Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ANATO second semester 23-24 > block I: diaphragm and posterior abdominla wall > Flashcards

block I: diaphragm and posterior abdominla wall Flashcards

1
Q

chief muscle of respiration

A

diaphragm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

describe the diaphragm

A
  • Double-domed
  • Musculotendinous
  • It divides the thoracic and abdominal part
  • Domes
  • (Right & Left)
  • Right one is higher and reaches
    the 5th rib during expiration,
    whereas the left reaches the 5th
    intercostal space
  • The level of domes varies according to:
  • Phase of respiration
    -Inspiration vs Expiration
  • Posture
  • Size & degree of abdominal viscera’s distension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

the pericardia; sac fuses with:

A

central tendon of diaphragm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Based on its peripheral attachments, the diaphragm can be divided in three descriptive
parts:

A

1) Sternal 2) Costal 3) Lumbar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Describe the components of the diaphragm

A
  1. Central tendon
  • Muscular part:
  • Sternal – arises from the xiphoid process
  • Costal – inferior six costal cartilages, it forms the right & left domes
  • Lumbar – arises from the medial & lateral arcuate ligaments and the L1-L3 vertebrae
    Crura of the diaphragm – musculotendinous bands
  • Left crus – L1 to L2
  • Right crus - L1 to L3
  • Splits to enclose the esophagus

Median arcuate ligament - Aortic
hiatus (T12)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the diaphragms openings or hiatus?

A

Allow structures to pass between thorax and abdomen
1. Caval opening (T8) = Vena caval foramen
2. Esophageal hiatus (T10)
3. Aortic hiatus (T12)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe the caval opening T8

A

Vena caval foramen
* Inferior vena cava (IVC)
– During inspiration, the diaphragm contracts, widens the opening and dilates the IVC
* Right phrenic (terminal branches)
* Lymphatic vessels (from the liver to the middle phrenic and mediastinal lymph nodes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe the esophageal hiatus (T10)

A
  • Esophagus (E)
  • Anterior & posterior vagal trunks
  • Esophageal branches of left gastric vessels
  • Lymphatic vessels
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe the Aortic hiatus (T12)

A
  • An opening to the descending aorta (A)
  • Thoracic duct
  • Azygous and hemi-azygos vein (occasionally)
  • Greater splanchnic nerve (occasionally)

The aorta does not pierce the
diaphragm, therefore, blood flow is not
alter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Describe sternocostal triangle (foramen)

A
  • Between the sternal and costal attachments
  • Transmits lymphatic vessels from the diaphragmatic surface of the liver and the superior epigastric
    vessels.
    Two small apertures in each crus of the diaphragm; one transmits the greater splanchnic nerve and the other the lesser splanchnic nerve.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Diaphragm: Blood Supply and Venous Drainage
to Superior Surface are:

A
  1. Pericardiacophrenic aa
  2. Musculophrenic aa - branches from internal
    thoracic artery
  3. Superior phrenic aa – from thoracic aorta

Venous Drainage:
The Pericardiacophrenic and Musculophrenic veins drain into the internal thoracic vein, whereas the superior phrenic drains into the IVC.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Diaphragm: Blood Supply and Venous Drainage
to Inferior Surface are:

A

Blood supply:
The inferior surface of the diaphragm is supply by the inferior phrenic artery

Venous Drainage:
Right side: Inferior phrenic to IVC
Left side: 2 Inferior phrenic veins – one drain into the IVC the other to the suprarenal vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Lymphatic Drainage of Diaphragm: Superior Surface

A

Lymphatic nodes in the diaphragm communicates
freely.

Superior surface:
Diaphragma)c lymph nodes:
1. Posterior
-Posterior Mediastinal Parasternal
2. Anterior
-Parasternal
3. Phrenic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Lymphatic Drainage of Diaphragm: Inferior Surface

A

Inferior surface:
Lymphatic vessels drain
into the:
Ø anterior diaphragmatic
Ø phrenic
Ø superior lumbar (caval/aortic) lymph nodes

In the inferior surface, lymphatic capillaries are dense constitute the primary means for absorption of
peritoneal fluid and substances introduced by intraperitoneal (I.P.) injection.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Diaphragm innervation

A

Motor:
1. Phrenic Nerves (C3 – C5)
Ø Left and right phrenic nerves

Sensory:
Pain & Proprioception
1. Phrenic nerves (Left & Right)
2. Intercostal nerves (T5-T12)
Ø Carries only afferent fibers from the peripheral part of the diaphragm
Ø Intercostal nerves 6-11 & subcostal nerves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

explain paralysis of diaphragm

A

During inspiration, the diaphragm contracts,
its convexity is somewhat flattened, the
diaphragm descend pushing the viscera
inferiorly.
^ increases volume of thoracic cavity
v decreases Intrathoracic pressure
Resulting in air going into the lungs

The paralyzed dome ascends as it is pushed
superiorly by the abdominal viscera that are
being compressed by the active contralateral
dome.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the muscles of the posterolateral wall?

A
  • External oblique
  • Internal oblique
  • Transversus abdominis
  • Latissimus dorsi
  • Serratus posterior inferior
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

CONTENTS OF THE POSTERIOR ABDOMINAL WALL

A
  • Lumbar vertebra (5) & IV discs
  • Muscles
    ü Psoas
    ü Quadratus lumborum
    ü Iliacus
    ü Transversus abdominis
    ü Oblique muscles
  • Diaphragm
  • Thoracolumbar fascia
  • Lumbar plexus
  • Nerves, vessels and lymph nodes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

describe Psoas major (psoas = muscle of the loin)

A

Attachments: Transverse process of
lumbar vertebra and side of T12-L5
bodies to lesser trochanter of femur
Action:
* Flexes the thigh (acting with Iliacus)
inferiorly
* Flexes vertebral column laterally,
superiorly
* Balance the trunk
* When sitting it flexes the trunk
(acting with Iliacus)
Innervation: anterior rami of lumbar
L1, L2, L3

20
Q

describe psoas minor

A

Attachments: Transverse process of
T12 iliopectineal arch and eminence
This muscle does not cross the inguinal
ligament.
Action:
* When present (~60%), its function
jointly with the Psoas major and
Iliacus muscles
Innervation: anterior rami of lumbar L1

21
Q

describe iliacus

A

Attachments: Iliac fossa (superior 2/3), ala of sacrum and anterior sacro-iliac ligaments
to lesser trochanter of the femur
Action: Flexes the thigh and stabilizes the hip joint (acts with Psoas major muscle)
Innervation: Femoral nerve (L2-L4)

22
Q

describe quadratus lumborum

A

Attachments: Inferior border of 12th rib
and tips of lumbar transverse process
to iliolumbar ligament and internal lip
of iliac crest
Action:
* Extends and laterally flexes the
vertebral column
* Fix 12th rib during inspiration
Innervation: Anterior branches of T12
and L1-L4 nerves

23
Q

explain quadratus lumborum posterior side

A

Attachments: Inferior border of
12th rib and tips of lumbar
transverse process to iliolumbar
ligament and internal lip of iliac
crest
Action:
* Extends and laterally flexes
the vertebral column
* Fix 12th rib during inspiration
Innervation: Anterior branches of
T12 and L1-L4 nerves

24
Q

the endo abdominal fascia lies where?

A

between parietal peritoneum and muscles

25
Q

whoch are the ligaments of the posterior abdominal wall

A

1 median arcuate ligament
2. medial arcuate ligament (formed by thickened of the psoas fascia sheath)
3. lateral arcuate ligament (froemd by thickened of the quadratus lumborum fascia)

26
Q

What is the thoracolumbar fascia?

A

an extensive fascial complex attached to the vertebral column medially that, in the lumbar region, has posterior, middle, and anterior layers with muscles enclosed between
them.

27
Q

Explain the subcostal n t12

A
  • Anterior rami of T12
  • Arises from the thorax and pass posterior to the lateral arcuate ligament into the abdomen
  • Pass through the transversus abdominis and internal oblique muscles
    Innervates:
  • External oblique m.
  • Skin of the anterolateral abdominal wall
28
Q

Explain the lumbar spinal nerves (L1-L5)

A
  • Anterior and Posterior rami
    – Anterior rami supply the skin and muscles
    of the inferior most trunk & lower limb
    – Posterior rami supply the muscles of the
    back
    – White communicating branches (Sosa’s
    lecture)
  • Anterior rami of L1, L2 and L3
  • Convey presynaptic sympathetic fibers to the
    lumbar sympathetic trunk
    Lumbar plexus of nerves
  • Formed by the union of the ventral rami
    L1 - L4
  • Localized anterior to the transverse
    process of lumbar vertebrae
29
Q

explain iliohypogastric n & ilioinguinal n (L1)

A

entering the abdomen posterior to
the medial arcuate ligament and
passing inferolaterally, anterior to
the quadratus lumborum.
* It pierces the transversus
abdominis muscle close to the
ASIS
Innervates:
* Abdominal muscles
* Skin inguinal and pubic region

30
Q

EXPLAIN genitofemoral nerve (L1, L2)

A
  • Genital branch
  • Enters the inguinal canal (deep inguinal ring)
  • Spermatic cord
  • Cremaster mm
  • Scrotum (Labium major)
  • Femoral branch
  • Supply skin of femoral triangle

PIERCES THE PSOAS MAJOR

31
Q

Explain lateral cutaneous nerve of the thigh (L2,L3)

A
  • Runs inferolateral on Iliacus muscle
    and enters the thigh (deep to inguinal
    ligament/iliopubic tract)
    Innervation:
  • Supplies the skin on the anterolateral
    surface of the thigh
32
Q

eXPLAIN FEMORAL NERVE (l2-l4)

A
  • Emerges from the lateral border of
    the Psoas major. After innervating
    the Iliacus muscle this nerve passes
    deep to the inguinal
    ligament/iliopubic tract
    Innervates:
  • Iliacus
  • Flexors of the hip (anterior thigh)
  • Extensors of the thigh
33
Q

Explain obturador (L2-L4)

A
  • Emerges from the medial border of the
    Psoas major muscle and passes inferior to
    the superior pubic ramus through the
    obturator foramen
    Innervation:
  • All muscles in the medial
    compartment of the thigh, except the
    hamstring part of the adductor
    magnus.
34
Q

Ex[lain accessory obturador n. (L3,L4)

A
  • Present ~10% of the time
  • Parallels the medial border of the Psoas
  • Innervates hip joint and Pectineus muscles
35
Q

THE MUSCLES OF THE POSTERIOR ABDOMINAL WALL ARE MAINLY SUPPLIED BY?

A

branches of the
abdominal aorta that starts at the aortic hiatus (T12) and ends at the level of L4.

36
Q

WHAT ARE TH ETHREE VASCULAR PLANES?

A
  1. Anterior midline
    - Digestive tract
  2. Lateral
    - Urogenital & Endocrine
    organs
  3. Posterolateral
    - Diaphragm & Body wall
37
Q

Where does abdominal aorta start?

A

aortic hiatus (T12)
~13 m lenght
-ends at level of L4

38
Q

What is the blood supply of the diapraghm?

A

-Superior phrenic, Musculophrenic
and pericardiophrenic
- Inferior phrenic

39
Q

blood supply to posterior mm.

A
  • Inferior phrenic
  • Lumbar (1-4)
  • Iliolumbar
  • Ascending branch of deep
    circumflex artery
40
Q

Veins if the posterior abdominal wall?

A

Tributaries of IVC. IVC begins at L5; caval opening T8

41
Q

EXPLAIN THE LYMPHATIC VESSELS AN LYMPH NODE SOF POSTERIOR ABDOMINAL WALL

A
  • Lie along the aorta, IVC, and iliac vessels
  • The common iliac lymph nodes receive lymph from the external and internal iliac lymph nodes. Lymph
    from the common iliac lymph nodes passes to the
    right and left lumbar lymph
    nodes.

Lymph from the alimentary tract, liver, spleen, and pancreas passes along the celiac and superior and inferior mesenteric arteries to the pre-aortic
lymph nodes(celiac and superior and inferior mesenteric nodes)

42
Q

What is the intestinal lymphatic trunk?

A

Efferent vessels from these nodes form
the intestinal lymphatic trunks, which may be
single or multiple, and participate in the
confluence of lymphatic trunks that gives rise
to the thoracic duct.

43
Q

what are the anatomical positions of kidneys

A

The right kidney related to rib 12, whereas the left kidney is related to ribs 11 & 12. transpyloric plane

44
Q

explain psoas abscess

A

Psoas Abscess (red
arrow can result from an
infection of the vertebral
column, due to
tuberculosis (TB) that
spread from the vertebral
column to the psoas
fascia.
Pus usually runs over the
pelvic brim and deep to
inguinal ligament

45
Q

explain posterior abdominla pain

A

The Iliopsoas test can rule out an intraabdominal
inflammation. Usually, movement
of the iliopsoas will produce pain if some
structures are diseased. For example, an
inflammation of the appendix.

As Moore and Dalley pointed out, “The person
is asked to lie on the unaffected side and
extend the thigh on the affected side against
the resistance of the examiner’s hand
(Bickley, 2009). The elicitation of pain with this
maneuver is a positive psoas sign.”

Thus, a positive right psoas sign in the right
side may indicate an acutely inflamed
appendix. In the left side, it could be an
inflammation of the sigmoid colon, lumbar
lymph nodes, among others

ANATO second semester 23-24 (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions