Topics of the lesson: Topographic anatomy of the lumbar region: borders, layers. The weak places: the lumbar triangle Petit, the lumbar rhombus Lesgaft-Grunfeld, the practical importance. Topographic anatomy of the retroperitoneal space: borders, fascia, spaces, ways of spreading of the burrowing pus and haematomas. Topography of the organs of the retroperitoneal space: kidney, adrenal glands, ureters, abdominal aorta and its branches, inferior vena cava, nervous structures. The formation Thoracic lymphatic ducts, azygos and hemiazygos veins.
Operative surgery of the retroperitoneal space: extraperitoneal and through the peritoneum accesses to kidneys and ureters. Operations on kidneys. Technique of the paranephral blockade. Kidney transplantation concept. Surgery for congenital malformations of the kidneys and ureters. Ureter suture, plastic surgery for ureters.
20.1. Apply a Fig. 20.1 border the lumbar region. Sign the external reference points. Draw the projection of kidneys.
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Fig. 20.1. Lumbar region
20.2. Denote the weak places of the lumbar region and the elements that limit them using Fig. 20.2.
The lumbar triangle Petit:
1. side_
2. side_
3. side_
4. fundus_
The lumbar rhombus Lesgaft-Grunfeld:
1. side_
2. side_
3. side_
4. side_
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Fig. 20.2. The weak places lumbar region
20.3. Sign the layer names of the lumbar region and retroperitoneal organs in the Fig. 20.3. Highlight the main fasciae of retroperitoneal space.
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Fig. 20.3. Cross-section at L4 Three cellular layers in retroperitoneal space:
1. __
2. __
3. __
Fasciae of retroperitoneal space:
1. __2. __3. __4. __5. __6. __
20.4. Sign the names of structures in the Fig. 20.4. What are the ways of spreading pus from the three departments of retroperitoneal space?