Arcuate line of rectus sheath
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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 vessels perforate the rectus abdominis.
|Arcuate line of rectus sheath|
|Latin||Linea arcuata vaginae musculi recti abdominis|
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. 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. Therefore, inferior to the arcuate line, the rectus abdominis rests directly on the transversalis fascia.
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.
The arcuate line is also known as the linea semicircularis, and the semicircular line of Douglas.
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- 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.
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- 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)
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- Atlas image: abdo_wall61 at the University of Michigan Health System - "Anterior Abdominal Wall, Lower Part, Posterior View"