1 - Posterior Abdomen Flashcards
Objectives: Explain the topography of the posterior abdominal wall
Objectives: Identify the major muscles, nerves, and vessels within this region
Objectives: Understand the anatomy of the diaphragm and its openings
Objectives: Explain the location and structure of the kidney
Quadratus Lumborum
Action
Innervation
- Action: Extend, Laterally flex trunk, fixes 12th rib during inspiration
- Innervation: T12 & L1-4
Psoas Major
Action
Innervation
- A:
- Flexes thigh and trunk
- I:
- L2-L4 via lumbar plexus
Iliacus
A
I
- A:
- Flex thigh and trunk
- I:
- L2-L4 femoral nerve
Clinical: What can serve as an initial test for appendicitis?
Iliposoas Test
Move knee to chest on right side
Diaphragm Openings?
Inferior Vena Cava Foramen
Esophageal Hiatus
Aortic Hiatus
What can occur at T12?
- Inferior Vena Cava Foramen
- T8
- IVC, R. Phrenic Nerve
- Esophageal Hiatus
- T10
- Esophagus, vagal trunks, esophageal branches of L. gastric vessels
- Aortic Hiatus (Red, White, Blue)
- T12
- Aorta, Thoracic Duct, Azygos Vein
- Celiac Compression can occur here
- I 8, 10 Eggs, At noon (12)
What is the source of the medial and lateral ligaments of the diaphragm?
What about the median?
Where are these three located?
- Medial and Lateral = thickenings of tranversalis fascia
- Median = crura of the diaphragm
- Median Arcuate Ligament:
- Ant. to aorta, connection b/t L/R crura
- Medial Arcuate Ligament
- Psoas Maj. fascia
- Lateral Arcuate Ligament
- Quadratus Lumborum fascia
What organs do the kidneys contact?
What are the fat/fascia layers that surround the kidney, superficial to deep?
What is the order of structures, anterior to posterior, at the Hilum?
What is unique about the blood supply of the kidneys?
- Liver, Stomach, Duodenym, Spleen, Pancreas, Colon
- Superficial to Deep:
- Paranephric Fat
- Renal Fascia
- Perinephric Fat
- Renal Capsule
- Hilum, Anterior to Posterior (VAP)
- Renal VEIN
- Renal ARTERY
- Renal PELVIS
- Kidney blood supply
- Segmental blood supply with end arteries
- No anastomoses
What three sites can ureter constriction occur? (kidney stone risk)
- Junction of Renal Pelvis and Ureter
- Pelvic Inlet
- Entrance to Bladder
What is the blood supply to the suprarenal glands? (3x)
- Superior Suprarenal (from Inferior phrenic)
- Middle Suprarenal (from Aorta)
- Inferior Suprarenal (freom Renal Artery)
Abdominal Aorta:
Unpaired visceral (3x)
Paired visceral (3x pairs)
Pairec parietal
- Unpaired Visceral
- Celiac Trunk (T12)
- Superior Mesenteric (L1)
- Inferior Mesenteric (L3)
- Paired Visceral
- Middle Suprarenal (L1)
- Renal (L1)
- Gonadal (L2) [testicular/ovarian]
- Paired Parietal
- Inferior Phrenic (T12)
- Subcostal (T12) [many]
- Lumbar (L1-L4) [many]
Where does the abdominal aorta bifurcation occur?
Where does the IVC lie? Where does the left renal vein cross? L Gonadal, L Suprarenal drainage? Right?
What is the result of such patterns with kidney problem presentation (especially in men)? What vessel specifically can cause this?
- Bifurcation into right and left (paired) common iliac arteries occurs at L4
- IVC lies to RIGHT of midline
- Left Renal Vein crosses anterior to aorta
- Left gonadal and suprarenal empty into left renal
- Right gonadal/right suprarenal direct off IVC
- Kidney dysfunction can lead to testicular pain
- Left side testes pain = check kidneys!
- Superior Mesenteric Artery sits anterior to left renal vein
