Arcuate line of rectus sheath
The arcuate line of rectus sheath, the linea semicircularis, the arcuate line, or the semicircular line of Douglas, is a horizontal line that demarcates the lower limit of the posterior layer of the rectus sheath. It is commonly known simply as the arcuate line. It is also where the inferior epigastric artery and vein perforate the rectus abdominis.
| Arcuate line of rectus sheath | |
|---|---|
 The interfoveolar ligament, seen from in front. (Linea semicircularis labeled at center top.) | |
| Details | |
| Identifiers | |
| Latin | Linea arcuata vaginae musculi recti abdominis |
| TA98 | A04.5.01.006 |
| TA2 | 2362 |
| FMA | 16919 |
| Anatomical terminology | |
Structure
Superior to the arcuate line, the internal oblique muscle aponeurosis splits to envelop the rectus abdominis muscle both anteriorly and posteriorly. The anterior layer is derived from the external oblique aponeurosis and the anterior lamina of the internal oblique aponeurosis.[1] The posterior layer is made up of the posterior lamina of the internal oblique aponeurosis and the transversus abdominis aponeurosis.
Inferior to the arcuate line, the aponeuroses of the external oblique muscle, the internal oblique muscle, and the transversus abdominis muscle merge and pass superficial to the rectus abdominis muscle.[1] Therefore, inferior to the arcuate line, the rectus abdominis rests directly on the transversalis fascia.
The arcuate line occurs about half of the distance from the umbilicus to the pubic crest, but this varies from person to person.
If one dissects the anterolateral abdominal wall, the arcuate line may be difficult to see, since all the aponeuroses are translucent.
Clinical significance
Spigelian hernias and, exceedingly rarely, arcuate line hernias may occur inferior to the arcuate line.
The arcuate line must be incised at its lateral-most point in order to enter the space of Retzius and space of Bogros from within the rectus sheath during surgery during retrorectus repair and transversus abdominis release.
History
The arcuate line is also known as the linea semicircularis, and the semicircular line of Douglas.[3]
References
- Raj, Prasanta K.; Sidhu, Ramandeep S.; Taylor, Michael D.; Buckley, Brooke M.; Scarcipino, Mario A. (2005-03-01). "New anatomic repair of midline abdominal wall incisions extending to suprapubic region". Current Surgery. 62 (2): 226–230. doi:10.1016/j.cursur.2004.07.015. ISSN 0149-7944. PMID 15796945.
- Montgomery, A.; Petersson, U.; Austrums, E. (2013-06-01). "The arcuate line hernia: operative treatment and a review of the literature". Hernia. 17 (3): 391–396. doi:10.1007/s10029-012-0982-6. ISSN 1248-9204. PMID 22941154.
- Cavagna, E.; Carubia, G.; Schiavon, F. (June 2000). "[Anatomo-radiologic correlations in spontaneous hematoma of the rectus abdominis muscles]". La Radiologia Medica. 99 (6): 432–437. ISSN 0033-8362. PMID 11262819.
External links
- Anatomy photo:35:13-0101 at the SUNY Downstate Medical Center - "Anterior Abdominal Wall: The Posterior Wall of the Rectus Sheath"
- Anatomy image:7113 at the SUNY Downstate Medical Center
- Anatomy image:7573 at the SUNY Downstate Medical Center
- rectussheath at The Anatomy Lesson by Wesley Norman (Georgetown University)
- Rizk N (1991). "The arcuate line of the rectus sheath--does it exist?". J Anat. 175: 1–6. PMC 1224464. PMID 1828798.
- Atlas image: abdo_wall61 at the University of Michigan Health System - "Anterior Abdominal Wall, Lower Part, Posterior View"
