Rectus Abdominis, Sheath and Rectus Sheath Block

Purpose Although the rectus abdominis and its sheath are well known structures, their development in the human fetus is poorly understood. Materials and Methods We examined rectus abdominis and sheath development in semiserial horizontal sections of 18 fetuses at 5-9 weeks of gestation. Results Rect...

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Detalles Bibliográficos
Autores: Yang, Jae Do, Hwang, Hong Pil, Kim, Ji Hyun, Rodríguez Vázquez, José Francisco, Abe, Shinichi, Murakami, Gen, Cho, Baik Hwan
Tipo de recurso: artículo
Fecha de publicación:2019
País:España
Institución:Universidad Complutense de Madrid (UCM)
Repositorio:Docta Complutense
Idioma:inglés
OAI Identifier:oai:docta.ucm.es:20.500.14352/110951
Acceso en línea:https://hdl.handle.net/20.500.14352/110951
Access Level:acceso abierto
Palabra clave:611
611.03
Rectus abdominis
Pectoralis
Sternalis
Sternum
Rib
Anatomía
2410.02 Anatomía Humana
2410.06 Embriología Humana
Descripción
Sumario:Purpose Although the rectus abdominis and its sheath are well known structures, their development in the human fetus is poorly understood. Materials and Methods We examined rectus abdominis and sheath development in semiserial horizontal sections of 18 fetuses at 5-9 weeks of gestation. Results Rectus muscle differentiation was found to commence above the umbilicus at 6 weeks and extend inferiorly. Until closure of the anterior chest wall via fusion of the bilateral sternal anlagen (at 7 weeks), the anterior rectal sheath originated from the external oblique and developed towards the medial margin of the rectus abdominis at all levels, including the supracostal part. After formation of the anterior sheath, fascial laminae from the internal oblique and transversus abdominis contributed to formation of the posterior rectus sheath. However, the posterior sheath was absent along the supracostal part of the rectus abdominis, as the transversus muscle fibers reached the sternum or the midline area. Therefore, it appeared that resolution of the physiological umbilical hernia (8-9 weeks) as well as chest wall closure was not required for development of the rectus abdominis and its sheath. Conversely, in the inferior part of the two largest fetal specimens, after resolution of the hernia, the posterior sheath underwent secondary disappearance, possibly due to changes in mechanical stress. Conclusion Upward extension of the rectus abdominis suddenly stopped at the margin of the inferiorly developing pectoralis major without facing the external intercostalis. The rectus thoracis, if present, might correspond to the pectoralis.