Abdominal musculature and the transversalis fascia: an anatomical viewpoint

Abstract

This anatomical study investigated the connection of the muscles of the abdominal wall to the transversalis fascia in the groin. In six unfixed male corpses we prepared the single levels of the inguinal abdominal wall and examined their interrelationships. Of special interest were the direction of the force vectors determined by the direction of the muscular fibers in relation to the transversalis fascia. We found no confirmation of a direct connection between the muscles of the abdominal wall and the transversalis fascia in the inguinal region. No force vector of the different muscular layers points away from the triangle of Hesselbach. By contraction each muscle thus relaxes the transversalis fascia of the Hesselbach triangle.

Location and sequence of muscle onset in deep abdominal muscles measured by different modes of ultrasound imaging

“…The following muscles were displayed in sequential depth orders from the transducer; obliquus externus abdominis (OE), obliquus internus abdominis (OI) and transversus abdominis (TrA). The transducer was placed transversally in a slightly oblique angle approximating the direction of the muscle fibres of TrA (Peiper et al, 2004;Vasseljen et al, 2009). In TVI mode the US scanner recorded echoes from the muscle tissue along 10-12 scan lines over time, discriminating regional tissue velocity gradients (towards or away from the transducer) along the US beam axis.…”

Anatomical changes after inguinal hernia treatment: a reason for chronic pain and recurrent hernia?

“…Thus, a contraction of the transverse abdominal muscle results in an approximation of the lateral edge of the rectus sheath and the anterior superior iliac spine [20]. The inguinal ligament is thus a site of origin rather than insertion.…”

“…Suturing or doubling the transverse fascia, which is the weakest structure of the groin region [23], is ineffective. Therefore the lateral abdominal muscles, which are otherwise supposed to cause approximation of the lateral edge of the rectus sheath to the anterior superior iliac spine [20], are sutured to the inguinal ligament. Thus, hernia recurrence can be traced to severe tension incurred by nonphysiological use of these muscles [11,13,15].…”

Simulation and study of the behaviour of the transversalis fascia in protecting against the genesis of inguinal hernias

“…To study the dynamics of the region, the oblique internal muscle has been simulated because this is the most important dynamic element (Abdalla and Mittelstaedt, 2001;Keith, 1924;Ajmani and Ajmani, 1983;Peiper et al, 2004), especially given its position in the Hessert's triangle (Abdalla and Mittelstaedt, 2001). The vertex of this triangle is the inguinal internal orifice; the triangle's side is the oblique internal muscle with the aponeurotic arch of the transverse muscle and the inguinal ligament; and the triangle's base is the aponeurotic edge of the rectus abdominis muscle.…”

“…2) triangle by the low fibres of the oblique internal muscle has been described as one of the main protection mechanisms against the appearance of a medial hernia (Keith, 1924). The dynamics are based on the movement of anatomical structures (specifically, the oblique internal muscle) whose real function and repercussions in the clinic are little known, since the conclusions regarding their dynamics and function are subjective extrapolations from static studies (Abdalla and Mittelstaedt, 2001;Ajmani and Ajmani, 1983;Peiper et al, 2004). The aim of this work is to study the effect of some biochemical parameters in the local dynamic, using the Hill-Maxwell model proposed by Bestel (Bestel, 2000) to simulate their contraction and dynamics at cellular level.…”