The median umbilical ligament is a structure in human anatomy.
It is a shrivelled piece of tissue that represents the remnant of the embryonic
urachus.
It extends from the apex of the bladder to
the umbilicus,
on the deep surface of the anterior abdominal wall. It is unpaired.
It is covered by the median umbilical fold
Lateral to this structure are the medial
umbilical ligament (which
is a different structure, not to be confused) and the lateral
umbilical ligament.
Significance
It may
be used as a landmark for surgeons who are performing laparoscopy, such as laparoscopic inguinal hernia repair. Other than this, it has no
function in a born human and may be cut or removed with impunity الإفلات من العقاب.
2- Medial
umbilical ligament
Origins
It represents the remnant of the fetal umbilical arteries, which serves no
purpose in humans after birth, except for the part that becomes the adult
umbilical artery.
Functions
It may be used as a landmark for surgeons
exploring the medial inguinal fossa during laparoscopic inguinal hernia
repair. Other than this, it has no purpose in an adult and it may be cut or
damaged with impunity.
Relations
The supravesical fossa, and therefore a
supravesical hernia, is medial to this structure. The medial inguinal fossa, and therefore a direct inguinal hernia, is lateral to it.
Lateral umbilical fold
Clinical
significance
3- Lateral Umbilical Ligaments
The
inferior epigastric artery is a medial branch of the distal segment of the
external iliac artery. It ascends along the medial margin of the deep inguinal ring,
continues between the rectus abdominis muscle and the posterior lamina of its
sheath, and then abuts محاذياً on the anterior parietal
peritoneum to create the lateral umbilical ligament. This ligament is the least
pronounced of the three aforementioned peritoneal folds, and it is not always
readily visualized. However, knowledge of its location is important to avoid
injury to these vessels during either insertion of the lateral trocars or
dissection of the space of Retzius.
Lateral umbilical fold
The lateral
umbilical fold overlies the inferior epigastric artery (a branch of the external
iliac artery) and its accompanying veins. Unlike the median
and medial
umbilical folds, the contents of
the Lateral Umbilical fold remain functional after birth. It extends from
inguinal ring to arcuate line.
Clinical
significance
The lateral umbilical fold is an important
reference site with regards to hernia classification. A direct hernia occurs
medial to the lateral umbilical fold, whereas an indirect hernia originates
lateral to the fold. This later case is due to the placement of the opening of
the deep inguinal ring in the space lateral to the lateral
umbilical fold, which allows the passage of the ductus
deferens, testicular
artery, and other components of the spermatic
cord in men, or the
round ligament of the uterus in women.
Posterior view of the
anterior abdominal wall in its lower half. The peritoneum is in place, and the
various cords are shining through.
