File:Diseases of the kidneys, ureters and bladder, with special reference to the diseases of women (1922) (14763390264).jpg

Identifier: diseasesofkidney01kell (find matches)
Title: Diseases of the kidneys, ureters and bladder, with special reference to the diseases of women
Year: 1922 (1920s)
Authors: Kelly, Howard A. (Howard Atwood), 1858-1943 Brödel, Max, 1870-1941 Burnam, Curtis Field, 1877-
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Publisher: New York, London : D. Appleton and company

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the sacro-spinalis (Fig. G). The upper region of this fascia is strengthenedby the ligamentum lumbo-costale, a strong band, which, as we have seen, isfound constantly and in the same position, regardless of the topography of theXII rib (Figs. 5, A and B). This fascia and ligament are attached median-wards to the posterior surface of the transverse processes of the lumbar vertebra^and the posterior surface of the XII rib. The fascia forming the anterior portion of the sheath of the quadratnslumborum is relatively thin. Although described by some writers as a thirdlamella of the lumbar fascia, its embryology proves that it is the fascia of thequadratns lumborum. Its upper portion is strengthened by the ligamentumarcuatum (Ilalleri) (Figs. G and 7), the fibers of which are interlaced withthose of the fascia. The fibers of the liganienruni arcuatum, Avliich consistsof two portions, a median and a lateral arch, form llie origin of the lat(r;\l 14 TOPOGRAPHICAL ANATOMY OF THE LUMBAR REGION.
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Fig. 7.—The Lumbar Region Viewed from the Front. Viscera and Peritoneum Removed. bundles of the vertebral portion of the diaphragm (Fig. 7). The fascia andligament just described are attached medianward to the anterior surface ofthe transverse processes of the lumbar vertebrie, near their base, and to theanterior surface of the XII rib. They separate the M. quadratus lumborumfrom the M. psoas major. SURGICAL RELATIONS OF MUSCLES OF THE LUMBAR REGION. 15 Between the lateral border of the qiiadi-atus and the tip of the XII rib thetwo ligaments (hiinbo-eostale and ligamentinn arcuatum) join and form a strongband, protecting the pleural cavity, situated a short distance above. A kidney in normal position extends from 1 to 3 cm. laterally to the lateralmargin of the quadratus lundwrum; therefore, it is not necessary to sacrificethe muscle to obtain a good exposure, as the (luadratus linnborum can readilybe drawn medianward, just as much room being thus gain-cd as though themuscle were cu

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