L4 - Posterior Abdominal Wall & Diaphragm Flashcards

1
Q

Posterior Abdominal Wall consists of how many lumbar vertebrae?

A

Five L1-L5

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2
Q

Which muscles are associated with the posterior abdominal wall?

A

Quadratus Lumborum Psoas Major and minor Illiacus

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3
Q

Quadratus Lumborum Muscle

A

Innervation : T12-L4 Action: Unilaterally Flexes the Trunk

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4
Q

Psoas Major

A

Inf Attachment : along with the illacus muscle, lesser trochanter of femur

Innervation : ventral rami L1-L3

Action : Flexes thigh and trunk

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5
Q

Illiacus Muscle

A

Inf attachment : Along with psoas major m, lesser trochanter of femur

Action : flexes thigh

Innervation : Femoral Nerve

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6
Q

Which of these matches are INCORRECT?

  • A. Psoas Major…Rami from T12-L4
  • B. Quadratus Lumborum…Rami from T12-L4
  • C. Iliacus…Femoral Nerve (L2-L4)
  • D. Psoas Major…Rami from L1-L3
A

•A. Psoas Major…Rami from T12-L4

actually

L1-L3

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7
Q

Quadratus Lumborum in relation to Psoas Major and Kidenys

A

Quadratus Lumborum:

  • LATERAL to the Psoas Major
  • POSTERIOR to the Kidney
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8
Q

How is the skeletal muscle arranged around the central tendon? and what tissue is the central tendon made up of?

A
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9
Q

IVC: # vertebrae?

Esophagus : # Vertebrae?

Aorta: # Vertebrae?

A

I ate 10 eggs at 12

IVC : 8

Esophagus : 10

Aorta : 12

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10
Q

Whats muscle is under the medial arcuate ligament?

A

Psoas Major

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11
Q

What muscle is under the lateral arcuate ligament?

A

Quadratus Lumborum Muscle

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12
Q

What is under the median arcuate ligament?

A

Aorta

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13
Q

The median arcuate ligament is made up of?

A

Left and Right Crus

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14
Q

The right crus forms the ?

A

Esophageal hiatus

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15
Q

Right phrenic nerve passes with?

A

IVC T8

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16
Q

Vagus nerve passes with?

A

Esophagus T10

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17
Q
A
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18
Q

Innervation of the diaphragm from the phrenic nerve…spinal level?

A

C3,C4,C5 keeps you ALIVE

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19
Q

Peripheral part of the Diaphragm

Supplied by?

Innervation?

A

Supplied by the body wall

and Intercostal nerves are the innervation which is important in reffered pain.

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20
Q

Referred pain from the Diaphragm will present as?

A

Bc of its innervation from the cervical plexus irritation of the diaphragm is often felt as pain in the right or left shoulders

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21
Q

Appendicitis reffered pain will present as?

A

Umbillicus Region

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22
Q

Gall bladder reffered pain will present as?

A

Right shoulder

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23
Q

Hiatial Hernia

A

Portion of the stomach in the thoracic cavity bc of a weak esophageal sphincter.

A loose RIGHT CRUS results in a hiatal Hernia because the right crus is makes up the esophageal sphincter!

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24
Q

Which structure goes under the lateral arcuate ligament?

  • A. Psoas Major Muscle
  • B. Aorta
  • C. Quadratus Lumborum Muscle
  • D. Iliacus Muscle
A

•C. Quadratus Lumborum Muscle

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25
Q

Blood supply of the Diagphragm

Thoracic Surface?

A

Pericardiphrenic arteries

Musculophrenic arteries

Superior phrenic arteries

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26
Q

Blood supply of the Diagphragm?

Abdominal Surface:

A

Inferior Phrenic Arteries

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27
Q

Lumbar Plexus : Remember the Date Mneumonic!

A

Interested in getting lunch on friday?

Illihypogastiral L1

illioinguinal L1

Gentiofemoral L1 L2

Lateral Gentiofemora L2, 3

Obtruator Nerve L2-L4

Femoral Nerve L2-L4

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28
Q

Accessory Obtruator Nerve, not everyone has this but know the Lumbar level

and lumbarsacral trunk, what does it do and what level?

A

L3-L4 = Accessory Obtruator Nerve

Lumbosacral = L4-L5, connects lumbar and sacral plexus

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29
Q

Is the subcostal nerve part of the lumbar plexus?

A

Hell NO, but still on the posterior wall of the abdomen.

and T-12

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30
Q

Nerves in relation to Psoas Major:

superior?

Lateral?

Medial?

A
31
Q

Female Inguinal Canal Contents :

A

Round Ligament of the Uterus

Genital Branch of the Gentiofemoral Nerve

Illioinguinal Nerve

32
Q

Male Inguinal Canal contents :

A
  • Spermatic Cord
  • (Surrounded by the External Spermatic Fascia, Cremaster Muscle and Internal Spermatic Fascia)
  • Testicular Artery and Vein
  • Vas Deferens
  • Genital branch of the Genitofemoral nerve
  • Ilioinguinal Nerve
33
Q
A
34
Q
A
35
Q
A
36
Q

Posterior Abdominal Wall Nerves

A
37
Q

Which of the following supply the abdominal portion of the diaphragm?

  • A. Musculophrenic Arteries
  • B. Inferior Phrenic Arteries
  • C. Pericardiophrenic Arteries
  • D. Superior Phrenic Arteries
A

•B. Inferior Phrenic Arteries

38
Q

Kidneys are ALWAYS and lie at what level, what nerves are associated with the kidney?

A

Retroperitoneal

Paravertebral gutters : T11-L3

•Subcostal, iliohypogastric and ilioinguinal nerves pass diagonally and laterally posterior to the kidneys

39
Q

Unpaired Arteries off of the Abdominal Aorta:

Superior to Inferior:

A

Celiac Trunk

SMA

IMA

Median Sacral Artery

40
Q

Right side of the abdomin:

A

IVC and Gonandal Vein draining into the IVC

41
Q

Left side of the abdomin:

A
  • Left Side:
  • Aorta
  • Gonadal Vein draining into Left Renal Vein
  • Left Renal Vein
  • Superior to the Aorta
  • Inferior to SMA
42
Q

The right kidney is lower or higher in its positioning? and why?

A

Lower due to the liver

43
Q

Subcostal, illohypogastric, and ilioinguinal nerves all run posterior to the kidneys?

A

TRUE

44
Q

The three nerves that run posterior to the kindeys and anterior to the psoas major and quadratus lumborum muscle?

A
45
Q

Pararenal fat :

Perirenal fat :

A

Outside of the Renal Fascia

Inside the Renal Fascia ( On the Kidney)

46
Q

Which of the following is the correct order of the unpaired arteries off the abdominal aorta from superior to inferior?

  • A. SMA à IMA à Celiac Trunk à Median Sacral Artery
  • B. Celiac Trunk à SMA à Median Sacral Artery à IMA
  • C. Celiac Trunk à SMA à IMA à Median Sacral Artery
  • D. SMA à Median Sacral Artery à IMA à Celiac Trunk
A

•C. Celiac Trunk à SMA à IMA à Median Sacral Artery

47
Q

Paired Vessels off Abdominal Aorta :

A
  • Inferior Phrenic Arteries
  • Suprarenal Arteries
  • Renal Arteries
  • Gonadal Arteries
  • Lumbar Arteries

THE ADRENAL AND RENAL ARTERIES ARE PAIRED VESSELS OFF THE AORTA

48
Q

Renal Artery gives off __ branches that supply ___ lobes of the kindey.

A

5 branches, 5 lobes

49
Q
A
50
Q
A
51
Q

renal sinus?

A
52
Q
A
53
Q

Ureter Crosses over the ?

A

External Illiac Artery and Vein

54
Q

Ureter goes under the ?

A

Uterine Artery in Females

Vas Deferens in Males

55
Q
A
56
Q
A
57
Q

Kidney Stones

spinal level?

How do patients feel?

A
58
Q

Right Adrenal lies ?

Left Adrenal faces?

A
59
Q

Adrenal Blood Supply

A

Superior

Middle

Inferior Adrenal artieries

60
Q

Does the cortex have innervation?

Is there parasympathetic innervation?

A

The greater splanchnic gives off

fibers directly to the adrenal gland. These preganglionic sympathetics synapse directly on neural

crest-derived cells in adrenal medulla. These chromaffin cells secrete epinephrine (80%) and norepinephrine (20%).

The cortex has no innervation.

There is no parasympathetic

innervation.

61
Q
A
62
Q

Abdominal Aorta picture

A
63
Q

Gonadal vein on left side dumps into?

Gonandal vein on right side dumps into?

A
64
Q
A
65
Q
A
66
Q
A
67
Q
A
68
Q
A
69
Q

Kidneys and testes drain into the ____ and other lump nodes in that region

A

Kidneys and testes drain into the paraaortic lymph nodes

70
Q

Chyle Cisternae -> drains into?

A

Chyle Cisternae ->Thoracic Duct ->Left Subclavian Vein

71
Q

All of the venous drainage

from the digestive organs

and the spleen enter the ____

system to be carried to

the ____.

A

All of the venous drainage

from the digestive organs

and the spleen enter the portal

venous system to be carried to

the liver.

72
Q

Portal-Caval Anastomoses

The anastomoses of the portal venous drainage with the somatic (caval) venous drainage has important clinical significance.

There are 3 main sites of anastomosis:

A

There are 3 main sites of anastomosis:

  1. Esophageal veins
  2. Paraumbilical veins
  3. Veins of anal canals
73
Q

Whihc anastomoses site ias assoiciated with alcohol abuse and cirrhosis?

A
  1. Esophageal veins
  2. Paraumbilical veins
74
Q
A