2. Ant. Abdominal Wall extends from:
• The Costal Margins And Xiphoid Process
Superiorly
• To The Iliac Crests, Pubis And Pubic Symphysis
Inferiorly.
• It Overlaps And Is Connected To Both The
Posterior Abdominal Wall And Paravertebral
Tissues.
By: Dr. Somaya Banaei 2
5. The anterior abdominal wall is made up of
I. Skin
II. Superficial fascia
III. Deep fascia
IV. Muscles
V. Extra peritoneal fascia
VI. Parietal peritoneum.
By: Dr. Somaya Banaei 5
6. Skin
Loosely attached to the underlying structures
except at the umbilicus Where it is tethered to the
scar tissue.
The umbilicus is a scar representing the site of
attachment of the Umbilical cord in the fetus; it is
situated in the linea alba and is a Common site of
infections
By: Dr. Somaya Banaei 6
7. Lines Of Cleavage
Or
Langer’s Line
The natural lines of cleavage in the skin are constant and run
Downward and forward almost horizontally around the trunk.
If possible, all surgical incisions should be made in the lines of
cleavage, Where the bundles of collagen fibers in the dermis
run in parallel rows.
An incision along a cleavage line will heal as a narrow scar.
By: Dr. Somaya Banaei 7
14. By: Dr. Somaya Banaei 14
Rectus muscle`
Hesselbach Triangle
15. Muscles of the
Anterior Abdominal Wall
The muscles of the anterior abdominal
wall consist of three broad thin sheets
that are aponeurotic in front; from
exterior to interior.
they are :
• THE EXTERNAL OBLIQUE
• THE INTERNAL OBLIQUE
• THE TRANSVERSUS ABDOMINIS
• On either side of the midline anteriorly
is, in addition, a wide vertical muscle, THE
RECTUS ABDOMINIS
By: Dr. Somaya Banaei 15
17. External oblique
It originates from the external surface and inferior
borders of the LOWER EIGHT RIBS.
The fibers from the lowest ribs pass downwards
and insert into the anterior half of the ILIAC
CREST whereas the middle and upper fibers,
directed inferiorly and anteriorly, insert into
XIPHOID PROCESS
LINEA ALBA
PUBIC CREST
PUBIC TUBERCLE.
By: Dr. Somaya Banaei 17
19. Internal Oblique
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• This muscle is also a broad thin muscle that lies
deep to the external oblique muscle.
• The muscle fibers run perpendicular to the external
oblique, beginning at the Thoracolumbar Fascia,
the Anterior 2/3 Of The Iliac Crest and the 2/3
lateral of the Inguinal Ligament. The muscles fibers
run from these points supero to the muscle’s
insertions on
The Inferior Border Of The 10th Through 12th Ribs
And The Linea Alba.
20. By: Dr. Somaya Banaei 20
Cremaster Muscle
Conjoint Tendonis A Structure Formed From The Lower
Part Of The Common Aponeurosis Of The Internal
Oblique Muscle And The Transversus Abdominis As It
Inserts Into The Crest Of The Pubis And Pectineal
Line Immediately Behind The Superficial Inguinal Ring.
Conjoint Tendon
21. Transverses Abdominis
By: Dr. Somaya Banaei 21
. It is a thin sheet of muscle whose fibers run horizontally
anteriorly. It arises as fleshy fibers from the Deep
Surface Of The Lower Six Costal Cartilages, the lumbar
fascia, the anterior two-thirds of the iliac crest and the
lateral third of the inguinal ligament.It inserts into
Xiphoid Process
Linea Alba
Symphysis Pubis.
The lowest tendinous fibers join similar fibers from the
interior obliques to form the conjoint tendon which is fixed
to the pubic crest and the pectineal line
22. Rectus
Each rectus abdominis is divided into three muscle
bellies divided by three tendinous inscriptions
one at the level of the xiphoid process,
one at the umbilicus
and one halfway between the two.
It arises from
Symphysis Pubis and Pubic crest
By: Dr. Somaya Banaei 22
And inserts into
5,6,7 Costal Cartilage
Xiphoid Process
Lineaseminularis
23. Muscle Pyramidalis
By: Dr. Somaya Banaei 23
The lower part of the rectus sheath
contains a small muscle called the
Pyramidalis.
24. Rectus Sheath
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• The Rectus Sheath, Also Called The Rectus
Fascia, Is Formed By The Aponeuroses Of
The Transvers Abdominal And The Internal
And External Oblique Muscles.
• It Contains The Rectus
Abdominis And Pyramidalis Muscles.
28. • is a fibrous structure that runs down the
midline of the abdomen.
• A connection point for most of the
abdominal muscles and runs from the
xiphoid process to the pubic symphysis.
Know for separating the right from left
rectus abdominis, also called the “6 Pack”.
• The linea alba is a common surgical
approach for us, we call the
“median incision”.
Lina Alba
By: Dr. Somaya Banaei 28
29. Often referred to as a PREGNANCY LINE,
is a linear hyperpigmentation that commonly
appears on the abdomen.
For pregnant women, linea nigra is attributed
to increased melanocyte-stimulating
hormone made by the placenta.
.
Linea Nigra
By: Dr. Somaya Banaei 29
30. Umbilical Region
• The microflora of the umbilicus contained a
large number of resident
• Following antiseptic skin preparation, bacteria
could still be cultured from 24.7% of the
patients' umbilici.
• In case of postoperative SSI, only 1/7 SSI
was caused by the micro organism that was
present in the umbilicus before and after
skin preparation.
• Antiseptic skin preparation fails to completely
eradicate the microflora of the umbilical
region in one quarter of the patients.
By: Dr. Somaya Banaei 30
Staphylococcus
Corynebacterium
Streptococcus
Pseudomonas
