 جببہتا ہوں ، آپ کو اگر ، سینج رابطہی Veronica سنیل مضروف رجل کی درمشہ کے لئے آپสبینوں کو آپ کی برمجہ ہوتے ہیں respecto لئے آپ کے پاسی برمجہ کادیبرز کا اربع کے لئے آپے اربع کے لئے اس کے لئے آپ کو اپنا اپنے کی حقی ساتھ ، اور آپ کے ساتھ اس کے لئے انہوں جو آپ کے لئے کردیبرز ہوتے ہیں یہاں ہم جانے کنی کی کرامیدا کو مصری حربی دور کی حقی ساتھ جو یعنی ہے کہ سطر ہوجنے کی دلہوں کو حکم کرنے کو رہے ہیں اور Lindsey میں جو صرفکل کرنے میں اور اسی ساتھ پرابہ دیکھنے میں بھینکیے اور بھینکیے میں ساتھ بھی اگر بھی امتہاری ابتہاریی جتاہے اور ابتہاری بھی حکناے ساتھ بھی ساتھ بھی ہمارے ساتھ بھی ساتھ بھی امتہاری امتہاری کے لیے اور اس جانتے ہیں اگر اس پرابہ ہے مجھے بہتراری ہمارے کی تقوم بھی کھوم کرنے اور اس کے لئے میرے کے لئے ومنطاس پارای دورکارلبیوں کے ماء ہتا ہے۔ تی than پارا کے صور پ viktigt دے ہیں просто تو یہ پارای د Hoje pareton ومنطان ، Seungam ۔ وینیم کو سالس回شا inside came. اس اس لئے و اپنے جو ب Reporting م々ورuen решائیکل تعلقاتинг ۔ چج Technology ہوتا ہے۔ وہана generationٹام ۔ بیکس watch ، کانیک Strange Conqueror ۔ ، akan دگر کہنذا کیا ۔ recognize اور также خواہانک ہے ہم میں ن腳 و دیگہ 크게 باہسل capacity ہی بود ہی تو Steorag bust because ہم پا ریا دیگہ 팬�ائز کو دیگہ لنڈے بات بکارٹ اسٹیگے critcycles اہلہ stretchشش رہ سکتا رہا ہے ہے اسٹی推د و ذب یاado وız ا'll었ی مسئل پیا suits 추가 اڑنم منخوبی conclude one because of the trance because of the اس سے سو Milo شاید ہے ، کے لئے island مخلوق مخلوق مخلوق تو ایاںantلی کردے۔ ابدی ہاتھا ہے ، یہ ٹھیک ہے جو پرانک ہے۔ اینجاہر سواخ سواخ پرانک ہے ، اریوں کی نام لے کی انہائی کیMUSIC بہت مخلوق مخلوق مخلوقان ہے ، تو اگر اسی بہت مخلوق امیوانی کو ایک انہائی کی نام لے گو پہنچ دے ، کہ یہ اشانے کی اشانے کی نام لے گا اس سواخ مخلوق مخلوق than جو یہ ایک مخلوق مخلوق ، ابوامی کی نام لے گا اگر کانندہ کنال ڈیسلین میں ہی برکی ہے۔ اس بھرک روک تب برکی ایک ایلی اکس مسل ہے۔ تھی جب آپ یہ نہیں کیا سکتا ہے کہ یہ ایک ایلی ایکس مسل آنے Nevertheless کی بھی جو اس کے بہت ہوتا ہے۔ اور ایک ایلی ایکس مسل کے لئے وہ درست اور وہ ایک پر ان کے لئے ایک ان پر ایک ایک نحتر جانے اور ایک انpire طرح ان پر ایک ایک strings کے لئے بھرک near ان پر انگوان لگوں کے لئے انگوان لگوں میں ہے اور ایک شخص لہذا یہ ایریاکس اور سواز مجھر کے بارے میں سواز مجھر کے بارے میں سواز مجھر کے بارے میں ہوتا ہے۔ now if there had been a soas miner as i said it would have been anterior and it would have formed a long thin tendon here which would have been attached to the iliopubic eminence to form what is known as an iliopectinial arch now in this can ever we notice that there is an iliopectinial arch and this iliopectinial arch separates the retro inguinal space into a lateral and a medial portion and you can see that this iliopectinial arch separates the lateral portion which is the muscular compartment and the medial portion which is the vascular compartment but in this particular can ever the iliopectinial arch has been derived from the fascia of the soas and that is the fascia here which we have lifted up here this is the fascia the lower portion is thickened here and this thickened fascia is the one which forms the iliopectinial arch and that's the one which separates the retro inguinal space into a lateral muscular and a medial vascular compartment so instead of the soas miner it's the soas fascia so how did the soas fascia direct soas fascia is an extension of the fascia tracemisalis which i mentioned earlier after it is given up the real fascia IT and posterior layers of gerotas fascia the transversalis fascia continues and it forms a covering of the soas major most of it we have removed but we have retained a little bit of this and this is the one which forms in this particular category it forms the iliopectinial arch that is what we can see here this has got a number of important clinical correlations if a person has got osteomulitis of the number vertebrae like for example carries fine the pus can track down under the soas sheath this soas sheath and it'll go under the inguinal ligament like this where my finger is going and it'll track down and it'll stop at the lecetro canter this is called the soas absis this is a well recognized entity though not very common nowadays second important clinical correlation put in the soas major muscle is in this particular category especially the appendix was located here where my instrument is located right now it was a pelvic appendix and it was touching the soas major if such an appendix gets inflamed then it can irritate the soas major muscle and the person will have flexion of the hip that's called the soas sign and passive extension of the hip will result in pain that's called the soas test so this brings me to the action of the soas major the soas major when it acts unilaterally causes lateral flexion of the lumbar spine when it acts bilaterally it causes forward flexion of the lumbar spine if the person is sitting the iliacus and the soas together the ilio soas tend together they cause flexion of the hip and the soas major alone it is responsible for maintaining the lumbar lordosis and it indirectly maintains the thoracic kyphosis so this is about the soas major and the soas sheath the soas sheath as it continues up it becomes a free tendinous margin here and that we can see that is known as the medial archivate ligament and that medial archivate ligament it gives attachment origin to some of the fibers to the diaphragm that we can see here so that is about the medial archivate ligament which is the upper free margin of the soas sheath most of the soas sheath has been removed from here now let us come to the iliacus muscle i want to mention the iliacus muscle takes origin from the inner surface of the ilium and the fibers they merge with the soas the iliacus muscle gets its nerve supply directly from the femoral nerve and we can see that this is the femoral nerve and it is giving branches to the iliacus while the soas major muscle it gets branches from the lumbar flexis now let us take a look at the third muscle of the posterior abdominal wall and that third muscle is this one here i am tracing with my finger right now this is the quadratus lumborum it is a quadrangular shaped muscle that is why it is called quadratus and it is attached to the lumbar transverse processes that is why it is called quadratus lumborum so where does this muscle take origin from this muscle it takes origin from upper margin of the iliac crest and it also takes origin from the ilio lumbar ligament which extends from the ilium to the fifth lumbar vertebra and the fibers as they go up they give multiple slips as shown by my finger and each of these slips they get attached to the transverse processes of the lumbar vertebra and I can feel them here one slip goes here one slip goes here one slip goes here and so on and so forth and finally the muscle ends by getting attached to the 12th rib and I can feel the 12th rib here this is the 12th rib where my finger is moving right now this is the 12th rib and it gets inserted onto the 12th rib quadratus lumborum muscle is also covered by a tough sheet and we can see that we have cut it here partly this is the anterior layer of the thoraco lumbor fascia which I mentioned and that forms the quadratus lumborum sheet and that quadratus lumborum sheet also forms an upper free margin where my finger is tracing right now and that is called the lateral archivate ligament and we can see that also gives origin to some of the fibers of the diaphragm the lumbor attachment of the fibers of the diaphragm so therefore to recap the medial archivate ligament is the upper free margin of the swast sheet the lateral archivate ligament is the upper free margin of the quadratus sheet and both of them give attachment to the lumbor fibers of the diaphragm and we can see that here what is the action of this quadratus lumborum this is supplied by branches of the lumbor plexus the quadratus lumborum again unilaterally it causes lateral flexion of the lumbar spine but when it is bilateral acting it causes extension of the lumbar spine which is opposite to that of the bilateral action of the swast major additionally because it is attached to the 12th rib here it also helps in forced explanation like for example in an emphysema and because it is also continuous with the fibers of the diaphragm it assists the diaphragm in inhalation so these are the actions of the quadratus lumborum so it is also an accessory muscle of respiration so these are the muscles that I wanted to tell you about and before I conclude I wanted to bring your attention to the diaphragm itself so we can see this is the right supra-renal gland and we can see the fascia of the supra-renal gland is continuous with the fascia of the diaphragm so the diaphragm here these are the fibers the costal fibers of the diaphragm anteriorly these are the sternal fibers of the diaphragm and posteriorly these fibers that we can see here these are the lumbar origin of the diaphragm lumbar origin of the diaphragm takes origin from L123 on the right side L12 on the left side the medial archivate ligament, the lateral archivate ligament and in between the two there is another ligament where my finger is going that is called the medial archivate ligament these are the complete origin of the diaphragm and the fibers they converge in the middle in this region here this is called the central tendon of the diaphragm which is a misnomer because it is a naponeurotic sheet and when the fibers contract they cause flattening of the central tendon like this and that's what produces the abdominal thoracic respiration that we are so familiar with I will draw your attention to this opening in the central tendon of the diaphragm this is the opening of the inferior vena keva we can see it here and we notice that the margins of the opening the keval hiatus is fused with the inferior vena keva so therefore when the central tendon flattens down it pulls and opens the inferior vena keva opening and therefore it helps to suck the blood up the venous blood into the thorax so it assists in venous drainage during inspiration the next thing I will draw your attention to is the isophagus and we can see that the isophagus is encircled by this muscle fiber and this muscle fiber these are the fibers of the right crust of the diaphragm which encircles and forms a pinch cock mechanism so this is the isophageal hiatus this is an active process and when this contract it acts as a lower isophageal sphincter and we can see the fibers of the right crust are splitting to enclose the lower end of the isophagus and that is the isophageal hiatus the isophageal hiatus is located at the level of T10 the keval hiatus is located at the level of T8 and the final thing which I wanted to show you which is visible here is the diaphragm is supplied by on the undersurface it is supplied by the inferior phrenic artery normally the inferior phrenic artery is supposed to arise from the aorta the first branch of the aorta but rarely it can also arise from the celiac trunk and we can see that here the artery that I picked up here this is the left inferior phrenic artery and the left inferior phrenic artery is coming from this artery here this is the celiac trunk and we can see it is giving this branch here this is the left inferior phrenic artery it is coming from the celiac trunk so this are some of the points that I wanted to show you in this particular cadaver dissection thank you very much for watching Dr. Sanger Sanyal signing out once per day is the camera person if you have any questions or comments please put them in the comment section below have a nice day please like and subscribe