Jayarani, J (2010) Study of lumbar plexus in 25 cadavers. Masters thesis, Madurai Medical College, Madurai.
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Abstract
INTRODUCTION: The study of lumbar plexus is interesting and useful because of • Various approaches to Lumbar plexus block. • Injury to femoral nerve in Psoas abscess, Inguinal block dissection in carcinoma penis, Dislocation of Hip joint, Fracture Pelvis due to Road traffic accidents can be avoided with above knowledge. • In case of Disc prolapse and Lumbar spondylosis – easily diagnosed by the study of dermatomal distribution of lumbar nerves. • In case of Iliac crest bone graft. • In procedures like Bladder tumour resection, Werthims operation, total hip replacement. • In Routine Herniorrhaphy injury to ilioinguinal Nerve can be avoided. AIM OF THE STUDY: To study Lumbar plexus in relation to its site, formation, branching pattern and variations. MATERIALS AND METHODS: Dissection of Lumbar plexus was conducted in 19 male and 6 female cadavers bilaterally. In this study cadavers, received at the Institute of Anatomy, Madurai Medical College – Madurai, were utilized. The cadavers were embalmed and stored in the tanks, filled with vat solutions. After detailed dissection of the lumbar plexus the collected data was tabulated under different headings and the important features of normal and its variations, were noted down. Instruments used: • Stainless steel scalpel. • Stainless steel 14” blade with handle. • Stainless steel long and short scissors curved and straight. • Stainless steel short forceps toothed and non toothed. • Cotton • Cream sheets used as markers. METHODS: Lumbar plexus was explored by Transperitoneal approach: Abdomen was opened as per cunningham’s volume II (115) peritoneum was incised. Visceral organs like stomach, liver, spleen, pancreas, kidney, jejunum, ilieum, ascending, transverse, descending and sigmoid colon removed alongwith mesentry. Aorta and its branches like coeliac, superior and inferior mesenteric vessels excised and removed. By exposing the ilio psoas fascia branches like femoral, lateral cutaneous nerve of thigh, iliohypogastric, ilioinguinal nerves were identified on the lateral border of psoas major muscle. Obturator nerve was seen medial to psoas major. Genitofemoral nerve was seen on the surface of psoas major muscle. Psoas fascia and muscle removed in piece meal to study the formation and site of lumbar plexus. Branches of the Lumbar Plexus were traced upto iliac crest laterally and inguinal ligament anteriorly. CONCLUSION: The present work was carried out to study the site, formation and branching pattern of lumbar plexus in 50 specimens. The site of lumbar plexus was noticed in the posterior part of substance of psoas major muscle in 50 specimens and in four specimens the lumbar plexus was located in the substance of psoas minor muscle also. Of all the specimens (50), one showed the pre fixed type and one showed the post fixed type of lumbar plexus. Variations for iliohypogastric, obturator and femoral nerve was observed in one specimen and for ilioinguinal, genitofemoral, and accessory obturator nerve was observed in four specimens. Variations in the formation of lateral femoral cutaneous nerve was observed in ten specimens, of which five were low form and five were high form. Thus the knowledge of anatomy of lumbar plexus in relation to its site, formation, branching pattern and variations are useful to surgeons, not only in surgical procedures, but also in diagnosing various clinical conditions associated with it, like referred pain, psoas abscess and hip joint diseases.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | lumbar plexus, 25 cadavers. |
| Subjects: | MEDICAL > Anatomy |
| Depositing User: | Subramani R |
| Date Deposited: | 05 Oct 2019 10:30 |
| Last Modified: | 05 Oct 2019 10:30 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/11690 |
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