10: Posterior Abdominal Wall

Question 1

Psoas major and minor O and I

Answer 1

O: transverse processes and sides of vertebral bodies, intervertebral discs of T12-L5
I: tendon to lesser trochanter

Question 2

Psoas major and minor N

Answer 2

Anterior rami L1-3

Question 3

Psoas abscess sx

Answer 3

Back or flank pain, fever, limp, inguinal mass, lower abd pain exacerbated by thigh extension

Question 4

Causes of psoas abscess

Answer 4

Diseases of the organs, CA, infection deep to psoas

Question 5

Iliacus O and I

Answer 5

O: superior 2/3rds iliac fossa, ala, anterior sacro-iliac ligaments
I: lesser trochanter and shaft below

Question 6

Iliacus N

Answer 6

Anterior T12-L4

Question 7

What forms the median, medial and lateral arcuate ligaments?

Answer 7

Median: tendinous arch of crura of diaphragm
Medial: psoas fascia
Lateral: quadratus lumborum fascia

Question 8

Where do medial and lateral arcuate ligaments run?

Answer 8

Medial: span lumbar body and tip of L1 transverse process
Lateral: L1 transverse process to tip of 12th rib

Question 9

Spinal level of kidneys

Answer 9

T12-L3

Question 10

What ribs cover superior kidneys?

Answer 10

11 and 12

Question 11

What plane crosses the superior pole of the right kidney + left kidney’s hilum

Answer 11

Transpyloric plane

Question 12

Which kidney is lower?

Answer 12

Right

Question 13

What muscle lies posterior to largest part of the kidney

Answer 13

Quadratus lumborum

Question 14

Three nerves posterior to the kidney

Answer 14

Subcostal, iliohypogastric, ilioinguinal N

Question 15

Four layers of renal fat and fascia from closest to kidney outward

Answer 15

1. Perinephric fat-adjacent kidney capsule
2. Layer of fat
3. Renal fascia
4. Paranephric fat

Question 16

What does the renal fascia cover and what is is continuous with

Answer 16

Ensheaths renal vessels, superiorly continuos with inferior diaphragmatic fascia

Question 17

Path of ureter

Answer 17

runs inferiorly from renal pelvis -> passing over pelvic brim + along lateral pelvic wall -> posterior to ductus deferens (males) or uterine artery (female)

Question 18

Three potential sites of ureter obstruction

Answer 18

Junction of ureter with renal pelvis, crossing pelvis brim, entering bladder wall

Question 19

Pyelogram

Answer 19

X-ray of ureter enhanced with contrast media

Question 20

Six arteries to the ureter

Answer 20

1. Renal
2. Gonadal
3. Abdominal aorta
4. Iliac
5. Superior vesical
6. Pelvic branches

Question 21

Four pelvic A branches

Answer 21

1. Rectal
2. Uterine
3. Vaginal
4. Inferior vesical A

Question 22

Four unpaired arteries of the posterior abdomen

Answer 22

1. Celiac trunk
2. SMA
3. IMA
4. Median sacral A

Question 23

Seven paired arteries of the posterior abdomen

Answer 23

1. Subcostal
2. Inferior phrenic
3. Suprarenal
4. Renal
5. Gonadal
6. Lumbar
7. Deep circumflex iliac

Question 24

What level does the IVC begin

Answer 24

L5

Question 25

Three paired visceral veins off the IVC

Answer 25

1. Suprarenal
2. Renal
3. Gonadal

Question 26

Four paired parietal veins off the IVC

Answer 26

1. Inferior phrenic
2. 3rd lumbar
3. 4th lumbar
4. Common iliacs

Question 27

Two veins that connect the SVC and IVC

Answer 27

Ascending lumbar V, azygos V

Question 28

Where do lumbar LNs run

Answer 28

Along both sides of IVC and aorta

Question 29

What do lumbar and pre-aortic LNs receive

Answer 29

1. Lumbar LNs: posterior wall, posterior pelvic wall organs

2. Pre-aortic LNs: alimentary tract, liver, spleen, pancreas