 So this is going to be a demonstration of the posterior abdominal wall preliminary deception namely the facial Relationships the fat and a few other structures. So we have reflected all the upper abdominal organs up here This is a supine cadaver. I'm standing on the right side. That is the left side The camera person is also on the right side towards the leg end. So we have exposed the two kidneys You can see them clearly here. So let's take a look at the facial relationships This is the reflected abdominal wall on the right side and this Chinese structure that we can see here on Both the sides and including the one which I have lifted up here This is the parietal peritoneum and inside the parietal peritoneum the next layer is the extra peritoneal fat And after that we have the facial transverse Alice The facial transverse Alice continues posteriorly and it becomes known as the Anterior layer of renal fascia or gerotas fascia and that's what we see here We have reflected it here the same facial transverse Alice also continues and it becomes the posterior layer of renal fascia and that is what we have lifted up here So therefore the facial transverse Alice splits to form the anterior and the posterior renal fascia completely surrounding the kidney We have this fat part of which we have written here This is the perinephric fat which is inside the renal fascia. It completely surrounds the kidney Therefore it is called perinephric fat now We shall demonstrate the same thing on the left side the camera person is on the left side So here again the shiny structure that we can see this is the parietal peritoneum And it is being reflected from the flat muscles of the abdomen and under the parietal peritoneum is this layer This it was the facial transverse Alice which split to form the anterior layer of renal fascia on the left side And we can continue that and we can see that it is continuing as the Posterior layer of renal fascia. So this whole thing is the gerotas fascia inside This was the perinephric fat which we have removed which also completely surrounds the kidney The posterior layer of renal fascia if we trace them carefully We find that it becomes continuous with the soas fascia This is the soas muscle and we can see it is becoming continuous with the soas fascia and Posterior to the posterior layer of renal fascia We have yet some more fatty structures that is referred to as the Pararenal fat body. Pararenal fat body is posterior to the posterior layer of gerotas fascia We should show the same thing on the right side again Now we are again on the right side the camera person is also on the right side And I am lifting up the posterior layer of renal fascia And we can see that the posterior of renal fascia which I've lifted up here is becoming continuous with the soas fascia Because this is the soas major muscle and when I lift that up also We can see yet some more fatty structures behind the posterior layer of gerotas fascia That is referred to as the Pararenal fat body So therefore the kidney is surrounded basically by three layers of fat in the front We have the extra phytonal fat then we have the two layers of the renal fascia anterior posterior and within that We have the completely surrounding the kidney. We have the perinephric fat and finally Behind the posterior layer of renal fascia. We have the Pararenal fat body kidney does not have much protection So therefore it is these layers of fat which give protection to the kidney when there's loss of fat Like for example rapid weight loss the patient can undergo what is known as nephroptosis That is descent of the kidney and loss of fat is one of the causes of nephroptosis How let me show you some of the structures? This is the aorta We have removed the fascia and perinephal peritoneum from front of the aorta and we can see the bifurcation and On the right of the aorta. We can see this structure here. This is the infri-avina keva We have lifted up this structure here This is the excess of nerves the sympathetic and the vagus Which completely invest invest the front of the great vessels so it starts from the celiac plexus Then it becomes a superior mesentric plexus the aortic orenal plexus and it continues as the inter-mesentric plexus Inferior mesentric plexus then it continues down here It becomes known as the superior hypergastric plexus and from there It goes into the pelvis as the inferior hypergastric plexus So that is the part of that which we can see here the next thing we can see here are these structures This is aortic or the aortic cable lymph node. They are also referred to as lumbar lymph nodes They are the drainage after the iliac lymph nodes the next structure Which I would like to draw your attention to is this which I have picked up here This is again a layer of parietal peritoneum Which was covering the posterior abdominal wall and which is going down into the pelvis and we have partly reflected up here So this is the parietal peritoneum under that is the Extrapatoneal fat and the fascia transversalis and we can see the structures going into the pelvis Next structure, which I would draw your attention to this is the ureter on the right side Coming out from the kidney and we can see that the ureter is slightly kicked and this is the Left ureter coming out from the kidney. This is the right renal vein This is the left renal vein This is the left renal artery and this is the right renal artery before I conclude I have already mentioned it. This is the swast major on the left side. This is the swast major on the right side When we reflect this further We will see yet one more muscle and we can see part of that muscle here on the left side That is the quadratus lumborum muscle. So these two muscles from the posterior relationships of the kidney That is all that we can see in this preliminary deception We will see more of this as we proceed further along because we will be removing most of these structures Thank you very much for watching. Dr. Sanjay Sanyal signing off. Have a nice day