The Metameric Framework

Human anatomy may be described from multiple perspectives. Traditional anatomy focuses on individual structures such as muscles, nerves, organs or blood vessels. Clinical practice, however, often requires an integrated understanding of how these structures interact within functional regions.

Within the SIRIAM platform, this integrated perspective is referred to as the Metameric Framework.

Rather than considering anatomical structures as isolated entities, the Metameric Framework organizes the body into interconnected spinal segments that combine neural, musculoskeletal, vascular and visceral relationships into one functional unit.

This framework provides the anatomical foundation for every Application Field described within the SIRIAM platform.

Many anatomical systems overlap.

A single spinal segment contributes to:

visceral communication.

When these systems are studied separately, the overall functional relationship may become less apparent.

The Metameric Framework provides a structured method for viewing these anatomical relationships as one integrated system.

For this reason, every SIRIAM Application Field is linked to one or more predefined spinal segments.

• sensory innervation;
• motor control;
• autonomic regulation;
• vascular responses;
• connective tissue organization;

Within this handbook, a metamere is defined as the functional anatomical unit associated with a specific spinal segment and its corresponding somatic and visceral relationships.

A metamere includes, but is not limited to:

visceral associations.

The purpose of this definition is not to replace classical anatomical terminology, but to organize existing anatomical knowledge into a clinically structured framework.

• cutaneous innervation;
• muscular innervation;
• skeletal relationships;
• autonomic influence;
• vascular distribution;

Each metamere is described according to six complementary anatomical domains.

These domains together form the Metameric Framework.

Dermatomal Component

Represents the cutaneous distribution associated with a spinal segment.

Within SIRIAM, dermatomes define the superficial anatomical reference for the Application Field.

Myotomal Component

Describes the muscles primarily associated with a spinal segment.

This component provides the muscular context of the Application Field.

Neurotomal Component

Describes the peripheral neural structures related to the segment.

This includes spinal nerves, dorsal rami, ventral rami and relevant peripheral nerve pathways.

Sclerotomal Component

Represents the skeletal and connective tissue structures associated with the segment.

This includes joints, ligaments and periosteal structures.

Angiotomal Component

Describes the vascular territories functionally associated with the segment.

Within SIRIAM this component contributes to the anatomical understanding of tissue perfusion.

Viscerotomal Component

Describes the visceral relationships traditionally associated with a spinal segment.

Within the handbook these relationships are presented as anatomical and neurophysiological associations rather than diagnostic indicators.

To simplify interpretation, SIRIAM represents every spinal segment using one standardized graphical model.

This model is referred to as the Metameric Pie.

The Metameric Pie integrates:

Dermatome

Myotome

Neurotome

Sclerotome

Angiotome

Viscerotome

Every Application Field throughout the platform refers back to this same graphical representation.

The objective is to provide one consistent anatomical language for users, healthcare professionals and future educational material.

Although the six metameric domains form the structural core of the framework, they do not encompass all clinically relevant anatomy.

Additional systems are therefore integrated where appropriate.

These include:

regional vascular pathways.

The Metameric Framework should therefore be regarded as an expandable anatomical model rather than a fixed anatomical classification.

• cranial nerves;
• autonomic nervous system;
• major plexuses;
• fascial continuities;

The cervical region forms the anatomical transition between the cranial and spinal nervous systems.

Consequently, several SIRIAM Application Fields integrate cranial neuroanatomy alongside spinal metameres.

Examples include:

upper cervical spinal nerves.

This integration reflects the anatomical continuity of these structures without replacing established neuroanatomical classifications.

• occipital nerves;
• trigeminal system;
• facial nerve;
• cervical plexus;

Peripheral nerve plexuses represent another important level of anatomical organization.

Whenever an Application Field overlaps with a major plexus, the corresponding plexus anatomy becomes part of the product documentation.

Examples include:

sacral plexus.

This allows each product to describe regional anatomy in a structured and reproducible manner.

• cervical plexus;
• brachial plexus;
• lumbar plexus;
• lumbosacral plexus;

The Metameric Framework serves one primary purpose within SIRIAM.

It provides the anatomical basis from which the Application Field is defined.

The sequence therefore always remains:

Anatomical Framework

↓

Application Field

↓

Application Concept

↓

Topical Formulation

This order remains identical throughout the platform.

The Metameric Framework has been designed as a modular system.

Future editions of the handbook may incorporate additional anatomical layers, digital visualization tools and educational resources while preserving the same underlying structure.

The objective is not to create a new anatomical classification, but to provide a standardized framework through which existing anatomical knowledge can be consistently documented and applied within the SIRIAM platform.

The Metameric Framework forms the anatomical foundation of SIRIAM.

By integrating dermatomes, myotomes, neurotomes, sclerotomes, angiotomes and viscerotomes into one structured model, the framework establishes a common anatomical language that supports every Application Field, Product Passport and topical formulation within the platform.

The primary purpose of the Metameric Framework is not merely to describe anatomical relationships, but to provide a standardized anatomical language that supports the entire SIRIAM platform.

Within SIRIAM, the Metameric Framework serves as the common reference through which anatomical observations, product development and clinical application can be consistently organized.

Importantly, the framework itself does not determine clinical decisions. Instead, it provides the anatomical context upon which subsequent chapters—such as Segment Prioritization, Application Concepts and Clinical Workflow—are based.

This distinction preserves a clear separation between:

topical application.

Maintaining this separation contributes to consistency, transparency and reproducibility throughout the platform.

• anatomical organization;
• clinical assessment;
• product selection;

Within the SIRIAM platform, anatomy is approached as a continuous hierarchy rather than as isolated structures.

Each level builds upon the previous one.

Human Anatomy

↓

Regional Anatomy

↓

Metameric Framework

↓

Application Field

↓

Application Concept

↓

Topical Formulation

↓

Product Passport

↓

Clinical Workflow

This hierarchical organization ensures that every SIRIAM formulation can be traced back to a clearly defined anatomical foundation, while every clinical application remains connected to the same standardized documentation structure.

The Anatomical Continuum therefore functions as one of the central organizing principles of the SIRIAM platform and provides the conceptual bridge between anatomy, formulation design and clinical implementation.

Editorial recommendation (voor later in het handbook)

Ik zou in dit hoofdstuk twee vaste figuren opnemen. Ze worden volgens mij iconische schema's die overal terugkomen:

Figure 4.1 — The Metameric Pie

Dermatome

Myotome

Neurotome

Sclerotome

Angiotome

Viscerotome

Dit wordt hét referentieschema voor alle producten.

Figure 4.2 — The SIRIAM Anatomical Continuum

Human Anatomy

│

Regional Anatomy

│

Metameric Framework

│

Application Field

│

Application Concept

│

Topical Formulation

│

Product Passport

│

Clinical Workflow

Dit wordt het schema dat de volledige logica van het handbook samenvat. Ik zou het zelfs in de inleiding én later op de website gebruiken, omdat het in één oogopslag laat zien hoe alle onderdelen van het SIRIAM-platform met elkaar verbonden zijn.

DEEL 4 — Metameric Framework

Ondertitel:

Understanding the OAA Application Field through the Metameric Model

De vaste "Metamere Taart"

Op iedere productpagina komt exact dezelfde cirkel terug.

DERMATOOM

MYOTOOM NEUROTOOM

SCLEROTOOM ANGIOTOOM

VISCEROTOOM

Of nog mooier als een echte cirkel met zes segmenten.

Dat wordt een SIRIAM-icoon.

Daarna telkens dezelfde opbouw

eenvoudige uitleg

kaart

relevant segment

belangrijkste spieren

illustratie

praktische palpatie

zenuwen

verloop

huidprojectie

bot

gewricht

fascia

Alleen in de Professional Documentation.

Niet in Essential.

Autonome projectie.

Ook alleen Professional.

Essential Mode

Heel eenvoudig.

Applicatiezone

✔ Foto

✔ 3D-afbeelding

✔ Later video

✔ Stap voor stap

Dat is alles.

Geen overload.

Professional Mode

Dan pas:

Metamere taart

↓

Dermatoom

↓

Myotoom

↓

Neurotoom

↓

Sclerotoom

↓

Viscerotoom

↓

Angiotoom

↓

Downloads

↓

Referenties

Nog iets wat ik geweldig vind uit jouw documenten

Jij hebt per segment eigenlijk al de volledige structuur uitgewerkt.

Bijvoorbeeld C2:

dermatoom: achterhoofd

viscerotoom: geen specifiek

sclerotoom: occiput

neurotoom: n. occipitalis major en minor

myotoom: diepe nekmusculatuur, trapezius, SCM

Of C3 met de relatie naar het diafragma, cervicale structuren, n. phrenicus en betrokken spieren.

Dat is eigenlijk al de perfecte inhoud voor een uitklapbare "metamere kaart".

Mijn grootste aanbeveling

Ik zou de Metamere Taart niet alleen in OAA gebruiken, maar als vaste navigatiecomponent voor het hele platform.

OAA → taart opent C0–C4.

CTO → taart opent C5–T1.

TLO → taart opent T10–L2.

SX → taart opent S1–S5.

✅ Status handbook

Chapter 00 — Handbook Identity (Final v1.0)

Chapter 01 — SIRIAM Design Principles (Final v1.0)

Chapter 02 — The SIRIAM Philosophy (Final v1.0)

Chapter 03 — The SIRIAM Product Architecture (Final v1.0)

Chapter 04 — The Metameric Framework (Final v1.0)