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Lumbar triangle(Petit’s triangle) and it’s anatomical characteristics

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Theme: «Lumbar triangle(Petit’s triangle) and it’s anatomical characteristics» Done By: Myrzakhanov Yerik 4course GMF 451 group Check By: Aldyngurov Daulet Kadirovich Semey 2014
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Theme: «Lumbar triangle(Petit’s

triangle) and it’s anatomical

characteristics»

Done By: Myrzakhanov Yerik

4course GMF 451 group

Check By: Aldyngurov Daulet

Kadirovich

Semey 2014

Plan: Introduction. Jean Louis Petit

Petit triangle, boundaries

Lumbar hernia, Treatment

Surgical significance

List of references

Introduction

Jean-Louis Petit (13 March 1674 – 20 April 1750)

was a French surgeon. He was first enthusiastic

about anatomy, received a master's certificate in

surgery in Paris in 1700. He became a member of the

French Royal Academy of Sciences, and was named

director of the French Royal Academy of Surgery by

the king when it was created. Offered ways of hernia

repair, enterography, amputations; invented a variety

of tools and devices (such as a tourniquet, the unit for

the treatment of foot deformities).

Introduction

His name is associated the name of the lumbar triangle (trigonum lumbale Petiti). Also wrote about the injuries of the skull, the treatment of cleft lip, gallstones, and many other issues in surgery.

Known for his work on the Achilles tendon rupture, dislocation of the jaw, he first described about osteomalation. Just the first to describe the relaxation of the diaphragm , implying that the notion of complete relaxation domes and its high standing.

Boundaries (borders) of

lumbar triangle The triangle of Petit

(trigonum lumbale, PNA, BNA, JNA; syn .: Petit triangle lumbar triangle) – site of the posterior abdominal wall. Bounded above and medial with tendon node latissimus dorsi, and laterally and left back edge of the external oblique muscle of the abdomen, extending from theXII rib, below with the iliac crest, the bottom is the internal oblique and transverse abdominal muscles.

The initial division of the latissimus dorsi muscle

(as well as the site of attachment of the external

oblique abdominal muscles to iliac crest) is divide

to individual differences, so the shape of the

lumbar triangle changeable. It resembles a narrow

hole between the edges of forming his latissimus

dorsi and external oblique abdominal muscles.

According by P. F. Lesgaft, lumbar triangle is

found only in 75% of people.

External view

The bottom of the triangle is the internal

oblique muscle, covered by fascia, weakness

which may cause the appearance of lumbar

hernia.

Lumbar hernia

Lumbar hernia(h. Lumbalis) - hernial protrusion on the back and side walls of the abdomen in the lumbar region. They are congenital and acquired (traumatic, muscle atrophy and etc.).

Place their output is lower and upper lumbar triangles between the XII rib and the iliac crest to the lateral edge of the latissimus dorsi muscle (m. Latissimus dorsi), as well as defects in the aponeurosis without specific localization due to rupture or inflammation.

Hernial ring at the lower lumbar hernia are

within the lower lumbar triangle (Petit).

Hernial ring at the upper lumbar hernia are

within the upper lumbar triangle (Grynfeltt-

Lesshaft)*. The base of the triangle, the apex

facing down is the transversus abdominis, the

outside is covered with a broad back muscles.

*

The superior lumbar (Grynfeltt-Lesshaft)

triangle is formed medially by the quadratus

lumborum muscle, laterally by the internal

abdominal oblique muscle, and superiorly by

the 12th rib. The floor of the superior lumbar

triangle is the transversalis fascia and its roof

is the external abdominal oblique muscle.

The mostly, the contents of a typical lumbar

hernia is small intestine, while sliding hernia -

ascending or descending colon. Often lumbar

hernia have no hernia sac, and through the

hernial ring out retroperitoneal fat, sometimes

kidney. In this case, the hernia will be false.

Treatment

Surgical - resection of the hernial sac, closure

of hernial ring, the reconstruction of the

transversal abdominal muscles. When lumbar

hernia with large hernial ring used to close the

defect synthetic materials or muscle flaps.

Surgical significances of triangle

of Petit

At peritonitis abdominal establish drainage through lumbar triangles of Petit by a cross-section of the skin, subcutaneous tissue, superficial fascia and private over the iliac crest at the intersection, with its posterior axillary line, with a further dislocation of internal oblique abdominal muscles in the course of its fibers and introduce of all drainages on the parietal peritoneum posterior wall of the abdominal cavity in the mesenteric sinuses under the root of the mesentery of the transverse colon.

Surgical significances of triangle

of Petit

Symptom Joure-Rozanov - pain when finger

pressure in the triangle of Petit. Used in the

diagnosis of acute appendicitis. In that case

peritoneum in this department is relatively

superficial.

Surgical significances of triangle

of Petit

At retrocecal appendicitis in this area can be

detected positive symptom Gabai – the sharp

increases of pain when palpated quickly

remove your hands after pressing, as the

symptoms of Shchetkina - Blumberg.

Surgical significances of triangle

of Petit

Extraperitoneal laparoscopic approach to

the adrenal glands.

In the angle between the rib XII and

sacrospinous muscle (m. Sacrospinalis) (the

so-called triangle of Petit) performed a cut

length of 15 mm. In this incision the surgeon

can accurately enter your finger to create

access to the retroperitoneal paranephral

space.

List of references: Анатомия человека: В 2 томах / Под ред.

М.Р.Сапина. – М.: Медицина, 1997.- Т.1.- 544 с.

http://en.wikipedia.org/wiki/Jean_Louis_Petit

http://en.wikipedia.org/wiki/Lumbar_triangle

Aguirre DA, Santosa AC, Casola G et-al. Abdominal wall hernias: imaging features, complications, and diagnostic pitfalls at multi-detector row CT. Radiographics. 2005;25 (6): 1501-20.

MILLARD DG. A Richter's hernia through the inferior lumbar triangle of petit. A radiographic demonstration. Br J Radiol. 1959;32 (382): 693-5

Большаков О.П., Семенов Г.М. Лекции по оперативной хирургии и клинической анатомии. –СПб.: Питер, 2000. – 480 с.


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