During breathing the diaphragm contracts and flattens, displacing the viscera and producing an outward movement of the upper abdominal wall (epigastric region). It is a convergence of the diaphragm and the abdominals, so that "when both sets of muscles (diaphragm and abdominals) tense, the epigastrium pushes forward".
The inferior epigastric artery supplies the rectus abdominis muscle, whereas the deep circumflex artery supplies the transversus abdominis and internal oblique muscles. The deep circumflex iliac artery also supplies blood to the iliac fossa and internal oblique muscles.
The musculophrenic artery runs along the costal slips of the diaphragm. It supplies the 7th, 8th and 9th intercostal spaces with paired anterior intercostal arteries, as well as fine branches that supply the superior part of the anterior abdominal wall.
The superficial epigastric artery is a small cutaneous branch of the common femoral artery which contributes to the arterial supply of the anterior abdominal wall below the umbilicus.
The inferior epigastric artery arises commonly from the external iliac artery just superior to the inguinal ligament. This artery runs superiorly in the transversalis fascia to enter the rectus sheath below the arcuate line, and finally anastomoses with the superior epigastric artery [1].
The arcuate line is an area of demarcation visible from the peritoneal surface of the abdominal wall, residing one-third the distance between the umbilicus and the pubis. The arcuate line can be a sharp demarcation, or it can be a gradual transition zone where the fibers of the posterior sheath gradually disappear.[1]
The superior epigastric artery anastomoses with the inferior epigastric artery, which is a branch of the external iliac artery, providing an important alternate blood supply if the aorta becomes occluded (see: coarctation of the aorta).
The superior epigastric artery originates at the level of the sixth or seventh costal cartilage. It descends to the anterior abdominal wall, crossing the diaphragm in the interval between the sternal and the costal parts of the muscle.
The obturator artery is a branch of the anterior division of the internal iliac artery. It provides vascular supply within the pelvis and lower limb.
The inferior epigastric artery (IEA) is a major blood vessel that supplies the anterior abdominal wall. The aim of the current study was to provide clinicians, surgeons, and obstetricians with sufficient anatomical data on the inferior epigastric artery, such as its origin and branching pattern.
The conjoint tendon (previously known as the inguinal aponeurotic falx) 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.
Blood Supply and LymphaticsThe four origins of the arterial supply of the wall are the internal thoracic artery, aorta, external iliac, and femoral artery—the internal thoracic artery branches to the musculophrenic and superior epigastric arteries.
Using anterior abdominal wall landmarks, the inferior epigastric artery can be identified midway between the anterior superior iliac spine and the pubic symphysis as it travels toward the umbilicus.
The superficial inferior epigastric artery (SIEA) flap allows for harvest of the lower abdominal fatty tissue based on the superficial inferior epigastric system. Occasionally, the flow from the superficial system may be more robust than that of the deep inferior epigastric system.
The rectus abdominis consists of two bands of muscle that run down from around the sternum. They have bands of connective tissue between them, which give the abs their distinctive six or eight pack look. The rectus abdominis muscle is important for maintaining posture and breathing.
The superior epigastric artery arises from the internal thoracic artery (referred to as the internal mammary artery in the accompanying diagram). It anastomoses with the inferior epigastric artery at the umbilicus.
The superior epigastric artery is a branch of the internal thoracic artery on each side. It forms deep to the sixth intercostal space on each side. Within this layer they ramify to widely anastomose with the inferior epigastric artery. The superior epigastric artery is a branch of the internal thoracic artery.
The internal thoracic artery functions to supply the anterior chest wall, from the clavicle to the umbilicus. This area of supply also includes supply to the sternum and breasts.
Epigastric vessels refer to the epigastric arteries and veins. There are three epigastric arteries the superficial, superior and inferior. The veins are named in the same way with a superficial, superior and inferior epigastric vein.
The thoracoepigastric vein provides a communication between the superficial epigastric vein and the lateral thoracic vein as it ascends superficially on the anterolateral chest and abdominal wall.
Muscles of the anterior abdominal wall are supplied by lower six thoracic nerves, the iliohypogastric nerve and the ilioinguinal nerve.
| Superficial epigastric vein |
|---|
| Drains to | great saphenous veinfemoral vein |
| Artery | Superficial epigastric artery |
| Identifiers |
| Latin | vena epigastrica superficialis |
-The upper 1/3 of the left posterior intercostal veins drain into the left brachiocephalic vein which drains to the SVC. -The middle 1/3 of the left posterior intercostal veins drain into the accessory hemiazygos vein, which drains to the azygos vein which drains to the SVC.
The femoral vein is the main deep vein of the thigh and accompanies the superficial femoral artery and common femoral artery.
The azygos vein drains the posterior thoracic and abdominal wall, and is formed by the confluence of the ascending lumbar veins and the right subcostal vein at vertebral level T12. The azygos vein arches over the right main bronchus, in order to join the superior vena cava.
The common femoral vein empties into the external iliac vein, which, when joined by the internal iliac vein, forms the common iliac vein. Both the right and left common iliac veins join to form the inferior vena cava. The lumbar veins, as well as the left and right renal veins, empty into the inferior vena cava.
The paraumbilical veins are small veins around the falciform ligament that drain venous blood from the anterior part of the abdominal wall and diaphragm directly into the liver, and communicate with other anterior abdominal wall veins.
