Diseases of the kidneys, ureters and bladder, with special reference to the diseases of women (1922) (14579314909)

Identifier: diseasesofkidney01kell (find matches)
Title: Diseases of the kidneys, ureters and bladder, with special reference to the diseases of women
Year: 1922 (1920s)
Authors: Kelly, Howard A. (Howard Atwood), 1858-1943 Brödel, Max, 1870-1941 Burnam, Curtis Field, 1877-
Subjects:
Publisher: New York, London : D. Appleton and company



Text Appearing Before Image:
Fig. 189.—T-Shaped Incision. This gives abundance of room and is suitable wlien alarge tumor of the kidney is to be dealt with. The perpendicular arm follows the linearsemilunaris; the transverse is approximately parallel to the last rib. The incisionsare carried through all the layers of the abdomen down to the peritoneum. 401 402 SURGICAL OPERATIONS ON THE KIDNEY. rated, as shown in Figure 186. The fibers of the transversalis are of aboutequal length in all parts of the muscles. The relation of the vessels and nervesto this incision are shown in Figures 192 and 193. At the upper and outer ^..^ Subcostal (xn.) \^-^ y- Latera-l cutkns
Text Appearing After Image:
Fig. 190.—Muscle-splitting Incision Shown in Preceding Figure. This may begreatly enlarged by upward incision across muscle, parallel to nerves, as shown. Thismakes the so-called frying-pan incision. margin are the abdominal branches of the subcostal nerve and vessels, whichlie between the internal oblique and transversalis. At the median margin arethe lateral cutaneous branches of the same vessels and nerves running super-ficially. Below and medianly are the first lumbar nerves and vessels lyingbetween the internal oblique and transversalis muscles. In the floor of thisincision lies the renal mass surrounded by its fatty capsule, Gerotas capsule, INCISIONS TO EXPOSE KIDNEY AND URETER. 403 and tho retrorcnal or pararenal fat. In cases of marked inflammation it isnot possible to distinguish the separate fatty layers; they may be fused into ahomogeneous mass. Normally, however, the orange-colored pararenal fat pre-