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GI Midterm > Lecture 11-Posterior Abdominal Wall > Flashcards

Lecture 11-Posterior Abdominal Wall Flashcards

1
Q

Psoas major

-Insertion?

A

Lesser trochanter of femur via common tendon with iliacus (iliopsoas tendon)

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2
Q

Psoas major

-Innervation?

A

L2-L4 via lumbar plexus

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3
Q

Psoas major

-Action?

A
  • Flexes thigh at the hip
  • With feet fixed flexes trunk on thigh (at the hip joint)
  • Acting unilaterally side-bends trunk to same side
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4
Q

Psoas minor

-Innervation?

A

L1, (L2)

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5
Q

Psoas minor

-Action?

A
  • Depresses rib 12, fixes 12th rib during deep inspiration
  • Assists in extension of trunk
  • Acting unilaterally side-bends trunk to same side
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6
Q

Quadratus lumborum

-Innervation?

A

T12-L4

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7
Q

Quadratus lumborum

-Action?

A
  • Extends and laterally flexes vertebral column

- Fixes rib 12 during inspiration

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8
Q

Iliacus

-Innervation?

A

Femoral n (L2-L4)

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9
Q

Iliacus

-Action?

A
  • Flexes thigh at hip

- With lower limb fixed, flexes pelvis on thigh

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10
Q

Psoas Syndrome

-Presentation??

A
  • Lumbosacral pain
  • Difficulty standing up straight
  • Pain in the contralateral gluteal region
  • Radiation of pain down the lower extremity (usually stopping at knee)
  • May mimic herniated disc
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11
Q

Blood supply of the abdomen picture

A

Slide 12

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12
Q

Abdominal openings

-Caval opening-what comes out?

A

IVC, branches of right phrenic nerve, and lymphatics from liver

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13
Q

Esophageal hiatus-what comes out?

A

Esophagus, anterior and posterior vagal trunks, esophageal branches of left gastric artery

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14
Q

Aortic hiatus-What comes out?

A

Aorta, thoracic duct, and azygous vein

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15
Q

Sternocostal hiatus-What comes out?

A

Superior epigastric vessels

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16
Q

Posterior abdominal wall muscles

A

Psoas major/minor, quadratus lumborum, iliacus

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21
Q

Posterior origins of the diaphragm form?

A

Arcuate ligaments

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23
Q

Respiratory diaphragm

-Superior surface extends upward as far as what rib?

A

Superior surface extends upward as far as the 5th rib

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24
Q

Respiratory diaphragm

-Three peripheral origins insert on central tendon?

A

-Sternal, costal, and lumbar origins

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25
Q

Respiratory diaphragm-Arcuate ligaments form openings for posterior wall abdominal structures
-Lateral arcuate ligament?

A

Gap for quadratus lumborum m.

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26
Q

Potential sites for diaphragmatic hernias

  • When do they occur?
  • Commonly occur on which side? Why?
A
  • Occur when attachments become stretched or ligaments become loose
  • Commonly occur on the left side due to protection of the right hemidiaphragm by the liver
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27
Q

Parasternal hernias

-Where do they occur?

A

Sternocostal triangle

-Located between the sternal and costal parts of the diaphragm

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28
Q

Pleuroperitoneal hernias

-Where do they occur?

A

Lumbocostal triangle-located between the 12th rib and the diaphragm

29
Q

Congenital diaphragmatic hernia

-Etiology?

A

Failure of the pleuroperitoneal membranes to fuse with other components of the diaphragm

30
Q

Congenital diaphragmatic hernia

-presentation?

A
  • Respiratory distress and cyanosis in the first mins/hours of life
  • Unusually flat abdomen
31
Q

Respiratory diaphragm

-Right crus compared to left crus?

A
  • Right crus is longer

- Left crus is short and lateral

32
Q

Respiratory diaphragm

-The muscular esophageal hiatus is formed by which crus?

A

Right crus

33
Q

Respiratory diaphragm

-The right and left crus join to form?

A

The aortic hiatus

35
Q

Respiratory diaphragm

  • Posterior origins of the lumbar part of the diaphragm form arcuate ligaments over posterior wall structures
    • 3 arcuate ligaments?
A
  • Median arcuate ligament
  • Medial arcuate ligaments
  • Lateral arcuate ligaments
36
Q

Respiratory diaphragm-Arcuate ligaments form openings for posterior wall abdominal structures
-Median arcuate ligament?

A

Aortic hiatus

37
Q

Respiratory diaphragm-Arcuate ligaments form openings for posterior wall abdominal structures
-Medial arcuate ligament?

A

Gap for psoas major m.

38
Q

Blood supply of the diaphragm

-Superior surface?

A

Pericardiacophrenic, musculophrenic, and superior phrenic

39
Q

Blood supply of the diaphragm

-Inferior surface?

A

Inferior phrenic a

-right passes posterior to IVC, left passes posterior to esophagus

40
Q

Innervation of the diaphragm

-Motor?

A

C3, 4, 5 keeps the diaphragm alive only motor innervation!

41
Q

Innervation of the diaphragm

-Sensory-central portion?

A

Phrenic nerve

42
Q

Innervation of the diaphragm

-Sensory-peripheral portion?

A

Intercostal n

43
Q

Lymphatics of the diaphragm

-Superior surface-anterior diaphragm?

A

Anterior diaphragmatic nodes–>parasternal nodes

44
Q

Lymphatics of the diaphragm

-Superior surface-posterior diaphragm?

A

Posterior diaphragmatic nodes–>mediastinal nodes

45
Q

Lymphatics of the diaphragm

-Inferior surface?

A

Celiac nodes, superior lumbar nodes

46
Q

Lymphatics

-Body wall

A

Lumbar lymph trunks

47
Q

Lymphatics

-Lower extremity, perineum, gluteal region-travel through?

48
Q

Lymphatics

-GI tract-enters?

A

Enters intestinal lymph trunks

49
Q

Lymphatics

-Body wall, lower extremity, perineum, gluteal region, and GI tract all contribute to?

A

Thoracic duct (forms L1-L2)

50
Q

Intestinal Lymphatic Trunk

-4 components?

A

-Celiac nodes, superior mesenteric nodes, lumbar nodes, and inferior mesenteric nodes

51
Q

Cisterna Chyli

-What is it and where is it found?

A
  • Dilation found at the end of the thoracic duct

- Retroperitoneal structure lies posterior to the aorta around LV1-2

52
Q

Cisterna chyli

-Function?

A

Collects lymph from intestinal lymphatic trunks and lumbar lymphatic trunks

53
Q
  • *Abdominal lymphatics**

- Para-aortic-area drained?

A

Testes, ovaries, kidneys, uterus

54
Q
  • *Abdominal lymphatics**

- Superficial inguinal-area drained?

A

Scrotum and anal canal below pectinate line, labium majora

55
Q
  • *Abdominal lymphatics**

- Internal iliac-area drained?

A

Anal canal above pectinate line

56
Q

Subdivisions of peritoneal cavity

-Greater sac-Accessed by?

A

Incision to anterior abdominal wall

57
Q

Lesser sac-where is it located?

A

Posterior to stomach and lesser omentum

58
Q

Supracolic and infracolic compartments

-Divided by?

A

Transverse mesocolon

59
Q

Organs within supracolic compartment?

A

Stomach, liver spleen

60
Q

Organs within the infracolic compartment?

A

Small intestine and ascending/descending colon

61
Q

Infracolic compartment-Further subdivided into right and left infracolic spaces by?

A

THE mesentery

62
Q

Paracolic gutters

A

Areas between lateral aspects of ascending and descending colon and the posterior abdominal wall

63
Q

Paracolic gutters

-The spread of fluid superiorly is prevented by?

A

Phrenicocolic ligament

GI Midterm (11 decks)

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