lumbar region - a d it's complications.pptx

lumbar region - a d it's complications.pptx

• 1.
  Topographical anatomy of lumbar region ofabdomen By – Shrivastav Deependra Л 326 В ин
• 2.
  Lumbar region of abdomen The*lumbar region* of the abdomen refers to the area in the lower back part of the abdominal cavity. It is located on either side of the spine, roughly between the ribcage and the pelvis. region include: 1. *Kidneys*: The lumbar region is where the kidneys are located, one on each side of the spine.  2. *Ureters*: The ureters, which carry urine from the kidneys to the bladder, also pass through this region.  3 suprarenal gland 
• 3.
  Topographical anatomy of Kidney Skeletopy – 1. Located retroperitoneally, against T12–L3 vertebrae. 2. Right kidney slightly lower (T12– L3) than left (T11–L2) due to liver. 3. Hilum at L1–L2 level; renal artery/vein enter/exit here.
• 4.
  Holotopy of kidney - Posterior projection: Paravertebral, between 11th rib and iliac crest.  Anterior projection: Right kidney in right hypochondrium/epigastrium; left kidney in left hypochondrium.  Murphy’s point (costovertebral angle): T12–L1, tenderness indicates renal pathology.
• 5.
  Syntopy of kidney-  Superior: Suprarenal glands.  Anterior:  Right: Liver, duodenum, hepatic flexure of colon.  Left: Stomach, spleen, pancreas, splenic flexure  .Posterior: Diaphragm, 12th rib, psoas major, quadratus lumborum, transversus abdominis.  Medial: Renal vessels, inferior vena cava (right), aorta (left).
• 6.
  Structure of kidney Size: ~11–12 cm long, 5–6 cm wide, 3 cm thick  .Layers: Fibrous capsule, perirenal fat, renal fascia, pararenal fat.  Internal: Cortex (glomeruli, tubules), medulla (pyramids, papillae), renal pelvis.
• 7.
  Function of kidney Filtration:Produces ~180 L/day of filtrate, reabsorbs 99% to form 1–2 L urine. Regulation: Maintains fluid/electrolyte balance, acid- base homeostasis. Endocrine: Secretes renin (blood pressure), erythropoietin (RBC production), and activates vitamin D.
• 8.
  Surgeries of kidney- Nephrectomy: Removal (partial/total) for cancer, trauma, or non-functioning kidney. Approach: Open (lumbotomy) or laparoscopic (retroperitoneal/transperitoneal). Risks: Bleeding, infection, injury to adjacent organs (e.g., spleen, liver). Pyeloplasty: Repair of pel Arrested Development viureteric junction obstruction.
• 9.
  Topographical anatomy of adrenalgland  Skeletopy Sits atop each kidney, at T11–T12 level.Right gland pyramidal, left crescent-shaped, aligned with vertebral column. Holotopy – Posterior: Overlies 11th –12th ribs, medial to kidney’s upper pole. Anterior: Right gland behind right lobe of liver; left gland behind stomach/spleen.
• 10.
  Syntopy of suprarenal gland-  Anterior: Right: Liver, inferior vena cava; Left: Stomach, pancreas.  Posterior: Diaphragm, crus of diaphragm.  Inferior: Upper pole of kidney.
• 11.
  Structure of adrenal gland Size: ~5 cm long, 3 cm wide, 1 cm thick.  Structure: Outer cortex (zona glomerulosa, fasciculata, reticularis) and inner medulla.  Encased in fibrous capsule with perirenal fat.
• 12.
   Cortex: Producesglucocorticoids (cortisol), mineralocorticoids (aldosterone), androgens.  Medulla: Secretes catecholamines (epinephrine, norepinephrine) for stress response. Function of adrenal gland -
• 13.
   Adrenalectomy: Removalfor tumors (e.g., pheochromocytoma, adenoma).  Approach: Laparoscopic (preferred) or open (large tumors).  Risks: Hormonal imbalance, vascular injury (inferior vena cava). Surgeries of adrenal gland
• 14.
  Topographical anatomy of ureter - Skeletopy Extends from renal pelvis (L1–L2) to bladder, crossing anterior to sacroiliac joint (S1). Lies along transverse processes of L2–L5 vertebrae.  Holotopy Posterior: Line from L1 to sacroiliac joint. Anterior: Follows a line from umbilical region to pubic symphysis.  Syntopy Anterior: Gonadal vessels, genitofemoral nerve, common iliac vessels. Posterior: Psoas major, iliac crest. Medial: Inferior vena cava (right), aorta (left).
• 15.
  Structure of ureter-  Length:~25–30 cm, diameter 3–4 mm.  Three layers: Mucosa (transitional epithelium), muscularis (smooth muscle), adventitia.  Constrictions: Pelviureteric junction, iliac vessel crossing, ureterovesical junction.
• 16.
  Function of ureter- Transportsurine from renal pelvis to bladder via peristaltic contractions. Prevents reflux via ureterovesical junction’s valve-like mechanism. Surgeries of ureter • Ureterolithotomy: Removal of ureteric stones. • Ureteral Reimplantation: Correction of vesicoureteral reflux or obstruction.Approach: Open or robotic-assisted. • Risks: Stricture, urine leak, infection.