Faculty of

Medicine

Academic Year: 2024-2025

Year: 1 Semester:1
Module: gastrointestinal(gis) 107
Anterior abdominal wall

By: Dr. Eman Ramadan

Assistant Prof of Anatomy & Embryology
faculty of medicine - Zagazig university

Department: Anatomy & Embryology

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 Objectives

• By the end of this session , the student must be able to:

1-Identify the arrangement of the Ant. Abdominal wall and
arrangement of its muscles
2-Identify the formation of Rectus Sheath and enumerate its
contents
3-Identify the action of the abdominal muscles
4-Identify Inguinal canal and Inguinal Hernia

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Ant. Abdominal Wall

5/28/2025 LCS - 105 4

Anterior abdominal wall
Layers of anterior abdominal
wall:
1.Skin. Muscles

2.Superficial fascia:
a.Superficial fatty layer.
b.Deep membranous
layer. Fascia
transversalis
3.Muscles.
4.Fascia transversalis. Extraperitoneal
fatty tissue
5.Extraperitoneal fatty
tissue.
6.Parietal peritoneum.
Parietal peritoneum over
the intestine
Muscles of anterior
abdominal wall
These are divided into two groups:
a) Muscles of the anterolateral part
of the anterior abdominal wall:
1. External abdominal oblique.
2. Internal abdominal oblique.
3. Transverses abdominis.
b) Muscles of the medial part of the
anterior abdominal wall:
1. Rectus abdominis.
2. Pyramidalis.
Ext. abd. oblique Internal abdominal oblique Transverses abdominis
External Oblique Muscle

Origin

Fleshy digitations
from the lower 8 ribs
External Oblique Muscle
Xiphoid
The muscle is inserted by fleshy fibers Process
as well as aponeurosis, as follows:

A- Fleshy fibers:
Outer lip of the iliac crest

B- Aponeurosis:
1. Medial part → linea alba from xiphoid
process to symphysis pubis
2. Lateral part → folded upwards & backwards
upon itself to form the inguinal ligament
(ASIS → pubic tubercle)
Symphysis
Pubis
External Oblique Muscle

Direction of fibers
Downward
Forwards
Medially
External Oblique Muscle

Nerve Supply

Intercostal nerves (T7 -T11) &

Subcostal nerve (T12)
Ext. abd. oblique
 ASIS
Inguinal ligament:
• Def: The aponeurosis of the
external abdominal oblique
between pubic tubercle and the
anterior superior iliac spine
(ASIS) is free (has no
Pubic tubercle
attachment) and is folded
upwards and backwards on itself
to form the inguinal ligament.
Superficial inguinal ring:
• It is a  opening in the aponeurosis of
external abdominal oblique muscle.
• Site: It lies immediately above & lateral
to the pubic tubercle.
• Shape: It has an apex, base & 2 crura;
med. & lat.. Superficial inguinal ring
-Apex: directed supero-laterally.
-Base: formed by pubic crest
 Internal Oblique Muscle
Origin
1. The lateral 2/3 of the inguinal
ligament
2. Anterior 2/3 of the intermediate
line of the iliac crest
3. Lumbar fascia

Insertion

1. Lower 6 costal
cartilages
2. Xiphoid process
3. Linea Alba
4. Pubic crest
Internal Oblique Muscle
Direction of fibers
Upwards
Forwards
Medially
Nerve Supply
T7-T12
Iliohypogastric n.
Ilioinguinal n.
Internal abdominal oblique
Transversus Abdominis Muscle
Origin
1.The lateral 1/3 of the
inguinal ligament
2.Anterior 2/3 of the
inner lip of the iliac
crest
3.Lumbar fascia
4.Lower 6 intercostal
cartilages
Transversus Abdominis Muscle
Insertion
1.Xiphoid Process
2.Linea Alba
3.Pubic Crest
Transversus Abdominis Muscle
Direction of fibers
Horizontally
 Transversus Abdominis Muscle
Nerve Supply

T7-T12
Iliohypogastric n.
Ilioinguinal n.
Transverses abdominis
Rectus Abdominis
Muscle
Insertion
7th, 6th, 5th costal cartilages
Xiphoid process

Origin
From the pubic crest
 Rectus Abdominis
Muscle

The muscle is divided into segments

by tendinous intersections, Which
indicate that the muscle arises from a
number of myotomes, fused together
 Pyramidalis
Muscle

It is a landmark of linea
alba intraoperative
• Mid-inguinal point: It is a point on the inguinal ligament midway between the symphysis pubis & the
ASIS. The femoral a. passes deep to this point.
• Mid- point of the inguinal lig.: It is a point on the inguinal lig. midway between the pubic tubercle &
ASIS.
It lies ½ inch lat. to the mid-inguinal point.
 Fascia transversalis
Deep inguinal ring
Deep inguinal ring
• A rounded opening in the fascia transversalis
lying ½ inch above mid-inguinal point.
• The margins of ring extend around the
spermatic cord to form a covering for it called
internal spermatic fascia.
• It has very important relations:
The external iliac a. descends behind fascia
transversalis.
:
Just below the ring the ext. iliac
a. gives 2 branches.
a) Inferior epigastric a. ascends upwards &
medially behind fascia transversalis to
enter the rectus sheath. Just after its origin
it gives a small but important branch called
Inf. epigastric a.
cremasteric a. which re-enters the ring to
continue into inguinal canal.
b) Deep circumflex iliac a. ascends upwards
& laterally up to ASIS. Ext. iliac a.
 The rectus sheath
Definition: the envelope which surrounds
the rectus abdominis muscle. 1st part of sheath
Formation & division:
o formed by aponeurosis of the 3 muscles
of the lateral abdominal wall. 1st line
oThe sheath is divided by 2 lines into 3
parts. 2nd part of sheath
 The 1st : at the level of costal margin.
 The 2nd :midway between the umbilicus 2nd line
and symphysis pubis.
3rd part of sheath

o The parts of the sheath are 3 ; part above the 1

st

line, part between the two lines & the 3rd below the
2nd line.
 Ant.
First part:
a. Ant.: aponeurosis of ext. abdominal oblique (EO).
b. Posteriorly: 5th, 6th, and 7th costal cartilages.

Second part: it lies between the two lines:

a. Ant.: aponeurosis of the Ext. abdominal oblique Ant.
(EO) and the ant. lamellae of the aponeurosis of int.
abdominal oblique muscle (IO).
b. Post.: the post. lamellae of the aponeurosis of int.
abdominal oblique muscle (IO), and transverses
abdominis muscle (TA) and the fascia transversalis.

Third part: it lies below the second line: Ant.

a. Ant.: the aponeurosis of external abdominal
oblique (EO) , internal abdominal oblique (IO) and
the transverses abdominis (TA) .
b. Post.: the post. wall of the sheath is deficient and is
formed by the fascia transversalis only. It ends in a
curved line concave downwards called arcuate
line. Horizontal sections of the abdominal wall
at each part of rectus sheath
 Above Arcuate Line Rectus Sheath
External Oblique

Ant. Layer of Rectus Sheath

Internal Oblique

Transversus Abdominis Rectus Abdominis

SKIN

Falciform Ligament Peritoneum

Transverslais Fascia
Post. Layer of Rectus Sheath
 Below Arcuate Line Rectus Sheath
External Oblique

Ant. Layer of Rectus Sheath

Internal Oblique

Transversus Abdominis Rectus Abdominis

SKIN

Transverslais Fascia
Peritoneum
Urachus in Median Umbilical Fold

Medial Umbilical Ligament

TA
IO
EO

Post. Wall of
rectus sheath

Arcuate line
Superficial
inguinal ring

Fascia
transversalis

Lower part of rectus sheath with inguinal lig. & On the right side: the ant. wall of Rectus sheath is removed
superficial inguinal ring On the left side the rectus muscles is removed illustrating
Contents of the rectus sheath:
 2 muscles: Rectus abdominis and Pyramidalis.
 2 vessels: Sup. epigastric vessels & Inf. epigastric vessels.
 2 groups of Nerves: Lower 5 intercostal & subcostal Sup.
nerves & vessels. Epigastric a.
7th
Rectus abdominis
8th
Inf.
Epigastric a.
9th
10th

11th

12th Pyramidalis
Pyramidalis muscle
• This is a small  muscle, present infront of Nerve Supply: subcostal nerve (T12).
the lower part of rectus abdominis muscle.
• It may be absent. Linea alba

Insertion: into the lower

part of linea alba.

Origin: from the front of the symphysis pubis and

the pubic crest.

Linea alba is diagrammatically drawn without muscles

Actions of the muscles of ant. abdominal
wall:
1. By their tone they support and protect the
abdominal organs and viscera.
2. They assist the diaphragm during
inspiration as they relax during contraction
of the diaphragm to enhance its descent.
3. They increase the intra-abdominal
pressure to help in expiratory acts as
sneezing, coughing, micturition, defecation,
vomiting, and parturition.
4. The oblique muscles flex the trunk
laterally.
5. The rectus abdominis flexes the trunk
forwards and stabilizes the pelvis
6. The pyramidalis muscle tightens the linea
alba.
 References

• Gray’s Anatomy. The anatomical basis of clinical practice.40th edition.

• Snell’s clinical anatomy by regions, 10 th edition.
• Netter atlas of human anatomy, atlas of human anatomy 6th edition.
• Last’s anatomy: regional and applied 12th edition.

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