Abdominal Wall Flashcards
Fascia
Above umbilicus single layer
Below superficial fatty (camper)
Deep membranous (scarpa)
3 layers investing fascia around muscles
Below muscles endoabdominal fascia
External oblique
T7-11 + SC nerves
Becomes inguinal ligament
From ext 5-12 rubs
To linea alba, pubic tubercle, and ant half iliac crest
Internal oblique
T6-12+L1
From thoracolumbar region, ant 2/3 iliac crest, CT deep to lat 1/3 inguinal lig
To 10-12th ribs, linea alba and pecton pubis via conjoint tendon
Transversus abdominus
T6-12+L1
Neurovascular plane lies superior to it
From int 7-12th ribs, thoracolumbar fascia, iliac crest + ct deep to lat 3rd inguinal lig (same as int oblique)
To linea alba, aponeurosis internal oblique, pubic crest, pecton pubis via conjoint tendon
becomes iliopubic tract
Rectus abdominus
T6-12 ant rami
From pubic symphysis and crest
To xiphoid process and 5-7th costal cartilages
Pyramidalis absent 20% people
Rectus sheath
Contains sup and inf epigastric arteries and veins, lymph vessels and distally nerves T7-12
Sup 2/3 post to obliques
Inf post to obliques and transverse
Thoracoabdominal nerves
T7-11
Continuation intercostals distal to costal margin
Between int oblique and transversus abdominus
Distal muscles and skin
Lateral cutaneous branches thoracic
T7-9 anterior rami
Skin R+L hypochindrium
Subcostal nerve
T12
Largest anterior ramus of t12
Between int oblique and transversus
Skin sup to iliac crest and inf to umbilicus
Iliohypogastric
L1
Sup terminal branch anterior ramus
Pierces transversus then between that and int oblique
Skin over iliac crest, upper inguinal and hypogastrium
Muscles int oblique and trans abdo
Ilioinguinal nerve
L1
Inferior terminal branch ant ramus
Normal route thn traverses inguinal canal NOT DEEP RING
Skin lower inguinal, mons pubis, ant scrotum, adjacent medial thigh
Muscle lower in oblique and transversus abdominus
Superficial veins ant abdo drainage
Sup medial internal thoracic
Sup lateral lat thoracic
Inf
Superficial epigastric to femoral
Inferior epigastric to external iliac
Superficial abdo arteries from internal thoracic
Musculophrenic - follows costal margin, supplies hypochondrium and ant lat diaphragm
Superior epigastric - in rectus sheath deep to rectus abdominus, supplies epigastric and supra umbilical plus rectus abdominus
Superficial abdo arteries from aorta
10+11 IC + subcostal
Supply lumbar and flank
Superficial abdo arteries from external iliac
Inferior epigastric - deep to rectus abdominus, supplies deep wall pubic and infra umbilical and rectus abdominus
Deep circumflex iliac - deep wal parallel to inguinal ligament, supplies deep wall inguinal + iliac fossa + iliacus muscle