hello anatomy colleagues this is dr alsup and in this supplementary dissection video we will
be discussing the umbilical fold sometimes referred to as the peritoneal umbilical folds
so recall umbilical folds are created by peritoneum and the surrounding structures
lying over or covering structures that will create a slight but often noticeable bump so let's get
our bearings regarding what is going on with this image the anterior abdominal wall has been incised
and reflected anteriorly and what we're looking at in this general region right here
is the deep portion or inside of the anterior abdominal wall you're looking
into the peritoneal cavity here you can see a bit of the mental apron but what we're going
to focus on is this deep portion of the anterior abdominal wall there are three types of umbilical
folds that are present here and depending on the individual these can be quite obvious
or markedly less so so understanding the basic areas and what is creating the fold
are really of what's important uh what of what is of importance here so let's start with the median
umbilical fold and i'm going to kind of outline where that is located this is unpaired and it's
in the midline so that there's only one median umbilical fold and this is created by peritoneum
covering the median umbilical ligament which is a remnant of the fetal uracus a connection
between the apex of the bladder so the bladder would be deep and inferior in this region and it
would connect that the bladder to the umbilicus so this is an example of a developmental remnant
in close proximity and just lateral to the median umbilical ligament are the medial
umbilical so i'm going to outline those right here so very close um to the medium also very
close in name so median umbilical ligament of which there's only one is in the median plane
and the medial umbilical ligaments are going to be medial to the lateral umbilical folds
now these medial umbilical folds are going to be formed by peritoneum covering the medial umbilical
ligaments and these are formed by the obliterated or closed portion of the umbilical arteries
there are some portions of the umbilical arteries that are patent or opened in an
adult but the portions that are here that we just outlined these are this portion is closed
so close to being involved in blood flow and that is why this is a developmental ligament
lastly there are the paired lateral umbilical folds which are notably lateral and on this
individual i think they're kind of difficult to observe i'm outlining one right here the other
one would be in this general region right here but it's not quite as noticeable you can see a bit of
it right in this middle portion here this fold is unique in that it is not peritoneum covering
a developmental remnant but it's covering the fully patent inferior epigastric vasculature
which is very important in supplying and draining the inferior portions of the abdominal wall
now in actual dissection i find it's typically these folds that i try to identify first because
you can often see the vessels pretty easily through the peritoneum and transversalis fascia
however i must admit it is a little difficult to differentiate in this image you can see
it here and not quite as obvious over here but these are in their general locations and quite
a bit lateral to this complex right here towards the middle okay so those are the umbilical folds
please understand basic locations here and as it's covered here and in the learning objective videos
understand what deep structures are causing these noticeable folds please let me or any of my
anatomy colleagues know if you have any questions and i hope you have a great rest of your day