ANAT Posterior Abdominal Wall - Week 7

Question 1

At what level does the IVC & phrenic nerve pass through the diaphragmatic hiatus?

Answer 1

T8.

Question 2

At what level does the internal thoracic become the superior epigastric vessels passing through the diaphragmatic hiatus?

Answer 2

T9.

Question 3

At what level does the esophagus and vagus nerve pass through the diaphragmatic hiatus?

Answer 3

T10.

Question 4

At what level does the median arcuate ligament pass through the diaphragmatic hiatus?

Answer 4

T12.

Question 5

What ligament appears as a thickening of the fascia over psoas major?

Answer 5

Median arcuate ligament.

Question 6

What ligament appears as a thickening of the fascia over quadratus lumborum?

Answer 6

Lateral arcuate ligament.

Question 7

At what vertebral level are the kidney hila located?

Answer 7

L1/2.

Question 8

Consequence of segmental artery occlusion @ kidneys?

Answer 8

Infarct & ischaemia as the segmental arteries are end points and do not anastomose.

Question 9

Paired organ vs unpaired organ pain referral locations & why (with neuro detail).

Answer 9

Paired organs (e.g., kidneys) = unilateral innervation -> pain refers to areas of the brain that are somatotopically mapped -> triggers pain sensation in dermatomes @ organ location.
(NB: Unpaired organs = bilateral innervation triggers pain signals from both sides of the body -> pain refers to areas of the brain that are not somatotopically mapped -> triggers pain sensation @ midline).
[Believed to be due to strong signals of visceral afferent nerves -> depolarisation (most likely @ dorsal horn) -> brain interprets pain origin @ dermatome (instead of organ site)].