GA - Posterior Abdominal Wall Flashcards
What are the muscles found in the posterior abdominal wall?
Diaphragm Psoas Major M. Psoas Minor M. Iliacus M. Quadratus Lumborum M.
What is Psoas Abcess?
Infection deep to Psoas fascia
Signs and symptoms:
- Back/flank pain
- Fever
- Inguinal mass
- limp
- anorexia (pain decreases appetite)
- weight loss
Psoas sign is an indicator - lower abdominal pain exacerbated by extending the leg (also seen in appendicitis
What are the three ligaments along the base of the diaphragm and where are they located?
Median Arcuate Ligament - tendonous arch of the crura of the diaphragm (overlays the aorta - forming the aortic hiatus)
Medial Arcuate Ligament - fascial thickening of the psoas fascia; found just lateral to the median arcuate ligament
Lateral Arcuate Ligament - fascial thickening of the quadratus lumborum; found lateral to the medial arcuate ligaments
What are the 3 muscular parts of the diaphragm and where do each attach?
Sternal Part - Attaches tot he xyphoid process
Costal Part - Attaches the 6 inferior costal cartilages
Lumbar Part - Attaches to the Medial and Lateral Arcuate Ligaments
What is the central tendon of the diaphragm and what is its embryonic origin?
It is the white tendonous portion of the diaphragm at the central/superior portion.
It is a remnant of the Septum Transversum
What are the crura and which vertebral body segments do they attach to?
The crura are two muscular portions of the diaphragm that makeup the Esophageal and Aortic hiatuses
They are the Right and Left Crus
Right Crus is longer and attaches to L3-L4, it wraps around the esophageal hiatus
Left Crus is shorter and attaches to L2-L3
What vertebral segment is the caval opening located, and what travels through it?
The caval opening is located at T8
The Vena Cava and the Right Phrenic N. travel through it
What vertebral segment is the Esophageal Hiatus located, and what travels through it?
The Esophageal Hiatus is located at T10
The Esophagus and the Vagus N. travel through it
What vertebral segment is Aortic Hiatus located, and what travels through it?
Aortic Hiatus is located at T12
The Aorta, Thoracic Duct, and Azygous V./Hemiazygous V. travel through it
What vertebral segment is the SMA located?
L1
What vertebral segment is the IMA located?
L3
What vertebral segment is the Celiac Trunk located?
T12
What vertebral segment are the Renal vessels located?
L1/L2
What vertebral segment are the Gonadal Arteries located?
L2
What vertebral segment is the bifurcation of the Abdominal Aorta located? What do you call the two arteries?
L4
Common Iliac Arteries
What vertebral segment is the body of the pancreas located?
L1 - L2
What vertebral segment is the Third (horizontal) Part of the Duodenum located?
L3
How are the left and right suprarenal veins different?
The right Suprarenal Vein branches off the vena cava
The Left Suprarenal Vein branches off the Left Renal Vein
What are the 3 Suprarenal Arteries and where do they come from?
The Superior Suprarenal Arteries come from the the Inferior Phrenic A.
The Middle Suprarenal Arteries come from the Aorta
The Inferior Suprarenal Arteries come from the Renal Arteries
What innervates the Suprarenal Glands?
Preganglionic Nerves from T6-L2
Celiac Ganglion and Splanchnic Nerves
What tissue layers are found on the anterior side of the kidney from Deep to Superificial?
Perinephric Fat
Renal Fascia
Peritoneum
What tissue layers are found on the posterior side of the kidney from Deep to Superficial?
Perinephric Fat Renal Fascia Paranephric Fat Transversalis Fascia Quadratus Lumborum M.
What do you call the medial portion of the kidney where the vessels enter/exit?
The Renal Hilum
What do you call the part of the kidney that the major calices drain into before entering the ureter?
Renal Pelvis
What do you call the tip of the Renal Pyramid?
Renal Papilla
What do you call the urinary vessels that drain into the Renal Pelvis?
The Major Calyx and Minor Calyx
What do you call the tissue between the Renal Pyramids?
Renal Columns
What do you call the most inferior portion of the Thoracic Duct
Cisterna Chyli
List the major lymph nodes from superior to inferior
Celiac Node
Superior Mesenteric Node
Inferior Mesenteric Node
Lumbar Nodes
Name the nerves seen along the posterior wall from most superior to most inferior
Subcostal N. (from T12)
Anterior Ramus of L1 (branches into Iliohypogastric N. and Ilioinguinal N.)
Lateral Femoral Cutaneous N.
Femoral N.
Genitofemoral N. (forms a Genital Branch and Femoral Branch)
Obturator N.
What are the functions of the Iliohypogastric N.?
Motor: Internal Oblique M. and Transversus Abdominus M.
Sensory: Posterolateral Gluteal skin and skin in pubic region
What are the functions of the Ilioinguinal N.?
Motor: Internal Oblique M. and Transversus Abdominus M.
Sensory: Upper medial thigh AND EITHER:
- Male - Anterior scrotum and skin over root of penis
- Female - Mons Pubis and labia majora
What are the functions of the Genital Branch of the Genitofemoral N.?
Motor: Cremaster M.
Sensory:
- Genital Branch - Skin of anterior scotrum or skin of mons pubis and labia majora
- Femoral Branch - Skin of upper anterior thigh
What are the functions of the Lateral Femoral Cutaneous N.?
Sensory: Skin of anterior lateral thigh
What are the functions of the Femoral N.?
Motor: Iliacus M., Pectineus M. Muscles of anterior compartment of the thigh
Sensory: Skin on medial and anterior thigh
What are the functions of the Obturator N.?
Motor: Obturator externus M., pectineus M., muscles in medial thigh compartment
Sensory: Skin on medial thigh
