Anatomy Topic 4 Case 7 Flashcards
How many lumbar vertebrae are there?
- 5
What type of curvature does the lumbar spine have?
- Secondary curvature
- Concave posteriorly
Identify features of a lumbar vertebrae
- Large
- Vertebral bodies increase in size
- Pedicles are short and stocky
- Transverse processes are long and slender
- Spinous processes are large and stubby
Aside from the lumbar vertebrae identify the other bony features that make up the posterior abdominal wall
- Sacrum
- Ilia
- Ribs 1 1 and 12
How are ribs 11 and 12 unique?
- They do not articulate with sternum
Identify the origin, insertion, action and innervation of psoas major
- Origin: Bodies/intervertebral discs of T12-L5, transverse processes of L1-L5
- Insertion: Lesser trochanter of femur
- Innervation: L1-L3
- Action: Flexion of hip
Identify the origin, insertion, action and innervation of psoas minor
- Origin: Bodies/intervertebral discs of T12-L1
- Insertion: Pectineal line
- Innervation: L1
- Action: Flexion of lumbar spine
Identify the origin, insertion, action and innervation of quadratus lumborum
- Origin: Iliolumbar ligament, iliac crest, transverse process of L5
- Insertion: Transverse processes of L1-L4, inferior border of rbi 12
- Innervation: T12-L4
- Action: Depresses and stabilises rib 12, lateral bending of trunk
Identify the origin, insertion, action and innervation of iliacus
- Origin: Iliac fossa, anterior sacro-iliac ligaments and iliolumbar ligaments
- Insertion: Lesser trochanter
- Innervation: L2-L4
- Action: Flexion at hip
What is the central tendon of the diaphragm?
- Point at which the circumferentially attached muscle fibres attach
What is the function of the crura?
- Anchors the diaphragm to the lumbar vertebra
- Blends with anterior longitudinal ligament
Identify differences between the right and left crura
- Right crus attaches to L1-L3
- Left crus attaches to L1-L2
How are the two crura conncted?
- By the median arcuate ligament
- Which passes anterior to the aorta
What forms the medial arcuate ligament?
- Fascia covering the upper part of psoas major
Which lumbar vertebrae is the medial arcuate ligament attached to?
- Medially: Bodies of L1-L2
- Laterally: Transverse process of L1
What forms the lateral arcuate ligament?
- Fascia covering quadratus lumborum
Which lumbar vertebrae is the lateral arcuate ligament attached to?
- Medially: Transverse process of L1
- Laterally: Rib 12
At which vertebral level is the aortic hiatus located?
- T12
What passes through the aortic hiatus?
- Aorta
- Thoracic duct
- Azygos vein
At which vertebral level is the oesophageal hiatus located?
- T10
What passes through the aortic hiatus?
- Oesophagus
- Anterior and posterior vagal trunks
- Oesophageal branches of left gastric artery and vein
At which vertebral level is the caval opening located?
- T8
What passes through the caval opening?
- Inferior vena cava
- Right phrenic nerve
How does the left phrenic nerve pass through the diaphragm?
- Passes through the muscular part of the diaphragm
- Just anterior to the central tendon on left side
What passes through the both crus?
- Greater, lesser and least splanchnic nerves
What passes through the left crus?
- Hemi-azygos vein
What passes posterior to the medial arcuate ligament?
- Sympathetic trunks
What passes anterior to the diaphragm?
- Superior epigastric vessels
What forms the right dome of the diaphragm?
- Liver
- Right kidney
- Right suprarenal gland
What forms the left dome of the diaphragm?
- Stomach
- Spleen
- Left kidney
- Left suprarenal gland
What is the arterial supply to the superior part of the diaphragm?
- Musculophrenic and pericardiacophrenic arteries (from internal thoracic artery)
- Superior phrenic artery (a branch of the thoracic aorta)
What is the arterial supply of the inferior part of the diaphragm?
- Inferior phrenic artery (a branch of thoracic aorta)
Outline the innervation of the diaphragm?
- Phrenic nerves C3-C5
Identify the four anterior branches of the abdominal aorta and what they supply
- Coeliac trunk: foregut
- Superior mesenteric artery: midgut
- Inferior mesenteric artery: hindgut
- Testicular ovarian arteries: ‘’
Identify the three lateral branches of the abdominal aorta
- Middle suprarenal arteries
- Renal arteries
- Inferior phrenic arteries
Identify two posterior branches of the abdominal aorta
- Lumbar arteries
- Median sacral artery
Identify 7 tributaries of the inferior vena cava
- Common iliac veins
- Lumbar veins
- Right testicular / ovarian veins
- Right suprarenal veins
- Inferior phrenic veins
- Hepatic veins
Why are there no tributaries form the abdominal part of the GI tract?
- They drain into the portal venous system
- Which first passes through the liver
Which vein does the fifth lumbar vein drain into?
- Iliolumbar vein
Which vein do the third and fourth lumbar veins drain into?
- Directly into inferior vena cava
Which vein do the first and second lumbar veins drain into?
- Ascending lumbar veins
- Which are anastomosing venous channels
- Which connect with common iliac, iliolumbar, and azygos veins
The lumbar plexus is formed by the anterior rami of which nerves?
- L1-L3
Identify the six branches of the lumbar plexus
- Iliohypogastric plexus
- Ilio-inguinal
- Genitofemoral
- Lateral cutaneous nerve of thigh
- Obturator
- Femoral
Which muscle does the lumbar plexus form in?
- Psoas major
Which branch(es) of lumbar plexus emerge anteriorly from psoas muscle?
- Genitofemoral
Which branch(es) of lumbar plexus emerge medially from psoas muscle?
- Obturator nerve
Which branch(es) of lumbar plexus emerge laterally from psoas muscle?
- Iliohypogastric
- Ilio-inguinal
- Femoral
- Lateral cutaneous nerve of thigh
Which spinal segment does the iliohypogastric nerve arise from?
- L1
What are the sensory functions of the iliohypogastric nerve?
- Posterolateral gluteal skin
- Skin in pubic region
What are the motor functions of the iliohypogastric nerve?
- Internal oblique
- Transversus abdominis
Which spinal segment does the ilio-inguinal nerve arise from?
- L1
What are the sensory functions of the ilio-inguinal nerve?
- Skin of upper medial thigh
- Skin over root of penis / anterior scrotum
- Skin over mons pubis and labium majora
What are the motor functions of the ilio-inguinal nerve?
- Internal oblique
- Transversus abdominis
Which spinal segment does the genitofemoral nerve arise from?
- L1-L2
What are the sensory functions of the genitofemoral nerve?
- Genital branch: skin of anterior scrotum / mons pubis and labium majora
- Femoral branch: Anterior thigh
What are the motor functions of the genitofemoral nerve?
- Cremasteric muscle
Which spinal segment does the lateral cutaneous nerve of the thigh arise from?
- L2-L3
What are the sensory functions of the lateral cutaneous nerve of the thigh?
- Skin on anterior and lateral thigh to knee
Which spinal segment does the obturator nerve arise from?
- L2-L4
What are the sensory functions of obturator nerve?
- Skin on medial aspect of the thigh
What are the motor functions of obturator nerve?
- Medial compartment
- Obturator nerve
- Pectineus
Which spinal segment does the femoral nerve arise from?
- L2-L4
What are the sensory functions of the femoral nerve?
- Anterior thigh and medial surface of leg
What are the motor functions of the femoral nerve
- Anterior compartment
- Iliacus
- Pectineus