Blood Supply of the Anterolateral Abdominal Wall

00:01 So we've spoken about various muscles and various landmarks on the surface of the abdomen.

00:06 Now let's quickly have a look at the blood supply of the anterolateral abdominal wall.

00:12 So as we can see here, we've got the abdomen and we can actually split it up into three areas or zones.

00:19 Zone I, Zone II, and Zone III.

00:21 And these are going to primarily be supplied by different blood vessels of different origin.

00:26 But as we'll see, there is quite a complex anastomotic network between these blood vessels, where blood vessels from different origins may actually contribute to areas outside their zones.

00:37 And we'll talk about that as we go through.

00:40 So here we can see on this image, we can see we've got various blood vessels.

00:44 And we're going to start off with really looking at some of the origin blood vessels that give rise to epigastric blood vessels.

00:51 So here we can see at the very top of the screen, we have the subclavian artery.

00:55 We can see here on the right hand side, but obviously you'd be on the left hand side as well, which has been covered by various muscles.

01:02 But coming off the subclavian artery, the internal thoracic artery is coming deep to the skin, deep to the intercostal muscles, deep to the ribs it's running down either side of the sternum, and around about the level of the 6th costal cartilage which is coming from the 6th rib, you'll see it gives rise to the superior epigastric artery.

01:24 It's important to note that the internal thoracic artery does then follow the curvature of the costal cartilage, and we'll see that in a moment because it gives rise to other anterior intercostal arteries.

01:35 But here we can see we have the superior epigastric artery coming off the internal thoracic.

01:41 So that's coming down superiorly.

01:43 If we look at the inferior aspect, we can see here we have the external iliac artery, which will go on to become the femoral artery and supply the lower limb.

01:52 But here within the pelvis, the external iliac artery gives rise to an important blood vessel, which is known as the inferior epigastric artery.

02:02 And here we can see the inferior epigastric artery, it's running up within the musculature of the anterolateral abdominal wall, and it can unite with the superior epigastric artery.

02:14 And here is the important anastomotic network.

02:18 What that means is that the area within this aspects of the abdomen, so we're talking about zone I, and zone II, could yes be supplied by the superior epigastric and the inferior epigastric arteries respectively.

02:32 So superior zone I, inferior zone II.

02:35 But actually what happens is it's a bit like a Spaghetti Junction, a roadmap that new little roads and pathways and channels can form by various junctions and various unions of these blood vessels forming anastomotic network.

02:50 So actually, at the union of these two arteries, although they have different origins, they can help to supply this area quite substantially.

02:59 What you can see over on the lateral aspect, so here we have Zone III, we have anastomosis between the musculophrenic, the intercostal, the subcostal and lumbar arteries.

03:10 Now what's happening here is the musculophrenic is the artery that comes off the internal thoracic that I mentioned previously, to course around supplying the diaphragm and giving rise to various arteries that go to the anterior intercostal spaces.

03:24 But it's also giving rise to numerous arteries, you can see them there, which is applying these lateral aspects of the abdomen.

03:32 So the blood supply to the anterior abdominal wall is relatively straightforward.

03:37 There's only a few arteries really to remember.

03:39 But I think the most important point is it can form a complex anastomotic circuit around the abdomen, allowing for compensation if some blood vessels were to be occluded.