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Design of Abdominal Wall Hernioplasty Meshes Guided by Mechanobiology and the Wound Healing Response
Published in Jiro Nagatomi, Eno Essien Ebong, Mechanobiology Handbook, 2018
Shawn J. Peniston, Karen J.L. Burg, Shalaby W. Shalaby
The rectus sheath is divided by the posterior and anterior layer relative to the rectus abdominis muscle and is comprised of the aponeurosis from each layer of the triple flat abdominal muscles. The anterior layer of the rectus sheath is made up of primarily aponeurosis fiber from the external and internal oblique muscles and the posterior layer is comprised of aponeurosis fibers from the internal oblique and transversus muscles above the level of arcuate line. The arcuate line is generally located midway between the umbilicus and pubis and represents the transition zone in which the aponeurosis of the external oblique, the internal oblique, and the transversus abdominis muscles all pass anterior to the rectus muscle [39]. Below the arcuate line the posterior sheath of the rectus abdominis lacks strength as it is comprised of only transversalis fascia, areolar tissue, and peritoneum [39]. It should be noted that aponeurosis are like tendons or ligaments, with the major difference being that they originate from large flat muscles and thus take on the form of large, flat, thin sheets. Fascial layers on the other hand are considerably more extensible and primarily function to separate layers of tissue rather than provide load bearing structural support. For this reason the myopectineal orifice is susceptible to herniation.
Functional Anatomy and Biomechanics
Published in Emeric Arus, Biomechanics of Human Motion, 2017
Action: Compresses the internal organs in the abdomen. Innervations are assured by intercostal nerves of T7-T12 and L1. As an observation about muscles obliquus externus abdominis, obliquus internus abdominis, and transversus abdominis they all have insertions on the iliac crest. See Figure 3.14.
A numerical study to determine the effect of strengthening and weakening of the transversus abdominis muscle on lumbar spine loads
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2020
Katarzyna Nowakowska-Lipiec, Robert Michnik, Paweł Linek, Andrzej Myśliwiec, Katarzyna Jochymczyk-Woźniak, Marek Gzik
The transversus abdominis (TrA) muscle is considered to be one of the main muscles providing stability of the lumbar spine and pelvis (Bergmark 1989; Hides et al. 2001; Richardson et al. 2002). Proper functioning of the TrA is associated with a protective mechanism of the lumbar spine (Hodges and Moseley 2003) and a decrease in laxity of the sacroiliac joint (Richardson et al. 2002). Some studies have demonstrated that contractions of the TrA have beneficial effects in relieving pain and disability in patients with the LBP (Hides et al. 2001). However, previous research on the TrA muscle morphology (thickness or thickness change during contraction) did not show any significant differences in LBP patients compared to healthy ones (Noormohammadpour et al. 2016; Linek et al. 2018). Thus far, a potential reduction of LBP symptoms following exercises of the TrA muscle has not been fully understood. On the other hand, Park et al. (Park and Yu 2013) showed that an increase in the TrA muscle thickness after core training corresponded to the diminishing of the LBP symptoms. From a biomechanical perspective, an increase in the TrA thickness plays a significant role, namely: a) decreases the laxity of the sacroiliac joints (Richardson et al. 2002), b) increases intra-abdominal pressure (IAP) (Crommert et al. 2011) and c) influences thoraco-lumbar fascia tension (Chen et al. 2016). These mechanisms could reduce the load exerted on the musculoskeletal system of the lumbar spine area. In particular, there is a number of experimental and model studies indicating the role of the IAP in spine unloading and stabilization (Hodges and Richardson 1999; Stokes et al. 2010; Arshad et al. 2016). Through the mechanism of generating the IAP, the TrA muscle may affect the loads exerted on the lumbar spine. Better understanding of the effect of its strength on spinal loading may elucidate its role in the development and presentation of low back pain symptoms. This knowledge could help improve the LBP prevention and rehabilitation. On the other hand, some experimental studies have questioned the unloading role of the IAP (Nachemson et al. 1986; Cholewicki et al. 2002).