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Anatomy
Published in Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams, Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
Reza Mirnezami, Alex H. Mirnezami
The ascending colon extends from the caecum to the inferior surface of the right hepatic lobe, where it turns sharply to the left at the hepatic flexure, becoming continuous with the transverse colon. The anterior aspect and sides of the ascending colon are covered with peritoneum. The lower part of the ascending colon lies on the iliopsoas muscle with the genital branch of the genitofemoral nerve. The upper part of the right colon lies on the quadratus lumborum muscle and the origin of the transversus abdominis. The hepatic flexure lies over the lower pole of the right kidney, medial to which are the second and third parts of the duodenum. The second or third part of the duodenum may be damaged during mobilisation of the hepatic flexure, particularly when resecting colonic Crohn’s disease with an associated abscess or a bulky, locally advanced carcinoma.
Effect of electromyographic activity using capacitive and resistive electric transfer on non-specific chronic low back pain: a double-blind randomized clinical trial
Published in Electromagnetic Biology and Medicine, 2022
Michio Wachi, Takumi Jiroumaru, Ayako Satonaka, Masae Ikeya, Yasumasa Oka, Takamitsu Fujikawa
Previous studies have reported altered morphology and function in NSCLBP. Regarding the altered morphology, atrophy of the lumbar multifidus on the impaired side (Hides et al. 2008a, 2008b; Ploumis et al. 2011), fatty degeneration (Mengiardi et al. 2006), and hypertrophy of the quadratus lumborum muscle (Hides et al. 2008b) have been reported. These morphological alterations might occur due to both inactivity caused by LBP, or LBP due to morphological changes; however, the cause is still unknown. LBP also causes functional alterations. Suehiro et al. (2015) showed delayed muscle activity of the lumbar multifidus and erector spinae during prone hip extension (PHE) in people with LBP. PHE is usually used for functional evaluation in patients with LBP and has a negative effect on coordination movement due to delayed onset of trunk muscle activity compared to the agonist muscle (hamstrings) (Takasaki et al. 2009). In addition, the motor cortical map of the trunk muscle shifts posteriorly and laterally in people with NSCLBP (Tsao et al. 2008), which causes difficulty in posture control (Diener et al. 1993), and may influence activities of daily living (Henschke et al. 2009). Therefore, treatment of NSCLBP is needed not only for pain, but also to improve the function of the muscles and nervous system.
Less painful ESWL with ultrasound-guided quadratus lumborum block: a prospective randomized controlled study
Published in Scandinavian Journal of Urology, 2019
Ahmet Murat Yayik, Ali Ahiskalioglu, Haci Ahmet Alici, Erkan Cem Celik, Sevim Cesur, Elif Oral Ahiskalioglu, Saban Oguz Demirdogen, Omer Karaca, Senol Adanur
Group QLB: Patients were taken into the operating room 30 min before the ESWL. Pulse, blood pressure and arterial and blood oxygen saturation (SpO2) were measured. Patients were positioned in the lateral decubitus position. The area for the procedure and the convex US probe were sterilized. The anterior wall of the abdomen muscles, external oblique, internal oblique, and transversus abdominis were visualized. Then, the US probe was lateralized and the transverse process, quadratus lumborum muscle, and psoas muscle were visualized. The quadratus lumborum muscle was passed transmuscularly (Figure 1). Subcutaneous injection was done with a 27 gauge dental needle with 2 ml 2% lidocaine then a needle was advanced to the area between the psoas and the quadratus lumborum muscle fascia. The absence of blood and air in the negative aspiration was determined, and the location of the needle was confirmed with normal saline of 2 ml. A block was applied using 10 mL 0.5% bupivacaine and 10 mL 2% lidocaine via a 22 G 100 mm sonovisible needle (Stimuplex® Ultra, Braun, Germany) with the in-plane technique (Figures 2A and B). After 20 min, sensory examination was performed. If loss of sensation was achieved at the T7-L1 dermatome site, the block was considered successful.
Incisional lumbar hernia after the use of a lumbar artery perforator flap for breast reconstruction
Published in Acta Chirurgica Belgica, 2020
Stijn Van Cleven, Karel Claes, Aude Vanlander, Koenraad Van Landuyt, Frederik Berrevoet
Lumbar arteries are somatic segmental branches of the abdominal aorta and are similar to the intercostal arteries. Normally there are four on each side of the body, arising from the back of the aorta and traveling behind the psoas major muscle. The upper three arteries run laterally and backward between the quadratus lumborum muscle and the erector spinae musculature, and the last set of arteries normally runs in front of the quadratus lumborum muscle. From each artery, a perforating artery branches off just lateral to the erector spinae muscles sending a few branches to the skin. They pierce the lumbar fascia at the lateral border of the erector spinae muscles [4].