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Anatomical variations of the liver and its suspensory system: a cadaver-based study

Journal: Journal of Bodywork and Movement Therapies Date: 2023/01, 33Pages: e60. doi: Subito , type of study: descriptive study

Full text    (https://www.bodyworkmovementtherapies.com/article/S1360-8592(22)00211-X/abstract)

Keywords:

anatomy [101]
cadaver [18]
descriptive study [65]
liver [51]

Abstract:

Introduction/Background Non-traumatic musculoskeletal (MSK) pain is a socio-economic burden, being the leading cause of absenteeism and prolonged disability [1]. The origin of this pain is unclear, yet studies have reported theories on the role of fascia, nociceptive stimulation, and visceral (im)mobility, and provided evidence for the success of visceral manipulation therapy [2,3,4]. The influence of viscera on the MSK system is understudied, even though the human body functions best when its components, including the viscera, are free to move in full range [5]. Thus, to understand the influence of visceral mobility on the MSK system, this study investigated the anatomical variation of the liver’s suspensory system via physical measurements and 3D surface scanning. Methods With ethics clearance, fourteen of twenty-two formaldehyde-fixed donors were selected; eight donors were excluded due to alteration of the region of interest. Using dissection, livers and diaphragms were isolated. Using a string and a digital micrometer, the length and thickness of the triangular ligaments, falciform ligament, and the circumference of the bare area were measured for each selected donor. Each isolated liver was weighed. Using a structured light scanner, each liver and its suspensory system were digitalized for future analysis. Results The mean lengths (mm) of the left triangular ligament edges were 55.70 ± 27.1, 88.38 ± 31.69, and 63.62 ± 28.76. The mean lengths of the right triangular ligament edges were 35.32 ± 21.15, 46.98 ± 51.83, and 33.28 ± 21.83. The mean lengths of the falciform edges were 102.75 ± 30.40, 172.32 ± 35.70, and 105.51 ± 49.25. The mean thicknesses of the left and right triangular ligaments, and the falciform, were 0.32 ± 0.16, 0.32 ± 0.20, and 0.34 ± 0.31, respectively. The bare area circumference was 443.12 ± 98.38mm, and the mean liver weight was 1439.09 ± 752.39g. Conclusion This dissection-based study provides evidence of a broad range of anatomical variations that exists between livers and the suspensory system, which suggests that the liver’s suspensory system has adapted to each body’s needs and demands. Recognizing these variations is important to understand the impact of viscera on the MSK system, which could lead to improved treatments.


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