Anatomy of the anterolateral abdominal wall

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Anatomy of the anterolateral abdominal wall

Figure 1: Muscles of the anterolateral abdominal wall A. Superficial B. Deeper dissection.
Figure 2: Layers of the anterolateral abdominal wall.
Figure 3: Rectus sheath. A. Sagittal view. B. Posterior view of anterior abdominal wall. Transverse sections superior (C) and inferior (D) to the arcuate line showing the structure of the rectus sheath. 
Figure 4: Posterior view of the anterolateral abdominal wall showing the umbilical peritoneal folds.
Figure 5: Arterial supply to the anterolateral abdominal wall.
Figure 6: Superficial veins of the anterolateral abdominal wall.
Figure 7: Deep veins of the anterolateral abdominal wall.
Figure 8: Dermatomes and nerves of the anterolateral abdominal wall.
Figure 9: Superficial (A.) and deep (B.) lymphatic drainage of the anterolateral abdominal wall. 
MUSCLE TABLE
Muscle
Origin
Insertion
Innervation
Action
External oblique
  • External surfaces of 5th-12th ribs

  • Linea alba
  • Pubic tubercle
  • Anterior half of iliac crest
  • Thoracoabdominal nerves (anterior rami of T7–T11 spinal nerves)
  • Subcostal nerve
  • Compresses and supports abdominal viscera
  • Flexes and rotates trunk
Internal oblique
  • Thoracolumbar fascia
  • Anterior two thirds of iliac crest
  • Connective tissue deep to lateral third of inguinal ligament
  • Inferior borders of 10th–12th ribs
  • Linea alba
  • Pecten pubis via conjoint tendon
  • Thoracoabdominal nerves
  • Subcostal nerve
  • First lumbar nerves
Transversus abdominis
  • Internal surfaces of 7th–12th costal cartilages
  • Thoracolumbar fascia
  • Iliac crest
  • Connective tissue deep to lateral third of inguinal ligament

  • Linea alba with aponeurosis of internal oblique
  • Pubic crest
  • Pecten pubis via conjoint tendon
  • Compresses and supports abdominal viscera
Rectus abdominis
  • Pubic symphysis
  • Pubic crest
  • Xiphoid process
  • 5th–7th costal cartilages
  • Thoracoabdominal nerves
  • Subcostal nerve

  • Flexes trunk
  • Compresses abdominal viscera 
  • Stabilizes tilt of pelvis

Pyramidalis
  • Anterior surface of pubis
  • Linea alba
Variable:
  • Subcostal nerve
  • Iliohypogastric nerve
  • Tenses linea alba
UNLABELLED

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The abdominal wall is subdivided into the anterior wall, the right and left lateral walls, and the posterior wall. These walls are musculoaponeurotic, meaning they are composed of muscles and fascial layers, except for the posterior wall which is also made up by the lumbar vertebral column. This musculoaponeurotic wall functions to enclose and protect the abdominal viscera, stabilize and contribute to movements of the trunk, and also increase the intra-abdominal pressure which is needed during urination, defecation, vomiting, and assisting in childbirth.

Now, the anterior and lateral abdominal walls are collectively known as the anterolateral abdominal wall, mainly because the boundary between the two is not distinct. So the anterolateral abdominal wall extends from the thoracic cage down to the pelvis. More specifically, it’s bounded superiorly by the cartilages of the seventh through tenth ribs as well as the xiphoid process, and inferiorly by the inguinal ligament and superior margins of the anterolateral aspects of the pelvic girdle

The anterolateral wall is composed of many different layers. There’s 12 of them in total. The most superficial layer is the skin, which covers a superficial fatty layer of subcutaneous tissue, or fat, known as Camper fascia, which is a major site of fat storage. Deep to the Camper fascia, there is a membranous layer of subcutaneous tissue known as Scarpa fascia, which is continuous inferiorly with the superficial perineal fascia, or Colles fascia. And deep to the superficial fascial layers, there are 3 muscle layers, each covered in a layer of a deep fascia - so 6 layers in total. So right after Scarpa fascia, there’s the superficial investing fascia, followed by the most superficial muscular layer: the external oblique muscle. Then comes the intermediate investing fascia and the internal oblique muscle. And finally, there are the deep investing fascia and the transversus abdominis muscle.
Deep to the transversus abdominis is the transversalis fascia. And finally, for our two deepest layers, there is a thin layer of extraperitoneal fat which is just above the parietal peritoneum, which is the deepest layer of the abdominal wall and lines the abdominal cavity.

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