The document summarizes the anatomy of the anterior abdominal wall and inguinal canal. It describes the layers of the abdominal wall including skin, fascia, muscles and peritoneum. It details the origins, insertions and actions of the abdominal wall muscles. It also outlines the nerve and blood supply of the abdominal wall and inguinal region. Finally, it provides an overview of the inguinal canal including its boundaries and contents such as the spermatic cord.

1. ANATOMY OF ANTERIOR
ABDOMINAL WALL AND
INGUINAL CANAL
DR. JHARNAVERMA
Mch. PLASTIC SURGERY

2. ABDOMINAL CAVITY
Abdominal cavity forms the superior
and major part of the
abdominopelvic cavity.
Located between diaphragm and the
pelvic inlet.
Continous inferiorly with the pelvic
cavity.
Space surrounded by multilayered
abdominal walls.

3. SURFACE ANATOMY

5. ANTEROLATERAL ABDOMINAL
WALL
 Bounded superiorly by the cartilages of the 7th through 10th ribs and the xiphoid process of
the sternum.
 Inferiorly by the inguinal ligament and pelvic bones
 The wall consisits of
Skin
Superficial fascia
Fat
Muscles
Deep fascia
Endoabdominal fat
Parietal peritoneum

8. FASCIA OF ANTEROLATERAL
ABDOMINAL WALL
 Superficial Fascia
Fatty superficial layer (camper’s fascia)
Membranous deep layer (scarpa’s fascia)
 Deep Fascia
Extremely thin , being represented only by
the fibrous sheath of the most superficial muscles.
 Transversalis Fascia
Covers the deep surface of the
transversus abdominis and right and left sides of fascia are
continous deep to linea alba.

10. ANTEROLATERAL MUSCLES
Five Muscles
3 Flat muscles
• External Oblique
• Internal Oblique
• Transverse abdominis
2 Vertical muscles
• Rectus abdominis
• Pyramidalis

12. EXTERNAL OBLIQUE MUSCLE

14. INTERNAL OBLIQUE MUSCLE

16. TRANSVERSE ABDOMINAL MUSCLE

17. RECTUS ABDOMINIS AND
PYRAMIDALIS MUSCLE

18. RECTUS SHEATH
Section above arcuate line
Aponeurosis of
external oblique
muscle
Aponeurosis of
internal oblique muscle
Aponeurosis of
transversus
abdominis muscle
Anterior layer of
rectus sheath
Rectus
abdominis
muscle
Posterior layer
of rectus sheath Linea alba
Section below arcuate line
External
oblique muscle
Internal
oblique muscle
Transversus
abdominis muscle
Transversalis
fascia

19. MUSCLE ORIGIN INSERTION INNERVATION MAIN ACTION
External
Oblique
External surfaces of
5th-12th ribs
Linea alba , anterior half
of iliac crest
Lower six thoracic
spinal nerves (T7 to
T12)
Compress and
support abdominal
viscera,flex and
rotate trunk
Internal oblique Thoracolumbar fascia,
anterior two thirds of
iliac crest and lateral
half of inguinal
ligament
Inferior borders of 10-12th
ribs, linea alba and pectin
pubis by conjoint tendon
Lower six thoracic
spinal nerves (T7toT12)
and L1
Compress and
support abdominal
viscera,flex and
rotate trunk
Transverse
abdominal
Int.surfaces of 7th-12th
costal
cartilages,thoracolumb
ar fascia,iliac crest and
lateral third of inguinal
ligament
Aponeurosis ending in
linea alba,pubic crest and
pectineal line
Lower six thoracic
spinal nerves (T7toT12)
and L1
Compresses and
supports
abdominal viscera.

20. MUSCLE ORIGIN INSERTION INNERVATION MAIN ACTION
Rectus abdominis Pubic symphysis and
pubic crest
Xiphoid process and
5th-7th costal
cartilages
Thoracoabdominal
nerves (ventral rami of
inferior six thoracic
nerves)
Flexes trunk
(lumbar vertebrae)
and compresses
abdominal viscera
Pyramidalis Front of pubis and
pubic symphysis
Into linea alba Anterior ramus of T12 Tenses the linea
alba.

21. FUNCTIONS AND ACTIONS OF
ABDOMINAL MUSCLES
 Form a strong expandable support for the anterolateral abdominal
wall.
 Protect the abdominal viscera from injury.
 Compress the abdominal contents.
 Help to maintain or increase the intra-abdominal pressure and in so
doing ,oppose the diaphragm and produce expiration.
 Move the trunk and help to maintain posture.

22. NERVE SUPPLY

23. NERVES ORIGIN COURSE DISTRIBUTION
Thoracoabdominal (T7-
T11)
Continuation of lower
intercostal nerves
Run between 2nd and 3rd
layers of abdominal
muscles
Anterior abdominal
muscles and overlying skin
; periphery of diaphragm
Subcostal (T12) Ventral ramus of 12th
thoracic nerve
Runs along inferior border
of 12th rib
Lowest slip of external
oblique muscle and skin
over anterior superior iliac
spine and hip.
Iliohypogastric (L1) Chiefly from ventral ramus
of 1st lumbar nerve
Pierces transverse
abdominal muscle ;
branches pierce external
oblique ap.
Skin of hypogastric region
and over iliac crest;internal
oblique and transverse
abdominal.
Ilioinguinal (L1) Ventral ramus of 1st lumbar
nerve
Passes between 2nd and
3rd layers of abdominal
muscles and passes
through inguinal canal
Skin of scrotum or
labium majus,mons
pubis and adjacent
medial aspect of
thigh;internal oblique
and transverse
abdominal.

24. ARTERIAL SUPPLY

25. ARTERY ORIGIN COURSE DISTRIBUTION
Superior epigastric Internal thoracic artery Descends into rectus
sheath deep to rectus
abdominis
Rectus abdominis and
superior part of
anterolateral abdominal
wall
Inferior epigastric External iliac artery Runs superiorly and enters
rectus sheath, runs deep to
rectus abdominis
Rectus abdominis and
medial part of anterolateral
abdominal wall
Deep circumflex artery External iliac artery Runs on deep aspect of
anterior abdominal
wall,parallel to inguinal
ligament
Iliacus muscle and inferior
part of anterolateral
abdominal wall
Superficial circumflex iliac Femoral artery Runs in superficial fascia
along inguinal ligament
Subcutaneous tissue and
skin over inferior part of
anterolateral abdominal
wall
Superficial epigastric Femoral artery Runs in superficial fascia
toward umblicus
Subcutaneous tissue and
skin over suprapubic region

26. LYMPHATICS AND VENOUS SUPPLY

27. The skin and subcutaneous tissue of the abdominal wall are served
by subcutaneous venous plexus
• draining superiorly to the internal thoracic vein medially
• the lateral thoracic vein laterally and
• inferiorly to the superficial and inferior epigastric veins
Cutaneous veins surrounding the umbilicus anastomose with para-
umbilical veins.
A relatively direct lateral superficial anastomotic channel, the
thoraco -epigastric vein, may exist or develop between the
superficial epigastric vein and the lateral thoracic vein.

28. The deeper veins of the anterolateral abdominal wall accompany
the arteries, bearing the same name.
A deeper, medial venous anastomosis may exist or develop between
the inferior epigastric vein and the superior epigastric/internal
thoracic veins.
The superficial and deep anastomoses may afford collateral
circulation during blockage of either venacava.

29. LYMPHATIC DRAINAGE
Superficial lymphatic vessels accompany the
subcutaneous veins;
• Superior to the transumbilical plane drain mainly to the
axillary lymph nodes , a few drain to the parasternal
lymph nodes.
• Superficial lymphatic vessels inferior to the
transumbilical plane drain to the superficial inguinal
lymph nodes.

30.  Deep lymphatic vessels accompany the deep veins of the abdominal
wall and drain to the
• external iliac
• common iliac
• right and left lumbar (caval and aortic) lymph nodes.

32. Anatomy of inguinal region
 Superficial inguinal ring-
 triangular aperture in the aponeurosis
of the ext oblique muscle .
 Lies 1.25 cm above the pubic tubercle .
 Normally it doesn’t admit the tip of the
little finger.
 Deep inguinal ring –
 U shaped condensation of the fascia
trasversalis
 Lies 1.25cm above the mid inguinal point.

33. Inguinal canal
 Oblique passage in the lower part of the anterior
abdominal wall.
 Extends from deep inguinal ring to superficial inguinal
ring.
 Directed downwards forwards and medially
 About 4cm long

36. Boundaries
 Anterior – Ext. oblique aponeurosis & conjoined muscle
laterally.
 Posterior – Fascia transversalis & the conjoined
tendon.
 Superiorly – conjoined muscle.
 Inferiorly – inguinal ligament.

37. Contents
 Spermatic cord
 Ilioinguinal nerve
 Genital branch of genitofemoral nerve
 Females – Round ligament is present instead of
spermatic cord.
Spermatic cord constitutes- vas deferens, testicular & cremastic
arteries , pampiniform plexus of veins, lymphatics

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