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Human Anatomy 2 > Posterior Abdominal Region > Flashcards

Posterior Abdominal Region Flashcards

1
Q

Diaphragm

A
  1. Action: respiration/increase intra-abdominal pressure
  2. Innervation: phrenic nerves C3-C5
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2
Q

Apertures in the diaphragm

A
  • caval hiatus: IVC
  • esophageal hiatus: esophagus and vagus nerve
  • aortic Hiatus: aorta
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3
Q

Psoas Major

A

Origin:
1. bodies and intervertebral discs of T12-L5
2. Lumbar TP L1-L5

Insertion:
1. Lesser trochanter of femur

Action:
1. Hip flexion
2. hip ER
3. trunk lateral flexion (ipsilateral)

Innervation:
1. ventral rami L2-L3

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4
Q

Iliacus

A

Origin:
1. iliac fossa

Insertion:
1. lesser trochanter

Action:
1. hip flexion

Innervation:
1. Femoral nerve L2-L4

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5
Q

Quadratus Lumborum

A

Origin:
1. L5 TP
2. iliac crest

insertion:
1. L1-4 TP
2. rib 12

Action:
1. depresses rib 12
2. ipsilateral trunk lateral flexion

Innervation:
1. T12-L4

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6
Q

Lumbar plexus

A

consists of the following nerves:

  • iliohypogastric
  • ilioinguinal
  • genitofemoral
  • lateral femoral cutaneous
  • obturator
  • femoral
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7
Q

Femoral nerve

A
  • emerges from the lateral surface of psoas major
  • travels deep to inguinal ligament
  • proceeds to femoral triangle
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8
Q

obturator nerve

A
  • emerges from medial surfaceof psoas major
  • traverses the obturator foramen
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9
Q

Path of

abdominal aorta

A
  • aortic hiatus of diaphragm at T 12
  • anterior surfaces of vertebral bodies
  • travels left of IVC
  • splits into common iliac arteries (L4)
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10
Q

path of

IVC

A
  • common iliac veins
  • anterior surfaces of vertebral bodies
  • travels right of abdominal aorta
  • caval hiatus of diaphragm at T8
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11
Q

blood supply

of abdominal aorta branches

A
  • inferior phrenic arteries = diaphragm
  • middle suprarenal arteries = adrenal glands
  • gonadal arteries = gonads
  • lumbar arteries = abdominal wall
  • celiac trunk = liver, gallbladder, pancreas, spleen
  • superior mesenteric artery = supplies mid gut
  • inferior mesenteric artery =. supplies the hind gut
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12
Q

Adrenal glands

A
  • located on the superior pole of the kidneys
  • regulate stress
  • produce glucocorticoids, mineralcorticoids, androgens and catecholamines
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13
Q

kidneys

A
  • locataed in the retroperitoneal space (T12-L3)
  • right kidney lower than left kidney due to liver
  • filters blood
  • excrete urine through ureters to bladder
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14
Q

Iliopsoas tendiopathy

A
  • usually an overuse injury from repetitive hip flexion
  • most commonly affects its insertion onto the femur
  • can become impinged as it passes the front of the hip
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15
Q

Iliopsoas tendiopathy

causes

A
  • repetitive compression/pinching causes inflammation and bursitis
  • ultimately leads to chronic degenerative changes of tendon
  • commonly occurs with iliopsoas bursitis, clinical presentation nearly identical
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16
Q

Iliopsoas tendiopathy

Etiology

A
  • acute trauma: avulsion fx of LT
  • overuse injuries: ballet, cycling, running, soccer, gymnastics
17
Q

Iliopsoas tendiopathy

clinical presentation

A
  • asymptomatic: palpable or audible snap with hip flexion and extension
  • chronic irriation: from degenerative changes
  • intermittent groin pain (deep ache) worse with hip flexion, radicular symptoms into anterior thigh, LBP
18
Q

Iliopsoas tendiopathy

diagnostic tools

A
  • psoas hypertonicity: pt holds affected hip in flexed and ER position
  • anterior plevic tilt
  • shortened stride length, increased knee flexion
  • palpation of deep iliopsoas palpation within femoral trigangel (lesser trochanter)
  • ROM: passive hip extension limited/painful ~15ºresisted hip flexion painful
  • thomas/mod thomas test
  • iliopsoas MMT ludloff’s sign, stinchfield test
  • snapping hip maneuver (anterior labral test)
19
Q

Iliopsoas tendiopathy

interventions

A
  • acute phase: PRICE, NSAIDs, gentle stretching
  • recovery phase: rectus femoris, stretching, hamstring strengthening - promote posterior pelvic tilt
  • abdominal strengthening
  • iliopsoas strengthening
20
Q

Quadratus lumborum syndrome

A
  • myofascial pain syndrome
  • tenderness
  • trigger points
  • palpable taut bands
21
Q

Quadratus lumborum syndrome

causes

A
  • poor posture
  • sendentary lifestyle
  • overuse
22
Q

Quadratus lumborum syndrome

presentation

A
  • LBP, discomfort at rest and with movement
  • sharp pain with sneezing
  • trigger points highly common
23
Q

Quadratus lumborum syndrome

diagnostic tools

A
  • palpable tightness/tenderness
  • trigger point identification with common referral patterns
  • lack of contralateral SB ROM in sitting
  • quadratus lumborum muscle test: hip hike to affect side while in Sidelying, apply opposing foces on 12rib and iliac crest, produce pain/weakness
24
Q

Quadratus lumborum syndrome

interventions

A
  • manual trigger point release (low pressure = 90 seconds/high pressure = 30 seconds)
  • dry needling
  • TENs US
  • QL stretching
25
Q

Lumbar plexus entrapment

A
  • formed by the ventral rami of L1-L4, sometimes including T12
  • these nerves emerge from the psoas major muscle and proximal sciatic nerve beneath the piriformis
  • this is a common problem which can involve significant morbidity
26
Q

Lumbar plexus entrapment

Causes

A
  • involved of lumbar plexus, lumboscaral trunk and proximal sciatic nerve within psoas major and piriformis
  • due to chronic weakness or injury to these muscles
  • after abdominal surgeries due to scar tissue formation
  • pregnancy
  • hematomas, aneurysms, trauma, tumors, abscesses, cysts, cancer, and iatrogenic injury
27
Q

Lumbar plexus entrapment

findings

A
  • tenderness throughout body (FMS DDX)
  • diffuse and non-specific pain patterns throughout the lumbopelvic complex and LE
  • myotomal weakness/dermatome symptoms
28
Q

Lumbar plexus entrapment

treatment

A
  • gentle strengthening of psoas major and piriformis muscles
  • slow eccentric exercises
29
Q

Phrenic nerve entrapment

A
  • provides motor supply to the diaphragm primary breathing muscle
  • originates from the anterior rami of C3-C5 nerve roots and has motor, sneory and sympathetic fibers
  • the phrenic nerves exits the spinal canal and descends caudally to the pericardial sac to innervate the diaphragm
  • there is a left and right phrenic nerve each innervating half of the diaphragm
  • the risk of this nerve being damaged can be life threatening
30
Q

Phrenic nerve entrapment

causes

A
  • surgery (runs between pericardium and mediastinal pleura)
  • blunt or penetrating trauma
  • metabolic disease
  • infections
  • direct invasion from a tumor
  • neurological diseases
  • can be post viral
  • idiopathic
31
Q

Phrenic nerve entrapment

findings

A
  • injury can present as diaphragm dysfunction or paralysis to one or both sides of the diaphragm
  • scar tissue can compress the nerve and lead to entrapment
  • it is rare for this nerve to be entraped
32
Q

Phrenic nerve entrapment

treatment

A
  • if one side has paralysis no treatment is requied
  • the underlying causes should be monitored
  • surgery is considered if the patient has symptoms after the underlying cause has been treated
  • plication of affected sit for B/L paraylsis
33
Q

imaging for the diaphragm

A
  • disease usually manifestes as asymmetic elevation with chest radiography and magnetic resonance imaging MRI
  • fluoroscopy is regarded as gold standard
34
Q

posterior abdominal wall imaging

A
  • CT scan is method most frequently used to provide visual images of abdomen
  • MRI is view as superior when differentiation of soft tissues is necessary
35
Q

Neuralgia parasetica

A
  • lateral femoral cuteneous entrapment
  • sensory symptoms
  • compressed under the inguinal ligament
  • can be caused by obesity and pregnancy
36
Q

ilioinguinal

A
  • transverse abdominus and IO entraped between
  • if someone had spinal instability the TA can possibel become hypertrophied
37
Q

femoral nerve

causes of injury

A
  • injured by femoral head fracture
  • anterior dislocation
  • anterior THA
38
Q

Obturator nerve

A
  • fracture of pelvic often injuries
  • sensory: medial thigh
  • motor: adductors

Human Anatomy 2 (14 decks)

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