Thoracolumbar fascia | |
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![]() Diagram of a transverse section of the posterior abdominal wall, to show the disposition of the lumbodorsal fascia. | |
![]() Superficial muscles of the back. The thoracolumbar fascia is the gray area at bottom center. | |
Details | |
Identifiers | |
Latin | fascia thoracolumbalis, fascia lumbodorsalis |
TA98 | A04.3.02.501 |
TA2 | 2242 |
FMA | 25072 |
Anatomical terminology |
The thoracolumbar fascia (lumbodorsal fascia or thoracodorsal fascia) is a complex, [1] : 1137 multilayer arrangement of fascial and aponeurotic layers forming a separation between the paraspinal muscles on one hand, and the muscles of the posterior abdominal wall (quadratus lumborum, and psoas major [1] : 1137 ) on the other. [2] [1] : 1137 It spans the length of the back, extending between the neck superiorly and the sacrum inferiorly. [3] It entails the fasciae and aponeuroses of the latissimus dorsi muscle, serratus posterior inferior muscle, abdominal internal oblique muscle, and transverse abdominal muscle. [4]
In the lumbar region, it is known as lumbar fascia and here consists of 3 layers (posterior, middle, and anterior) enclosing two muscular compartments. In the thoracic region, it consists of a single layer (an upward extension of the posterior layer of the lumbar fascia). [3] The thoracolumbar fascia is most prominent at its lower end [1] : 814–815 where its various layers fuse into a thick composite. [2]
In the thoracic region, the thoracolumbar fascia consists of a single layer - an upward extension of the posterior layer of the lumbar fascia, becoming progressively thinner before fading out above the 1st rib, replaced by the splenius muscle. [3]
In the thoracic region, it forms a thin fibrous fascial covering for extensor muscles associated with the spine, separating them from muscles interconnecting the spine and upper extremity. [1] : 814–815 Here it attaches to costal angles of all ribs, the spinous processes of all thoracic vertebrae, and the thoracic portion of the supraspinous ligament. [3] It is situated deep to the serratus posterior superior muscle. Superiorly, it terminates by becoming continuous with the superficial layer of deep cervical fascia of the posterior neck. [1] : 814–815
The thoracolumbar fascia is most prominent inferiorly - adjacent to the caudal lumbar spine, between the posterior superior iliac spines on either side - where its aponeurotic layers meld, forming a thickened sheet. [1] : 1137 The thickened, united inferior portion attaches firmly to the posterior superior iliac spine, and the sacrotuberous ligament. [2] The thoracolumbar fascia extends as far inferiorly as the two ischial tuberotities. [1] : 1137
The thoracolumbar fascia is thought to be involved in load transfer between the trunk and limb (it is tensioned by the action of the latissimus dorsi muscle, gluteus maximus muscle, and the hamstring muscles), and lifting. [1] : 814–815
It is endowed with nociceptive receptors, and may be involved in some forms of back pain. [1] : 814–815
The latissimus dorsi is a large, flat muscle on the back that stretches to the sides, behind the arm, and is partly covered by the trapezius on the back near the midline. The word latissimus dorsi comes from Latin and means "broadest [muscle] of the back", from "latissimus" ' and "dorsum". The pair of muscles are commonly known as "lats", especially among bodybuilders. The latissimus dorsi is the largest muscle in the upper body.
An aponeurosis is a flattened tendon by which muscle attaches to bone or fascia. Aponeuroses exhibit an ordered arrangement of collagen fibres, thus attaining high tensile strength in a particular direction while being vulnerable to tensional or shear forces in other directions. They have a shiny, whitish-silvery color, are histologically similar to tendons, and are very sparingly supplied with blood vessels and nerves. When dissected, aponeuroses are papery and peel off by sections. The primary regions with thick aponeuroses are in the ventral abdominal region, the dorsal lumbar region, the ventriculus in birds, and the palmar (palms) and plantar (soles) regions.
The transverse abdominal muscle (TVA), also known as the transverse abdominis, transversalis muscle and transversus abdominis muscle, is a muscle layer of the anterior and lateral abdominal wall which is deep to the internal oblique muscle. It is thought by most fitness instructors to be a significant component of the core.
The serratus posterior inferior muscle, also known as the posterior serratus muscle, is a muscle of the human body.
The abdominal external oblique muscle is the largest and outermost of the three flat abdominal muscles of the lateral anterior abdomen.
The lumbar plexus is a web of nerves in the lumbar region of the body which forms part of the larger lumbosacral plexus. It is formed by the divisions of the first four lumbar nerves (L1-L4) and from contributions of the subcostal nerve (T12), which is the last thoracic nerve. Additionally, the ventral rami of the fourth lumbar nerve pass communicating branches, the lumbosacral trunk, to the sacral plexus. The nerves of the lumbar plexus pass in front of the hip joint and mainly support the anterior part of the thigh.
The erector spinae or spinal erectors is a set of muscles that straighten and rotate the back. The spinal erectors work together with the glutes to maintain stable posture standing or sitting.
The fascia lata is the deep fascia of the thigh. It encloses the thigh muscles and forms the outer limit of the fascial compartments of thigh, which are internally separated by the medial intermuscular septum and the lateral intermuscular septum. The fascia lata is thickened at its lateral side where it forms the iliotibial tract, a structure that runs to the tibia and serves as a site of muscle attachment.
The transversalis fascia is the fascial lining of the anterolateral abdominal wall situated between the inner surface of the transverse abdominal muscle, and the preperitoneal fascia. It is directly continuous with the iliac fascia, the internal spermatic fascia, and pelvic fascia.
The crest of the ilium is the superior border of the wing of ilium and the superiolateral margin of the greater pelvis.
The iliac fascia is the fascia overlying the iliacus muscle.
The iliolumbar ligament is a strong ligament which attaches medially to the transverse process of the 5th lumbar vertebra, and laterally to back of the inner lip of the iliac crest.
The lumbar triangle can refer to either the inferior lumbar (Petit) triangle, which lies superficially, or the superior lumbar (Grynfeltt) triangle, which is deep and superior to the inferior triangle. Of the two, the superior triangle is the more consistently found in cadavers and is more commonly the site of herniation; however, the inferior lumbar triangle is often simply called the lumbar triangle, perhaps owing to its more superficial location and ease in demonstration.
The superior cluneal nerves are pure sensory nerves that innervate the skin of the upper part of the buttocks. They are the terminal ends of the L1-L3 spinal nerve dorsal rami lateral branches. They are one of three different types of cluneal nerves. They travel inferiorly through multiple layers of muscles, then traverse osteofibrous tunnels between the thoracolumbar fascia and iliac crest.
The muscles of respiration are the muscles that contribute to inhalation and exhalation, by aiding in the expansion and contraction of the thoracic cavity. The diaphragm and, to a lesser extent, the intercostal muscles drive respiration during quiet breathing. The elasticity of these muscles is crucial to the health of the respiratory system and to maximize its functional capabilities.
The lumbar fascia is the lumbar portion of the thoracolumbar fascia. It consists of three fascial layers - posterior, middle, and anterior - that enclose two muscular compartments. The anterior and middle layers occur only in the lumbar region, whereas the posterior layer extends superiorly to the inferior part of the neck, and the inferiorly to the dorsal surface of the sacrum. The quadratus lumborum is contained in the anterior muscular compartment, and the erector spinae in the posterior compartment. Psoas major lies anterior to the anterior layer. Various superficial muscles of the posterior thorax and abdomen arise from the posterior layer - namely the latissimus dorsi, and serratus posterior inferior.
The following outline is provided as an overview of and topical guide to human anatomy:
The hip bone is a large flat bone, constricted in the center and expanded above and below. In some vertebrates it is composed of three parts: the ilium, ischium, and the pubis.
The pelvis is the lower part of the trunk, between the abdomen and the thighs, together with its embedded skeleton.
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