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Purpose It is unknown whether maximal voluntary co-contraction of abdominal muscles, called abdominal bracing, can be a training maneuver for improving strength and power of trunk and lower limb muscles. The present study aimed to elucidate this. Methods Twenty young adult men (23.3 ± 1.8 years) were allocated to training (TG, n  = 11) or control (CG, n  = 9) group. TG conducted an 8-week training program (3 days/week) consisting of 2-s maximal abdominal bracing followed by 2-s muscle relaxation (5 × 10 repetitions/day). Maximal voluntary isometric strength during trunk flexion and extension, hip extension, and knee extension, maximal lifting power from sitting position, and the thicknesses of abdominal muscles were measured before and after the intervention. In addition, surface electromyograms from trunk and lower limb muscles and intra-abdominal pressure (IAP) during the maximal abdominal bracing and maximal lifting tasks were also determined. Results After the intervention, TG showed significant increases in isometric trunk extension (+14.4 %) and hip extension (+34.7 %) strength and maximal lifting power (+15.6 %), while CG did not show any changes in strength and power variables. Furthermore, TG had significant gains in the muscle thickness of the oblique internal (+22.4 %), maximal IAP during abdominal bracing (+36.8 %), and the rate of IAP rise during lifting task (+58.8 %), without corresponding changes in CG. Conclusion The current study indicates that a training style with maximal voluntary co-contraction of abdominal muscles can be an effective maneuver for increasing strength and power during movements involving trunk and hip extensions, without using external load.

Background and objectivesThe subcostal transversus abdominis plane block (scTAPB) provides analgesia to the anterior abdominal wall but analgesic spread following a single injection remains modest and variable. The oblique scTAPB, which is performed with a continuous injection during needle progression into the TAP along the oblique subcostal line, may extend the block to the whole anterior abdominal wall but needle progression by hydrodissection may be difficult, explaining why this block is not widely used. This study investigated if two sequential scTAPB injections (2scTAPI) may reach more nerves than a single scTAPB (1scTAPI).MethodsAfter institutional approval and under ultrasound guidance, a single injection of 20 mL of blue dye was performed in 16 cadaveric subjects into the TAP along the costal margin and lateral to the semilunaris line (1scTAPI). On the opposite side, a 20 mL of green solution was split into two injections (2scTAPI), using one injection medial and one lateral to the semilunaris line. Dye spread was assessed via gross anatomical dissection using an indirect method to quantify the involvement of the anterior cutaneous branches of the intercostal nerves with each technique. A nerve was considered stained if the dye was observed in the TAP, reaching the costal margin aligned with the bony extremity of its corresponding rib.ResultsAccording to the spread to the costal margin, the estimated median number of consecutive nerves reached by dye after 2scTAPI was 5 (IQR 5–6) vs 3 (IQR 3–4) for 1scTAPI (p=0.00001). Spread after 2scTAPI suggested coverage of nerves originating from T8 to T12 in 85% of the subjects, and from T7 to T12 in 5 out of 17 cases. Spread following the 1scTAPI suggested coverage of nerves from T9 to T11 in most cases.ConclusionsIn a cadaveric model, a larger spread at the costal margin was obtained after 2scTAPI, suggesting a greater coverage of anterior branches of abdominal wall nerves compared with 1scTAPI. Clinical studies are needed to confirm these results.

This study investigates gender differences in core muscle morphology among elite alpine skiers using ultrasonography, highlighting significant disparities that could influence training and injury prevention strategies. Methods: A cross-sectional design was employed, examining ultrasound imaging (USI) in 22 elite skiers (11 male, 11 female) to assess the thickness of the external oblique (EO), internal oblique (IO), transversus abdominis (TrAb), and rectus abdominis (RA) muscles. Results: Significant differences were noted, with male skiers displaying greater muscle thickness, particularly in the right IO and RA and left IO, EO, TrAb, and RA. Conclusions: These findings suggest that male and female skiers may require different training approaches to optimize performance and reduce injury risks. This research contributes to a deeper understanding of the physical demands on elite skiers and underscores the need for gender-specific training regimens to enhance athletic outcomes and prevent injuries.

Low back pain represents the leading cause of disability since 1990. In 90% of cases, it is classified as non-specific low back pain, being chronic in 10% of subjects. Ultrasound has proven to be an effective measurement tool to observe changes in the activity and morphology of the abdominal muscles. This article reviews which core synergies are studied with ultrasound in healthy subjects and with chronic non-specific low back pain. A systematic review was conducted on studies analyzing synergies between two or more core muscles. Publications from 2005 until July 2021 were identified by performing structured searched in Pubmed/MEDLINE, PEDro and WOS. Fifteen studies were eligible for the final systematic review. A total of 56% of the studies established synergies between the core muscles and 44% between the homo and contralateral sides of the core muscles. The most studied core synergies were transversus abdominis, internal oblique and external oblique followed by the rectus abdominis and the lumbar multifidus. No studies establishing synergies with diaphragm and pelvic floor were found. Eight studies were conducted in healthy subjects, five studies in subjects with chronic non-specific low back pain compared to healthy subjects and two studies in subjects with chronic non-specific low back pain.

The turtle body plan differs markedly from that of other vertebrates and serves as a model system for studying structural and developmental evolution. Incorporation of the ribs into the turtle shell negates the costal movements that effect lung ventilation in other air-breathing amniotes. Instead, turtles have a unique abdominal-muscle-based ventilatory apparatus whose evolutionary origins have remained mysterious. Here we show through broadly comparative anatomical and histological analyses that an early member of the turtle stem lineage has several turtle-specific ventilation characters: rigid ribcage, inferred loss of intercostal muscles and osteological correlates of the primary expiratory muscle. Our results suggest that the ventilation mechanism of turtles evolved through a division of labour between the ribs and muscles of the trunk in which the abdominal muscles took on the primary ventilatory function, whereas the broadened ribs became the primary means of stabilizing the trunk. These changes occurred approximately 50 million years before the evolution of the fully ossified shell. The origin of the unique turtle lung ventilatory apparatus is poorly understood. Here the authors show an increase in body wall rigidity early in evolution that allowed the abdominal muscles to become specialized for breathing and the ribs to eventually form the iconic turtle shell.

Some authors in the past based their conclusions about the limits of the metapostnotum of Chrysidoidea based on the position of the mesophragmo-metaphragmal muscle, rather than aspects of the skeleton and musculature associated with the metapectal-propodeal complex. The latter character system suggests another interpretation of the metapostnotum delimitation. Given this scenario, the main goal of this work is to present a new perspective on the metapostnotum in Chrysidoidea, especially Bethylidae, helping to resolve questions related to the evolution of the metapostnotum. This is based on homologies established by associating of insertion points of ph2-ph3 and ph3-T2 muscles with the delimitation of the respective sclerite the muscles insert into. Our results indicate that, according the position of the metaphragmal muscles, the metapostnotum in Bethylidae is medially expanded in the propodeal disc and has different forms of configuration. Internally, the limits of the metapostnotum can be tracked by the shape of the mesopostnotum, and vice versa. Thus, the anteromedian area of the propodeal disc sensu Evans was reinterpreted in the current study as the metapostnotum. In conjunction with associated structures, we provide evidence to clarify the relationships between the families within Chrysidoidea, although certain families like Embolemidae, Dryinidae and Chrysididae exhibit extreme modifications of the condition found in Aculeata, as observed in Bethylidae. We review the terminology used to describe anatomical features on the metapectal-propodeal complex in Bethylidae in general, and provide a list of recommended terms in accordance with the online Hymenoptera Anatomy Ontology. The morphology of the studied subfamilies are illustrated. Studies that focus on a single structure, across a larger number of taxa, are more insightful and present specific questions that can contribute to broader issues, thus providing a better understanding of the morphology and evolution of insects.

IntroductionThe structure and function of the human anterolateral abdominal wall have been thoroughly described. However, there has been limited anatomical study of the pyramidalis muscle and its arterial supply. The aim of this study was to analyse the patterns of arterial supply to the pyramidalis in a female population.MethodsA retrospective study of 32 computed tomography angiography scans of the abdominal wall of adult women was performed to assess the prevalence (bilateral or unilateral presence, or absence), morphology (medial border height, base width and thickness) of pyramidalis and patterns of arterial supply.ResultsPyramidalis prevalence was bilateral in 75% of computed tomography angiography studies (24/32), unilateral in 6.3% (2/32) and absent in 18.8% (6/32). Of the five patterns of pyramidalis arterial supply observed and described in detail, the most frequent (68%, 34/50 of cases) originated from an exclusive muscular branch of the inferior epigastric artery. Origin from the pubic branch of the inferior epigastric artery was seen in 4% (2/50). There was a single case (2%, 1/50) of artery origin from a variant obturator artery, a common trunk with the pubic branch from the inferior epigastric artery, and from the muscular branch to rectus abdominis. The artery could not be defined in 22% (11/50).ConclusionIn this computed tomography angiography study of women, five patterns of Pyramidalis arterial supply were identified. In the majority of cases, the pyramidalis derived its arterial supply from an exclusive, isolated muscular branch of the inferior epigastric artery.

Background:Recently, ultrasound-guided transversus abdominis plane blockade for abdominal wall analgesia has been described, and it involves injection of local anesthetic into the transversus abdominis plane. The posterior approach involves injection of local anesthetic in the lateral abdominal wall between the costal margin and the iliac crest and is suitable for postoperative analgesia after surgery below the umbilicus. The subcostal approach is suitable after abdominal surgery in the periumbilical region. The subcostal block can be modified, and the needle can be introduced along the oblique subcostal line from the xyphoid process toward the anterior part of the iliac crest.Objective:The purpose of this brief technical report was to describe in detail the anatomy and the technique of continuous oblique subcostal blockade. The goal of this approach was to produce a wider sensory blockade suitable for analgesia after surgery both superior and inferior to the umbilicus.Conclusions:A catheter can be placed along the oblique subcostal line in the transversus abdominis plane for continuous infusion of local anesthetic. Multimodal analgesia and intravenous opioid are used in addition because visceral pain is not blocked. Continuous oblique subcostal transversus abdominis plane block is a new technique and requires both a detailed knowledge of sonographic anatomy and technical skill for it to be successful.

Purpose Chronic inguinodynia is one of the most frequent complications after groin herniorrhaphy. We investigated the retroperitoneal anatomy of the iliohypogastric, ilioinguinal, genitofemoral, and lateral femoral cutaneous nerve to prevent direct nerve injury during hernia repairs and to find the most advantageous approach for posterior triple neurectomy. Methods We dissected the inguinal nerves in 30 human anatomic specimens bilaterally. The distances from each nerve and their entry points in the abdominal wall were measured in relation to the posterior superior iliac spine, anterior superior iliac spine, and the midpoint between the two iliac spines on the iliac crest. We evaluated our findings by creating high-resolution summation images. Results The courses of the iliohypogastric and ilioinguinal nerve are most consistent on the anterior surface of the quadratus lumborum muscle. The genitofemoral nerve always runs on the psoas muscle. The entry points of the nerves in the abdominal wall are located as follows: the iliohypogastric nerve is above the iliac crest and lateral from the anterior superior iliac spine, the ilioinguinal nerve is with great variability, either above or below the iliac crest and lateral from the anterior superior iliac spine, the genital branch is around the internal inguinal ring, the femoral branch is either cranial or caudal to the iliopubic tract, and the lateral femoral cutaneous nerve is either medial or lateral to the anterior superior iliac spine. Conclusion Nerve injury during inguinal hernia repairs can be avoided by taking the topographic anatomy of the inguinal nerves into consideration. The most advantageous plane to look for the iliohypogastric and ilioinguinal nerve during posterior neurectomy is on the anterior surface of the quadratus lumborum muscle. For the surgical treatment of severe chronic inguinodynia, especially after posterior open or endoscopic mesh repair (TAPP/TEP), the retroperitoneoscopic or open retroperitoneal approach for posterior triple neurectomy can be considered.

BackgroundThere has been confusion in the anatomical recognition when performing inguinal hernia operations in Japan. From now on, a paradigm shift from the concept of two-dimensional layer structure to the three-dimensional space recognition is necessary to promote an understanding of anatomy.Anatomy and EmbryologyAlong with the formation of the abdominal wall, the extraperitoneal space is formed by the transversalis fascia and preperitoneal space. The transversalis fascia is a somatic vascular fascia originating from an arteriovenous fascia. It is a dense areolar tissue layer at the outermost of the extraperitoneal space that runs under the diaphragm and widely lines the body wall muscle. The umbilical funiculus is taken into the abdominal wall and transformed into the preperitoneal space that is a local three-dimensional cavity enveloping preperitoneal fasciae composed of the renal fascia, vesicohypogastric fascia, and testiculoeferential fascia. The Retzius’ space is an artificial cavity formed at the boundary between the transversalis fascia and preperitoneal space. In the underlay mesh repair, the mesh expands in the range spanning across the Retzius’ space and preperitoneal space.