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Transcript
Anatomic investigation of the connections of the iliopsoas
muscle along its course from the 4th lumbar vertebra to its point
of attachment at the lesser trochanter
Bromm S1, Bartmer-Leitl E1, Kaufer C1, Keller M1, Schwerla F2
COE - European College of Osteopathy, Germany
German Academy of Osteopathy (AFO), Research Commission
1
2
Objective
Background
To examine the connections of the iliopsoas muscle
g its course from the 4th lumbar vertebra to its
along
point of attachment at the lesser trochanter.
Material and Methods
Possible connections of M. iliopsoas
Psoas
major
Study design:
Psoas
minor
Caecum
Sigmoid
L5
¾ A baseline study in anatomy consisting of a
systematic literature research and examinations
of anatomical preparations.
Linea
terminali
s
Literature review:
¾ Search in electronic databases (Medline) as well
as in the collections of libraries at the anatomical
institutions in Munich and Nuremberg, Germany.
Inguinal
ligament
Hi
Hip
joint
Dissections:
¾ Examination of 19 preparations (FriedrichAlexander University Nuremberg); photographic
and descriptive documentation.
The results gained from the literature research and the examination of the preparations were evaluated and processed for the use in
osteopathic practice.
Results
¾ Some authors described the existence of a firm connection between the caecum, the sigmoid colon, the common iliac vessels, the
inguinal ligament and the iliopsoas muscle. The preparations confirmed a connective tissue-like substance.
¾ Most of the literature sources examined illustrated a connection of the 5th lumbar vertebra, the iliolumbar ligament, the sacroiliac joint,
the sacrum, the anterior, sacroiliac ligaments and the hip joint to the iliopsoas muscle. The connections found in the preparations in this
area consisted of muscle fibers and fascial connections.
¾ In the current literature there was no description of a connection between the organs of the pelvis and the iliopsoas muscle. In this
regard the fascial connection between the psoas and the pelvic fascia is considered an indirect connection. The same was true for the
correlation of the iliopsoas muscle and organs of the lesser pelvis.
Connection to the caecum
and to the sigmoid colon
Connection to
the iliolumbar
ligament
Connection to the iliac
vessels
Intersection
to the fascia
of the pelvis
Iliac vessels
Caecum
Iliopsoas
muscle
Strong connection
to peritoneum
through a ligamentsimilar structure
Peritoneum overlying
iliopsoas muscle
Fascia iliaca
Web-like
Web
like tissue
between peritoneum
and fascia iliaca
Connection between
iliopsoas and iliac vessels
Iliolumbar
ligament
Connection to sacroiliac joint, iliolumbar
lig., inguinal lig., and ant. sacroiliac ligg.
Iliolumbar
ligament
Capsule
l off the
h hi
hip
joint
L5
Peritoneum
Connection to the capsule
of the hip joint
Iliopsoas muscle
Iliopsoas muscle
Summary
The descriptions of the connections of the iliopsoas muscle found in the literature are partly inconsistent, and in some cases there is no
information available at all. Nearly all structures examined in the anatomical preparations show connections to the iliopsoas muscle, part
of which are direct, others indirect, via the fascia. From an osteopathic point of view it may be possible that all firm connections of the
iliopsoas muscle which were found could transmit mobility restrictions to other structures.