Regional anatomy of the abdominal wall

Regional / topographic anatomy of the abdominal wallKey facts about the topographic relations of the abdominal wall. Fascia. Inguinal ligament. Linea alba
~ 6 min

The muscles of the abdomen region are covered with several fasciae:

Superficial abdominal fascia (fascia superficialis)

Superficial fascia of the abdomen (fascia superficialis)
Superficial fascia of the abdomen (fascia superficialis)

It is a continuation of the superficial fascia of the chest. Below the umbilical ring, the fascia is divided into two layers:

  • Superficial fatty layer (Campers’ fascia), which continues into the superficial fascia of the thigh

  • Deep connective tissue layer (Scarpa’s fascia) The superficial abdominal fascia forms two ligaments:

  • Fundiform ligament of the penis/clitoris (lig. fundiforme penis/clitoridis)

  • Suspensory ligament of the penis/clitoris (lig. suspensorium penis/clitoridis)

Fundiform ligament of penis/clitoris (lig. suspensorium penis/clitoridis)
Fundiform ligament of penis/clitoris (lig. suspensorium penis/clitoridis)

Fascia of abdominal organ (fascia propria) It lies deeper. It forms several layers:

  • The superficial layer (lamina superficialis) covers the external oblique muscle. In the region of the superficial inguinal ring, it forms the intercrural fibres and passes into the cremasteric fascia

  • The middle layer (lamina media) covers the internal oblique muscle.

  • The deep layer (lamina profunda) covers the transversus abdominis muscle.

    Endo-abdominal fascia (fascia endoabdominalis)

    It covers the abdominal cavity from the inside, adheres to the parietal layer of the peritoneum. Depending on its location, it can be called:

  • Transversalis fascia (fascia transversalis), which covers the transversus abdominis muscle. It also forms the internal spermatic fascia (fascia spermatica interna).

    Transversalis fascia (fascia transversalis)
    Transversalis fascia (fascia transversalis)
    Transversalis fascia (fascia transversalis)
    Transversalis fascia (fascia transversalis)
  • Diaphragmatic fascia (fascia diaphragmatica)

  • Iliac fascia (fascia iliaca)

    Iliac fascia (fascia iliaca)
    Iliac fascia (fascia iliaca)
  • Quadratus lumborum fascia (fascia m. quadratus lumborum)

  • Pelvic fascia (fascia pelvis)

  • On the interior surface, in the lower parts of the anterior abdominal wall, the peritoneum forms folds:

  • The median umbilical fold (plica umbilicalis mediana) contains an obliterated urinary duct

    Median umbilical fold (plica umbilicalis mediana)
    Median umbilical fold (plica umbilicalis mediana)
  • The medial umbilical fold (plica umbilicalis medialis) contains an obliterated umbilical artery

    Medial umbilical fold (plica umbilicalis medialis)
    Medial umbilical fold (plica umbilicalis medialis)
  • Lateral umbilical fold (plica umbilicalis lateralis) contains the inferior epigastric artery and veins

    Lateral umbilical fold (plica umbilicalis lateralis)
    Lateral umbilical fold (plica umbilicalis lateralis)

    Fossae are formed between these folds, which are weak points, where hernias may form:

  • Supravesical fossa (fossa supravesicalis)

    Supravesical fossa (fossa supravesicalis)
    Supravesical fossa (fossa supravesicalis)
  • The medial inguinal fossa (fossa inguinalis medialis) corresponds to the superficial inguinal ring

    Medial inguinal fossa (fossa inguinalis medialis)
    Medial inguinal fossa (fossa inguinalis medialis)
  • The lateral inguinal fossa (fossa inguinalis lateralis) corresponds to the deep inguinal ring

    Lateral inguinal fossa (fossa inguinalis lateralis)
    Lateral inguinal fossa (fossa inguinalis lateralis)

    Various connective tissue structures form the so-called rectus sheath (vagina m. recti abdominis).

    Above the arcuate line (3-5 cm below the Umbilical region), the anterior wall of this sheath forms the following structures:

  • Aponeurosis of the external oblique muscle

  • Anterior layer of the aponeurosis of the internal oblique muscle

    Rectus sheath (vagina m. recti abdominis) – anterior wall
    Rectus sheath (vagina m. recti abdominis) - anterior wall

    The posterior wall is formed by:

  • Posterior layer of the aponeurosis of the internal oblique muscle

  • Aponeurosis of the transversus abdominal muscle

  • Transversalis fascia

  • Peritoneum

    Rectus sheath (vagina m. recti abdominis) – posterior wall
    Rectus sheath (vagina m. recti abdominis) - posterior wall

    Below the arcuate line, the anterior wall of the vagina is formed by:

  • Aponeurosis of the external oblique muscle

  • Aponeurosis of the internal oblique muscle

  • Aponeurosis of the transversus abdominal muscle The posterior wall is formed by:

  • Transversalis fascia

  • Peritoneum

    Rectus sheath (vagina m. recti abdominis) – posterior wall
    Rectus sheath (vagina m. recti abdominis) - posterior wall

    Passing to the anterior wall, lateral wall muscles of the abdomen form large tendon laminae called aponeuroses. These aponeuroses are involved in the formation of several important topographic structures.

    The inferior border of the aponeurosis of the external oblique muscle forms the inguinal ligament (lig. inguinale), which is also called arcus inguinalis. It is stretched between the anterior superior iliac spine and the pubic tuber-

    Inguinal ligament (lig. inguinale)
    Inguinal ligament (lig. inguinale)

    cle. Near the pubis , the ligament bifurcates and forms two cruses:

  • The medial crus (crus mediale) inserts into the pubic symphysis

    Medial crus (crus mediale)
    Medial crus (crus mediale)
  • Lateral crus (crus laterale) is attached to the pubic tubercle

    Lateral crus (crus laterale)
    Lateral crus (crus laterale)

    Between the cruses of the ligament, there is a so-called intercrural fissure.

    Two additional ligaments arise from the lateral crus:

  • Reflected ligament (lig. reflexum)

    Reflected ligament (lig. reflexum)
    Reflected ligament (lig. reflexum)
  • Lacunar ligament (lig. lacunare)

Another topographic formation is the linea alba of the abdomen (linea alba). It is a place where the aponeuroses of the muscles of the abdomen cross. Approximately in the middle of the line there is an umbilical ring (anulus umbilicalis), this is the site of formation of inguinal hernias.

Linea alba of the abdomen (linea alba)
Linea alba of the abdomen (linea alba)
Umbilical ring (anulus umbilicalis)
Umbilical ring (anulus umbilicalis)
Dictionary

Regional / topographic anatomy of the abdominal wall

Superficial fascia of the abdomen
fascia superficialis
Fundiform ligament of penis/clitoris
lig. fundiforme penis/clitoridis
Suspensory ligament of penis/clitoris
lig. suspensorium penis/clitoridis
Fascia of abdominal organ
fascia propria
Parietal abdominal fascia
fascia endoabdominalis
Transversalis fascia
fascia transversalis
Diaphragmatic fascia
fascia diaphragmatica
Iliac fascia
fascia iliaca
Quadratus lumborum fascia
fascia m. quadratus lumborum
Pelvic fascia
fascia pelvis
Median umbilical fold
plica umbilicalis mediana
Medial umbilical fold
plica umbilicalis medialis
Lateral umbilical fold
plica umbilicalis lateralis
Supravesical fossa
fossa supravesicalis
Medial inguinal fossa
fossa inguinalis medialis
Lateral inguinal fossa
fossa inguinalis lateralis
Rectus sheath
vagina m. recti abdominis
Inguinal ligament
lig. inguinale
Medial crus
crus mediale
Lateral crus
crus laterale
Reflected ligament
lig. reflexum
Lacunar ligament
lig. lacunare
Linea alba of the abdomen
linea alba
Umbilical ring
anulus umbilicalis
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