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The rectus sheath, also called the rectus fascia,. is formed by the aponeuroses of the transverse abdominal and the
internal Internal may refer to: * Internality as a concept in behavioural economics *Neijia, internal styles of Chinese martial arts *Neigong Neigong, also spelled ''nei kung'', ''neigung'', or ''nae gong'', refers to any of a set of Chinese breathing, ...
and external oblique muscles. It contains the
rectus abdominis The rectus abdominis muscle, ( la, straight abdominal) also known as the "abdominal muscle" or simply the "abs", is a paired straight muscle. It is a paired muscle, separated by a midline band of connective tissue called the linea alba. It exte ...
and pyramidalis muscles.


Structure

The rectus sheath can be divided into anterior and posterior laminae. The arrangement of the layers has important variations at different locations in the body.


Below the costal margin

For context, above the sheath are the following two layers: #
Camper's fascia The fascia of Camper is a thick superficial layer of the anterior abdominal wall. It is areolar in texture, and contains in its meshes a varying quantity of adipose tissue. It is found ''superficial'' to the fascia of Scarpa. Structure Superfici ...
(anterior part of Superficial fascia) # Scarpa's fascia (posterior part of the Superficial fascia) Within the sheath, the layers vary: Below the sheath are the following three layers: # transversalis fascia # extraperitoneal fat # parietal peritoneum The rectus, in the situation where its sheath is deficient below, is separated from the
peritoneum The peritoneum is the serous membrane forming the lining of the abdominal cavity or coelom in amniotes and some invertebrates, such as annelids. It covers most of the intra-abdominal (or coelomic) organs, and is composed of a layer of mesot ...
only by the transversalis fascia, in contrast to the upper layers, where part of the internal oblique also runs beneath the rectus. Because of the thinner layers below, this region is more susceptible to herniation.


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 The term abdominal surgery broadly covers surgical procedures that involve opening the abdomen (laparotomy). Surgery of each abdominal organ is dealt with separately in connection with the description of that organ (see stomach, kidney, liver, etc ...
. This has a higher risk of
infection An infection is the invasion of tissues by pathogens, their multiplication, and the reaction of host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmissible disease or communicable d ...
than many other attachment sites.


Additional images

File:Gray396.png, The Cremaster File:Gray398.png, The interfoveolar ligament, seen from in front.


References


External links

* - "Incisions and the contents of the rectus sheath." * - "Anterior Abdominal Wall: The Rectus Abdominis Muscle" * - anterior layer * - posterior layer above arcuate line * - posterior layer above arcuate line * * - "The Rectus Sheath, Anterior View & Transverse Section" {{Authority control Abdomen Muscles of the torso