Clinical Biomechanics 20 (2005) 233241

www.elsevier.com/locate/clinbiomech

Regional morphology of the transversus abdominis and

obliquus internus and externus abdominis muscles
Donna M Urquhart a,*, Priscilla J Barker b, Paul W Hodges c,d
,
Ian H Story a, Christopher A Briggs b
a
School of Physiotherapy, The University of Melbourne, Victoria 3010, Australia
b
Department of Anatomy and Cell Biology, The University of Melbourne, Victoria 3010, Australia
c
Prince of Wales Medical Research Institute, New South Wales 2031, Australia
d
Division of Physiotherapy, The University of Queensland, Queensland 4072, Australia

Received 14 August 2004; accepted 15 November 2004

Abstract

Background. The mechanisms by which the abdominal muscles move and control the lumbosacral spine are not clearly under-
stood. Descriptions of abdominal morphology are also conicting and the regional anatomy of these muscles has not been compre-
hensively examined. The aim of this study was to investigate the morphology of regions of transversus abdominis and obliquus
internus and externus abdominis.
Methods. Anterior and posterolateral abdominal walls were dissected bilaterally in 26 embalmed human cadavers. The orienta-
tion, thickness and length of the upper, middle and lower fascicles of transversus abdominis and obliquus internus abdominis, and
the upper and middle fascicles of obliquus externus abdominis were measured.
Findings. Dierences in fascicle orientation, thickness and length were documented between the abdominal muscles and between
regions of each muscle. The fascicles of transversus abdominis were horizontal in the upper region, with increasing inferomedial
orientation in the middle and lower regions. The upper and middle fascicles of obliquus internus abdominis were oriented supero-
medially and the lower fascicles inferomedially. The mean vertical dimension of transversus abdominis that attaches to the lumbar
spine via the thoracolumbar fascia was 5.2 (SD 2.1) cm. Intramuscular septa were observed between regions of transversus abdo-
minis, and obliquus internus abdominis could be separated into two distinct layers in the lower and middle regions.
Interpretation. This study provides quantitative data of morphological dierences between regions of the abdominal muscles,
which suggest variation in function between muscle regions. Precise understanding of abdominal muscle anatomy is required for
incorporation of these muscles into biomechanical models. Furthermore, regional variation in their morphology may reect dier-
ences in function.
2004 Elsevier Ltd. All rights reserved.

Keywords: Anatomy; Abdominal muscles; Transversus abdominis; Obliquus internus abdominis; Obliquus externus abdominis; Regional morph-
ology; Spinal control

*
Corresponding author. Address: Department of Epidemiology
and Preventive Medicine, Central and Eastern Clinical School,
Monash University, Alfred Hospital, Commercial Road, Melbourne
3004, Vic., Australia.
E-mail address: donna.urquhart@med.monash.edu.au (D.M
Urquhart).
1. Introduction
There is increasing evidence to indicate the impor-
tance of the anterolateral abdominal muscles in con-
trol and movement of the lumbar spine and pelvis
(Cholewicki et al., 1999; Cresswell et al., 1992; Hodges
and Gandevia, 2000). However, few studies have

0268-0033/$ - see front matter 2004 Elsevier Ltd. All rights reserved.
doi:10.1016/j.clinbiomech.2004.11.007
234 D.M Urquhart et al. / Clinical Biomechanics 20 (2005) 233241
comprehensively investigated the morphology of these
muscles. Transversus abdominis (TrA), obliquus inter-
nus abdominis (OI) and obliquus externus abdominis
(OE) have a number of primary bro-osseous attach-
ments that include the costal cartilages, the lumbar spine
via the thoracolumbar fascia (TLF), and the iliac crest
and pubis (Williams et al., 1999). It is hypothesised that
the muscle fascicles originating from these dierent
structures may have dierent functions. For example,
the upper fascicles of TrA arising from the costal carti-
lages may stabilise the rib cage, the middle fascicles
attaching to the TLF may contribute to control of the
lumbar spine, and the lower fascicles arising from the
iliac crest may support the abdominal contents and gen-
erate forces that compress the sacroiliac joints (Richard-
son et al., 2002 and Snijders et al., 1995).
Recent evidence from electromyographic (EMG)
studies suggests there is regional variation in abdominal
muscle function. During upper limb movements, greater
tonic activity of the lower region of TrA was reported
compared to middle region (Hodges et al., 1999). The
supercial abdominal muscles of the lower abdominal
wall were also more active in erect standing than those
of the upper abdominal wall (Strohl et al., 1981).
Furthermore, dierences in the recruitment of regions
of OI and OE have been documented during trunk
extension and rotation (Davis and Mirka, 2000; Mirka
et al., 1997).
While these studies provide preliminary evidence of
regional dierences in function, investigation of regional
morphology is critical for evaluation of the mechanical
eect of each region on the lumbar spine, pelvis and
rib cage. Although one study has described the fascicle
orientation of regions of TrA, OI and OE (Askar,
1977), there has been no detailed, quantitative investiga-
tion of regional morphology of the abdominal muscles.
The aims of this study were to compare the morphology
(fascicle orientation, thickness and length) of the
abdominal muscles and regions of these muscles.
2. Methods
Twenty-six human cadavers, embalmed in a solution
of 4% formaldehyde, were serially dissected to investi-
gate the morphology of TrA, OI and OE. Twenty-four
sides of 12 specimens (6 female, 6 male, mean age: 84
(7395) years) were dissected to investigate the anterior
abdominal wall, and 28 sides of 14 specimens (6 female,
8 male, mean age: 83 (6096) years) to expose the
inner aspect of the posterolateral wall. A midline inci-
sion was made from the xiphoid process to the pubic
symphysis, and OE, OI and TrA were separated and
reected. The abdominal viscera and overlying fascia
were subsequently removed to reveal the posterolateral
wall.
2.1. Regional anthropometric measures
Anthropometric measures were documented to dene
regions of the abdominal wall and to determine the ex-
tent to which TrA attaches to the costal cartilages (upper
region), TLF (middle region) and the pelvis (lower re-
gion) (Fig. 1). The upper region was measured with a
tape measure (accuracy 0.1 cm) from the 6th costal
cartilage or the superior border of the T9 vertebral body
to the inferior border of the rib cage. The T9 vertebral
body is in close alignment to the notch of the 6th costal
cartilage (Snell, 2000) and was selected in specimens
where parts of the rib cage had been previously removed.
The middle region was dened as the distance between
the inferior border of the rib cage and a line connecting
the superior borders of the iliac crest, and the lower re-
gion was measured from this line to the pubic symphysis.
2.2. Fascicle orientation
The orientation of fascicles of TrA, OI and OE was
examined in the anteriorly dissected specimens with ref-
erence to a line connecting the left and right anterior
superior iliac spines (ASIS). Fascicles parallel to this ref-
erence line were considered to be horizontal. The upper,
middle and lower regional measures of TrA and OI were
documented bilaterally at the level of the 11th costal car-
tilage, halfway between the iliac crest and rib cage, and
adjacent to the ASIS. Additional orientation measures
were reported for TrA, 2 cm below the ASIS, and for
OI, halfway between the ASIS and pubic symphysis.
The fascicle orientation of OE was calculated at the level
of the 8th costal cartilage (upper region) and halfway be-
tween the iliac crest and the rib cage (middle region).
The fascicles of OE did not extend below the ASIS
and therefore no measurements for a lower region of
Fig. 1. Anterior and lateral view of the upper, middle and lower
regions of the abdominal wall. Horizontal lines show the borders of the
regions. Key landmarks for the measurement of muscle length and
fascicle orientation are indicated by A (8th costal cartilage), B (11th
costal cartilage), C (halfway between the iliac crest and rib cage), D
(ASIS) and E (a line connecting the left and right ASIS). Note the
dierent bro-osseous attachments for each region of TrA; the costal
cartilages in the upper region, the TLF in the middle region, and the
pelvis in the lower region.
 D.M Urquhart et al. / Clinical Biomechanics 20 (2005) 233241 235

this muscle were made. The orientation measures were
calculated from digital photographic images using an
image analysis program, Image J 1.20s (National Insti-
tute of Mental Health, Bethesda, Maryland, USA; accu-
racy 0.001 deg). To standardise the photographic
conditions, the distance between the camera and the ca-
daver was kept constant and the centre of eld of view
was maintained halfway between the level of the pubic
crest and the manubriosternal joint.
analysis. Dierences between the abdominal muscles
and muscle regions for each variable were compared
using one-way repeated measures analysis of variance
(ANOVA). Duncans multiple range test was used for
the post-hoc analysis and the alpha level was set at
0.05. Intraclass correlation coecients (ICCs), (two-
way mixed-model with absolute agreement), were calcu-
lated to determine the repeatability.

2.3. Muscle thickness 3. Results

Thickness of the upper, middle and lower regions of
TrA and OI, and the upper and middle regions of OE
was measured using a manual micrometer (Mituyo, To-
kyo, Japan; accuracy 0.001 mm). TrA and OI thick-
ness measures were obtained from the same locations
as the orientation measures, while the OE thickness
measures were recorded adjacent to the 11th costal car-
tilage and halfway between the rib cage and iliac crest.
2.4. Fascicle length
Fascicle length was measured bilaterally with a tape
measure (accuracy 0.1 cm). The lengths of TrA and
OI fascicles were measured from the anterior edge of
the musculotendinous aponeurosis to the osseous or fas-
cial attachment at the 11th costal cartilage (upper), mid-
way between the rib cage and iliac crest (middle), and at
the ASIS (lower). The fascicle lengths of OE in the upper
region were measured from the aponeurosis to their
insertion on the 8th costal cartilage, and those of the
middle region (halfway between the rib cage and iliac
crest) from the musculotendinous junction to their
attachment on the lower rib cage.
2.5. Inferior extent
The distal extent of the fascicles of TrA and OI was
categorised as terminating at the mid-point of the ingui-
nal ligament or above, or extending below the mid-point
of the inguinal ligament.
3.1. Regional anthropometric measures
The vertical dimensions of each region, expressed as a
mean and a proportion of the total vertical dimension of
the abdominal wall, are summarised in Table 1.
3.2. Fascicle orientation
There were regional dierences in the orientation of
TrA and OI fascicles (Table 2). The fascicle orientation
of upper TrA was horizontal, however 8 of the 23 sides
had fascicles angled greater than 10 deg from the hori-
zontal, both superomedially and inferomedially. The
middle and lower fascicles of TrA were inferomedially
directed and the angle of the lower fascicles was greater
than that of the middle region (P = 0.007) (Fig. 2A).
Superior to the iliac crest, the upper and middle fascicles
of OI were directed superomedially (Fig. 2B). In con-
trast, below the iliac crest the OI fascicles were oriented
horizontally (P < 0.001), with increasing inferomedial
Table 1
Mean vertical dimensions (cm) and proportions of the abdominal wall
and upper, middle and lower TrA (n = 52)
Region Vertical dimensions
Mean (SD) Proportion (%)
Upper 15.0 (3.3) 40
Middle 5.2 (2.1) 14
Lower 17.0 (2.6) 46

2.6. Repeatability
Table 2
Mean (SD) fascicle orientation (deg) for regions of TrA, OI and OE
Three separate measures of each parameter were doc- (n = 24)
umented for the middle region of TrA to evaluate mea-
Region Fascicle orientation
surement consistency. It was predicted that greater error
TrA OI OE
may be associated with these data because determina-
tion of the site for measurement required location of Upper 2.7 (9.3) 48.2 (12.9) 49.3 (7.0)
Middle 13.3 (9.8) 35.3 (9.9) 58.6 (10.5)
several anatomical landmarks.
Lower (1) 21.2 (10.5) 0.0 (7.2)
Lower (2) 20.3 (11.3) 8.2 (9.1)
2.7. Statistics Lower (3) 15.5 (10.3)
Lower (1)ASIS level; lower (2)2 cm below ASIS; lower (3)
As there was no systematic dierence between mea- halfway between ASIS and pubic symphysis. Negative values
sures for left and right sides, the data were pooled for inferomedial orientation, positive valuessuperomedial orientation.
236 D.M Urquhart et al. / Clinical Biomechanics 20 (2005) 233241

Fig. 2. Fascicle orientation of the abdominal muscles. Serial dissections of the right abdominal wall showing right TrA (A), OI (B) and OE (C) for a
single specimen. Horizontal lines divide the upper, middle and lower abdominal regions in each panel. Dierences in fascicle orientation can be
observed between muscles (compared between panels) and between regions (compared within each panel). In the middle region, fascicles of TrA are
the most horizontal. The fascicles of OI radiate superomedially and inferomedially from the iliac crest. Fascicles of OE are inferomedial in all regions.
RA-rectus abdominis.

angulation below the ASIS. The fascicles of OE were 3

also directed inferomedially, with greater angulation in
the middle region (P = 0.009) (Fig. 2C). Standard devi- 2.5
ations were large indicating high variability in fascicle
Thickness SD (mm)

orientation between specimens. 2

3.3. Muscle thickness 1.5

There were regional dierences in thickness of TrA, 1

OI and OE (Table 3, Fig. 3). The upper region of TrA
had a greater mean thickness than the lower and middle 0.5
regions (P < 0.001), while the lower and middle regions
did not dier in their thickness (P = 0.9). Lower and 0
Upper MiddleLower Upper Middle Lower Upper Middle
middle regions of OI had a similar thickness (P = 0.4),
TrA OI OE
which diered from the thickness of the upper region
(P < 0.001). However, on closer examination of OI, Fig. 3. Muscle thickness of upper, middle and lower TrA and OI, and
two layers of muscle were evident in the lower and mid- upper and middle OE. Thickness of lower OI is shown in two sections
dle regions (refer to Section 3.7). The middle region of with dierent shading. These represent the division of OI into the
true OI and the additional muscle layer (horizontal shading). In the
OE was thicker than the upper region (P < 0.001). middle region, OI is thicker than OE, and OE thicker than TrA.
The upper regions of OI and TrA had a similar thick-
ness (P = 0.5), but in the middle region both OI and OE
were thicker than TrA (P < 0.001). In the lower region,
OI was 24% thicker than TrA (P < 0.002).
Table 3
Mean (SD) muscle thickness (mm) for regions of TrA, OI and OE 3.4. Fascicle length
(n = 24)
Region Muscle thickness Dierences in fascicle length were evident between
TrA OI OE TrA, OI and OE, and between regions of each muscle
Upper 1.2 (0.4) 1.3 (0.5) 1.4 (0.5)
(Table 4). The fascicles of all muscles were longest in
Middle 0.7 (0.2) 1.8 (0.9) 1.7 (0.8)a the middle region and shortest in the lower region.
Lower 0.7 (0.3) 1.9 (0.7)b The middle fascicles of OE were the longest of all muscle
a
Posterior aspect of OE in the middle region. regions, measuring approximately 7 cm greater than
b
Includes the additional muscle layer. TrA and OI in the middle region (P < 0.001). In con-
 D.M Urquhart et al. / Clinical Biomechanics 20 (2005) 233241 237

Table 4 71% of these the fascicles reached the pubic crest

Mean (SD) fascicle lengths (cm) for regions of TrA, OI and OE (n = 24). In contrast, the fascicles of TrA terminated
(n = 24)
more superiorly, with only 4% extending below the
Region Fascicle length mid-point of the inguinal ligament (n = 24).
TrA OI OE
Upper 9.0 (1.2) 8.8 (2.3) 10.6 (2.4) 3.6. Intramuscular septa of TrA
Middle 11.3 (1.5) 10.8 (2.4) 18.4 (3.0)a
Lower 3.6 (1.1) 5.7 (1.1) Septa between muscle fascicles of TrA were observed
a
Posterior aspect of OE in the middle region. just below the rib cage and at the level of the iliac crest
(Fig. 4A). The upper septa, with a mean width of 0.5 cm,
trast, the lower fascicles of TrA were the shortest, reach- were present in 42% of specimens (n = 52). In contrast,
ing only 3.6 (SD 1.1) cm, and were approximately 2 cm the lower septa had a greater mean width (0.8 cm) and
shorter than those of OI (P < 0.001). were observed more frequently (77% of cases).

3.5. Inferior extent 3.7. Subdivision of OI

The muscle fascicles of OI extended below the mid- In all of the anteriorly dissected cadavers (n = 24), OI
point of the inguinal ligament in all specimens and in could be separated into two muscle layers in the lower

Fig. 4. Features of the deep abdominal muscles. (A) Intramuscular septa separating the fascicles of TrA in the middle and upper regions. The right
panel shows a line drawing highlighting the extent of the septa, from the lateral raphe around the lateral abdominal wall to three quarters along the
length of the TrA fascicles. ISintramuscular septa; RCrib cage; ICiliac crest. (B) Anterior fascial attachment of TrA and the two distinct
muscle layers of OI in the lower and middle abdominal region. From left to right; attachment of supercial fascicles of OI, deeper fascicles of OI
(additional muscle layer), and TrA can be observed medial to the ASIS. The additional muscle layer is shaded in the right panel. Note the tiered
arrangement of the muscle layers as they become aponeurotic, with the fascicles of TrA being the shortest and deepest. ASISanterior superior iliac
spine; RArectus abdominis.
238 D.M Urquhart et al. / Clinical Biomechanics 20 (2005) 233241
and middle regions (with the exception of one damaged
side). The muscle layer was located between the umbili-
cus and the pubic symphysis, becoming aponeurotic
medial to the insertion of TrA, and 1.0 (SD 0.6) cm lat-
eral to the insertion of OI (Fig. 4B). The thickness of this
layer was 0.98 (SD 0.39) mm at the level of the ASIS
(n = 24), and its fascicle orientation at the ASIS level
and halfway between the ASIS and pubic symphysis
was 5.9 (SD 15.3) deg and 18.9 (SD 10.7) deg inferome-
dial respectively (n = 12). The thickness and fascicle ori-
entation of this layer were similar to those of the more
supercial component of OI at the level of the ASIS
(thickness: P = 0.7, orientation: P = 0.1).
3.8. Anatomical variations
Five variations in the morphology of TrA were iden-
tied in separate specimens. These were; complete and
partial detachment of the muscle from the iliac crest
and an abrupt change in fascicle orientation between
the lower and middle regions, absence of fascicles below
the iliac crest, passage of the iliohypogastric and ilioin-
guinal nerves through the septa in the muscle, and
fusion of the lower fascicles with OI.
3.9. Repeatability
ICCs for repeated measures of the middle region of
TrA were high for the vertical dimension (ICC = 0.99),
fascicle orientation (ICC = 0.96), thickness (ICC =
0.82) and length data (ICC = 0.95).
4. Discussion
Regional dierentiation in the morphology of TrA,
OI and OE may suggest functionally distinct zones of
the abdominal wall. While all the regions of TrA may
contribute to increasing intra-abdominal pressure and
support of the abdominal contents, individual regions
may be recruited independently to perform specic func-
tions. For example, the upper region may stabilise the
rib cage, the middle region may tension the TLF, and
suggest that the lower regions may compress the sacro-
iliac joints Richardson et al., 2002 and Snijders et al.,
1995. The reported variation in fascicle orientation,
thickness and length between regions of TrA, along with
the presence of septa dividing the fascicles of TrA and
the separation of OI into two distinct muscles in the low-
er and middle regions, provide structural evidence to
support these hypotheses.
4.1. Regional anthropometric measures
The middle region of TrA has been primarily investi-
gated in EMG and biomechanical studies because of its
attachment to the lumbar spine via the TLF (Cresswell
et al., 1992; De Troyer et al., 1990; Dumas et al.,
1991; Hodges and Richardson, 1996). It has been pro-
posed that one mechanism by which TrA may increase
spinal control is by tensioning the TLF. The mean ver-
tical distance between the rib cage and iliac crest was
found to be 5.2 (SD 2.1) cm, suggesting that only a lim-
ited region of TrA or OI may attach to the middle layer
of lumbar fascia and inuence vertebral motion of pre-
dominately the mid-lumbar levels. However, due to the
inferomedial and superomedial orientation of the lami-
nae of the posterior layer (Barker and Briggs, 1999; Bog-
duk and Macintosh, 1984; Tesh et al., 1987; Vleeming
et al., 1995), TrA and OI may attach to the spinous pro-
cesses of the lumbar vertebrae over a larger area.
4.2. Fascicle orientation
An assumption in many anatomical texts is that the
fascicles of TrA are consistently directed horizontally
(with the exception of the lower inferomedial bres)
(Moore and Dalley, 1999; Snell, 2000; Williams et al.,
1999). In contrast, this study found the fascicles of
TrA varied in their orientation between regions. The fas-
cicles were horizontal in the upper region, and became
increasingly inferomedial in the middle and lower re-
gions. Similarly, Askar (1977) observed the upper fasci-
cles of TrA to be superomedially angulated, the middle
fascicles almost transverse, and the lower fascicles
inferomedially directed. Although 40 cadavers were
examined in that study, quantitative measures were
not reported. Fascicle orientation of the abdominal
muscles has been measured previously, however, com-
parison of results is dicult as only reference to the
semilunaris and the rib cage was reported (McGill,
1996).
Regional dierences in fascicle orientation were also
evident for OI. The upper and middle fascicles of OI
that attach to the costal cartilages and iliac crest were
oriented superomedially. This is consistent with the role
of this muscle in trunk exion and rotation (Carman
et al., 1972; Cresswell et al., 1992; Goldman et al.,
1987). In agreement with previous reports, the lower fas-
cicles of OI were horizontal at the ASIS level (0.0 (SD
7.2) deg) and were directed inferomedially 2 cm below
the ASIS (8.2 (SD 9.1) deg) (Ng et al., 1998). These
ndings support proposals that lower OI may be in-
volved in compression of the sacroiliac joint (Richard-
son et al., 2002; Snijders et al., 1995). However,
considerable variation in fascicle orientation between
specimens has been reported in this and other studies
(Ng et al., 1998), with measures varying from 13 deg
inferomedial to 20 deg superomedial at the ASIS level.
Such variation needs to be carefully considered when
determining the function of the lower fascicles of both
OI and TrA.
 D.M Urquhart et al. / Clinical Biomechanics 20 (2005) 233241
Several methodological issues require consideration
in the measurement of fascicle orientation. The posture
of the cadaver, photographic technique and clarity of
muscle fascicles may have inuenced the measures.
These eects were minimised by using macrophotogra-
phy and a digital camera, standardising the photo-
graphic and measurement conditions, and comparing
all angles to an internal reference.
4.3. Muscle thickness
Dierences in thickness were evident between muscles
and between regions. In agreement with ultrasound
studies, the upper abdominal wall was thicker than the
lower abdominal wall (Strohl et al., 1981) and the mid-
dle region of OI was thicker than OE, and OE thicker
than TrA (Cresswell et al., 1992; De Troyer et al.,
1990; McGill et al., 1996). In contrast, one study re-
ported OE to be thinner than both OI and TrA at func-
tional residual capacity (Misuri et al., 1997). With
respect to regional measures, McGill et al. (1996) also
found the lower region (2 cm superior to the ASIS) of
TrA to have a similar thickness to the middle region
(midway between iliac crest and rib cage). While the
upper region of OI was previously reported to be thicker
than the lower region (Carman et al., 1972), similar re-
sults were only obtained in this study if a single layer
of lower OI was measured.
Although the relative thicknesses reported in this
study are consistent with previous studies, the absolute
thickness values are considerably smaller (Cresswell
et al., 1992; De Troyer et al., 1990; McGill et al.,
1996; Misuri et al., 1997). This may be explained by
muscle atrophy in the elderly specimens dissected and
tissue changes that can occur with preparation and
embalming processes. Nonetheless, the cross sectional
area of a muscle is associated with force production
and these data may provide a relative indication of force
generating capacity of dierent regions (Williams et al.,
1999).
4.4. Fascicle length
The fascicle length of each abdominal muscle and re-
gion has important functional implications. The lower
fascicles of TrA and OI were the shortest and OE fasci-
cles the longest. Similar results were reported in a previ-
ous study that measured between the attachments of OI
and OE, including the length of the aponeuroses (McG-
ill, 1991). Although the relative change in length for
short and long fascicles is the same, there is less absolute
change in length of short fascicles (Gans and de Vree,
1987; Williams et al., 1999). This suggests dierences
in function of these muscle regions. The fascicles of
OE may therefore have a greater role in torque produc-
tion and movement, whereas the lower fascicles of TrA
239
and OI may sustain isometric tension (Hodges et al.,
1999; Snijders et al., 1995). These hypotheses are sup-
ported by EMG studies that have reported recruitment
of OE during trunk movements (Carman et al., 1972;
Cresswell et al., 1992; Goldman et al., 1987) and tonic
activation of TrA with repetitive movement tasks (Hod-
ges et al., 1999). While biomechanical studies have rep-
resented the abdominal musculature with multiple-force
vectors (Davis and Mirka, 2000; Dumas et al., 1991;
Stokes and Gardner-Morse, 1999), the results of this
study emphasise the need to consider the lower, middle
and upper regions of the abdominal muscles.
4.5. Inferior extent
Although OE fascicles have been reported to consis-
tently become aponeurotic above the iliac crest, consid-
erable variability in the termination of the TrA and OI
fascicles has been reported (Anson et al., 1960; Chandler
and Schadewald, 1944; Zimmerman et al., 1944). Ab-
sence of TrA has even been observed below the iliac
crest (McGill et al., 1996; Strohl et al., 1981). While
TrA and OI were found to be variable in their distal ex-
tent, TrA was consistently aponeurotic proximal to OI
and extended below the ASIS in 23 of the 24 specimens.
These ndings provide anatomical evidence for the con-
tribution of TrA and OI to sacroiliac joint control and
support of the lower abdominal contents (Richardson
et al., 2002; Snijders et al., 1995). There is little consen-
sus regarding the role of TrA and OI in the aetiology
and management of inguinal hernia, however, the vari-
ability in the lower extent of these muscles suggests their
contribution may dier between individuals.
4.6. Intramuscular septa of TrA
Although absent from most current anatomical texts,
septa between the fascicles of TrA have been previously
described as aponeurotic intersections or cracks in
early French and German texts (Eisler, 1912; Poirier and
Charpy, 1901) and more recently have been referred to
as defects or banding (Williams et al., 1999; Zim-
merman et al., 1944). They have been reported to occur
in TrA where the fascicles originating from the TLF do
not connect with those from the iliac crest (Eisler, 1912).
Septa have also been observed between fascicles of OI
(Geller and Machado Da Costa, 1970; Williams et al.,
1999; Zimmerman et al., 1944). However, in the current
study septa between the fascicles of TrA just below the
rib cage were reported.
There are a number of possible explanations for these
intersections. Firstly, they may prevent the lateral trans-
mission of force (see Sheard (2000) for review) at the
interface between adjacent muscle regions allowing inde-
pendent function. Secondly, they may serve as pathways
for the iliohypogastric and ilioinguinal nerves. Thirdly,
240 D.M Urquhart et al. / Clinical Biomechanics 20 (2005) 233241
the septa may be the result of incomplete fusion of
myotomes that are separated by connective tissue septa
during development (Keith, 1921; Schafer et al., 1923).
Finally, as suggested by Eisler (1912) they may be a sign
of atrophy or pathology. Additional studies are required
to determine their aetiology and function.
4.7. Subdivision of OI
The subdivision of OI into two separate muscle layers
has been previously reported in early dissection studies
(Anson and McVay, 1938; Chouke, 1935). However, its
frequency and dimensions have been variably reported
and it has not been documented in recent investigations.
Chouke (1935) observed the muscle division to be pres-
ent bilaterally in 63% of 136 specimens and unilaterally
in 35%, while Anson and McVay reported its presence
in 40% of 125 cadavers. In addition, a previous report
indicated this additional muscle layer to be 23 in. wide,
to fuse with TrA before inserting into the linea alba and
to extend inferiorly as far as the linea semicircularis
(Chouke, 1935). The remainder of OI was reported to
be separated from this additional layer by the iliohypo-
gastric nerve, a branch of the deep circumex iliac artery
and one or two layers of fascia (Chouke, 1935). How-
ever, in the present study the muscle was observed to
vary in width, extend from the umbilicus to at least the
mid-point of the inguinal ligament, and to insert into
the anterior fascias medial to TrA and lateral to OI.
While the similarities in fascicle orientation with the low-
er region of OI may suggest a synergistic function, the
muscle layer was distinctly separate from the more super-
cial portion of OI with a dierent site of insertion.
4.8. Future investigations
This study indicates that there are morphological dif-
ferences between regions of TrA, OI and OE. The results
provide important foundations and normative data for
future biomechanical, EMG and clinical studies, and
highlight the need to consider the role of dierent re-
gions of TrA and OI in control of the lumbopelvic re-
gion and in therapeutic exercise approaches. Future
EMG investigations are required to determine if there
are dierences in function between these muscle regions
and to examine the regional activation of the abdominal
wall in subjects with and without spinal pain.
Acknowledgments
We thank the Department of Anatomy and Cell Biol-
ogy for provision of cadaveric specimens, Stuart Thyer
for photographic support, Ivica Grkovic for his valued
advice, Matthew Jackson for technical assistance
(Department of Anatomy and Cell Biology, The Univer-
sity of Melbourne), and Steve Martin for his imaging
support (School of Physiotherapy, The University of
Melbourne). Paul Hodges was supported by the
NHMRC.
References
Anson, B.J., McVay, C.B., 1938. Inguinal Hernia. I. The anatomy of
the region. Surg. Gynecol. Obstet. 66, 186191.
Anson, B.J., Morgan, E.H., McVay, C.B., 1960. Surgical anatomy of
the inguinal region based upon a study of 500 body-halves. Surg.
Gynecol. Obstet. 111, 707725.
Askar, O.M., 1977. Surgical anatomy of the aponeurotic expansions of
the anterior abdominal wall. Ann. R. Coll. Surg. Engl. 59, 313321.
Barker, P.J., Briggs, C.A., 1999. Attachments of the posterior layer of
lumbar fascia. Spine 24, 17571764.
Bogduk, N., Macintosh, J.E., 1984. The applied anatomy of the
thoracolumbar fascia. Spine 9, 164170.
Carman, D.J., Blanton, P.L., Biggs, N.L., 1972. Electromyographic
study of the anterolateral abdominal musculature utilising indwell-
ing electrodes. Am. J. Phys. Med. 51, 113129.
Chandler, S.B., Schadewald, M., 1944. Studies on the inguinal region.
I. The conjoined aponeurosis versus the conjoined tendon. Anat.
Rec. 89, 339343.
Cholewicki, J., Juluru, K., McGill, S.M., 1999. Intra-abdominal
pressure mechanism for stabilizing the lumbar spine. J. Biomech.
32, 1317.
Chouke, K.S., 1935. The constitution of the sheath of the rectus
abdominis muscle. Anat. Rec. 61, 341349.
Cresswell, A.G., Grundstrom, H., Thorstensson, A., 1992. Observa-
tions on intra-abdominal pressure and patterns of abdominal intra-
muscular activity in man. Acta Physiol. Scand. 144, 409418.
Davis, J.R., Mirka, G.A., 2000. Transverse-contour modeling of trunk
muscle-distributed forces and spinal loads during lifting and
twisting. Spine 25, 180189.
De Troyer, A., Estenne, M., Ninane, V., Van Gansbeke, D., Gorini,
M., 1990. Transversus abdominis muscle function in humans.
J. Appl. Physiol. 68, 10101016.
Dumas, G.A., Poulin, M.J., Roy, B., Gagnon, M., Jovanovic, M.,
1991. Orientation and moment arms of some trunk muscles. Spine
16, 293303.
Eisler, P., 1912. Die muskeln des stammes. Verlag von Gustav Fischer,
Jena, Germany.
Gans, C., de Vree, F., 1987. Functional bases of ber length and
angulation in muscle. J. Morphol. 192, 6385.
Geller, M., Machado Da Costa, R., 1970. Anatomic considerations of
a variable tendinous intersection in the obliquus abdominis
internus muscle. Hospital 77, 10051016.
Goldman, J.M., Lehr, R.P., Millar, A.B., Silver, J.R., 1987. An
electromyographic study of the abdominal muscles during postural
and respiratory manoeuvres. J. Neurol. Neurosurg. Psychiatry. 50,
866869.
Hodges, P.W., Richardson, C.A., 1996. Inecient muscular stabiliza-
tion of the lumbar spine associated with low back pain. A motor
control evaluation of transversus abdominis. Spine 21, 2640
2650.
Hodges, P., Cresswell, A., Thorstensson, A., 1999. Preparatory trunk
motion accompanies rapid upper limb movement. Exp. Brain Res.
124, 6979.
Hodges, P.W., Gandevia, S.C., 2000. Changes in intra-abdominal
pressure during postural and respiratory activation of the human
diaphragm. J. Appl. Physiol. 89, 967976.
Keith, A., 1921. Human Embryology and Morphology. Edward
Arnold, London, pp. 6673.
 D.M Urquhart et al. / Clinical Biomechanics 20 (2005) 233241
McGill, S.M., 1991. Kinetic potential of the lumbar trunk musculature
about three orthogonal orthopaedic axes in extreme postures.
Spine 16, 809815.
McGill, S.M., 1996. A revised anatomical model of the abdominal
musculature for torso exion eorts. J. Biomech. 29, 973977.
McGill, S.M., Juker, D., Axler, C., 1996. Correcting trunk muscle
geometry obtained from MRI and CT scans of supine postures for
use in standing postures. J. Biomech. 29, 643646.
Mirka, G., Kelaher, D., Baker, A., Harrison, A., Davis, J., 1997.
Selective activation of the external oblique musculature during
axial torque production. Clin. Biomech. 12, 172180.
Misuri, G., Colagrande, S., Gorini, M., Iandelli, I., Mancini, M.,
Duranti, R., Scano, G., 1997. In vivo ultrasound assessment of
respiratory function of abdominal muscles in normal subjects. Eur.
Respir. J. 10, 28612867.
Moore, K.L., Dalley, A.F., 1999. Clinically Oriented Anatomy.
Lippincott Williams and Wilkins, Philadelphia.
Ng, J.K.-F., Kippers, V., Richardson, C.A., 1998. Muscle bre
orientation of abdominal muscles and suggested surface EMG
electrode positions. Electromyogr. Clin. Neurophysiol. 38, 51
58.
Poirier, P., Charpy, A., 1901. Traite danatomie humaine. Masson,
Paris.
Richardson, C.A., Snijders, C.J., Hides, J.A., Damen, L., Pas, M.S.,
Storm, J., 2002. The relation between the tranvsersus abdominis
muscles, sacroiliac joint mechanics, and low back pain. Spine 27,
399405.
241
Schafer, E.S., Symington, J., Bryce, T.H. (Eds.), 1923. Quains
Elements of Anatomy. Longmans Green and Co, London.
Sheard, P.W., 2000. Tension delivery from short bres in long muscles.
Exerc. Sport Sci. Rev. 28, 5156.
Snell, R.S., 2000. Clinical Anatomy for Medical Students. Lippincott
Williams and Wilkins, Baltimore.
Snijders, C.J., Vleeming, A., Stoeckart, R., Mens, J.M.A., Kleinren-
sink, G.J., 1995. In: Dorman, T.A. (Ed.), State of the Art Reviews.
Hanley and Belfus, Philadelphia, pp. 419432.
Stokes, I.A.F., Gardner-Morse, M., 1999. Quantitative anatomy of the
lumbar musculature. J. Biomech. 32, 311316.
Strohl, K.P., Mead, J., Banzett, R.B., Loring, S.H., Kosch, P.C., 1981.
Regional dierences in abdominal muscle activity during various
maneuvers in humans. J. Appl. Physiol. 51, 14711476.
Tesh, K.M., Shaw Dunn, S.J., Evans, J.H., 1987. The abdominal
muscles and vertebral stability. Spine 12, 501508.
Vleeming, A., Pool-Goudzwaard, A.L., Stoeckart, R., van Wingerden,
J.-P., Snijders, C.J., 1995. The posterior layer of the thoracolumbar
fascia. Its function in load transfer from spine to legs. Spine 20,
753758.
Williams, P.L., Bannister, L.H., Berry, M.M., Collins, P., Dyson, M.,
Dussek, J.E., Fergusson, M.W.J. (Eds.), 1999. Grays Anatomy.
The Anatomical Basis of Medicine and Surgery. Churchill Living-
stone, London.
Zimmerman, L.M., Anson, B.J., Morgan, E.H., McVay, C.B., 1944.
Ventral hernia due to normal banding of the abdominal muscles.
Surg. Gynecol. Obstet. 78, 535540.