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Rectus Sheath (rectus + sheath)

Distribution by Scientific Domains

Medical Sciences	40%

Selected Abstracts

A subfascial variant of the deep inferior epigastric artery demonstrated by preoperative multidetector computed tomographic angiography: A case report

MICROSURGERY, Issue 2 2010
Cristina Garusi M.D.
Precise preoperative imaging by multidetector computed tomographic (MDCT) angiography for planning of deep inferior epigastric artery perforator (DIEP) flap dissection has been reported for enormous advantages in terms of reduced operative time and minimized flap-related complications. This case report shows a particularly rare anatomical subfascia variant of deep inferior epigastric artery (DIEA) which can be preoperatively demonstrated by MDCT angiogram. Therefore, the intraoperative finding also confirms the radiologic data and results in meticulous flap harvesting during incision on anterior rectus sheath. Additionally, the authors emphasize on performing preoperative high quality imaging for DIEP intervention precisely for specific vulnerable course of subfascial plane DIEP, which is rare but tends to be at risk without foreknowing its exact course. © 2009 Wiley-Liss, Inc. Microsurgery, 2010. [source]

Trunk blocks for abdominal surgery

ANAESTHESIA, Issue 2010
O. Finnerty
Summary In this review, we discuss the central non-neuraxial regional anaesthesia blocks of the abdomen, including intercostal and intrapleural blocks, rectus sheath and ilioinguinal-iliohypogastric blocks, transversus abdominis plane blocks and paravertebral blocks. [source]

Locating the arcuate line of Douglas: Is it of surgical relevance?

CLINICAL ANATOMY, Issue 1 2010
P.M. Mwachaka
Abstract Ventral hernia formation is a common complication of rectus abdominis musculocutaneous flap harvest. The site and extent of harvest of the flap are known contributing factors. Therefore, an accurate location of the arcuate line of Douglas, which marks the lower extent of the posterior wall of the rectus sheath, may be relevant before harvesting the flap. This study is aimed at determining the position of the arcuate line in relation to anatomical landmarks of the anterior abdominal wall. Arcuate lines were examined in 80 (44 male, 36 female) subjects, aged between 18 and 70 years, during autopsies and dissection. The position of the arcuate line was determined in relation to the umbilicus, pubic symphysis, and intersections of rectus abdominis muscle. Sixty four (80.4%) cases had the arcuate line. In most cases (52), this line was located in the upper half of a line between the umbilicus and the pubic symphysis. Most males (93%) had the arcuate line, while more than a third of females did not have it. In all these cases, the line occurred bilaterally as a single arcade, constantly at the most distal intersection of the rectus abdominis muscle. Consequently, the arcuate line is most reliably marked superficially by the distal tendinous intersection of the rectus abdominis muscle. Harvesting of the muscle cranial to this point will minimize defects in the anterior abdominal wall that may lead to hernia formation. Clin. Anat. 23:84,86, 2010. © 2009 Wiley-Liss, Inc. [source]

Fetal development of the human gubernaculum with special reference to the fasciae and muscles around it

CLINICAL ANATOMY, Issue 6 2008
Hitoshi Niikura
Abstract Previous descriptions of human gubernacular embryology failed to follow some basic developmental processes, and surgically relevant structures, such as the iliopubic tract, had not been discussed relative to gubernacular development. We addressed these shortcomings in this study that examined two stage-groups of human fetuses. At 8,12 weeks of gestation, the gubernaculum arose from the mesonephric fold at or near the gonad. Gubernacular mesenchyme communicated with the subcutaneous tissue via a narrow slit in the rectus aponeurosis. The inguinal fold, containing the inferior epigastric vessels, was separated from the gubernaculum. At 20,25 weeks of gestation, the gubernaculum connected to the testis or uterus. When the testis successfully descended to a peritoneal recess on the lateral side of the umbilical artery, the gubernaculum connected to the testis free of interference by the thick artery and its associated peritoneal fold. This may explain the known asymmetry in testicular descent. The inguinal canal was enclosed by a sheet-like aponeurosis: its ventromedial part was composed of the rectus sheath and the external oblique aponeurosis, whereas the dorsolateral part consisted of a thick aponeurosis covering or facing the iliopsoas. The former (latter) aponeurosis seemed to develop into the inguinal ligament (the iliopubic tract) in adults. According to the topohistology of the muscles associated with the interfoveolar ligament, we identified muscle fragments around the gubernaculum as derivatives of the transversus and/or internal oblique. Consequently, the inguinal canal contained the cremaster proper developing within the gubernaculum and parts of the abdominal wall muscles mechanically incorporated into the canal. Clin. Anat. 21:547,557, 2008. © 2008 Wiley-Liss, Inc. [source]

Coexistence of a pectoralis quartus muscle and an unusual axillary arch: Case report and review

CLINICAL ANATOMY, Issue 5 2002
Victoria Bonastre
Abstract A pectoralis quartus muscle and an unusual axillary arch were found on the left side of a female cadaver. The axillary arch was a musculoaponeurotic complex continuous with the iliacal fibers of the latissimus dorsi. The muscular part, together with the tendon of pectoralis major, inserted into the lateral lip of the bicipital groove of the humerus, whereas the aponeurotic part was formed by a fibrous band that extended deep to the pectoralis major to insert into the coracoid process between the attachments of the coracobrachialis and pectoralis minor. The pectoralis quartus originated from the rectus sheath, and joined the inferior medial border of the fibrous band of the axillary arch, at the lateral edge of the pectoralis major. The axillary arch muscle crossed anteriorly the axillary vessels and the brachial plexus. The clinical importance of these muscles is reviewed. Clin. Anat. 15:366,370, 2002. © 2002 Wiley-Liss, Inc. [source]