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GI- Week 2 > Ach: Kidney, Posterior Abdominal Wall, Diaphragm > Flashcards

Ach: Kidney, Posterior Abdominal Wall, Diaphragm Flashcards

1
Q

What are the muscles that line the posterior abdominal wall?

A 
Psoas major
Psoas minor
iliacus
quadratus lumborum
transverse abdominus
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2
Q

Psoas major
O:
I:

A

O: lumbar vertebral bodies
I: joins iliacus muscle after tapering at L5

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3
Q

What does the iliopsoas pass beneath and where does it insert?

A

inguinal ligament

lesser trochanter of the femur

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4
Q

Action of iliopsoas?

A

Flexes vertebral column

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5
Q

Action of iliacus?

A

flexes hip joint

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6
Q

Psoas minor

A

Antererior to psoas major

T12/L1—> pectineal line and iliacus fascia

Weak FLEXOR of the vertebral column

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7
Q

Iliacus

A

Superior part of the iliac fossa–> joins psoas to insert on the lesser trochanter

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8
Q

Flexion of the iliacus and psoas will…

A

flex the thigh at the hip joint

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9
Q

Movements of the iliopsoas may be accompanied by pain if…

A 
There is disease in the:
ureters
kidneys
cecum
appendix
sigmoid colon
pancreas
lumbar LN
nerves on posterior abdominal wall
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10
Q

Quadratus lumborum

A

Iliac crest/2-4 lumbar transverse processes–> 12 rib

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11
Q

What does the quadratus lumborum in relation to the diaphragm and the trunk?

A

Holds 12th rib down against traction exerted by the diaphragm

Alone–flexes the trunk

together both sides can EXTEND the trunk

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12
Q

What is the third and innermost of the 3 flat muscles of the anterior abdominal wall?

A

Transverse abdominus

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13
Q

What is the transversalis fascia?

A

The fascia that covers the posterior abdominal muscles. Each has it’s own name, but this is the general term for all of it.

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14
Q

The muscular portion of the diaphragm that surrounds the periphery is derived from what mesoderm?

A

somatic

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15
Q

What is the sternal portion of the diaphragm derived form?

A

xiphoid process of sternum and the

adjacent aponeurosis of the transversus abdominus

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16
Q

What is the costal portion of the diaphragm derived from?

A

cartilage and bony surfaces of ribs 7-12

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17
Q

What are the sternocostal triangles?

A

Gaps between the sternal and costal portions through which the SUPERIOR EPIGASTRIC VESSELS continue into the abdomen

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18
Q

What does the lumbar portion of the diaphragm arise from?

A

vertebral column in the form of 2 crura

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19
Q

What is the difference between the left and right crus?

A

Right- longer, better developed, form V1-3

Left- from L1-2

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20
Q

What forms the esophageal hiatus and the suspensory ligament of the duodenum?

A

Right crus

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21
Q

What is the median arcuate ligament and what does it form?

A

the tendinous arch that unites the two crura in the midline forming the AORTIC HIATUS

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22
Q

What does the mediaN arcuate ligament pass over?

A

the anterior surface of hte aorta

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23
Q

What are the mediaL arcuate ligaments?

A

thickenings of fascia ARCHING over the PSOAS MAJOR

attach to L1 and vertebral body of L1-2

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24
Q

The thickening of fascia that arches over the superior part of hte QUADRATUS LUMBORUM is? What is it’s O and I?

A

lateral arcuate ligament

Transverse process of the FIRST lumbar vertebrae to the 12th rib

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25
Q

What is the central tendon?

A

a strong aponeurosis upon which all the muscle fibers of the diaphragm insert on

26
Q

Where does a CDH usually occur?

A

periphery of diaphragm in the lumbocostal triangle

5 x more likely on the LEFT side

27
Q

What causes a CDH?

A

POSTEROLATERAL DEFECT

Failure of fusion of the pleuroperitoneal membrane w/ the septum transversum–> weak area that organs/intestines can herniate through

28
Q

What is a hiatal hernia?

A

when adominal viscera herniate through the ESOPHAGEAL HIATUS

29
Q

What passes through the hiatus for the IVC? What level?

A

RIGHT T8

IVC
Right phrenic nere

30
Q

What passes through the esophageal hiatus? WHat level?

A

Left at T10

Esophagus
Vagal trunks
anastomotic vessels between esophagus and stomach

31
Q

What passes through the aortic hiatus? What level?

A

T12 (R and L crura, Median AL, vertebral column)

Aorta
thoracic duct
azygos and hemiazygos veins

32
Q

Minor openings in the diaphragm are for…

A

Splanchnic nerves in the R and L crus

superior epigastric vessels at sternocostal triangle

33
Q

What a. supplies the posterior aspect of the diaphragm?

A

thoracic aorta> SUPERIOR PHRENIC ARTERIES

34
Q

What a. supplies the central area of the diaphragm?

A

internal thoracic arteries > PERICARDIOPHRENIC ARTERIES (accompany phrenic nerves)

35
Q

What a. supplies the periphery of the diaphragm?

A

(terminal branch) internal thoracic a. –> MUSCULOPHRENIC ARTERY

36
Q

What arteries that supply the diaphragm arise superior to it?

A

SUPERIOR PHRENIC A.
PERICARDIOPHRENIC A.
MUSCULOPHRENIC A.

37
Q

What arteries that supply the diaphragm arise inferior to it (from the 1st branches of the aorta in the abdomen)?

A

branch from abdominal aorta inferior to the hiatus> INFERIOR PHRENIC A.

38
Q

What is the major source of blood to the diaphragm?

A

inferior phrenic a.

39
Q

Venous drainage of the diaphragm parallels the arteries, so the chief route is through what vein?

A

INFERIOR PHRENIC VEIN> L. suprarenal v. > L renal vein

40
Q

What is the motor supply to the diaphragm?

A

SOMATIC efferents in the PHRENIC nerves

C3,4,5 keep the diaphragm alive!

41
Q

What are the two somatic afferent sources to the diaphragm?

A

PHRENIC = central area of diaphragm

INTERCOSTAL= peripheral inch of diaphragm

42
Q

What causes referred pain to the shoulder?

A

Irritation to the peritoneum covering the diaphragm > phrenic nerve C3,4,5 (same as shoulder–supraclavicular nerves C3,C4 from cervical plexus)> wrongly interpreted at higher centers.

43
Q

What causes parietal referred pain?

A

Peripheral irritation of the peritoneum> afferents in intercostal nerves> pain in thoracic wall

44
Q

What causes hiccups?

A

Irritation of aff or eff endings in the phrenic nerves> involuntary spasm of diaphragm and glottis

45
Q

What causes abdominal straining?

A

Diaphragm contracting increases the intraabdominal pressure that is needed to poop and shit.

46
Q

What is the cisterna chyli?

A

Sac like structure between the aorta and right crus of the diaphragm that passes behind the median AL to empty into the THORACIC DUCT.

47
Q

Lymph nodes in the posterior abdominal wall are where?

A

surrounding the aorta

48
Q

What tributary of the cisterna chyli drains the lumbar lymph nodes and organs supplied by systemic circulation?

A

Lumbar lymph trunks

(lower extremity, viscera of pelvis, kidney, body wall

49
Q

What tributary of the cisterna chyli drains the organs supplied by PORTAL circulation?

A

Intestinal lymph trunk

intestine, stomach, spleen, pancreas, liver

50
Q

What forms the somatic nerves of the lumbar plexus?

A

L1-L5 exit the intervertebral foramina and divide into the dorsal and ventral rami

51
Q

What supplies the muscle and skin of the back?

A

dorsal rami

52
Q

What forms the lumbar plexus?

A

ventral rami of L1-3 and upper 1/2 of L4

53
Q

What nerves sometimes sends a branch to L1?

A

subcostal nerve (T12)

54
Q

What forms the lumbosacral trunk which ultimately joins the sacral plexus in the pelvis?

A

Lower 1/2 of L4 and L5

55
Q

ilioinguinal and iliohypogastric

A

L1

56
Q

genitofemoral

A

L1-L2

57
Q

Lateral femoral cutaneous nerve

A

L2-3

58
Q

Obturator nere

A

L2-4

59
Q

Femoral nerve

A

L2-4

60
Q

Lumbosacral trunk

A

1/2 of L4, L5

descents into pelvis to join the 1st sacral nerve

GI- Week 2 (11 decks)

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