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About the ligaments of the pleural dome

Journal: Unpublished MSc thesis Wiener Schule für Osteopathie, Date: 2008/02, Pages: 134, type of study: clinical trial

Free full text   (https://www.osteopathicresearch.org/s/orw/item/3009)

Keywords:

ligaments [14]
pleura dome [1]
pleura parietalis [2]
anatomical study [2]
clinical trial [612]
WSO [433]

Abstract:

Study Design Fundamental research, anatomical study Outline/Problem Definition In the osteopathic literature mainly ligamentous structures are described to be responsible for the suspension of the pleural dome. This study wants to find out whether this is really the case. Research Question & Objective Do ligaments of the pleural dome really exist in the body and if yes, in how many cases can they be detected? Does the group of the scalene muscles have a connection with the pleural dome and if yes, how strong is this connection? Hypothesis Ligaments are present in the region of the pleural dome. Nevertheless, these are inconsistent structures. Relevance for the Patients Osteopathic treatment is strengthened by a better underpinning knowledge and furnished with a scientific foundation which for the patient means more reliability of the treatment. Relevance for Osteopathy This kind of study furnishes an anatomical foundation onto which osteopathic theories and treatment techniques can be based. Methodology Dissection of 20 cadavers (12 embalmed, 8 not embalmed). The pleural dome is exposed to look for the Lig. vertebropleurale, Lig. costopleurale and Lig. transversopleurale. Also the presence of a M. scalenus minimus is explored and it is investigated whether the M. scalenus anterior and medius send fibres into the pleural dome. Detected ligaments are measured and documented with photographs. Results In the examination of a total of 40 pleural domes two Lig. vertebropleurale, two Lig. costopleurale and one Lig.transversopleurale could be found. The statistical probability that all three ligaments are present in one person tends towards zero. The M. scalenus minimus could be detected in nine cases. In 24 cases the M. scalenus anterior sent fibres into the pleural dome, the M. scalenus medius did so in 34 cases. The connections varied between only a few delicate fibres and quite broad attachments. Critical Reflection/Perspectives/Conclusions : If at all, the ligaments play a minor role and regarding these ligaments the applied osteopathic techniques have to be reconsidered. The group of the scalene muscles play a more important role. In any case, it would have been desirable to look at more cadavers. The exact mechanism of the suspension is still not clear, in particular because in one body neither muscles nor ligaments had a connection with the pleural dome.


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