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GI Exam I > Lecture 12: Posterior Abdominal Wall > Flashcards

Lecture 12: Posterior Abdominal Wall Flashcards

1
Q

What are the attachments of the Psoas major ms.; main action; innervation?

A
  • TP’s and bodies of T12-L5
  • Lesser Trochanter
  • Main hip flexor
  • Anterior rami of L1-L3
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2
Q

What are the attachments of the iliacus m; innervated by?

A
  • Iliac crest to Greater trochanter
  • Femoral nerve (L2-4)
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3
Q

What are the attachments of the Quadratus Lumborum m.; innervation?

A
  • 12th rib - lliac crest
  • Anterior T12, L1-L4
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4
Q

Where is a Psoas infection found (tissue wise)?

A

Deep to psoas fascia, between the fascia and muscle

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5
Q

Signs and symptoms of a Psoas Abscess?

A

Back or flank pain, inguinal mass, fever, limp, anorexia, and weight loss

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6
Q

What can elicit a positive psoas sign?

A
  • Psoas abscess
  • Retro-cecal appendix (appendicitis)
  • Kidney and ureter pathologies
  • Pathologies of the sigmoid colon
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7
Q

What pathology is this?

A

Psoas Abscess

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8
Q

What are the landmarks for the median, medial, and lateral arcuate ligaments; which have attachements to the diaphragm?

A

Median - superior to aorta

Medial - thickening of Psoas fascia (diaphragm attachment)

Lateral - thickening of fascia lining Quadratus lumborum (diaphragm attachment)

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9
Q

What nerve is found just inferior to the lateral arcuate ligament?

A

Subcostal n. (T12)

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10
Q

What are the 3 parts of the diaphragm and their attachment?

A

Sternal part: may NOT be present. Attaches to Xiphoid

Costal part: attahces to inferior 6 costal cartilages

Lumbar part: attaches to medial and lateral arcuate ligs.

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11
Q

What are the spinal levels of the right and left crus of diaphragm?

A

Right: (larger and longer) - L3-L4

Left: L2-L3

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12
Q

What comes thru Caval opening?

A

IVC and Rt. Phrenic n

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13
Q

What comes through the Esophageal Hiatus?

A

Esophagus, ant. and post. Vagal trunks, and Esophageal branches

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14
Q

What comes through the Aortic Hiatus?

A

Aorta, Thoracic duct, and sometimes Azygous/Hemi-azygos veins

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15
Q

What spinal level is the body of the pancreas at?

A

L1

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16
Q

What spinal level is the horizontal part of the duodenum at?

A

L3

17
Q

What is found anteriorly, superiorly and inferior to the Lf. Adrenal gland?

A

Superiorly: Lf. crus of diaphragm

Anteriorly: Stomach, spleen, and pancreas

Inferiorly: Left kidney

18
Q

How do the veins of the suprarenals differ?

A

Right: drains directly into IVC

Left: drains into L. Renal V.

19
Q

What is the innervation of the adrenal glands (plexus and nerve)?

A
  • Preganglionic sympathetics from T6-L1
  • Celiac plexus and splanchnic nerves
20
Q

What is found anterior to the Rt. and Lf. Kidneys?

A

Right: liver, duodenum, ascending colon

Left: stomach, spleen, pancreas, jejunum, and descending colon

21
Q

Which spinal levels do the kidneys sit between?

A

T11-L3

*The left kidney is higher due to the liver

22
Q

What is the best point of incision for removing kidney; why?

A
  • Posterolateral
  • Will only require transection of transversalis fascia
23
Q

What are layers immediately external to renal capsule; where will a perinephric abscess form?

A
  • Perinephric fat (abscess forms here)
  • Renal Fascia
24
Q

What is the most anterior structure in the renal hilum?

A
  • Renal vein (most anterior)
  • Renal artery (middle)
  • Renal pelvis (posterior)
25
Q

What structures are the ureters found posterior to in males and females?

A

Males: ductus deferns

Females: Uterine artery

26
Q

What are the 3 constriction points of the ureters?

A
  1. Ureteropelvic junction
  2. Crossing external iliac artery and/or pelvic brim
  3. Ureters entering bladder wall
27
Q

What are the lymph nodes for foregut, midgut, and hindgut structures; where do they all drain into eventually?

A

Foregut: Celiac LN’s

Midgut: Superior Mesenteric LN’s

Hindgut: Inferior Mesenteric LN’s

*ALL drain into the Lumbar (lateral aortic) LN’s

28
Q

Which nerve is responsible for innervation of the posterolateral gluteal skin and skin in pubic region?

A

Iliohypogastric (L1)

29
Q

Which nerve is responsible for the skin in the upper medial thigh, skin over the root of penis, anterior scrotum, mons pubis, and labium majus?

A

Ilioinguinal (L1)

30
Q

Which nerve innervates the skin on anterior and lateral thigh to the knee?

A

Lateral femoral cutaneous (L2, L3)

GI Exam I (14 decks)

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