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العنوان
UPDATE IN MANAGEMENT OF
RETROPERITONEAL NEOPLASMS
المؤلف
Ibrahim ,Mohamed El-Sayed Goda El-Zayat
هيئة الاعداد
باحث / Ibrahim Mohamed El-Sayed Goda El-Zayat
مشرف / Awad Hassan ElKayal
مشرف / Hisham Abd El-Raoof El-Akad
مشرف / Osama Mahmoud El-Sayed
الموضوع
Unclassified tumors-
تاريخ النشر
2003
عدد الصفحات
131.p:
اللغة
الإنجليزية
الدرجة
الدكتوراه
التخصص
جراحة
تاريخ الإجازة
1/1/2003
مكان الإجازة
جامعة عين شمس - كلية الطب - General Surgery
الفهرس
Only 14 pages are availabe for public view

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from 131

Abstract

Six nerves are present in the retroperitoneal space. All are branches of the lumbar plexus, which is formed by a branch of 12th thoracic nerve and by the anterior primary division of the first through fourth lumbar nerves.
1) Iliohypogastric nerve (T12 and L1 or L1 only). It emerges from the lateral border of the psoas muscle. After relating to the quadratus lumborum muscle, it travels downwards between the internal oblique and transversus abdominis muscles. It has two branches, the lateral cutaneous nerve that supplies the posterolateral skin of the gluteal area, and the anterior cutaneous nerve that supplies the skin over the symphysis pubis.
2) Ilioinguinal nerve (L1). It has the same pathway as iliohypogastric nerve. It transverses the inguinal canal together with the spermatic cord. In the thigh, it innervates the triangle of Scarpa, and part of the scrotal or labia major skin.
3) Genitofemoral nerve (L1–2). It pierces the psoas muscle anteriorly. Its genital branch, within the inguinal canal, is related to the iliopubic tract and supplies the cremaster muscle and part of the scrotal skin. Its femoral branch passes below the inguinal ligament and innervates the skin of the triangle of Scarpa.
4) The lateral femoral cutaneous nerve (L2–3). It emerges from the lateral border of the psoas muscle at the area of L4 vertebra. It perforates the inguinal ligament close to the anterior superior iliac spine and passes into the lateral aspect of the thigh.
5) The obturator nerve (L2–4). It emerges from the medial border of the psoas muscle. It enters the obturator foramen with the obturator vessels downwards to innervate the medial part of the thigh.
6) The femoral nerve (L2–4). It emerges from the lateral border of the psoas muscle. It passes under the inguinal ligament and is closely associated with the iliopsoas muscle.
7) The lumbar sympathetic chain lies on both sides along the medial border of the psoas muscle. It is located anterior to the lumbar vertebrae and covered by IVC on right and right para-aortic nodes on the left. It is formed by four ganglia, which vary in size and position. These ganglia communicate with each other and with thoracic trunk above and the pelvic trunk below. Each trunk consists of a series of ganglia united by nerve fibres. The cells in the ganglia send their postganglionic fibres principally to the spinal nerves (grey rami communicantes) for the supply of the body wall. Bundles of preganglionic fibres, which enter each trunk through the white rami communicantes, extend along it and end on the cells of the ganglia at various levels. They also pass directly through the trunk and descend in front of it, as splanchnic nerves, to the visceral plexuses and ganglia on the aorta and its branches at muh lower levels (Karakousis et al., 1995).