Laboratory Identifications and Relations - Abdominal Wall and Inguinal Region

Structural Basis of Medical Practice -- Human Gross Anatomy, Radiology, and Embryology

The Pennsylvania State University College of Medicine

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Note: This guide is not exhaustive.  The relations are incomplete.  The intent is to highlight observation through dissection.
  1. Superior epigastric a. - entering superior aspect of rectus abdmonins, terminal branch of internal thoracic a.
  2. Inferior epigastric a. - entering rectus sheath inferior to arcuate line on deep surface of rectus abdominis
  3. Tendinous intersections - rectus abdominis "attaches" to itself, septa from anterior lamina rectus sheath
  4. Scarpa's fascia - membranous superficial fascia below the level of the umbilicus, attaching to fascia lata 2 cm below inquinal lig., contributing to fundiform lig. (superficial aspect of suspensory ligament of the penis or clitoris), extending into the scrotum to become dartos, attaching lateral at thoracolumbar fascia
  5. Paraumbilical vv. - eminating from around the umbilicus within superficial fascia.
  6. Linea alba - midline separation of right and left rectus sheaths
  7. Transversalis fascia - inferior to arcuate line
  8. Posterior lamina rectus sheath superior to arcuate line - contributions from internal oblique and transversus abdominis
  9. Fundiform ligament - midline structure near pubic crest
  10. Anterior cutaneous nerve at umbilicus - derived from T10, projection to L3/4
  11. Thoracoabdominal nerves - piercing rectus sheath along linea semilunaris, running in neurovascular plane
  12. Anterior cutaneous nerve at pubic crest - derived from iliohypogastric n. (L1/2)
  13. Medial cural fibers - extending to medial border of superficial ring, specialization of external oblique aponeurosis
  14. Lateral cural fibers - extending to lateral border of superfical ring
  15. Intercrual fibers - supporting medial and lateral cural fibers from separating and thus, supporting the inguinal region
  16. Ilioinguinal nerve - issuing through the superficial ring toward the "pudendal" region
  17. Anterior scrotal or labial nn. - distal ramifications of the ilioinguinal nerve
  18. Inguinal ligament - attaching to the pubic tubercle
  19. Reflected Inguinal ligament - fibers from inguinal ligament reflecting off the pubic tubercle and coursing medial superior toward linea alba, crossing anterior to conjoint tendon
  20. Conjoint tendon - combined tendon of transversus abdominis and internal oblique arching toward inferior aspect of linea alba, posterior to reflected inguinal ligament, lateral to lateral free edge is transversalis fascia of the medial inguinal fosssa (direct inguinal hernia pushes conjoint tendon medially)
  21. Lacunar ligament - fibers of inguinal ligament falling short of pubic tubercle and filling gap (lacuna) between inguinal ligament and pectineal ligament (on pectin line), medial boundary of femoral ring
  22. Pectineal ligament - continuation of fibers from lacunar ligament blending with periosteum of pectin line, posterior boundary of femoral ring
  23. Inguinal ligament - anterior boundary of femoral ring
  24. Deep ring - lateral to inferior epigastric a. at the medial inguinal fossa
  25. Inferior epigastric a. - superificial to the lateral umbilical fold and defining the medial border of the lateral inguinal fossa
  26. Lateral inguinal fossa - identifies deep ring and site of indirect inguinal hernia
  27. Medial umbilical ligament - superficial to the medial umbilical fold, defines medial border of medial inguinal fossa
  28. Medial umbilical fossa - site of direct inguinal hernia
  29. Urachus - superficial to median umbilical fold
  30. Median umbilical fold - defines medial border of supravesical fossa
  31. Cremasteric fascia within inquinal canal - outermost layer of spermatic cord at this location (no external spermatic fascia here)
  32. Genital branch of genitofemoral n. - applied to the cremasteric fascia
  33. External spermatic fascia 1 cm distal to superficial ring - notice derivation from superficial ring (external oblique)
  34. Pampiniform plexus of veins - surrounding testicular a. in distal spermatic cord
  35. Testicular a. - deep to the internal spermatic fascia, notice the autonomic plexus
  36. Vas deferens - deep to the internal spermatic fascia, notice the autonomic plexus
  37. Parietal layer of tunical vaginalis - surrounded by internal, cremasteric, and external spermatic fascia
  38. Visceral layer of tunica vaginalis - undissectable from the tunica albuginea
  39. Head of the epididymis - receiving efferent ductules from the testis
  40. Tail of the epididymis - continuous with the vas deferens

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