M104 T3 L5 Flashcards
What bones make up the posterior abdominal wall?
Ribs 11 & 12
Lumbar vertebrae
Sacrum
Ilia
What muscles make up the posterior abdominal wall?
Diaphragm
Quadratus Lumborum
Psoas Major & minor
Iliacus
Where is the diaphragm attached?
the costal margin and vertebrae
What is the diaphragm made up of?
a combination of skeletal muscle and the central tendon
What three hiatuses are in the diaphragm?
T8, T10 & T12
What structures do the three hiatuses in the diaphragm allow to pass through?
the IVC, oesophagus and aorta
What is the diaphragm supplied by?
the superior and inferior phrenic vessels
What is the motor aspect of the diaphragm innervated by?
Phrenic - C3-5
What is the sensory aspect of the diaphragm innervated by?
Intercostal (T5-11) & Subcostal (T12)
Which structure passes through the diaphragmatic hiatus at T8?
the IVC
Which structure passes through the diaphragmatic hiatus at T10?
oesophagus
Which structure passes through the diaphragmatic hiatus at T12?
aorta
What mneumonic is used for the vertebral levels that structures that pass through in the diaphragm?
I ate ten eggs at twelve with Voices Of America
What does the mneumonic (I ate ten eggs at twelve with Voices Of America) stand for?
I 8 (V) [T8 - Inferior Vena Cava] E 10 (O) [T10 - Oesophagus] A 12 (A) [T12 - Aorta]
Where is the Quadratus Lumborum located?
posterior to the kidneys
extends from iliac crest to Rib 12
Where is the Quadratus Lumborum attached?
the transversus abdominis muscle, laterally
What is the role of the Quadratus Lumborum muscle?
to provide abdominal stability and cause lateral flexion
What is the neurovascular supply of the Quadratus Lumborum muscle?
blood - Lumbar vessels
nerves - Lumbar (T12-L4)
What are the origins of the Psoas muscles?
the lumbar vertebrae
What are the origins of the Iliacus?
the iliac fossa
What muscles make up the Iliopsoas?
the Psoas major and minor muscles
Where do the Psoas muscles and the Iliacus insert?
the lesser trochanter femur
What are the roles of the Psoas muscles and the Iliacus?
hip flexors
What is the neurovascular supply of the Psoas muscles and the Iliacus?
blood - Lumbar vessels
nerves - Femoral (L2 - L4)
At what point does the aorta enter the abdomen?
at T12
At what point does the IVC enter the abdomen?
at T8
What is the role of the IVC and of the aorta?
to provide and drain blood from the abdomen, pelvis and lower limbs
What are the three categories of aorta branches in the abdomen?
Midline
Parietal
Visceral
What are the branches of the aorta in the Midline category?
coeliac (T12)
sup. mesenteric (L1)
inf. mesenteric (L3)
What is the branche of the aorta in the Parietal category?
Lumbar
What are the branches of the aorta in the Visceral category?
Renal and gonadal (L2)
Where do the branches of the abdominal aorta bifurcate into the common iliac vessels?
at L4/5
Above what size is an abdominal aortic aneurysm considered at significant risk of rupture?
above 5.5cm
What does the somatic abdominal innervation cover?
Voluntary movement via skeletal muscle
Abdominal wall, intercostal, vertebral and intervertebral musculature
Sensation and skin
What does the Autonomic abdominal innervation cover?
Unconscious control
Blood vessels, sweat glands
Abdominal organs (digestive tract to control peristalsis etc.)
Smooth muscle
What is the somatic abdominal innervation from the nerve plexuses?
Lumbar plexus
Sacral plexus
What is a nerve plexus made up of?
afferent and efferent fibers that arise from the merging of the anterior rami of spinal nerves and blood vessels
What is the Autonomic abdominal innervation from the nerve plexuses?
sympathetic and parasympathetic divisions
Splanchnic nerves for organs
What is the role of Splanchnic nerves in abdominal innervation?
innervate organs - the adrenal glands and kidneys
What do Splanchnic nerves synapse to?
postganglionic neurones at the prevertebral ganglia
Where are the Prevertebral Ganglia located?
anterior to the vertebral column and aorta
Where do the greater, lesser and least splanchnic nerves synapse at?
the coeliac and aorticorenal ganglion
What structure is innervated by the greater, lesser and least splanchnic nerves?
the suprarenal glands
Which splanchnic nerve innervates the kidneys?
Least S.N
What are features of somatic abdominal pain?
Well localised, sharp or stabbing
What are features of visceral abdominal pain?
Poorly localised, dull ache or throbbing
What is visceral abdominal pain caused by?
stretching, ischaemia or chemical damage
In what structures is somatic abdominal pain felt?
skin, muscle, fascia and parietal peritoneum
What are the clinically significant origins of referred pain? (SAG)
Stomach
Appendix
Gallbladder
In what dermatomes is referred pain from the stomach felt?
in the skin of dermatomes T5-9
In what dermatomes is referred pain from the appendix felt?
T10 (umbilicus)
In what dermatomes is referred pain from the gallbladder felt?
T7-9
In what dermatomes is referred pain from the gallbladder (with parietal peritoneum involvement) felt?
C3,4
What causes a haemorrhage?
when an aneurysm bursts
Where would you feel referred pain from the diaphragm?
the shoulder
What is the primary function of mesangial cells?
to remove trapped residues and aggregated protein from the basement membrane
this keeps the filter free of debris
What are the side effects of sotagliflozin?
genital infection
diabetic ketoacidosis
diarrhoea
What is the pathological effect of ketoacidosis?
changes in blood pH and requires medical attention
What is the most common type of ketoacidosis?
diabetic ketoacidosis
What are the causes of ketoacidosis?
diabetes (most common) medications alcohol toxins starvation (rare)
What are the most common symptoms of ketoacidosis?
nausea, vomiting, abdominal pain, and weakness
What does Kussmaul breathing indicate?
that the body or organs have become too acidic
What is Kussmaul breathing caused by?
an attempt to expel co2 from the body and reduce ketoacidosis
What are some less common symptoms of ketoacidosis?
Kussmaul breathing
breath may develop the smell of acetone
altered mental status
What type of ketoacidosis is an altered mental status more common in?
diabetic ketoacidosis rather than alcoholic ketoacidosis
What might diabetic ketoacidosis be caused by?
the body is running out of insulin, resulting in the build up of ketones (harmful) in the body, which can be life-threatening if it’s not found and treated quickly
What does a small amount of ketones in urine indicate?
that the body is breaking down fat. However, high levels of ketones can poison the body, leading to a condition called ketoacidosis.
What does ketonuria indicate?
can be dangerous and needs monitoring in people with diabetes who are prone to high blood glucose levels
tend to be produced as a result of insufficient insulin in the body and therefore people with type 1 diabetes, in particular, are at a greater risk of ketonuria
Is ketosis dangerous?
depends
type 1 diabetics need to be careful
but it can be beneficial for a number of people
Is ketosis dangerous?
depends
type 1 diabetics need to be careful
but it can be beneficial for a number of people
What cells release atrial natriuretic peptide hormone?
atrial myocytes
synthesized, stored, and released
What is atrial natriuretic peptide hormone released in response to?
atrial distension
angiotensin II
symp NS stimulation
What is the function of atrial natriuretic peptide? (ANP) acts acutely by at least 3 mechanisms:
to reduce plasma volume
What three mechanisms are increased by atrial natriuretic peptide IOT reduce plasma volume?
renal excretion of salt and water
vasodilation
vascular permeability
