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Rectus sheath

The rectus sheath (also called the rectus fascia[1]) 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.[2]

Structure

The rectus sheath extends between the inferior costal margin and costal cartilages of ribs 5-7 superiorly, and the pubic crest inferiorly.[2]

Studies indicate that all three aponeuroses constituting the rectus sheath are in fact bilaminar.[3]

Below the costal margin

Superficial/anterior to the anterior layer of the rectus sheath are the following two layers:[4]

  1. Camper's fascia (anterior part of superficial fascia)
  2. Scarpa's fascia (posterior part of the superficial fascia)

Deep/posterior posterior layer of the rectus sheath (where present) are the following three layers:[citation needed]

  1. transversalis fascia[4]
  2. extraperitoneal fat[5]
  3. parietal peritoneum[4]

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.[citation needed]

Clinical significance

The rectus sheath is a useful attachment for surgical meshes during abdominal surgery.[6] This has a higher risk of infection than many other attachment sites.[6]

Additional images

References

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

  1. ^ Te Linde, Richard W. (1977), Rock, John A.; Jones Howard W. (eds.), Te Linde's Operative Gynecology (PDF) (10th ed.), Philadelphia, PA: Lippincott (published 2003), p. 107, retrieved 2018-10-01.
  2. ^ a b c d e f 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
  3. ^ a b c d e f Sinnatamby, Chummy (2011). Last's Anatomy (12th ed.). p. 224. ISBN 978-0-7295-3752-0.
  4. ^ a b c Flynn, William; Vickerton, Paula (2023), "Anatomy, Abdomen and Pelvis: Abdominal Wall", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID 31869113, retrieved 2023-05-16
  5. ^ "extraperitoneal fascia". TheFreeDictionary.com. Retrieved 2023-05-16.
  6. ^ a b Hollinsky, C. (2011-01-01), Ducheyne, Paul (ed.), "6.638 - Biomaterials for Hernia Repair", Comprehensive Biomaterials, Oxford: Elsevier, pp. 593–604, ISBN 978-0-08-055294-1, retrieved 2021-01-21

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