Diaphragm and Posterior Abdominal Wall Flashcards
What is the nerve supply to Diaphragm?
Phrenic Nerve from roots C3,4,5
What does the Diaphragm consist of?
- Central Tendon
- Peripheral Muscle Structure
- Arcuate Ligaments
What are the Arcuate Ligaments of the Diaphragm?
- Median Arcuate Ligament
- Medial Arcuate Ligament
- Lateral Arcuate Ligament
What goes through the Central Tendon of the Diaphragm and which vertebral level do they go through?
Inferior Vena Cava and Right Phrenic Nerve go through at level T8
What goes through the Peripheral Muscular Structure of the Diaphragm and which vertebral level do they go through?
Oesophagus and Vagal Nerve at level T10
What goes through the Diaphragm behind the Median Arcuate Ligament and which vertebral level do they go through?
Aorta, Thoracic duct and Azygos Vein at level T12
What are the muscles of the Posterior Abdominal Wall?
- Psoas Major
- Trasversus Abdominis
- Quadratus Lumborum
What nerve roots make up the Lumbar Plexus?
L1 to L4 with a small contribution from T12
Which root of the Lumbar Plexus does the Subcostal Nerve come off?
T12
What are the Nerves coming off the Lumbar Plexus?
- Subcostal Nerve
- iliohypogastric Nevre
- Ilioinguinal Nerve
- Genitofemoral Nerve
- Femoral Nerve
- Obturator Nerve
- Lateral Cutaneous of Thigh
Which root of the Lumbar Plexus does the Iliohypogastric Nerve come off?
L1
Which root of the Lumbar Plexus does the Ilioinguinal Nerve come off?
L1
Which root of the Lumbar Plexus does the Genitofemoral Nerve come off?
L1 , L2
Which root of the Lumbar Plexus does the Femoral Nerve come off?
L2,L3,L4
Which root of the Lumbar Plexus does the Obturator Nerve come off?
L2,L3,L4
Which root of the Lumbar Plexus does the Lateral Cutaneous Nerve of Thigh come off?
L2, L3
Which of the Lumbar Plexus Nerves are Medial to Psoas Major?
Obturator Nerve and Lumbosacral trunk
Which of the Lumbar Plexus Nerve are Anterior to Psoas Major?
Genitofemoral Nerve
Which of the Lumbar Plexus Nerves are Lateral to Psoas Major?
Femoral Nerve, Iliohypogastric Nerve, Ilioinguial Nerve, Lateral Cutaneous Nerve of thigh, Subcostal Nerve
Where does the Abdominal Aorta enter the abdomen?
Behind the Median Arcuate Ligament at T12
What are the branches of the Abdominal Aorta in general terms (4,4,4)?
4 Unpaired Branches
4 Paired Branches
4 Pairs of Lumbar Arteries
What are the 4 Unpaired Branches of the Abdominal Aorta and what vertebral level do they come off?
T12–> Coeliac Trunk
L1–> Superior Mesenteric
L3–> Inferior Mesenteric
L4–. Median Sacral
What are the 4 Paired Branches of the Abdominal Aorta and what vertebral level do they come off?
T12–> Inferior Phrenic
L1–> Middle Supra Renal
L1–> Renal
L2–> Gonadal
What artery gives off the Superior Suprarenal Artery?
Inferior Phrenic Arteries
What artery gives off the Inferior Suprarenal Artery?
Renal Arteries
Where is Cisterna Chyli located?
Posterior to the aorta on L1/L2 vertebral body, then ascends as the thoracic duct together with the aorta and azygos vein at T12
Describe the Embryological Formation of the Diaphragm
The Septum Transversum fuses with Pleuroperitoneal Membrane to form primitive diaphragm that partitions thoracic from abdominal contents
What happens if there is a defect in the fusion of the Pleuroperitoneal Membrane (normal in the left posterolateral aspect)?
Congenital Hernia of Bochdalek–> Abdominal organs can herniate up into the thorax if the Pleuroperitoneal membrane fails to close
What is an Abdominal Aortic Aneurysm?
Dilation in the Abdominal Aorta–> need to know if it is below or above the renal arteries
What is Pneumoperitoneum?
Free air under the diaphragm that can be caused by perforation of the lung and diaphragm
Why can diaphragmatic pain be referred to the shoulder?
Nerve Supply C3,4,5 also gives off cutaneous supply to the shoulder
