Layer of anterior abdominal wall:

A- Lateral:
1- Skin.
2- Subcutaneous tissue.
3- External oblique muscle.
4- Internal oblique muscle.
5- Transversus abdominis muscle.
6- Fascia transversalis.
7- Peritoneum.

B- Medial:
1- Skin.
2- Superficial fascia.
3- Anterior wall of rectus sheath.
4- Rectus muscle.
5- Posterior wall of rectus sheath.
6- Peritoneum.
1- Skin
A- Lateral
2- Subcutaneous tissue
A- Lateral
3- External Oblique m.
A- Lateral
4- Internal Oblique m.
A- Lateral
5- Transversus abdominis m.
A- Lateral
6- Fascia Transversalis m
A- Lateral
7- Peritoneum
A- Lateral
Layer of anterior abdominal wall:
B- Medial:
1- Skin.
2- Superficial fascia.
3- Anterior wall of rectus sheath.
4- Rectus muscle.
5- Posterior wall of rectus sheath.
6- Peritoneum.
1- Skin
B- Medial
2- Subcutaneous tissue
B- Medial
3- Ant. Wall of Rectus
sheath
B- Medial
4- Rectus Muscle
B- Medial
B- Medial
5- Post. Wall of Rectus
sheath
B- Medial
6- Peritoneum
External Oblique Muscle
Origin
Fleshy digitations
from the lower 8 ribs
External Oblique Muscle
The muscle is inserted by fleshy fibers 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)
Insertion

Xiphoid
Process
Symphysis
Pubis
External Oblique Muscle
Direction of fibers
Downward
Forwards
Medially
External Oblique Muscle
Nerve Supply
Intercostal nerves (T
7
-T
11
) &
Subcostal nerve (T
12
)
Internal Oblique Muscle
Origin
Insertion
1. Anterior 2/3 of the intermediate line of the iliac crest
2. The lateral 2/3 of the inguinal ligament
3. Lumbar fascia
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
T
7
-T
12
Iliohypogastric n.
Ilioinguinal n.
Transversus Abdominis Muscle
Origin
1- Lower 6 intercostal cartilages
2- Lumbar Fascia
3- Ant. 2/3 of inner lip of iliac crest
4- Lat. 1/3 of inguinal ligament
Transversus Abdominis Muscle
Insertion
1- Xiphoid Process
2- Pubic Crest
3- Linea Alba
Direction of fibers
Transversus Abdominis Muscle
Horizontally
Nerve Supply
Transversus Abdominis Muscle
T
7
-T
12
Iliohypogastric n.
Ilioinguinal n.
Rectus Abdominis
Muscle
Origin
From the pubic crest
Insertion
7th, 6th, 5th costal cartilages
Xiphoid process
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
1- Segmental nerve supply.
2- Hematoma of rectus m. is localized
2- In paramedian incision displace m.
laterally (n. supply comes from lateral)
Surgical Importance
Pyramidalis
Muscle
It is a landmark of linea
alba intraoperative
Actions of Anterior Abdominal
Wall Muscles
They assist in raising the intra-bdominal pressure (so,
they help in vomiting, cough, delivery, etc.)
Keep the abdominal viscera in position.
Rectus abdominis flexes the trunk, while the 2 oblique
muscles bend the trunk laterally.
Act as accessory expiratory muscles.
Lower midline & paramedian incisions.

Medially
Laterally
Rectus Sheath
Linea Alba
Linea Semilunaris
Arcuate Line
Rectus Sheath
Falciform Ligament
External Oblique
Internal Oblique
Transversus Abdominis
Ant. Layer of Rectus Sheath
Post. Layer of Rectus Sheath
Rectus Abdominis
Above Arcuate Line
SKIN
Peritoneum
Transverslais Fascia
Rectus Sheath
External Oblique
Internal Oblique
Transversus Abdominis
Ant. Layer of Rectus Sheath
Rectus Abdominis
Below Arcuate Line
Urachus in Median Umbilical Fold
Medial Umbilical Ligament
Transverslais Fascia
SKIN
Peritoneum
Superior epigastric a.
Subcostal a.
Inferior epigastric a.
Deep circumflex iliac a.
- I -
Internal Mammary a.
- III -
External Iliac a.
- II -
Descending Aorta
10
th
, 11
th
intercostal a.