THE ABDOMEN. 



395 



Lumbar incisions are made to evacuate pus or to operate on the kidney. 

 Incisions to evacuate pus should be made obliquely from the outer edge of the 

 quadratus lumborum in order to avoid wounding the nerves. 



Serratus posticus 

 inferior 



Latissimus dorsi 



Quadratus lumborum 



Eleventh rib 



Kidney 



.Capsule of kidney 



Fascia of internal 

 blique and 

 ransversalis 



Iliohypogastric nerve 

 Ilio-inguinal nerve 



Fatty tissue below 

 the kidney 



FIG. 409. Lumbar region, showing the kidney and quadratus lumborum muscle exposed. 



First lumbar vertebra 



f / 



Mass of erector spinae muscles / 

 Vertebral aponeurosis 

 Middle layer of lumbar fascia I 



Posterior layer of lumbar fascia 



Perirenal fat 



\ Kidney 



Quadratus lumborum 



Transversalis 



Internal oblique 

 External oblique 



Anterior layer of lumbar fascia 

 Latissimus dorsi 

 FIG. 410. Transverse section of the lumbar region, showing the lumbar fascias and muscles. 



Longitudinal Incision, If it is desired to expose the kidney, a straight incision 

 10 cm. (4 in. ) long may be made between the last rib and middle of the crest of 

 the ilium along the outer edge of the quadratus lumborum. This may sometimes 

 necessitate cutting the last thoracic nerve near the rib and the iliohypogastric and 



