• Source: Rectus sheath

The rectus sheath (also called the rectus fascia) 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.




Structure


The rectus sheath extends between the inferior costal margin and costal cartilages of ribs 5-7 superiorly, and the pubic crest inferiorly.
Studies indicate that all three aponeuroses constituting the rectus sheath are in fact bilaminar.




= Below the costal margin

=

Superficial/anterior to the anterior layer of the rectus sheath are the following two layers:

Camper's fascia (anterior part of superficial fascia)
Scarpa's fascia (posterior part of the superficial fascia)
Deep/posterior posterior layer of the rectus sheath (where present) are the following three layers:

transversalis fascia
extraperitoneal fat
parietal peritoneum




= Above the costal margin

=
Since the tendons of the internal oblique and transversus abdominis only reach as high as the costal margin, it follows that above this level the sheath of the rectus is deficient behind, the muscle resting directly on the cartilages of the ribs, and being covered only by the tendons of the external obliques.




Clinical significance


The rectus sheath is a useful attachment for surgical meshes during abdominal surgery. This has a higher risk of infection than many other attachment sites.




Additional images















References


This article incorporates text in the public domain from page 416 of the 20th edition of Gray's Anatomy (1918)




External links


Anatomy figure: 35:04-02 at Human Anatomy Online, SUNY Downstate Medical Center - "Incisions and the contents of the rectus sheath."
Anatomy photo:35:10-0103 at the SUNY Downstate Medical Center - "Anterior Abdominal Wall: The Rectus Abdominis Muscle"
Anatomy image:7180 at the SUNY Downstate Medical Center - anterior layer
Anatomy image:7133 at the SUNY Downstate Medical Center - posterior layer above arcuate line
Anatomy image:7574 at the SUNY Downstate Medical Center - posterior layer above arcuate line
rectussheath at The Anatomy Lesson by Wesley Norman (Georgetown University)
Atlas image: abdo_wall60 at the University of Michigan Health System - "The Rectus Sheath, Anterior View & Transverse Section"

Kata Kunci Pencarian:

• Rectus sheath
• Rectus sheath hematoma
• Rectus abdominis muscle
• Arcuate line of rectus sheath
• Diastasis recti
• Sheath
• Inferior epigastric artery
• Surgical incision
• Sternalis muscle
• Pyramidalis muscle