Muscles Of The Anterior abdominal Wall Flashcards
Origin of external Oblique
8 fleshy fibre from the shaft of the lower 8 ribs
Upper 4 interdigital with serratus anterior
Lower 4 latissimus dorsi
Direction fo external oblique
Downwards forwards medially↘️!
Insertion of external oblique
Broad aponeurosis 1.Xiphoid process
2.Linea alba tendinous, fibrous raphe that runs vertically down the midline of the abdomen. It extends between the inferior limit of the sternum and the pubis, separating the rectus abdominis muscles.
- Pubic symphysis
- Pubic crest
- Pectineal line of pubis
Lower Fibres - Ant 2/3rds of outer lip of iliac crest
Nerve supply EOM
Lower 6 thoracic
Structures formed from EOM
The free inferior margin between the ASIS and pubic tubercle fold upon itself to form INGUINAL LIGAMENT
Between linea semilunaris and linea Alba helps to form anterior wall of rectus sheath
Just above pubic crest, EOM Aponeourosis has a triangular aperture - Superfical INGUINAL RING
Free ends of EOM
Upper and Posterior
Inferior involved in inguinal ligament
Functions of EXTERNAL OBLIQUE
Lateral flex ion with internal oblique
Rotation of trunk wihh the internal oblique
Origin of internal oblique
Lateral 2/3 INGUINAL LIGAMENT
Anterior 2/3 intermediate area of iliac crest
Thoracolumbar fascia
UPWARDS FORWARDS MEDIALLY
Insertion
Uppermost- Lower 3-4 Ribs Rest- 7,8,9 costal cartilage Aponeurosis Ciphoid process Linea Alba Pubic crest Pectineal line of pubis
DOESNOT EXTEND BEYOND COSTAL MARGIN
Nerve supply of IOM
T7-T12 L1
Structures formed by IOM
Aponeurosis helps in formation of rectus sheath
Con joint tendon
Cremaster muscle
What is Conjoint tendon or falx inguinalis
formed by fusion of aponeurotic fibres of Internal oblique and transversus
Attachment: pubic crest and medial part of pectin pubis
Medially: anterior wall of rectus sheath
Laterally:Free
Function: strengthens abdominal wall where it’s weakened by the superficial inguinal ring
What is interfoveolar ligament
Inconstant ligamentous band
Continuous with conjoint tendon sometimes
Connects lower border of transversus to superior ramps of pubis
Origin of transversus abdominis
Lateral 2/3 Inguinal L
Any 2/3 inner lip of iliac crest
Thoracolumbar fascia
Inner surface of lower 6 costal cartilage
Insertion
Broad aponeurosis
Nerve supply
T7-T12 L1
Neuromuscular structures are present between
Internal and transversus
Rectus abdominus
O: lateral head- lateral part of pubic crest
Medial head- medial part of pubic crest
Anterior pubic ligament
I: along a horizontal line passing laterally from xiphoid 7,6,5 costal cartilage
Nerve supply
T7-T12
Tendinous intersections
Transverse fibrous bands 3
Umblicus
Xiphoid process
Thirds between 2
Represent segmental origin of muscle
Functionally make muscle more powerful
Preventing bow string of rectus abdominus
Functions
Support of abd viscera against gravity- TONE OF OBLIQUE MUSCLES
EXPULSIVE Acts- oblique and transversus by compressing abd viscera
Forceful exploratory acts- External oblique by compressing and depressing lower part of thorax
Movements of abdomen
Lateral flex ion- obliques
Rotation obliques
Flexion of trunk- rectus abdominus
Nerve supply of cremaster muscle
Genital branch of genitofemoral nerveL1
Actions of cremaster
Sup spends the testes
Elevate testes
Close superficial inguinal ring when intrabd pressure increases
Cremaster reflex
Stroking of upper part of medial side of thigh reflex contraction of cremaster muscle
More in children
Lesions over L1 reflex lost
Origin and insertion of cremaster
Origin
Lateral part: Lower edge of internal abdominal oblique and transversus abdominis muscles, inguinal ligament
Medial part: Pubic tubercle, lateral part of pubic crest
Insertion
Tunica vaginalis of testis
Blood supply
Blood supply
Cremasteric branch of inferior epigastric artery
Pyramidalis
Anterior surface of body of pubis to linea Alba
Inguinal ligament
Lateral half rounded and oblique
Medial grooved horizontal
Attachments of inguinal ligament
Lower border- fascia lata
Upper surface - lateral 2/3 origin IOM
Lateral 1/3 transversus abdominus
Middle cremaster
Relations
Upper grooved surface - floor of inguinal canal
Extensions of inguinal ligament
1.Pectineal part of inguinal ligament
Trainglular Anteriorly- medial end of inguinal ligament Post- pecten pubis Medially femoral ring Apex pubic tubercle
Function supports spermatic cord
- pectineal ligament or ligament of Cooper- extension from post part of base of lacunar ligament
- Reflected part of inguinal ligament- interlace with those of opposite side
- intercrural fibres arise from middle of inguinal ligament. Arch over it to keep it’s crura together.
Visceroptosis
Loss of tone of abdominal muscles due to lack of exercise resulting in protrusion of wall
Safest incisions in any abdominal wall
Paramedian safer than medial because laterally the rectus is retracted to protect the nerves supplying it.
Infraunblical median incisions better than supraunblical
Infra close approximation of rectus prevents ventral hernia
Supra through linea alba- bloodless
Ventral hernia changes more
Why does tubercular infection of lung and pleura cause pain in abdomen
Supplied by T7-T12 L1
Effect of peritonitis and respiration on abdominal muscles
Reflex contraction
Contraction
Examination of muscles
Knees and hips flexed