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Abdomen
Published in Bobby Krishnachetty, Abdul Syed, Harriet Scott, Applied Anatomy for the FRCA, 2020
Bobby Krishnachetty, Abdul Syed, Harriet Scott
The thoracolumbar fascia has three layers: the posterior layer surrounds the erector spinae muscle; the middle layer passes between the erector spinae muscles and quadratus lumborum; and the anterior layer lies anterior to both quadratus lumborum and psoas major muscles.
The Skin and Muscles of the Back
Published in Gene L. Colborn, David B. Lause, Musculoskeletal Anatomy, 2009
Gene L. Colborn, David B. Lause
In the thoracic region, where the thoracolumbar fascia is relatively thin, it ensheathes the aponeurotic origin of the serratus posterior superior. In the lumbar region the thoracolumbar fascia consists of posterior, intermediate and anterior layers which enclose the intrinsic back muscles. The posterior layer is thickened considerably by its fusion with the aponeuroses of several muscles, including the latissimus dorsi.
Comparison of the electromyographic recruitment of the posterior oblique sling muscles during prone hip extension among three different shoulder positions
Published in Physiotherapy Theory and Practice, 2021
Lumbopelvic instability can result from poor neuromuscular control, muscle weakness, and imbalances in lumbopelvic muscle activity (Janda, 1996). Both deep intersegmental local muscles and large superficial global muscles contribute to the maintenance of lumbopelvic stability (Bergmark, 1989; Kim and Kim, 2015). The global muscles are primarily related to movement and control of the spine and directly related to transfer loads from the spine to the lower extremities during movement (Danneels et al., 2001). The muscles around the hip joint and spine are required to train lower back stability (Comerford and Mottram, 2012; McGill, 2015). The GM is important for transferring the load through the hip during functional activities that rely on lower extremities. It links the contralateral latissimus dorsi (LD) with the ipsilateral bicep femoris (BF) via the thoracolumbar fascia and multifidus (MF) (Vleeming et al., 1995). These muscles comprise the posterior oblique sling and provide dynamic lumbopelvic stability (Vleeming et al., 1995). The myofascial sling is anatomically interconnected and can facilitate the transfer of force through the trunk, particularly from the lower extremity to the arm (Vleeming et al., 1995). Myers (2013) described three major lines that consist of myofascial or connective tissue units: the superficial back, the superficial front, and the lateral lines.
A finite element analysis of the intra-abdominal pressure and paraspinal muscle compartment pressure interaction through the thoracolumbar fascia
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2020
Khaled El-Monajjed, Mark Driscoll
While the thoracolumbosacral spine arguably provides the foundational structural support of our bodies, its stabilization has been believed to be complemented via of a spring-like structure of fascial substance surrounding the torso; the Thoracolumbar Fascia (TLF) (Willard et al. 2012; Driscoll 2018). Composed of interweaved aponeurotic and fascial layers, the TLF divides the torso transversally into compartmental regions occupied by different skeletal muscles (Figure 1) and spans longitudinally between the thoracolumbosacral spine to connect with different active muscles. The unique structure of the TLF has for long enticed researchers to investigate its capability in withstanding and transferring forces between different regions of the body under static and dynamic loads who hypothesize its potential functions. Mathematical modelling of the TLF connectivity suggests its necessity in stabilizing the vertebral column when tensioned as a result of Paraspinal and Abdominal muscles (Gracovetsky et al. 1981; Macintosh et al. 1987). Barker et al. (2004) conducted cadaveric studies and observed an effective transmission of low values of tensional force (up to 5 N) when applying 10 N between the Transverse Abdominis and the anterior (ALF) or posterior (PLF) layer of the TLF. In-vitro experimentation of the TLF by Vleeming et al. (2014) studied the Paraspinal muscle activation and observed a clear transfer of force from the ALF to PLF realizing a point of equal tension within the Common Transversus Tendon (cTrA).
Incisional lumbar hernia after the use of a lumbar artery perforator flap for breast reconstruction
Published in Acta Chirurgica Belgica, 2020
Stijn Van Cleven, Karel Claes, Aude Vanlander, Koenraad Van Landuyt, Frederik Berrevoet
The patient was put under general anesthesia and a single dose of prophylactic antibiotic was given. An incision was made over the previous scar and the hernia sac was freed. The margins of the defect were identified. The defect was located paravertebrally on the right side and measured 6.0 × 4.5 cm. The retroperitoneal space was opened and the dissection extended behind the ribs cranially, caudally behind the iliac crest and laterally behind the lateral abdominal muscles. Dissection medially was limited by the spine. We chose the use of a synthetic mesh located in a retromuscular position with a tension-free technique. A large polypropylene, macro-porous mesh (REBOUND™, MMDI, Minnesota, USA) of 16 × 11 cm was used. An overlap of the defect of 3–5 cm was achieved except medially, with the interference of the spinal column. The mesh was fixed medially with 2 non-absorbable monofilament 2/0 sutures. The thoracolumbar fascia was then closed in 2 layers with a running slowly absorbable suture. A closed suction drain was left in the subcutaneous space. Postoperative recovery was uneventful. The drain was removed after 1 week. Follow-up at 5 weeks and 6 months demonstrated no hernia recurrence. A control CT-scan showed no recurrence (Figures 3, 4).