SURGICAL ANATOMY OF APONEUROTIC EXPANSIONS OF ANTERIOR ABDOMINAL-WALL

  • 1 January 1977
    • journal article
    • research article
    • Vol. 59  (4) , 313-321
Abstract
Dissection of the anterior abdominal wall in 40 fresh cadavers, with confirmation of the anatomical findings at operation in 25 patients, has enabled the distribution pattern of the abdominal muscle aponeurotic expansions to be traced and the relation of structure to function to be determined. The linea alba should not be regarded as the line of insertion of the abdominal muscles, but as the area of decussation of the tendinous aponeurotic fibers of the muscular strata passing from one side to the other, for which the name midline aponeurotic area is proposed. Two separate functional areas are described, a parachute respiratory mechanism in the upper abdomen and a belly support in the lower abdomen. Attention is drawn to the functional derangement that may follow some of the standard abdominal incisions and to possible mechanisms of herniation through the midline aponeurotic area.