Arcuate line of rectus sheath

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Arcuate line of rectus sheath
Gray398.png
The interfoveolar ligament, seen from in front. (Linea semicircularis labeled at center top.)
Details
Identifiers
Latin linea arcuata vaginae musculi recti abdominis
TA98 A04.5.01.006
TA2 2362
FMA 16919
Anatomical terminology

The arcuate line of rectus sheath (the arcuate line or the semicircular line of Douglas) is a line of demarcation [1] corresponding to the free inferior margin of the posterior layer of the rectus sheath [2] inferior to which only the anterior layer of the rectus sheath is present [3] and the rectus abdominis muscle is therefore in direct contact with the transversalis fascia. [1] The arcuate line is concave inferior-wards. [2]

Contents

The arcuate line is visible upon the inner surface of the abdominal wall. [1] The arcuate line may be a well-defined, [1] [2] or may be represented by a gradual waning of the aponeurotic fibres with concomitant increasing prominence of the transversalis fascia. [2] The arcuate line occurs about midway between the umbilicus and pubic symphysis, [3] however, this varies from person to person.[ citation needed ]

The inferior epigastric artery and vein pass across the arcuate line to enter the rectus sheath. [2]

Anatomy

Superior to the arcuate line, the internal oblique muscle aponeurosis splits to envelop the rectus abdominis muscle both anteriorly and posteriorly. The anterior layer is derived from the external oblique aponeurosis and the anterior lamina of the internal oblique aponeurosis. [4] The posterior layer is made up of the posterior lamina of the internal oblique aponeurosis and the transversus abdominis aponeurosis. [1]

Inferior to the arcuate line, the aponeuroses of the external oblique muscle, the internal oblique muscle, and the transversus abdominis muscle merge and pass superficial to the rectus abdominis muscle. [4] Therefore, inferior to the arcuate line, the rectus abdominis rests directly on the transversalis fascia. [1]

Clinical significance

Spigelian hernias and, exceedingly rarely, arcuate line hernias may occur inferior to the arcuate line.[ citation needed ]

The arcuate line must be incised at its lateral-most point in order to enter the space of Retzius and space of Bogros from within the rectus sheath during surgery during retrorectus repair and transversus abdominis release.[ citation needed ]

History

The arcuate line is also known as the linea semicircularis, and the semicircular line of Douglas. [5]

Related Research Articles

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The inguinal canal is a passage in the anterior abdominal wall on each side of the body, which in males, convey the spermatic cords and in females, the round ligament of the uterus. The inguinal canals are larger and more prominent in males.

<span class="mw-page-title-main">Aponeurosis</span> Tissue which connects muscles to other organs

An aponeurosis is a flattened tendon by which muscle attaches to bone or fascia. Aponeuroses exhibit an ordered arrangement of collagen fibres, thus attaining high tensile strength in a particular direction while being vulnerable to tensional or shear forces in other directions. They have a shiny, whitish-silvery color, are histologically similar to tendons, and are very sparingly supplied with blood vessels and nerves. When dissected, aponeuroses are papery and peel off by sections. The primary regions with thick aponeuroses are in the ventral abdominal region, the dorsal lumbar region, the ventriculus in birds, and the palmar (palms) and plantar (soles) regions.

<span class="mw-page-title-main">Rectus abdominis muscle</span> Paired straight muscle

The rectus abdominis muscle, also known as the "abdominal muscle" or simply the "abs", is a pair of segmented skeletal muscle on the ventral aspect of a person's abdomen. The paired muscle is separated at the midline by a band of dense connective tissue called the linea alba, and the connective tissue defining each lateral margin of the rectus abdominus is the linea semilunaris. The muscle extends from the pubic symphysis, pubic crest and pubic tubercle inferiorly, to the xiphoid process and costal cartilages of the 5th–7th ribs superiorly.

<span class="mw-page-title-main">Inguinal ligament</span> Band running from the pubic tubercle to the anterior superior iliac spine

The inguinal ligament, also known as Poupart's ligament or groin ligament, is a band running from the pubic tubercle to the anterior superior iliac spine. It forms the base of the inguinal canal through which an indirect inguinal hernia may develop.

<span class="mw-page-title-main">Transverse abdominal muscle</span> Muscle of the abdominal area

The transverse abdominal muscle (TVA), also known as the transverse abdominis, transversalis muscle and transversus abdominis muscle, is a muscle layer of the anterior and lateral abdominal wall, deep to the internal oblique muscle. It is thought by most fitness instructors to be a significant component of the core.

<span class="mw-page-title-main">Abdominal internal oblique muscle</span> Muscle in the abdominal wall

The abdominal internal oblique muscle, also internal oblique muscle or interior oblique, is an abdominal muscle in the abdominal wall that lies below the external oblique muscle and just above the transverse abdominal muscle.

<span class="mw-page-title-main">Abdominal external oblique muscle</span> Skeletal muscle in the abdomen

The abdominal external oblique muscle is the largest and outermost of the three flat abdominal muscles of the lateral anterior abdomen.

<span class="mw-page-title-main">Inferior epigastric artery</span> Blood vessel

In human anatomy, the inferior epigastric artery is an artery that arises from the external iliac artery. It is accompanied by the inferior epigastric vein; inferiorly, these two inferior epigastric vessels together travel within the lateral umbilical fold The inferior epigastric artery then traverses the arcuate line of rectus sheath to enter the rectus sheath, then anastomoses with the superior epigastric artery within the rectus sheath.

<span class="mw-page-title-main">Superior epigastric vein</span> Blood vessel

In human anatomy, the superior epigastric veins are two or more venae comitantes which accompany either superior epigastric artery before emptying into the internal thoracic vein. They participate in the drainage of the superior surface of the diaphragm.

<span class="mw-page-title-main">Abdominal wall</span> Boundary of abdominal cavity

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<span class="mw-page-title-main">Iliohypogastric nerve</span>

The iliohypogastric nerve is a nerve that originates from the lumbar plexus that supplies sensation to skin over the lateral gluteal and hypogastric regions and motor to the internal oblique muscles and transverse abdominal muscles.

<span class="mw-page-title-main">Conjoint tendon</span> Medial part of the posterior wall of the inguinal canal

The conjoint tendon is a sheath of connective tissue formed from the lower part of the common aponeurosis of the abdominal internal oblique muscle and the transversus abdominis muscle, joining the muscle to the pelvis. It forms the medial part of the posterior wall of the inguinal canal.

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In human anatomy, the falciform ligament is a ligament that attaches the liver to the front body wall and divides the liver into the left lobe and right lobe. The falciform ligament is a broad and thin fold of peritoneum, its base being directed downward and backward and its apex upward and forward. It droops down from the hilum of the liver.

<span class="mw-page-title-main">Transversalis fascia</span> Aponeurosis between the transverse abdominal muscle and the extraperitoneal fat

The transversalis fascia is the fascial lining of the anterolateral abdominal wall situated between the inner surface of the transverse abdominal muscle, and the preperitoneal fascia. It is directly continuous with the iliac fascia, the internal spermatic fascia, and pelvic fascia.

The subcostal arteries, so named because they lie below the last ribs, constitute the lowest pair of branches derived from the thoracic aorta, and are in series with the intercostal arteries.

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The deep circumflex iliac artery is an artery in the pelvis that travels along the iliac crest of the pelvic bone.

<span class="mw-page-title-main">Linea semilunaris</span>

The linea semilunaris is a curved tendinous intersection found on either side of the rectus abdominis muscle.

<span class="mw-page-title-main">Rectus sheath</span> Laminas around abdominal muscles

The rectus sheath is a tough fibrous compartment formed by the aponeuroses of the transverse abdominal muscle, and the internal and external oblique muscles. It contains the rectus abdominis and pyramidalis muscles, as well as vessels and nerves.

<span class="mw-page-title-main">Thoraco-abdominal nerves</span>

The anterior divisions of the seventh, eighth, ninth, tenth, and eleventh thoracic intercostal nerves are continued anteriorly from the intercostal spaces into the abdominal wall; hence they are named thoraco-abdominal nerves.

The lumbar fascia is the lumbar portion of the thoracolumbar fascia. It consists of three fascial layers - posterior, middle, and anterior - that enclose two muscular compartments. The anterior and middle layers occur only in the lumbar region, whereas the posterior layer extends superiorly to the inferior part of the neck, and the inferiorly to the dorsal surface of the sacrum. The quadratus lumborum is contained in the anterior muscular compartment, and the erector spinae in the posterior compartment. Psoas major lies anterior to the anterior layer. Various superficial muscles of the posterior thorax and abdomen arise from the posterior layer - namely the latissimus dorsi, and serratus posterior inferior.

References

  1. 1 2 3 4 5 6 Sevensma, Karlin E.; Leavitt, Logan; Pihl, Kerent D. (2023), "Anatomy, Abdomen and Pelvis, Rectus Sheath", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID   30725838 , retrieved 2023-05-16
  2. 1 2 3 4 5 Sinnatamby, Chummy (2011). Last's Anatomy (12th ed.). Elsevier Australia. pp. 224–225. ISBN   978-0-7295-3752-0.
  3. 1 2 Nassereddin, Ali; Sajjad, Hussain (2023), "Anatomy, Abdomen and Pelvis: Linea Semilunaris", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID   32310443 , retrieved 2023-05-16
  4. 1 2 Raj, Prasanta K.; Sidhu, Ramandeep S.; Taylor, Michael D.; Buckley, Brooke M.; Scarcipino, Mario A. (2005-03-01). "New anatomic repair of midline abdominal wall incisions extending to suprapubic region". Current Surgery. 62 (2): 226–230. doi:10.1016/j.cursur.2004.07.015. ISSN   0149-7944. PMID   15796945.
  5. Cavagna, E.; Carubia, G.; Schiavon, F. (June 2000). "[Anatomo-radiologic correlations in spontaneous hematoma of the rectus abdominis muscles]". La Radiologia Medica. 99 (6): 432–437. ISSN   0033-8362. PMID   11262819.