Abdominal wall

Muhammad Rashid
muhammad.rashid@rmi.edu.pk
Major Components

There are some major components of abdominal wall are:

• Skin
• Muscles
• Nerve supply
• Blood Supply
skin

• The skin is loosely attached to the underlying structures except at the umbilicus, where it is
tethered (tie (like an animal with a rope or chain so) as to restrict its movement) to the scar
tissue.
• The natural lines of cleavage in the skin are constant and run downward and forward almost
horizontally around the trunk.
• The umbilicus is a scar representing the site of attachment of the umbilical cord in the fetus; it
is situated in the linea alba.
Skin fascia

• Skin fascia is divided into two fascia

1. Superficial Fascia
2. Deep fascia

The superficial fascia is divided into

• superficial fatty layer (fascia of Camper)
• deep membranous layer (Scarpa’s fascia)
Deep fascia
fascia in the anterior abdominal wall is merely a
thin layer of connective tissue covering the muscles;
it lies immediately deep to the membranous layer of superficial fascia.
Nerve Supply

• The cutaneous nerve supply to the anterior abdominal wall

• intercostal and the subcostal nerves
• iliohypogastric and the
• ilioinguinal nerves
Arterial supply

• The skin near the midline is supplied by branches of the superior and inferior epigastric
arteries
• The skin of the flanks is supplied by branches of the intercostal, lumbar, and deep circumflex
iliac arteries
• the skin in the inguinal region is supplied by the superficial epigastric, the superficial
circumflex iliac, and the superficial external pudendal arteries, branches of the femoral artery.
Venous supply

• The venous drainage passes above mainly Into the lateral thoracic vein and below into the
femoral vein via the superficial epigastric and the great saphenous veins.
Muscles of the anterior abdominal wall

• The muscles of the anterior abdominal wall consist of three broad thin sheets that are
aponeurotic.( A sheet like fibrous membrane, resembling a flattened tendon, that serves as a
fascia to bind muscles together)
• In front; from exterior to interior they are the external oblique, internal oblique, and
transversus.
• On either side of the midline anteriorly is a wide vertical muscle, the rectus abdominis.
• They enclose the rectus abdominis to form the rectus sheath.
• The lower part of the rectus sheath might contain a small muscle called the pyramidalis.
External oblique

Nerve supply
• Lower six thoracic nerves and iliohypogastric and ilioinguinal nerves (L1)
Action
• Supports abdominal contents; compresses abdominal contents; assists in flexing and rotation
of trunk; assists in forced expiration, micturition, defecation and vomiting.
External oblique muscle
Internal oblique

Nerve supply
• Lower six thoracic nerves and iliohypogastric and ilioinguinal nerves (L1)
Action
• Supports abdominal contents; compresses abdominal contents; assists in flexing and rotation
of trunk; assists in forced expiration, micturition, defecation and vomiting.
Transversus

• Nerve supply
Lower six thoracic nerves and iliohypogastric and ilioinguinal nerves (L1)
Action
• Compresses abdominal contents
Rectus abdominis

• Nerve supply
Lower six thoracic nerves
• Action
Compresses abdominal contents and
flexes vertebral column; accessory muscle
of expiration
Pyramidalis

• Nerve supply
12th thoracic nerve
• Action
Tenses the linea alba