The AAO Journal, 2024/06, 34(2):26-27. doi: 10.53702/i2375-5717-34.2.16, type of study: ,obs,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

Full text    (https://meridian.allenpress.com/aaoj/article/34/2/16/500954/LBORC-NUFA-Poster-Abstracts-2024-Students)

Keywords:

anatomy [113]
cadaver [21]
diaphragm [99]
fascia [313]
observational study [246]
psoas muscle [5]
respiration [35]

Abstract:

Introduction/Background: Current literature describes connections between the thoracoabdominal diaphragm (TAD) and iliopsoas through the crura and arcuate ligaments. Additionally, the iliopsoas fascia (IPF) connects with the transversalis fascia (TF) of the abdominal cavity. TF is known to connect with fascia on the inferior surface of the TAD. Anatomical dissection can help to better appreciate fascial connections between the psoas and TAD. We hypothesize this dissection will further understanding of how dysfunctions within the psoas impact the TAD and highlight the importance of treating the psoas for patients with respiratory complaints. Objective: Identify fascial connections between the psoas and TAD. Methods: In the supine position, 5 cadavers of various sex, age, and stature were examined. The thoracic and abdominal cavities were previously dissected. The psoas major, TAD, and overlying fascia were identified in the abdominal cavity. We dissected the fascia away from the corresponding musculature to determine anatomical relationship. Palpation was utilized throughout the dissection to determine landmarks and evaluate motion of the TAD while manipulating the psoas. Results: Using dissection, we found the IPF and TF to be intimately connected and converging prior to ascending to the TAD. We dissected an intact portion of the IPF and followed that connection to the inferior surface of the TAD. Discussion/Conclusion: Identifying fascial connections between IPF, TF, and TAD allows for better understanding of the relationship between the psoas and TAD and suggests somatic dysfunctions in the psoas may impact normal motion of the TAD. This highlights the osteopathic relevance of treating the psoas in cases where improving respiration is a primary goal. Limitations include the utilization of previously dissected cadavers, tissue stiffness secondary to preservation technique, and small sample size.