Introduction to retroperitoneal structure, posterior body wall and diaphragm Flashcards
What layers are there in the abdominal wall
- 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
What are the functions of the muscles in the abdominal wall
Support our core and stabilise our back
Protect our abdominal structures because we are stood upright and our abdomen is exposed
What is the parietal peritoneum made of
Mesothelium cells- simple squamous epithelial cells that produce a small amount of fluid and a little bit of connective tissue
What is a mesentery
Double layer of visceral peritoneum
What are peritoneal structures
Surrounded by peritoneum
What are retroperitoneal structures and examples of these
Outside the peritoneum (related to the dorsal abdominal wall)
Ascending colon
Kidneys and ureter
What muscles are in the posterior abdominal wall
PSoas major
Psoas minor
Quadratus lamborum
Iliacus
What action does the psoas major have
HIp flexor
Whta action does the iliacus have
Hip flexor
What action does the quadratus lamborum have
Stabilise things and maintain intraabdominal pressure
Where does the vena cava enter diaphragm
tendinous bit of diaphragm at T8
Where does oesophagus enter diaphragm
T10
Where does the aorta enter the diaphragm
T12
What level are the right and left domes of the diaphragm at in normal expiration
Right- rib 5
left-ics5
Blood supply to the diaphragm
Phrenic artery
How does the diaphragm attach to the body
Via the ‘crus’ which attach to the lumbar vertebrae
Why is the inguinal canal important
A natural channel between the abdominal cavity and the outside of the abdominal cavity
What female and male reproductive parts does the inguinal canal contain
Spermatic cord
Ligament of the uterus
Where does the inguinal canal run
From the inguinal ligament (on ASIS of pelvis) to the pubic tubercle
What are the boundaries of the inguinal Canal
Aponeurosis of the external oblique
(roof) Internal oblique and transversus abdominis
Transversalis fascia
Inguinal ligament
Where is the deep inguinal ring and what passes through here
It is in the posterior wall of the inguinal canal
Spermatic cord enters the inguinal canal here
Where is the superficial inguinal ring and what passes through here
In the anterior wall of the inguinal canal
Spermatic cord exits the inguinal canal here
What is an inguinal hernia and why does this occur
Where pieces of the gut can pass through the inguinal rings
Happens because some rings may be large
What is the difference between a direct an indirect inguinal hernia
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
what goes through the inguinal Canal
Round ligament of the uterus
Spermatic cord
Iliolingual nn
Blood and lymph vessels
Why are inguinal hernias more common in men
Inguinal canal is bigger
What inguinal hernia is more common
Indirect
What is an indirect inguinal hernia
Herniated bowel passes lateral to inferior epigastri vessels
Commonly passes into scrotum/labium majus
What is a direct inguinal hernia
Herniated bowel passes medial to inferior epigastric vessels
rarely enters the scrotum
How to diaphragmatic hernias occur
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)
What levels are the kidneys
L-T12/L3
R- slightly lower
Where are kidneys in a kidney Transplant placed
Non-functioning kidneys are not removed
new kidneys are placed In the iliac fossa
Where are the constrictions of the ureter
Renal pelvis (where the ureter begins)
Pelvic brim
Entry to the bladder
Why are the constrictions of the ureter important
Sites for potential obstruction of kidney stones
Origin of iliohypogastric nerve and its motor and sensory function
L1
Sensory- skin above pubis and lateral buttocks
Motor-INternal oblique and transversus abdominis
Motor and sensory function of iliolingual nn
L1
Sensory- skin on proximal and medial thigh and external genitalia
Motor- internal oblique and transversus abdominis
Motor and sensory function of genitofemoral nerve
L1 and L2
Sensory- skin on proximal and medial thigh and external genitalia
Motor- cremaster muscle
Sensory function of lateral cutaneous nerve of thigh
L3
Sensory to skin of lateral thigh
Sensory and motor function of posterior femoral nerve
L234
Sensory- thigh and medial leg
Motor- to iliacus (pelvic flexor) anterior thigh
Sensory and motor function fo anterior obturator nerve
L234
Sensory- medial thigh
Motor- adductor muscles in thigh plus flexor and rotator muscle
