Anatomy Practical 3 Flashcards
What are the muscles of the posterior abdominal wall?
Quadratus Lumborum
Transversus abdominis
Psoas major
What is the posterior abdominal wall formed by?
- psoas major
- quadratus lumborum
- iliacus
- transversus abdominis
- diaphragm
- 5 lumbar vertebrae
Where is psoas major?
Arises from lumbar vertebral bodies and IV discs -> passes under inguinal ligament -> inserts on lesser trochanter of femur
Where is quadratus lumborum?
originates on transverse process of lumbar vertebrae and last rib -> inserts on iliac crest of pelvis
What roots makes up the lumbar plexus? Where do these nerves arise from?
L1-L4
From anterior primary rami
What nerves make up the lumbar plexus and what are their roots?
- ilioinguinal (L1)
- iliohypogastric (L1)
- lateral femoral cutaneous (L2-L3)
- genitofemoral nerve (L1-L2)
- obturator nerve (L2-L4)
- lumbosacral trunk (L4-L5)
- femoral (L2-L4)
- subcostal (T12)
What do the nerves in the lumbar plexus innervate?
Subcostal - motor to abdominal muscles, sensory to lower anterior abdominal wall
Ilioinguinal - motor to abdominal muscles, sensory to groin
Iliohypogastric - motor to abdominal muscles, sensory to upper and medial thigh, root of penis, mons pubis and labia majora
Genitofemoral - cremaster motor, sensory genital branch genitals, femoral branch upper anterior thigh
Lateral cutaneous nerve of thigh - lateral thigh
Obturator - motor to medial compartment of thigh, sensory to medial thigh
Femoral - motor to anterior compartment of thigh, sensory to anterior thigh
Where does the abdominal aorta bifurcate and into what?
L4/5 into common iliac arteries
What are the anterior branches of the abdominal aorta?
- coeliac trunk
- SMA
- IMA
What are the lateral branches of the abdominal aorta?
- renal arteries (L1) and suprarenal/adrenal arteries
- gonadal arteries (L2)
- four paired lumbar arteries
Where does the IVC form and by what?
Common iliac veins joining at L5
What are the tributaries of the IVC? Where do they enter?
Renal veins
Suprarenal/adrenal veins
Gonadal veins
Enter laterally
What is the difference in drainage of the gonadal veins?
Left gonadal vein drains to left renal vein but right drains straight to IVC
Which vein crosses the midline anterior the aorta?
Left renal vein
What does the urinary system consist of?
Kidneys, ureters, urinary bladder, urethra, adrenal glands
Where do the renal arteries arise?
From abdominal aorta at L1
What is the blood supply to the adrenal glands?
- superior suprarenal
What is the lymphatic drainage of the adrenal glands?
Same as kidneys: para-aortic lymph nodes
What do the adrenal glands receive blood from?
3 sources:
- branch from renal artery
- branch from abdominal aorta
- branch from inferior phrenic
What structures are between the renal columns?
Columns of Bertin
between the pyramids
What is the tip of the medullary pyramid in the kidneys called?
Renal papilla
What is at the top of each pyramid?
Calyx
What is the position/course of the ureters in males?
Leave hilum
pass downwards behind peritoneum
lie on psoas major
pass medially across common iliac bifurcation and enter pelvis
pass laterally and turn medially to enter bladder
pierce detrusor muscle obliquely and open at ureteric orifices
What is the PUJ?
Pelvic-ureteric junction
What is the CUJ/VUJ?
Cystoureteric junction
Vesicoureteric junction
Where are the 3 narrowing’s of the ureters where calculi may get obstructed?
- PUJ
- CUJ/VUJ
- when ureters enter pelvic brim (cross external iliac artery)
Where is the bladder?
- anterior part of pelvic cavity
- behind pubic symphysis
- anterior to rectum
- inferior to prostate
What is the retro-pubic space?
Fat filled recess between anterior wall of bladder and pubic symphysis
What is the rectovesical pouch?
Superior surface of bladder reflected up on to rectum anterior wall
Where is the EUS in males?
Surrounds membranous urethra, then through corpus spongiosum towards penis tip
What is the navicular fossa?
Vertical slit of urethra - external urethral meatus
Which part of the prostate usually enlarges the most?
Middle lobule
Obstructs IUS
Where are the ureters in females?
Close proximity to the ovarian vessels
Medial to ischial spine
Close to lateral fornix of vagina
Enters bladder superiorly/posteriorly
What is close near the pelvic brim?
Uterine arteries and ovarian vessels
Why is the ureter in danger of damage during a hysterectomy?
Ureter passes immediately inferior to uterine artery near fornix of agina
Uterine artery ligated and severed to remove uterus
Where is the bladder in females?
Between pubic symphysis and uterus
What is the vesicouterine pouch?
Peritoneum forms it
Between bladder and utertus
What is the rectoutertine pouch?
Pouch of Douglas
Peritoneum forms it
Between uterus and rectum
What is the blood supply to the bladder?
From superior and inferior vesicle arteries
Branches of internal iliac
Female bladder receives branches from uterine and vaginal arteries
Where is the urethra in the female?
Traverses the urinogenital diaphragm (pelvic floor) before opening in vulva
Surrounded by striated EUS muscle
