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Regional Anatomy 1 > Posterior abdominal wall > Flashcards

Posterior abdominal wall Flashcards

1
Q

describe the fascia of the abdominal wall

A
  • continuous with that of pelvis
  • lies between the peritoneum and the muscles of abdominal wall
  • named after muscles it overlies
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2
Q

in the inguinal region, the fascia extends to form what

A

femoral sheath that surrounds the femoral artery and vein

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3
Q

does the femoral nerve lie within the femoral sheath

A

no: vessels inside, nerve outside

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4
Q

the transversalis fascia continues as what layer of the spermatic cord and scrotum

A

internal spermatic fascia

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5
Q

after the arcuate line, what lies behind the rectus abdominis

A

transversalis fascia

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6
Q

what is the name of the quadrangular muscle that lies in the lumbar region

A

quadratus lumborum

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7
Q

what are the attachments of quadratus lumborum

A

iliac crest to 12th rib and L1-4 transverse processes

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8
Q

what is the function of quadratus lumborum

A

bends trunk to same side (one used) - lateral flexion
supports abdominal wall (both) - pressure, forced expiration and support for 12th rib

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9
Q

what is the nerve supply of quadratus lumborum

A

T12 - L4 anterior rami

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10
Q

the fascia over quadratus lumborum is thickened near the diaphragm to form what ligament

A

lateral arcuate ligament

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11
Q

what are the attachments of iliacus

A

iliac fossa of the pelvis and then joins with psoas muscle to become iliopsoas and attach to lesser trochanter of femur

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12
Q

what is the attachment of the iliopsoas

A

lesser trochanter of femur

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13
Q

what is the function of iliopsoas

A

flex hip

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14
Q

what is the innervation of iliacus

A

femoral nerve (L2-4)

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15
Q

what are the roots of the femoral nerve

A

L2-4

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16
Q

what are the attachments of psoas

A

superficial: T12-L4 vertebral bodies and IVDs
deep: L1-L5

to join iliacus as iliopsoas and attach to lesser trochanter of femur

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17
Q

what is the function of psoas

A

as iliopsoas: flex hip
superiorly - bend trunk laterally (one) or raise trunk from supine (both)

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18
Q

what is the innervation of psoas

A

direct branches of L2 - L4 anterior rami

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19
Q

what is the psoas minor

A

long tendon anterior to psoas major

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20
Q

the fascia over the psoas is thickened near the diaphragm to form what ligament

A

medial arcuate ligament

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21
Q

what other muscles contribute to the posterior abdominal wall

A

transversus abdominis
crura of diaphragm

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22
Q

what is the attachments of the right crus of the diaphragm

A

vertebral bodies L1 - L3

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23
Q

what is the attachments of the left crus of the diaphragm

A

vertebral bodies L1 and L2

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24
Q

when does the aorta enter the abdomen

A

T12 through aortic hiatus

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25
Q

level of celiac axis

A

T12

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26
Q

level of SMA

A

L1

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27
Q

level of IMA

A

L3

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28
Q

what level does the aorta bifurcate and into what

A

L4
into right and left common iliac arteries

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29
Q

what branches of the abdominal aorta supply the body wall

A

lumbar (L1-4)
median sacral

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30
Q

the abdominal aorta gives what branch to the diaphragm

A

inferior phrenic

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31
Q

lateral sacral arteries are a branch of what

A

internal iliac arteries

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32
Q

when do the common iliac arteries divide into internal and external

A

at pelvic brim

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33
Q

where does the internal iliac artery go

A

enters the pelvis

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34
Q

the common iliac artery follows what muscle after the bifurcation of the aorta

A

follows the medial border of the psoas muscle to the pelvic brim

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35
Q

what muscle does the external iliac artery follow

A

iliopsoas muscle

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36
Q

just before leaving the abdominal cavity the external iliac artery gives rise to what

A

inferior epigastric artery and deep circumflex artery which supply anterolateral abdominal wall

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37
Q

level of renal artery

A

L1

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38
Q

level of suprarenal artery

A

L1

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39
Q

level of gonadal artery

A

anterolateral surface at L2

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40
Q

at what level does the inferior vena cava form and from what

A

L5 from union of right and left common iliac veins
(slightly to right of median plane)

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41
Q

the IVC drains blood from where

A

posterior abdominal wall, kidneys and suprarenal glands (+ hepatic veins)

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42
Q

the IVC drains blood to where

A

right atrium

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43
Q

blood from the gut drains where

A

portal system

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44
Q

how does blood from the gut get to the IVC

A

blood from portal system passes through the liver before entering IVC via hepatic veins

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45
Q

where does the IVC peirce the diaphragm

A

T8

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46
Q

where does the left gonadal vein drain

A

left renal vein

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47
Q

where does the right gonadal vein drain

A

IVC

48
Q

where does the IVC form

A
  • L5 level
  • slightly to right of median plane
  • inferior to aortic bifurcation
  • Posterior to right common iliac artery
49
Q

the left suprarenal vein drains where

A

into left renal vein

50
Q

the right suprarenal vein drains where

A

into IVC

51
Q

how many lumbar veins are there

A

5

52
Q

how many hepatic veins are there

A

3 - right, middle and left

53
Q

what veins drain the posterior abdominal wall

A

lumbar veins

54
Q

(some variation of pattern of lumbar veins)

typically, lumbar veins 1 and 2 drain where

A

ascending lumbar veins

55
Q

typically, lumbar veins 3 and 4 drains where

A

IVC

56
Q

typically, lumbar vein 5 drains where

A

iliolumbar vein (into common iliac)

57
Q

ascending lumbar veins connect what

A

external iliac and lumbar veins to azygous and hemiazygous veins

58
Q

what does the connection of the lumbar veins to iliac veins and azygous system allow

A

pathway for venous return from abdomen that does not use IVC

59
Q

why might someone have a swollen ascending lumbar vein

A

if they have a variation called an interrupted IVC where part of IVC doesnt form

60
Q

what lymph nodes drain the gut tube

A

pre-aortic lymph nodes assoc. with the large anterior branches of the abdominal aorta that supply the foregut, midgut and hindgut

61
Q

what nodes drain the foregut

A

coeliac pre-aortic nodes at T12

62
Q

what nodes drain the midgut

A

superior mesenteric pre-aortic nodes at L1

63
Q

what nodes drain the hindgut

A

inferior mesenteric pre-aortic nodes at L3

64
Q

what nodes drain the kidneys

A

para-aortic renal nodes at L1

65
Q

where is the start of the thoracic duct and what is found here

A

cisterna chyli (in some)
L1 vertebral level

66
Q

lymph from intestines drains where

A

intestinal trunk which then passes into end of thoracic duct

67
Q

internal and external iliac nodes drain where

A

common iliac lymph nodes

68
Q

lymph from common iliac lymph nodes drains where

A

to right and left lumbar nodes

69
Q

how are the intestinal lymphatic trunks formed

A

efferent vessels from pre-aortic lymph nodes

70
Q

how are the lumbar lymphatic trunks formed

A

efferent vessels from large lumbar nodes

71
Q

describe the sympathetic supply of the abdominal viscera

A

fibres from splanchnic nerves join to form plexuses around aorta and its branches

72
Q

where does the greater splanchnic nerve come from

A

sympathetic chain in thorax

73
Q

where do lumbar splanchnic nerves come from

A

sympathetic chain in the abdomen

74
Q

the greater and lumbar splanchnic nerves add fibres to what

A

coeliac, superior mesenteric and inferior mesenteric plexuses

75
Q

parasympathetic fibres for the plexuses come from

A

vagus nerve (CN X)
pelvic splanchnic nerves (S2 3 4)

76
Q

where is the superior hypogastric plexus

A

bifurcation of the aorta

77
Q

where is the inferior hypogastric plexus

A

both lateral walls of pelvis

78
Q

what do the superior and inferior hypogastric plexuses carry

A

sympathetic and parasympathetic fibres

79
Q

the vagus nerve carries parasympathetic innervation to

A

foregut and midgut

80
Q

the pelvic splanchnic nerves supply parasympathetic innervation to

A

hindgut - distal transverse colon to anal canal

81
Q

the inferior hypogastric plexuses also carry autonomic fibres to

A

pelvic organs

82
Q

the lumbar plexus is formed by what

A

somatic nerves from anterior rami of L1 - L4

83
Q

where does the lumbar plexus lie

A

under psoas - branches form within psoas

84
Q

what does the lumbar plexus carry

A

some sensory branches to skin of pelvis but mostly motor and sensory supply to lower limb

85
Q

name the nerves of the lumbar plexus

A

iliohypogastric
ilioinguinal
genitofemoral
lateral femoral cutaneous
femoral
obturator

86
Q

the lumbar plexus also forms what

A

lumbosacral trunk to carry L4 and L5 fibres into pelvis to join with sacral nerve roots

87
Q

what is the name of the large nerve that lies immediately inferior to rib 12

A

subcostal

88
Q

what is the root of the subcostal nerve

A

anterior rami of T12

89
Q

why is it useful to identify the subcostal nerve

A

guide you to iliohypogastric and ilioinguinal nerves that form from L1 nerve roots

90
Q

describe the course of the subcostal nerve

A

arises in thorax
passes posterior to lateral arcuate ligament into abdomen
runs inferolaterally on anterior surface of quadratus lumborum

91
Q

what does the subcostal nerve pass through to supply what

A

passes through transversus abdominis and internal oblique muscles to supply the external oblique and skin of anterolateral abdominal wall

92
Q

what are the 2 nerves from L1 in lumbar plexus

A

iliohypogastric
ilioinguinal

93
Q

iliohypogastric nerve supplies sensory innervation to what

A

lateral gluteal and pubic skin

94
Q

the iliohypogastric nerve supplies motor innervation to what

A

internal oblique and transversus abdominis

95
Q

the ilioinguinal nerve supplies sensory innervation to

A

skin on medial thigh and perineum - root of penis/scrotum or mons pubis/labium majus

96
Q

the ilioinguinal nerve supplies motor innervation to

A

internal oblique and transversus abdominis

97
Q

root of iliohypogastric and ilioinguinal nerves

A

anterior ramus L1

98
Q

what nerve passes through the posterior wall of the inguinal canal and exits through the superficial inguinal ring to supply cutaneous innervation to medial thigh and perineum

A

ilioinguinal nerve

99
Q

what is the root of the genitofemoral nerve

A

L1 and L2 anterior rami

100
Q

describe the course of the genitofemoral nerve

A

pierces psoas and runs along the anterior surface and divides into a femoral and genital branch

101
Q

the femoral branch of the genitofemoral nerve supplies what

A

sensory to skin of upper part of anterior surface of thigh

102
Q

the genital branch of the genitofemoral nerve supplies what

A

sensory to perineum (scrotum/mons pubis)
motor to cremasteric muscle

103
Q

the genital branch of the genitofemoral nerve is found where

A

enters deep inguinal ring to join spermatic cord

104
Q

what are the roots of the lateral cutaneous nerve of the thigh (aka lateral femoral cutaneous nerve

A

anterior rami L2-L3

105
Q

where does the lateral cutaneous nerve of the thigh run

A

on the iliacus

106
Q

what does the lateral cutaneous nerve of the thigh supply

A

sensory to skin on anterior and lateral thigh (above knee)

107
Q

what is the largest nerve from the lumbar plexus

A

femoral nerve

108
Q

what are the roots of the femoral nerve

A

anterior rami L2 3 4

109
Q

the femoral nerve gives sensory innervation where

A

anterior thigh and via its saphenous branch to the medial side of the leg

110
Q

the femoral nerve gives motor innervation where

A

pectineus and iliacus muscles and anterior compartment of the thigh e.g. quads

(flexors of hip, extensors of knee)

111
Q

how does the femoral nerve reach the anterior compartment of the thigh

A

passes under the inguinal ligament and into femoral triangle

112
Q

what are the roots of the obturator nerve

A

anterior rami L2 3 4

113
Q

describe the course of the obturator nerve

A

passes close to sacrum and into pelvis where it passes through the obturator muscles and membrane of obturator foramen to the medial compartment of the thigh

114
Q

the obturator nerve supplies sensory innervation where

A

skin on medial thigh

115
Q

the obturator nerve supplies motor to what

A

adductor muscles
obturator externus
medial compartment of thigh e.g. gracilis
may supply pectineus

116
Q

what nerve supplies posterior compartment of thigh

A

sciatic nerve

117
Q

what are the roots of the sciatic nerve

A

L4 - S3

Regional Anatomy 1 (30 decks)

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