posterior abdominal wall Flashcards
what bones compose the posterior abdominal wall?
- ribs (11 and 12)
- lumbar vertebrae
- sacrum
- ilia
what muscles compose the posterior abdominal wall?
- diaphragm
- quadratus lumborum
- psoas major (and minor)
- iliacus
where is the diaphragm attached to?
the costal margin and vertebrae
what are the 3 hiatuses of the diaphragm?
- T8
- T10
- T12
what are the arteries and veins that supply the diaphragm?
superior and inferior phrenic vessels
what are the nerves that supply the diaphragm?
- phrenic (C3-5) = motor
- intercostal (T5-11) and subcostal (T12) = sensory
where does the IVC pass through the diaphragm?
T8
where does the oesophagus pass through the diaphragm?
T10
where does the aorta pass through the diaphragm?
T12
where is the quadratus lumborum located?
- posterior to the kidneys
- extends from iliac crest to rib 12
where is the quadratus lumborum attached?
attached laterally to the transversus adbominis muscle
what is the function of the quadratus lumborum?
provides abdominal stability and causes lateral flexion
what arteries and veins supply the quadratus lumborum?
lumbar vessels
what nerves supply the quadratus lumborum?
lumbar (T12-L4)
where does the psoas muscle originate?
the lumbar vertebrae
where does the iliacus originate?
iliac fossa
what is another term for the psoas major and minor converge?
iliopsoas
where does the psoas and iliacus insert?
lesser trochanter femur and function as hip flexors
what arteries and veins supply the psoas and iliacus?
lumbar vessels
what nerves supply the psoas and iliacus?
femoral (L2-L4)
what are the 3 categories of abdominal aorta branches?
- midline
- parietal
- visceral
what branches branch from the midline abdominal aorta?
- coeliac (T12)
- superior mesenteric (L1)
- inferior mesenteric (L3)
what branch branches from the parietal abdominal aorta?
lumbar vessels
what branches from the visceral abdominal aorta?
- renal
- gonadal (L2)
what does the abdominal aorta bifurcate into and where?
common iliac vessels at L4/5
what size does an AAA get to before there is risk of rupture?
5.5cm
what is the role of somatic abdominal innervation?
voluntary movement
what is involved in somatic abdominal innervation?
- abdominal wall
- intercostal
- vertebral
- intervertebral musculature
what organ is responsible for somatic sensation?
skin
what is the role of autonomic abdominal innervation?
unconscious control
what is involved in the autonomic abdominal innervation?
- blood vessels
- sweat glands
- abdominal organs
what nerve plexuses provides the somatic innervation?
- lumbar plexus
- sacral plexus
what does the autonomic innervation unconsciously control?
- organs
- smooth muscle
- sweat glands
what do the splanchnic nerves synapse to?
synapse to postganglionic neurones at specific central ganglia: the prevertebral ganglia
where are the prevertebral ganglia located?
located anterior to the vertebral column and aorta
where do the greater, lesser and least splanchnic nerves synapse?
at the coeliac and aorticorenal ganglion to immediate the suprarenal glands
what nerve innervates the kidneys?
the least splanchnic nerve
what are the 3 categories for abdominal pain?
- somatic
- visceral
- referred
what are the key characteristics for somatic pain?
- well localised, sharp or stabbing
- felt in skin, muscle, fascia and parietal peritoneum
what are the key characteristics for visceral pain?
- poorly localised, dull ache or throbbing
- caused by stretching, ischaemia or chemical damage
what is the key characteristics of referred pain?
felt elsewhere than the affected structure
where is the pain felt for the stomach (dermatomes)?
felt in the skin of the dermatomes (T5-9)
where is the pain felt for the appendix (dermatomes)?
T10 (umbilicus)
where is the pain felt for the gallbladder (dermatomes)?
T7-9 with parietal peritoneum involvement C3/4
