Introduction to retroperitoneal structure, posterior body wall and diaphragm

Question 1

What layers are there in the abdominal wall

Answer 1

• Skin
• Subcutaneous tissue (camper fascia and scarpa fascia)
• Muscle (rectus abdomens and internal and external oblique and transverses abdominus)
• Endoabdominal fascia
• Extraperitoneal fat

Then we get to our parietal peritoneum

Question 2

What are the functions of the muscles in the abdominal wall

Answer 2

Support our core and stabilise our back

Protect our abdominal structures because we are stood upright and our abdomen is exposed

Question 3

What is the parietal peritoneum made of

Answer 3

Mesothelium cells- simple squamous epithelial cells that produce a small amount of fluid and a little bit of connective tissue

Question 4

What is a mesentery

Answer 4

Double layer of visceral peritoneum

Question 5

What are peritoneal structures

Answer 5

Surrounded by peritoneum

Question 6

What are retroperitoneal structures and examples of these

Answer 6

Outside the peritoneum (related to the dorsal abdominal wall)

Ascending colon
Kidneys and ureter

Question 7

What muscles are in the posterior abdominal wall

Answer 7

PSoas major
Psoas minor
Quadratus lamborum
Iliacus

Question 8

What action does the psoas major have

Answer 8

HIp flexor

Question 9

Whta action does the iliacus have

Answer 9

Hip flexor

Question 10

What action does the quadratus lamborum have

Answer 10

Stabilise things and maintain intraabdominal pressure

Question 11

Where does the vena cava enter diaphragm

Answer 11

tendinous bit of diaphragm at T8

Question 12

Where does oesophagus enter diaphragm

Answer 12

T10

Question 13

Where does the aorta enter the diaphragm

Answer 13

T12

Question 14

What level are the right and left domes of the diaphragm at in normal expiration

Answer 14

Right- rib 5

left-ics5

Question 15

Blood supply to the diaphragm

Answer 15

Phrenic artery

Question 16

How does the diaphragm attach to the body

Answer 16

Via the ‘crus’ which attach to the lumbar vertebrae

Question 17

Why is the inguinal canal important

Answer 17

A natural channel between the abdominal cavity and the outside of the abdominal cavity

Question 18

What female and male reproductive parts does the inguinal canal contain

Answer 18

Spermatic cord

Ligament of the uterus

Question 19

Where does the inguinal canal run

Answer 19

From the inguinal ligament (on ASIS of pelvis) to the pubic tubercle

Question 20

What are the boundaries of the inguinal Canal

Answer 20

Aponeurosis of the external oblique

(roof) Internal oblique and transversus abdominis

Transversalis fascia

Inguinal ligament

Question 21

Where is the deep inguinal ring and what passes through here

Answer 21

It is in the posterior wall of the inguinal canal

Spermatic cord enters the inguinal canal here

Question 22

Where is the superficial inguinal ring and what passes through here

Answer 22

In the anterior wall of the inguinal canal

Spermatic cord exits the inguinal canal here

Question 23

What is an inguinal hernia and why does this occur

Answer 23

Where pieces of the gut can pass through the inguinal rings

Happens because some rings may be large

Question 24

What is the difference between a direct an indirect inguinal hernia

Answer 24

Indirect inguinal hernia - goes through the inguinal rings

direct Inguina hernia- doesn’t go through the inguinal rings it goes directly down through the abdominal wall

Question 25

what goes through the inguinal Canal

Answer 25

Round ligament of the uterus
Spermatic cord
Iliolingual nn
Blood and lymph vessels

Question 26

Why are inguinal hernias more common in men

Answer 26

Inguinal canal is bigger

Question 27

What inguinal hernia is more common

Answer 27

Indirect

Question 28

What is an indirect inguinal hernia

Answer 28

Herniated bowel passes lateral to inferior epigastri vessels

Commonly passes into scrotum/labium majus

Question 29

What is a direct inguinal hernia

Answer 29

Herniated bowel passes medial to inferior epigastric vessels

rarely enters the scrotum

Question 30

How to diaphragmatic hernias occur

Answer 30

When there is a failure of the 4 embryonic parts of the diaphragm to fuse properly (bowel herniates into mediastinum)

or
Through parts of the central tendon

Or
via the oesophageal hiatus (stomach herniates)

Question 31

What levels are the kidneys

Answer 31

L-T12/L3

R- slightly lower

Question 32

Where are kidneys in a kidney Transplant placed

Answer 32

Non-functioning kidneys are not removed

new kidneys are placed In the iliac fossa

Question 33

Where are the constrictions of the ureter

Answer 33

Renal pelvis (where the ureter begins)

Pelvic brim

Entry to the bladder

Question 34

Why are the constrictions of the ureter important

Answer 34

Sites for potential obstruction of kidney stones

Question 35

Origin of iliohypogastric nerve and its motor and sensory function

Answer 35

L1
Sensory- skin above pubis and lateral buttocks

Motor-INternal oblique and transversus abdominis

Question 36

Motor and sensory function of iliolingual nn

Answer 36

L1
Sensory- skin on proximal and medial thigh and external genitalia

Motor- internal oblique and transversus abdominis

Question 37

Motor and sensory function of genitofemoral nerve

Answer 37

L1 and L2
Sensory- skin on proximal and medial thigh and external genitalia

Motor- cremaster muscle

Question 38

Sensory function of lateral cutaneous nerve of thigh

Answer 38

L3

Sensory to skin of lateral thigh

Question 39

Sensory and motor function of posterior femoral nerve

Answer 39

L234
Sensory- thigh and medial leg

Motor- to iliacus (pelvic flexor) anterior thigh

Question 40

Sensory and motor function fo anterior obturator nerve

Answer 40

L234
Sensory- medial thigh

Motor- adductor muscles in thigh plus flexor and rotator muscle