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Anatomy 314 - Urogen > Posterior abdominal wall > Flashcards

Posterior abdominal wall Flashcards

1
Q

Overview of structures

A
  1. bony components
  2. Muscles and fascia
  3. Structures
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2
Q

Bony components

A

5 lumbar vert and IVD’s

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3
Q

Muscles and fascia

A

Psoas major & minor, iliacus, quadratus lumborum, transversus abdominus, diaphragm

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4
Q

Structures

A

Nerves
Arteries
Veins
Lymphatics

Middle of posterior abdominal wall, mostly close to bodies of lumbar vertebrae

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5
Q

How many lumbar vert?

A

5

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6
Q

Spines of lumbar vert are

A

short and horizontal

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7
Q

bodies of lumbar vert are

A

large and kidney
shaped: weight bearing

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8
Q

Facets orientation of lumbar vert allows:

A

flexion, extension and lateral
flexion, no rotation.

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9
Q
A
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10
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A
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11
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A
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12
Q
A
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13
Q
A
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14
Q

Pelvic brim (inlet)

A

Extends from the sacral promontory posteriorly to the symphasis pubis anteriorly

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15
Q

Pelvis major is the part of the pelvis

A

Located superior to the pelvic brim
- abdominal structures

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16
Q

Pelvic minor is the part of the pelvis

A

Located inferior to the pelvic brim
- pelvic organs

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17
Q

Three parts of the pelvic brim are:

A
  • Anterior border of the ala of the sacrum (sacral part)
  • Arcuate line of the ilium (iliac part)
  • Pecten pubis and pubic crest (pubic part)
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18
Q

The pelvis has 4 articulations

A
  • Two synovial joints
    [ Sacroiliac joints]
  • Two symphysis joints (symphysis pubis and sacrococcygeal joint)
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19
Q

Sacrum & coccyx consist of

A

Five fused vertebrae.

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20
Q

Sacrum & coccyx features

A

Triangular with apex inferior (articulates
with coccyx).
* Base superior (body articulates with L5).
* Ala laterally (represents transverse processes).
* Concave anterior surface & convex posterior surface.
* Anterior and posterior sacral foramina: for anterior & posterior rami of spinal nerves.
* Auricular surface: articulates with pelvic bones.
* Sacral hiatus (injection of anesthetic).
* Coccyx: 3 or 4 fused vertebrae.

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21
Q
A
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22
Q
A

Psoas major

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23
Q

Psoas major origin/prox:

A

lateral surface of bodies, intervertebral discs and transverse processes of lumbar vertebrae (& T12)

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24
Q

Psoas major insertion/distal:

A

lesser trochanter of femur

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25
Q

Psoas major innervation

A

Anterior rami of L1, L2, L3

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26
Q

Psoas major action

A

Flexes thigh at hip

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27
Q
A

Psoas minor

28
Q

Psoas minor origin/prox:

A

lateral surface of bodies of T12 & L1, intervertebral disc

29
Q

Psoas minor insertion/distal:

A

Pectineal line, iliopubic eminence

30
Q

Psoas minor innervation

A

Anterior rami of L1

31
Q

Psoas minor action

A

weak flexor of vertebral column

32
Q
A

Quadratus lumborum

33
Q

Quadratus lumborum origin/prox:

A

Transverse process of L5, iliolumbar ligament, iliac crest

34
Q

Quadratus lumborum insertion/distal:

A

Transverse processes of L1-L4, inferior border of rib 12

35
Q

Quadratus lumborum innervation

A

Anterior rami of T12, L1, L2, L3, L4

36
Q

Quadratus lumborum action

A

Depresses and stabilizes rib 12, lateral flexion of trunk.

37
Q
A

Iliacus

38
Q

Iliacus prox:

A

anterior iliac fossa of os coxa

39
Q

Iliacus distal:

A

Anterior lesser trochanter of femur

40
Q

Iliacus innervation

A

Femoral nerve

41
Q

Iliacus action

A

Flexes thigh at hip

42
Q

Diaphragm
* Position varies (breathing, posture, abdominal viscera).

A
43
Q

Diaphragm
Structure & attachments:

A
  • Central tendon
  • Surrounding muscular part
    Sternal
    Costal
    Lumbar
44
Q

Median, medial and lateral arcuate ligaments of diaphragm

A
45
Q
  • Blood supply (inferior surface) of diaphragm
A

inferior phrenic arteries & veins

46
Q

Nerve supply of diaphragm:

A

phrenic nerves (C3, C4, C5).

47
Q
A
48
Q

Diaphragm
* Openings

A
  • Caval opening: IVC: T8
  • (O)Esophageal hiatus: T10
  • Aortic hiatus: T12
49
Q
A
50
Q

Retroperitoneal space:

A

behind peritoneum.

51
Q

Retroperitoneal structures:

A

peritoneum on anterior side only.

52
Q

Fascia lining posterior abdominal wall is continuous

A

with fascia that lines transversus abdominis muscle.

53
Q

Retroperitoneal fascia
* Lies between parietal peritoneum & muscles.
* Named according to structure it covers:

A

o Psoas fascia:
* Forms medial arcuate ligament - thickening
of fascia.
* Fuses laterally with quadratus lumborum and thoracolumbar fascias.
* Continuous inferiorly with iliac fascia.

o Quadratus lumborum fascia (anterior layer of
thoracolumbar fascia).
* Forms lateral arcuate ligament.

54
Q

Structures on posterior abdominal wall
Nerves

A

lumbar plexus, sympathetic nerves.

55
Q

Structures on posterior abdominal wall
Arteries

A

Abdominal aorta & branches.

56
Q

Structures on posterior abdominal wall
Veins

A

Inferior vena cava & tributaries.

57
Q

Structures on posterior abdominal wall
Lymph nodes

A
58
Q

Lumbar plexus

A
59
Q
A
60
Q
A
61
Q

https://www.youtube.com/watch?v=RYk7rbgK1Z4

A
62
Q

Abdominal Aorta

A
  • Starts at T12 – aortic hiatus.
  • Ends at L4 – bifurcation into left and right common iliac arteries.
  • Anterior to vertebral bodies, IVC on right hand side.
  • Left lumbar veins pass posterior to aorta.
  • Common iliac arteries – medial border of psoas major to pelvic brim:
  • Divide into external and internal iliac arteries.
63
Q

Abdominal Aorta - Branches
Three vascular planes:

A
  1. Anterior midline - Unpaired visceral
    branches – digestive system – celiac, superior mesenteric, inferior mesenteric arteries.
  2. Lateral - Paired visceral branches – urogenital and endocrine organs – suprarenal, renal, gonadal arteries.
  3. Posterolateral – Paired parietal branches – diaphragm, body wall – subcostal, inferior phrenic, lumbar arteries
64
Q

Inferior Vena Cava

A
  • Begins anterior to L5: union of common iliac veins.
  • Ascends on right side of L3, L4 &L5 vertebral bodies, on the right psoas major, on the right of the aorta.
  • Passes through the caval opening of the diaphragm at T8.
  • Tributaries: correspond to the paired visceral and paired parietal branches of abdominal aorta.
  • Unpaired branches from digestive tract – hepatic
    portal vein.
  • Left inferior phrenic & left gonadal vein drain
    into left renal vein.
  • Ascending lumbar & azygous veins connect IVC
    and SVC.
65
Q

Lymphatic drainage

A
  • Lymph nodes & lymphatic vessels – lie along aorta, IVC, and iliac vessels.
  • Common iliac nodes: lymph from external & internal lymph nodes
    –> lumbar lymph nodes.
  • Lymph from digestive organs: pre- aortic lymph nodes:celiac, superior mesenteric, inferior mesenteric (around the origins of the arteries).
  • Intestinal lymphatic trunks: pre-aortic nodes.
  • Lumbar lymphatic trunks: from lumbar nodes.
  • Thoracic duct: all the lymph from below the diaphragm.
    ➢Inferior end – dilation called cisterna chyli – anterior to L1, L2.
    ➢Ascends through aortic hiatus in diaphragm.
    ➢Ultimately enters venous system: junction of left subclavian & internal jugular veins.
66
Q
A
67
Q

Slide 27 - 29

A

Anatomy 314 - Urogen (10 decks)

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