Lecture 3 - Posterior Abdominal Walls Flashcards

1
Q

What are the four cavities of the trunk

A

Two pleural, one pericardial, one abdominal

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2
Q

What membrane are the cavities lined with?

A

Serous (simple epithelium plus connective tissue)

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3
Q

Organs including blood and lymph vessels and nerves are sandwiched between serous membranes and body wall true or false

A

True

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4
Q

What do cavities contain

A

Fluid and isolated cells e.g. lymphocytes and macrophages

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5
Q

What is parietal serous membrane

A

Serous membrane adjacent to outer wall

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6
Q

What is visceral serous membrane

A

Membrane covering organs within cavity or structures entering and leaving cavity

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7
Q

What is the lining of pleural cavities?

A

Pleura

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8
Q

What is the lining of pericardial cavity

A

Pericardium

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9
Q

What is the lining of abdominal cavity

A

Peritoneum

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10
Q

Retroperitoneal organs are attached to the posterior body wall and covered with a drape of peritoneum true or false

A

True

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11
Q

What are the pleural cavities separated by?

A

Mediastinum

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12
Q

What is the pericardial cavity contained within?

A

Mediastinum

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13
Q

What separates the thorax from the abdomen/pelvis

A

Diaphragm

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14
Q

The pelvis and abdomen are the same single cavity true or false

A

True

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15
Q

Where does the mediastinum span

A

Thoracic inlet to diaphragm

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16
Q

What divides the mediastinum into superior and inferior

A

Sternal angle

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17
Q

What are three further divisions of the mediastinum

A

Anterior, posterior and middle

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18
Q

What can occur to the mediastinum when a lung collapses

A

It can be displaced to one side

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19
Q

The mediastinum is flexible and elongates true or false

A

True

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20
Q

What is contained within the superior mediastinum? (4)

A

Upper thymus
Arch of aorta + immediate brancehs
SVC and tributaries - brachicephalic veins
Upper oesophagus

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21
Q

What is contained within the anterior mediastinum

A

Lower thymus

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22
Q

What is contained within the middle mediastinum (2)

A

Pericardium (heart and associated vessels)

Phrenic nerves passing through the fibrous parietal pericardium

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23
Q

What does the middle mediastinum span?

A

T4-T8

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24
Q

What is the posterior mediastinum adjacent to

A

Vertebral bodies

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25
Q

Where does the posterior mediastinum extend into?

A

Angle between posterior diaphragm to level of 12th thoracic vertebra

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26
Q

What is in the posterior mediastinum? (4)

A

Descending aorta, azygos vessels, thoracic duct, oesophagus

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27
Q

The splanchnic nerves travel in the posterior mediastinum true or false

A

False

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28
Q

What are the three sections of the thoracic diaphragm?

A

Muscular left and right domes

Fibrous central tendon

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29
Q

What does the central tendon form?

A

Base of pericardial cavity

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30
Q

What is the sternal attachment of the diaphragm

A

From back of xiphoid process

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31
Q

What are the costal attachments of the diaphragm (3)

A

Lower 6 costal cartilages and ribs and transverse abdominus

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32
Q

What are the lumbar attachments of the diaphragm

A

Left and right crura which join to form the median arcuate ligament
Medial arcuate ligament
Lateral arcuate ligament

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33
Q

What does the medial arcuate ligament overly

A

Psoas major and psoas minor

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34
Q

What does the lateral arcuate ligament overly

A

Quadratus lumborum

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35
Q

What does the median arcuate ligament overly

A

Aorta

36
Q

Medial and lateral ligaments are actually thickenings of the fascia overlying psoas and quadratus lumborum into which the fibres of the diaphragm insert true or false

A

True

37
Q

What is the blood supply to the superior side of the diaphragm?

A

Musculophrenic branches of the internal thoracic vessels

38
Q

What is the blood supply to the inferior side of the diaphragm?

A

Inferior phrenic branches of the aorta

39
Q

What is the innervation of the diaphragm

A

Phrenic nerve

40
Q

The phrenic nerves are cervical in origin true or false

A

True

41
Q

What else can travel in the diaphragmatic aperture for the inferior vena cava

A

Right phrenic nerve

42
Q

Where is the vena cava aperture of the diaphragm

A

T8

Edge of right dome of diaphragm near junction of muscle and central tendon

43
Q

Right phrenic nerves and splanchnic have their own small openings true or false?

A

False

44
Q

Where do the splanchnic nerves pass through the diaphragm

A

Crura

45
Q

Where do the left phrenic nerves pass through the diaphragm

A

Just left of central tendon

46
Q

Where is the aperture for the oesophagus and vagus nerves

A

Above and in front of, left of aperture for aorta at T10

47
Q

Where is the aperture for the aorta

A

T12, lowest and most posterior in the diaphragm

48
Q

What else travels with the aorta through the diaphragm

A

Thoracic duct, azygos and hemiazygos (variable)

49
Q

The thoracic splanchnic nerves are postganglionic branches of the thoracic sympathetic trunk true or false

A

False

50
Q

How do the thoracic splanchnics cross the vertebral bodies

A

Anteroinferior direction from sympathetic trunk to diaphragm

51
Q

What are the three possible pairs of splanchnics

A

Greater, lesser and least

52
Q

What does the greater splanchnic form from

A

T5-T9

53
Q

What does the lesser splanchnic form from in 90% of individuals

A

T10 to T11

54
Q

What does the least splanchnic form from in 50% of individuals

A

T11

55
Q

What is the function of the thoracic splanchnic nerves

A

To carry preganglionic sympathetic fibres which will synapse in sympathetic ganglia in the abdomen e.g. coeliac ganglion

56
Q

What will the thoracic splanchnics supply? (2)

A

Foregut (greater)

Midgut (lesser and least)

57
Q

What are the phrenic nerves derived from

A

Ventral branches of cervical spinal nerves 3-5, in particular C4

58
Q

What do the phrenic nerves cross to enter the thorax

A

Anterior surface of scalenus anterior

59
Q

The phrenic nerves descend posterior to the root of lung true or false

A

False

60
Q

What do the left and right phrenic nerves pass through?

A

Left: Adjacent to central tendon
Right: Caval aperture

61
Q

What is the function of the phrenic nerves (8)

A

Sole somatic motor supply to diaphragm
Sensory supply to pericardium, parietal pleura, diaphragm, liver ligaments (coronary and falciform), suprarenal, IVC and gallbladder

62
Q

What is the general path of the vagus nerve

A

Descend through jugular foramen

Travels down side of neck with internal jugular and internal/common carotid arteries

63
Q

What does the vagus pass anterior to on the left side and give off

A

Arch of aorta

Left recurrent laryngeal branch

64
Q

Where do the recurrent laryngeal branches travel

A

Behind aortic arch, and back up neck to larynx

65
Q

What does the vagus pass anterior to on the right side and give off

A

Subclavian artery

Right recurrent laryngeal branch

66
Q

What do the vagi do after passing into the thorax?

A

They pass posterior to roots of lung and break up into smaller branches to form cardiac, pulmonary and oesophageal plexuses

67
Q

What do the split vagi reform as in the lower thorax

A

Vagal trunks which pass into the abdomen with the oesophagus

68
Q

Which plexuses do the preganglionic parasymapthetic fibres synapse on

A

Myenteric

Submucosal

69
Q

What is the function of the vagus

A

Supplies pharynx, larynx, soft palate (motor and sensory), thoracic viscera, foregut and midgut (parasympathetic and sensory)

70
Q

What do the abdomen/pelvic regions extend from

A

Thoracic diaphragm to pelvic diaphragm

71
Q

Which organs sit within the thoracic cage due to diaphragm doming (4)

A

Liver, stomach, spleen and upper kidneys

72
Q

Which organs are enclosed within and protected by the pelvis

A

Reproductive organs

Bladder

73
Q

What does the transpyloric plane mark?

A
Halfway between sternal notch and upper pubic symphysis 
Pylorus of stomach
Hila of kidneys
Body of L1
End of spinal cord
74
Q

How is the abdomen divided into quadrants

A

Line through umbilicus in vertical and horizontal planes

75
Q

During forced expiration where is the right dome approximately in males

A

Level of the nipple

76
Q

During force expiration where is the left dome approximately in males

A

One rib lower than right lobe

77
Q

What does the quadratus lumborum join?

A

Rib 12 and bodies of L1-4 to the iliac crest

78
Q

What are two functions of the quadratus lumborum?

A
  1. Extend lower back

2. Stabilise rib position

79
Q

What is the quadratus lumborum

A

Lateral spine flexor

bends back laterally on the side of the contracting muscle

80
Q

What does the psoas minor join

A

Bodies of T12 and L1 to pecten pubis

81
Q

Psoas minor is in all individuals true or false

A

False, 40% dont have

82
Q

What is the role of psoas minor if it exists

A

Weak trunk flexor

83
Q

What does psoas major join

A

Transverse processes and bodies of lumbar vertebrae via common tendon with iliacus to upper femur

84
Q

What does iliacus join

A

Iliac fossa to upper femus

85
Q

What are the functions of psoas and iliacus (3)

A

Flexion of the thigh on pelvis
Bending trunk
Tilt pelvis forward against resistance e.g. rising from a sitting position