Anatomy of Posterior Abdominal Wall Flashcards
Major componets in the posterior wall
Remember it all retroperitoneal
aorta
Inferior Vena Cava
Kidneys
Ureters
Suprarenal
Bones associated with the posterior wall
11th and 12th rib illiac crest and T12-L5
Muscles in the posterior abdominal wall
- Quadratus lumborum
- Iliacus (not shown here)
- Psoas Major and Minor
- Diaphragm.
- upper limit of the abdominopelvic cavity.
- structures travel through or behind the diaphragm to gain access to the abdomen or thorax.
Explain what arcuate ligmanets are, list them and what can be a probelm here
They are attachment sites of the diaphgram and associated with specific structures.
Median Arcuate- at T12 associated with the abdmoinal arota
Lateral Arcuate ligmanet- quadratus lumborum MM
Medial Arcuate- associate with psoas major and minor
Potential site of weakness– clinical SI can push through allowing hernia
Two kinds of hiatal hernia
Hiatal hernia happen at the level of esophageal hiatus
- Sliding hiatal hernia - most common; gastroesophageal junction moves above the diaphragmtogether with some of the stomach.– Gerta!
- Rolling hiatal hernia - (a.k.a. paraesophageal); part of the stomach herniates through theesophageal hiatus without movement of the gastroesophageal junction.Risk factors (anything accompanied by increased pressure within the abdominal
Risk factos
- Pregancy
- Heavy lifting
- Obestiy
- Straining with constipation
- Frequent hard coughing
Position of the kidneys and suprarenal glands
Both are retroperitoneal
- Right kidney is lower (starts in 11-12 intercostal space) because of liver. Left starts at 11th rib.
- Reside between the endoabdominal fascia and posterior parietal peritoneum.
• surrounded and protected by perinephric fat, surrounded by renal fascia and more perinephric fat.
Suprarenal are upper poles of kidney and encolosed by renal fascia
Flow of urine
from renal papilla—> minor calyces—> major calyces—> pelvix—> ureter—> bladder
Blood suplly to the ureters
Several supplies of renal, gonad, and common iliac
Possible entrapment
- Uteropelvic junction
- Pelvic outlet when common iliac spilts
- Entrance to bladder
Most common site of abdominal aorta? What is it?
An abdominal aortic aneurysm is a dilatation of the aorta (in excess of 4 cm in diameter) can occur anywhere. Without surgical or endovascular intervention, the dilated artery usually continues to enlarge and may subsequently rupture.
Between renal arteries and bifurcation to common iliac
Blood Supply to the kidneys
Right and left both have a renal artery off the abdomial arota
Right is longer and passes deep to the IVC
Left is short and passes deep to the renal vein
Blood supply to suprarenal glands
- Superior superrenal- off the inferio phrenic arteries
- Middle suprarenal- off the abdominal aorta
- Left inferior- from left renal
Right inferior—?????? right inferior phrenic artery
Which renal veins drain in pairs to the IVC
RICH L
Renal Veins
Inderior Phrenic Veins
COmmon Illian Veins
Hepatic Veins
Lumbar veins
Which veins dont drain in pairs into the IVC
Suprarenal- right to IVC and left to renal
Gonadal- right to IVC and left to renal
What are the somatic nerves of the posterior wall
Subcostal T12
L1- Illiohypogastric and Illioinguinal
Genitofemoral L1-L2 - over psoas muscles
Later femoral cutaneous- L2-L3 sweeps acrooss ilacus and under inguinal ligament
Femoral L2-4 lateral to pasos
Obturator L2-L4 medial to psoss
Parasym innervation of abdominal vicersa
vagus(enters with esophagus without synpasing on the prevereterbral ganglia) and pelvic splanchi(sacal 2-4)
