Abdominal wall


Fig. 1. The abdomen (scheme): 1 - left Podnebesnaya; 2 - the left side; 3 - left iliac; 4 - suprapubic; 5 - right ilio-inguinal; 6 - umbilical; 7 - right side; 8 - actually epigastric; 9 - right podreberie. Fig. 2. The abdominal muscles: 1 - front wall of the vagina rectus; 2 - the rectus abdominis; 3 - tendon jumper; 4 - internal oblique muscle of the abdomen; 5 - external oblique muscle of the abdomen; b - pyramid muscle; 7 - cross fascia; 8 - curved line; 9 - moon line; 10 - transverse muscle of the abdomen; 11 - white line of the abdomen.
The abdominal wall is divided into front-side and rear sections. Antero-lateral Department is limited from above costal arch, bottom - mahovymi folds on the sides - the average axillary line. Two horizontal lines drawn through the bottom point of the tenth rib and front top iliac spine, this Department of the abdominal wall is divided into three areas: epigastric, celiac and hypogastric. Each of these areas in turn is divided into two vertical lines, corresponding to the outer edges of recti, on three areas (Fig. 1).
Anatomically Antero-lateral abdominal wall consists of three layers. The surface layer includes the skin, subcutaneous tissue and superficial fascia. Average, muscle layer in the medial part consists of direct and pyramid of the abdominal muscles, lateral - two slashes (external and internal) and transverse muscles (Fig. 2). These muscles together with the chest-abdominal obstruction, pelvic diaphragm and the muscles of the posterior abdominal wall form abdominal press, whose main function is to keep the organs of the abdomen in a certain position. In addition, the contraction of the abdominal muscles provides the acts of urination, defecation, childbirth; these muscles involved in breathing, vomiting movements etc. Oblique and transverse abdominal muscles front moving in the aponeurosis, which form the vagina rectus and connecting on the middle line, white line of the abdomen. Place of transition muscle bundles transverse muscle tendon is bulging outwards line, called the moon. The back wall of the vagina rectus ends below the navel curved line.
Deep layer of the front side of the Department of abdominal wall is formed by transverse fascia, preperitoneal fiber and the peritoneum. Held in the thickness of fiber residue urinary flow (urachus), obliteriruuchi umbilical arteriesand lower epigastric vessels form on the peritoneum folds, between which there are deepening, or pits, which are very important in the pathogenesis of hernias of the groin area. No less important in the pathogenesis of hernias are white line of the abdomen and the navel (see Hernia).
The back part of the abdominal wall is formed of the lower thoracic and lumbar part of the spine adjacent ventral located muscles - square and iliopsoas and located dorsal - muscle erector the spine, and a wide muscle of the back.
The blood supply to the abdominal wall is carried out by branches intercostal, lumbar spine and femoral arteries, innervation - branches VII-XII intercostal nerves, iliac-hypogastric and ilio-inguinal. Lymph from the coverings of the front-side of the Department of abdominal wall sent to the axillary lymph nodes (from the upper part of the abdomen), in the inguinal (from the lower part of the abdomen), intercostal, lumbar and iliac lymph nodes (from the deep layers of the abdominal wall).
Pathology. On the abdominal wall possible boils, omphalitis (inflammation of the navel). From tumors occur lipoma, neurofibromas, occasionally cancer ( scars). Damage of the abdominal wall - beats, breaks, aponeurosis and muscles. The wounds of the abdominal wall in time of peace, often stab, in time of war by shooting. Isolated gunshot wounds abdominal wall are very rare. Primary surgical wound treatment of the abdominal wall is mandatory, because the wound is often penetrating. With closed injury of the abdominal wall is also possible rupture of abdominal organs, therefore, patients with damage to the abdominal wall should be sent to the surgeon. Cm. also Abdomen, Groin.