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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s upper portion it is strengthened by the ligamentumlumbo-costale (Figs. 5, A and B). As shown in Figures 5, A and B, theligamentum lumbo-costale is relatively in the same position in cases eitherwith long, short, or deficient XII rib. In front of this anterior leaf is thecovering of the M. quadratus lumborum, described by some writers as a thirddivision of the lumbar fascia (Figs. 4 and 6). It is thin, and arises from TOPOGRAPHICAL ANATOMY OF THE LUMBAR REGION. the anterior surface of the transverse processes, and passes in front of theM. qnadratus himboriim. The npper poition is strengthened by the ligamen-tum arcnatum Halleri (Figs. 6 and 7), which is about in the same positionas the liganientum himbo-costalo, bnt anterior to it, where it serves as an originfor the posterior niuscidar bundles of the diapliragm. Both these ligamentsform a very strong band from the I and II lumbar vertebra to the lowest rib,and, although effectually protecting the pleura during a renal operation, may
Text Appearing After Image:
Fig. 5.—Ligamentum Lumbo-costale. A, position in cases with well-developed twelfthrib; B, with rudimentary or missing twelfth rib. sometimes form quite an obstacle to the easy exposure of the kidney, esj)eciallyif the organ lies high and is fixed. In kidney incisions the lumbar fascia comes into consideration only as faras its lateral portion is concerned, i. e., laterally to the outer fibers of the M.qnadratus lumborum, where it fuses into the aponeurosis of the broad abdominalmuscles. In this region its fibers run transversely, similar to the muscle bundlesof the M. transversus abdominis. Being much thinner, the other fasciae of thelumbar region are relatively unimportant. They are: Fascia superficialis (Fig. 4), SURGICAL RELATIONS OF MUSCLES OF THE LUMBAR RECJION. 9 a thin fascia, situated just below tlie skin and covering the entire outer mus-cuLar coat of the back, Fascia iliaca (Figs. 4 and 6), a thin fascia, situated anterior to the fascia of the M. quadratus lumborumand cove

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