ANTR 510 ABPP
Superior epigastric aa. - ✔️✔️-Arises from the internal thoracic artery (referred to as
the internal mammary artery in the accompanying diagram).
-Forms deep to the sixth intercostal space on each side and runs from the plane
superficial to the transversus thoracis muscle inferiorly to pass between the
diaphragmatic origins on the xiphoid process and costal margin respectively.
-It anastomoses with the inferior epigastric artery at the umbilicus
-Supplies the peripheral portion of the anterior diaphragm and superficial muscles of the
anterior abdominal wall
Parietal peritoneum - ✔️✔️A serous membrane lining located deep to the
extraperitoneal fat. In the anatomic position, the parietal peritoneum is deep to the
extraperitoneal fat and endoabdominal fascia layers of the posterior wall
. The parietal peritoneum is continuous with the visceral peritoneum of intraperitoneal
abdominal organs
Parietal peritoneum is richly innervated with somatic afferent neurons traveling back to
the CNS in the anterior primary rami of segmental spinal nerves. irritation & pain of the
parietal peritoneum is easily localizable because of these somatic afferent neurons
Fatty layer = Camper's Fascia - ✔️✔️1. predominantly adipose "fatty" layer
2. is sandwiched between dermis and
deep‐superficial fascia
3. continuous with mammary gland
4. crosses inguinal ligament to merge
with superficial fatty fascia of thigh
Membranous layer = Scarpa's
Fascia - ✔️✔️1. the "membranous" layer
2. thicker and stronger than superficial fatty fascia and can hold sutures
3. in midline is fused with linea alba
4. continuous in chest as deep layer of the superficial fascia
5. foreshadowing: fuses tightly to the deep fascia of the thigh
6. foreshadowing: continuous with superficial perineal fascia of the pelvis
Investing fascia - ✔️✔️Deep fascia
1. completely coats all of the skeletal muscles and their neurovascular
2. is extremely thin and delicate and difficult to separate from the muscle
3. NOTE: this is a separate layer distinct from the membranous superficial fascia but
because of old age and some pathologies, they may be adherent in the gross anatomy
lab donors
Abdominal skeletal muscle - ✔️✔️1. External abdominal oblique (EAO) -continuation of
external intercostal muscle; most superficial layer of anterolateral wall mm.
,2. Internal abdominal oblique (IAO) -continuation of internal intercostal muscle;
intermediate layer of anterolateral wall muscles
3. Transversus abdominis -deepest layer of anterolateral wall muscles
4. EAO, IAO, & Transversus abdominis mm insert via aponeuroses that interweave to
form rectus sheath and linea alba
Transversalis fascia - ✔️✔️Top of extraperitoneal fatty layer
(NOT Pinnable object)
Extraperitoneal fat - ✔️✔️Males, in general, will have more of this than females
1. Layer of loose connective tissue lying between the endoabdominal fascia and the
parietal peritoneum 2. Where we will find the structures that form the folds in lab
(median umbilical fold, medial umbilical folds, and lateral umbilical folds) 2. Anteriorly
much more prominent in males than females and much more prominent in obese males.
3. Continuous posteriorly in both male and females where it becomes abundant on the
posterior wall of the abdomen to provide support and protection to (retroperitoneal
structures) such as the kidneys, ureters, aorta and inferior vena cava
Hemidiaphragm (Left and right) - ✔️✔️
Caval foramen - ✔️✔️
Esophageal hiatus - ✔️✔️
Aortic hiatus - ✔️✔️
External abdominal oblique - ✔️✔️most superficial layer, continuation of external
intercostal muscles
"hands in pockets"
Unilateral (rotation of trunk)
Bilateral (flexion of trunk)
Insertion (linea alba and crest of ilium) Origin (costal cartilages of 512) Innervation
(ventral rami of T8L1 spinal nerves)
Functions (increases intraabdominal pressure, childbirth, respiration, antagonistic to
diaphragm,
straining, lifting, sit ups, defecation, urination, )
At right angle with IAO
Internal abdominal oblique - ✔️✔️2 layer,
continuation of internal intercostal muscles
-"hands on hips"
-Unilateral (rotation of trunk)
-Bilateral (flexion of trunk)
-Insertion (linea alba and crest of ilium)
,-Origin (costal cartilages of 710) Innervation (ventral rami of T8L1 spinal nerves)
Functions (increases intraabdominal pressure, childbirth, respiration, antagonistic to
diaphragm,
straining, lifting, sit ups, defecation, urination)
At right angle with EAO
Transversus abdominis - ✔️✔️Runs laterally
-long strap‐like muscles on each side of midline that span between the rib cage and
pubic symphysis; sheathed by the aponeuroses of EAO, IAO, and this to form the rectus
sheath and the linea alba Insertion (pubis, linea alba, sternum, xiphoid process)
-Origin (crest of ilium, inguinal ligament, thoracolumbar fascia, costal cartilage)
Innervation (ventral rami of T8L1 spinal nerves)
Functions (increases intraabdominal pressure, childbirth, respiration, straining,
defecation, urination)
Rectus abdominis - ✔️✔️Runs vertically
Commonly known as "six packs" Insertion (sternum, xiphoid process, costal cartilage
57)
Origin (pubis)
Innervation (ventral rami of T112 spinal nerves)
Functions (increases intraabdominal pressure, childbirth, respiration, antagonistic to
diaphragm,
straining, defecation, urination, flex vertebral column about lumbar vertebra)
INGUINAL LIGAMENT -(ALSO WRITTEN AS POUPART'S LIGAMENT)
1. Ligament spans from the ASIS of the ilium to the pubic tubercle of the pubis.
2. This ligament is not a true "ligament" but rather a fibrous band formed by the thick
inferior border or lower margin of the aponeurosis of the EAO muscle as it folds
posteriorly to form a shallow trough - ✔️✔️What is the anatomical relationship of the
inguinal ligament to the external abdominal oblique muscle?
Anterior rectus sheath - ✔️✔️-Anterior fibrous covering of rectus abdominis muscle
-Formed by aponeuroses (flat tendons) of external and
-internal abdominal oblique muscles
Posterior rectus sheath - ✔️✔️Posterior fibrous covering of rectus abdominis muscle
Formed by aponeuroses (flat tendons) of external and transversus abdominis muscles
Arcuate line - ✔️✔️This occurs about 1/3 of the distance from the umbilicus to the
pubic crest
-Marks where the rectus abdominis changes where it is running in rectus sheath
-Where the inferior epigastric vessels perforate the rectus abdominis
-Superior to arcuate line: rectus abdominis runs w/in the aponeurosis of the internal
abdominal oblique, the aponeurosis surrounds it
-Inferior to arcuate line: rectus abdominis runs posterior to transversus abdominis and
anterior to the transversalis fascia
, -Inferior to the arcuate line, the rectus abdominis rests directly on the transversalis
fascia
Semilunar line - ✔️✔️Curved line along the lateral border of the rectus abdominis
Line about midclavicular which is where the external/internal abdominal oblique &
transversus abdominis muscles become aponeuroses, and where the rectus abdominis
is most lateral
Linea alba - ✔️✔️Tendinous raphe (or seam) where the abdominal wall muscle
aponeurosis come together midline from xiphoid process to pubic symphysis, EAO,
IAO, & Transversus abdominis mm insert via aponeuroses that interweave to form
rectus sheath and linea alba
No neurovasculature runs across it, so it is safe to cut (opening the abdomen through
the linea alba avoids cutting through muscle fibers and nerves) Umbilicus is located in
linea alba
-Superior to arcuate line
○ Skin, Campers fascia (fatty superficial fascia), Scarpa's fascia (membranous
superficial fascia),
investing fascia, external abdominal oblique, investing fascia (x2), internal abdominal
oblique, investing fascia (x2), rectus abdominis (w/in aponeurosis of internal abdominal
oblique), investing fascia (x2), transversus abdominis, investing fascia, transversalis
fascia (endoabdominal fascia), extraperitoneal fat, parietal peritoneum - ✔️✔️List in
order the layers pierced by a knife entering an inch inferior to the costal margin along
the midclavicular plane.
Inferior to arcuate line
○ Skin, Campers fascia (fatty superficial fascia), Scarpa's fascia (membranous
superficial fascia),
investing fascia, external abdominal oblique, investing fascia (x2), internal abdominal
oblique, investing fascia (x2), transversus abdominis, investing fascia (x2), rectus
abdominis, investing fascia, transversalis fascia (endoabdominal fascia), extraperitoneal
fat, parietal peritoneum - ✔️✔️List in order the layers pierced by a knife entering an
inch lateral to the umbilicus along the supracristal plane.
Inferior epigastric aa. - ✔️✔️-Lateral umbilical fold contains this
-Arises from the external iliac artery
-The vas deferens , as it leaves the spermatic cord in the male, and the round ligament
of the uterus in the female, winds around the lateral and posterior aspects of the artery
Inguinal triangle (Hesselbach's
Triangle) - ✔️✔️located between the medial and lateral umbilical folds
[1] medial = semilunar line or lateral border of the rectus muscle
[2] lateral = inferior epigastric vessels
[3] inferior = inguinal ligament
