Lecture 11 - Posterior Abdominal wall and retroperitoneal viscera Flashcards
As we move laterally from the vertebral coloum there are _ musclces, what are they?
4 muscles:
pair of psoas major muscle
Psoas minor (missing in 1/3 of people)
Quadratus lumborum
Iliacus below
Where does iliacus originate?
iliac fossa - its tendon converges with psoas to insert into the lesser trochanter
Psoas majors origin is from the lower border of..
T12 - -vertebral bodies and medial side of the transverse process
The tendon of psoas passes ____ the inguinal ligament and attaches to..
The tendon of psoas passes beneath the inguinal ligament, attaches to the lesser trochanter
Psoas major is slender (disappearing - not in 1/3 of people) - the tendon blends with the …
perisoteum of the pelvis
Quadratus Lumboum (QL) has to fill what space?
gap inferior to the 12th rib, superior to the poster half of the iliac crest and edge to edge with psoas major - stabilises the 12th rib
Where are the vessels, lumbar plexus, sympathetic trunk and ureter in relation to psoas major?
vessels 0 behind
lumbar plexus - within
sympathetic trunk and ureter - in front
Each of iliacus and Psoas is enclosed in ..
their own fascial sheath
- Psoas Fascia and iliacus fascia
QL and erector spinae are enclosed by..
thoracolumbar fascia
The thoracolumbar fascia has _ layers to it
Where do each of the layers come from?
3
Posterior - from the tip of spinous process
middle - from the tip of transverse process
anterior - from the front of the transverse process
The 3 layers of thoracolumbar fascia fuse along the line of the ___ rib
How many compartments does this create and what is in each one?
12th
2 compartments
anterior - contains QL
posterior - contains ES
What constitutes a psoas abscess?
bursting into psoas by contained in the fascial envelope
Which muscle do the kidney lie on?
QL
Which vertebrae are the Kidneys adjacent to?
T12/L3 - but related to diaphragm also, so will move with it
Surgeons can got in from behind - take out 12th rib
The right kidney sits a bit lower because of the ___
liver
The kidney have their own fibrous capsule called..
the renal capsule - also surrounded by a lot of fat
What is the organisation of the Kidney?
Outer cortex - continuous
inner medulla - discontinous (darker), divided into discrete pyramids with their apex pointing to the collecting system
Once the hilum enters the Kidney they are embedded in fat know as the …
renal sinus
From anterior to posterior, the Kidney hilum:
renal vein,
renal artery (branches of aorta)
renal pelvis
(also nerves and lymphatics)
Just proximal to the kidney the renal artery divides into …
5 Segmental arteries
The Right renal artery goes ____ the IVC to get to kidney
The left vein goes _____ of the aorta
The Right renal artery goes behind the IVC to get to kidney
The left vein goes in front of the aorta
What do the vessels migrate up?
Because of the differential growth rate relative to the posterior wall
Minor ____ form at the bottom of the medullar pyramids, then 2 or 3 of them form the major _____
Minor calyces form at the bottom of the medullar pyramids, then 2 or 3 of them form the major calyses
How many major calyses form the renal pelvis?
3
