Teach or demonstrate the following: The four layers of the abdominal fascia



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Anatomy Block 5 Oral Quiz Review 03/02/2013

  • Teach or demonstrate the following:



  • 1.) The four layers of the abdominal fascia



  • 1. Superficial Fascia (Camper’s)=fatty, subcutaneous fascia

  • 2. Membranous fascia (Scarpa’s) = deeper membranous fat

  • 3. Deep Investing Fascia = ‘felt’ fascia that covers the abdominal muscles

  • 4. Endoabdominal Fascia = fascia of the transversalis muscle

  • Note: arcuate line differences





  • 2.) The four muscles of the abdominal wall



  1. Rectus abdominus

    1. Paired muscles that run vertically

      1. Origin – Pubis

      2. Insertion – Costal cartilages 5-7, xiphoid process

      3. Innervation – (T7-T12) segmental nerves

      4. Action – Flexion of the lumbar spine

  2. Transversus abdominus

    1. Muscle of the lateral & anterior abdomen

    2. Horizontal (transverse) fibers & deepest muscle layer

      1. Origins

        • Iliac crest

        • Inguinal ligament

        • Thoracolumbar fascia

        • Costal cartilages 7-12

      1. Insertions

      1. Innervation

        • Thoracoabdominal nn. (T6-T11)

        • Subcostal nerve (T12)

        • Iliohypogastric nerve (L1)

        • Ilioinguinal nerve (L1)

      1. Action – Compresses abdominal contents

  1. External oblique

    1. Largest, most superficial abdominal muscle

    2. ‘Hands in pockets’ fiber direction

      1. Origin – Ribs 5-12

      2. Insertions

        • Iliac crest

        • Pubic tubercle

        • Linea alba

      1. Innervation

        • Thoracoabdominal nn. (T7-T11)

        • Subcoastal nerve (T12)

      1. Action – contralateral rotation of the torso

  1. Internal oblique

    1. Rotate your ‘hands in pockets’ 90°

    2. Inferior layer to external oblique

      1. Origin

        • Inguinal ligament

        • Iliac crest

        • Thoracolumbar fascia

      1. Insertions

        • Linea alba

        • Pectin pubis (via conjoint tendon)

        • Ribs 10-12

      1. Innervation

        • Thoracoabdominal nn. (T6-T11)

        • Subcostal nerve (T12)

        • Iliohypogastric nerve (L1)

        • Ilioinguinal nerve (L1)

      1. Action



  • 3.) The organization of the neurovascular bundles in the abdominal wall and relate these structures to back, flank and anterior abdominal wall pain.



  • When considering pain of the lower back, flank, or anterior abdomen, one should know that the dermatomal map of the anterolateral abdomen is almost identical to the distribution of peripheral nerves. The spinal levels T7-T12 do not participate in plexus formation. The exception to this rule is at the L1 level (iliohypogastric & ilioinguinal). Here, the dermatome has two peripheral nerves and explains why a swift kick to Sam Sauce’s nuts will also elicit epigastric pain.



  • Between the internal oblique and transversus abdominis muscles is a neurovascular plane, which corresponds with a similar plane in the intercostal spaces.  In both regions, the plane lies between the middle and deepest layers of muscle.  The neurovascular plane of the anterior abdominal wall contains nerves and arteries supplying anterolateral abdominal wall.  In the anterior part of abdominal wall, nerves and vessels leave neurovascular plane and lie mostly in subcutaneous tissue (Moore’s 191).





  • This photo is sort of helpful and sort of hilarious.



  • 4.) Describe the four routes of the venous drainage of the anterior and posterior abdominal wall



  • 1. Superior epigastric vein & branches of musculophrenic vein

  • 2. Inferior epigastric vein & deep circumflex iliac vein

  • 3. Superficial circumflex iliac vein & superficial epigastric vein

    • to the femoral vein

  • 4. Posterior intercostal vein of 11th intercostal space & anterior branches of the subcostal veins

    • to the azygos/hemiazygos system



  • 5.) The five umbilical peritoneal folds


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