Ultrasound Blocks for the Anterior Abdominal Wall
Ultrasound Blocks for the Anterior Abdominal Wall
Ultrasound Blocks for the Anterior Abdominal Wall
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22 | <strong>Ultrasound</strong> <strong>Blocks</strong> <strong>for</strong> <strong>the</strong> <strong>Anterior</strong> <strong>Abdominal</strong> <strong>Wall</strong><br />
lata to supply <strong>the</strong> proximal-medial area of <strong>the</strong> thigh and over <strong>the</strong><br />
triangle of Scarpa. It may share branches with <strong>the</strong> genital branch<br />
in some cases (Rab 2001).<br />
Rectus Sheath<br />
The rectus sheath is a bilaminar fibrous extension of <strong>the</strong><br />
aponeurotic layer of <strong>the</strong> EOM, IOM and TAM (Figure 1.3, 1.8, 6.3).<br />
It encases <strong>the</strong> RAM on both sides from <strong>the</strong> costal margin down<br />
to <strong>the</strong> level of <strong>the</strong> anterior-superior iliac spine, fusing in <strong>the</strong><br />
midline as <strong>the</strong> linea alba. The superior and inferior epigastric<br />
vessels run longitudinally through <strong>the</strong> medial portion of <strong>the</strong><br />
RAM.<br />
Figure 1.8 – Rectus sheath (line).<br />
A virtual space exists between <strong>the</strong> posterior rectus sheath and<br />
<strong>the</strong> RAM. Local anes<strong>the</strong>tic can spread freely in this space in a<br />
caudal and cephalic direction.