in an indirect inguinal hernia, the hernia passes througt deep inguinal ring, lateral to the inferior epigastric vessels in a direct inguinal hernia, the hernia passes medial to the inferior epigastric vessles, "directly" throught the posterior wall of the inguinal canal.