Diaphragm, Posterolateral Abdominal Wall and Kidneys Flashcards
What is attached to the central tendon superiorly?
Fibrous pericardium
What are the 3 muscular components of the diaphragm? and where do they arise from?
Sternal- xiphoid process
Costal- ribs 7-12
Crura (lumbar)- anterior aspects of the L1-L3 vertebrae
Where does the right crus of the diaphragm arise and what runs through its apertures? Is the right larger or smaller than left?
Arises from L1-L3
Has 2 apertures– one for greater and 1 for lesser right splanchnic nerves
Larger and longer than left
Where does the left crus of the diaphragm arise and what runes through its apertures?
Arises from L1-L2
Has three apertures- one for greater, one for lesser left splanchnic nerves and one for hemiazygous vein
Shorter and smaller than right
Where does the central portion of the diaphragm receive motor and sensory innervation from? Where will referred pain be felt from this region?
Phrenic formed by C3-C5 ventral rami
Over the shoulder
Where does the diaphragm receive sensory innervation from the peripheral portion? Where will referred pain be felt from this region?
T6-T9/10- intercostal and subcostal(T12) nerve
skin over the ribs of anterolateral abdominal wall
What are the 3 vessels for blood supply to the diaphragm?
Musculophrenic
pericardiophrenic
superior/inferior phrenic
Medial and lateral arcuate ligaments travel over the anterior portion of what two muscles and what is their purpose?
Psoas muscle and quadratus lumborum, respectively
Provide addition attachment for the diaphragm
How is the median arcuate ligament formed and where does it pass?
Joining of the right and left crura of the diaphragm
Passes anteriorly over the aorta
Where is the caval aperture located and what passes through it?
T8
IVC/right phrenic nerve branches/lymphatics from the liver
(I 8) 10 Eggs at 12
Where is the Esophageal Hiatus located and what passes through it?
T10
Esophagus/Vagus/esophageal branches of left gastric artery and vein
Site of Hiatal Hernias!!!!
I 8 (10 Eggs) at 12
Where is the Aortic Hiatus located and what passes through it?
T12
NOT within the diaphragm–runs BEHIND it–posterior to the median arcuate ligament
Aorta/thoracic duct/sometimes azygos vein
I 8 10 Eggs (at 12)
What are the superior/lateral/inferior boundaries of the posterolateral abdominal wall?
Superiorly- 10-12 ribs
Inferiorly- superior margin of the iliac crests
Laterally- midaxillary line
What are some important aspects of the posterolateral abdominal wall?
site of surgical incisions to each organs in the retroperitoneum
common site of blunt and penetrating wounds
common site of muscle strains and vertebral fractures
What forms the costovertebral angle and what is its significants?
formed by the incomplete 12th rib and the vertebral column
tenderness in this area= Lloyd’s sign–kidney punches/renal/perirenal/subdiaphragmatic dz
Swelling= abscess/tumor of a retroperitoneal organ
What are the 3 hip flexor muscles and what are there origins and insertions?
Psoas major- T12 and All Lumbar/lesser trochanter on femur
Psoas minor- T12 and L1/ pectineal line of pubic bone
Iliacus- iliac fossa, iliac crest, base of sacrum/tendon of psoas major onto lesser trochanter of femur
What is the function of the Quadratus Lumborum and what is its origin and insertion?
Depresses the 12th rib during respiration and flexes the vertebral column ipsilaterally
Origin and insertion- iliac crest/inferior surface of 12th rib and transverse process of L1-L4
What fibers do the Splanchnic nerves carry?
Preganglionic sympathetic info to the viscera
Also contain visceral Afferents-pain fibers
What are the 4 splanchnic nerves and where do they arise and synapse?
Greater-T5-T9–celiac ganglion
Lesser- T10-11–superior mesenteric ganglia
Least- T12–aorticorenal ganglia
Lumbar- L1-2– near Inferior mesenteric artery
What fibers do the Vagus nerve branches carry?
Preganglionic parasympathetic –anterior and posterior gastric branches
What nerve supplies SENSORY info from the skin of lower abdomen and lateral glut region and MOTOR info to the transverse/oblique/and rectus abdomens muscles?
Subcostal Nerve (T12)
What nerve supplies SENSORY info from skin of suprapubic and inguinal regions and MOTOR to the 3 abdominal muscles?
Iliohypogastric Nerve (L1)
What nerve supplies SENSORY to the skin of the pubic region,root of the penis/clitoris and anterior walls of the scrotum/labia major and MOTOR to the 3 abdominal muscles?
Ilioinguinal Nerve (L1)
What nerve supplies SENSORY from the parietal peritoneum of the iliac fossa/skin on the anterior and lateral thigh and patellar plexus?
Lateral Cutaneous Nerve (L2-3)
