Applied Anatomy the Construction of the Human Body Considered in Relation to I

Cover Applied Anatomy the Construction of the Human Body Considered in Relation to I
Applied Anatomy the Construction of the Human Body Considered in Relation to I
Gwilym George Davis
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(Consult the Lumbar Muscles, page 392 ; Fascia, page 393; and Incisions, page 395).
Nerves. The nerves to be avoided in making lumbar incisions are the last thoracic, the iliohypogastric, and the ilio-inguinal. The last thoracic nerve, ac- companied by the first lumbar artery, runs parallel to the last rib a short distance below 1. 25 cm. (^ in. ) and thence pursues a direct course toward a midpoint between the umbilicus and top of the pubes. It emerges from beneath the external arcuate ligamen
...t about the middle of the kidney, crossing the quadratus lumborum, pierces the tendon of the transversalis muscle and runs between it and the internal oblique to pierce the sheath of the rectus and be distributed to the skin midway between the umbilicus and top of pubes and supply the pyramidalis muscle. This portion of the nerve will be injured only if the incision is carried up to the twelfth rib. When it is about opposite the tip of the eleventh rib it gives off a lateral (or iliac) branch which goes downward and slightly forward to pierce the internal and external oblique muscles above the crest of the ilium, about 5 cm.

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