Anatomy Of Anterior

Abdominal Wall
Sajan Skaria
Assistant Professor, Anatomy
AIIMS Udaipur
Boundaries
Posterior Abdominal Wall
Quadrants of Abdomen
Layers of Anterior Abdominal Wall
 Cleavage lines
(Langer’s line)
 Linea gravidarum

• Gravid - Gravis (L) – heavy

• Gravid uterus
Umbilicus / Ompholos
1.Position :
2.Anatomical significance:
3.Embryological significance
Meckel’s diverticulum

▪ Faecal fistula
▪ Urinary fistula
▪ Examphalos
Examphalos
Superficial fascia -Camper’s Fascia(fatty layer)
Superficial fascia - Scarpa’s Fascia( membranous layer)

Holden’s line Colle’s fascia

Buck’s fascia
 Holden’s line &
extravasation of urine
Neurovascular structure
Cutaneous veins & lymph vessels Caput Medusae
Muscles of Anterior Abdominal Wall
Anterolateral muscles-External oblique, Internal oblique.
Transversus abdominis.
Vertical muscles- Rectus abdominis. Pyramidalis
Rectus abdominis
Linea alba

A wider, supraumbilical part

A thinner, infraumbilical part.
 Structures derived from flat muscles’

Inguinal ligament
 Structures derived from flat muscles’

Conjoint tendon
 Structures derived from flat muscles’

Cremaster muscle

Cremasteric reflex
Rectus sheath
Rectus sheath
 Formation of rectus sheath

❑ Above the level of costal

margin

❑ Between costal margin and

arcuate line

❑ Below the level of arcuate line

Formation of
rectus sheath
Neurovscular structure
of
anterior abdominal wall
Divarication of Recti
Epigastric hernia
Haematoma of rectus
sheath
 Anatomical basis of Surgical
incisions on Anterior Abdominal Wall

❑Vertical incisions

❑Transverse incisions
Vertical incisions- Median

Anatomical basis

Midline incisions in the anterior

abdominal wall are easily performed above
the umbilicus.

❑ Advantages- bloodless area, no muscles

cut
❑ Disadvantages- poor healing, incisional
hernia
Vertical
incisions-Paramedian
Transverse incisions / Pfannenstiel’s incision
Oblique incisions - Grid iron incision

Mc- Burney’s incision

Incisional hernia
Kocher’s incision/ Right subcostal incision