Posterior abdominal wall Flashcards
What are the 4 parts of the abdominal aorta
ascending aorta, aortic arch, thoracic aorta and abdominal aorta.
Where does the abdominal aorta begin
at T12
How does the aorta enter the diaphragm
the aortic opening
Where does the abdominal aorta lie
It lies to the left of the inferior vena cava within the retroperitoneal space.
What are the 3 main branches of the abdominal aorta
coeliac trunk, superior mesenteric artery and inferior mesenteric artery.
How does the abdominal aorta end
Ends at L4, by giving off the median sacral artery and bifurcating into right and left iliac arteries
Name the 3 large paired lateral branches of the abdominal aorta
supra-renal, renal and gonadal branches
Name the 5 paired abdominal wall branches of the aorta
inferior phrenic artery and 4 lumbar arteries
Name the unpaired visceral arteries of the aorta
coeliac trunk, superior mesentery, inferior mesenteric.
Name the paired visceral arteries of the aorta
suprarenal, renal, gonadal (testicular or ovarian)
Name the paired parietal arteries of the aorta
inferior phrenic, lumbar
Name the unpaired parietal arteries of the aorta
median sacral
What is a tributary
a small river or stream flowing into a large river
Lymphatic drainage of the alimentary tract etc…
Alimentary tract, liver, spleen and pancreas (lymphatic vessels travel along the coeliac trunk, superior mesenteric artery and inferior mesenteric artery to) Pre-aortic lymph nodes (coeliac, superior and inferior mesenteric nodes) – scattered around the origin of these arteries (efferent vessels from these nodes join to form) intestinal lymphatic trunk
What is alimentary
nourishment, sustenance
Lymphatic drainage of the posterior abdominal wall
Posterior abdominal wall, kidneys, ureters and testes or ovaries (the lymphatic vessels drain into lumbar lymph nodes (lie on IVC and aorta) (efferent vessels from nodes join to form) lumbar lymphatic vessels.
What forms the lumbar plexus
Formed from anterior rami from L1 – L4, also received fibred from thoracic nerve T12
Name the 6 main nerves that come off the lumbar plexus
iliohypogastric nerve, ilioinguinal, genitofemoral, lateral femoral cutaneous, obturator, femoral nerves
Where do the iliohypogastric nerve, ilioinguinal, lateral femoral cutaneous, femoral nerves arise from
lateral aspect of psoas major
What branches does the genitofemoral branches split into
genital and femoral branches
Where does the genitofemoral branch emerge
anterior to the posaos major
Where does the obturator nerve emerge
medial to the psoas
Which nerves come from L1 root
Iliohypogastric nerve (superior) and ilioinguinal nerve (inferior
Which nerve comes from L1 and L2
Genitofemoral nerve
What nerve comes from L2 and L3
Lateral femoral cutaneous nerve
Which nerve comes from L2, L3 and L4
obturator nerve
What nerve comes from L2, L3 and L4
femoral nerve
What is the subcostal nerve
a branch from T12 and contributed to the lumbar plexus
What are the 2 branches that can come off L3 and L4
the acessory obturator nerve
What are the 2 little nerves that come off the femoral nerve
Muscular branches if the psoas and iliacus muscle
What does the iliohypogastric nerve innervate
muscles of abdominal wall. Skin of suprapubic region.
What does the ilioinguinal nerve innervate
muscles of abdominal wall, skin of the anteromedial part of the thigh, skin of scrotum and root of penis (male), skin of labia majora and root of clitoris (female)
What does the lateral cutaneous nerve of the thigh innervate
skin of the anterolateral part of the thigh
What does the femoral nerve innervate
iliacus, muscles of the thigh that flex the thigh and extend the knee
What does the genitofemoral nerve innervate
genital branch – cremaster muscle, skin of anterior scrotum (male), skin of labia majora and mons pubis (female). Femoral branch – skin of upper and anterior part of thigh.
What does the obturator nerve innervate
abductor muscles of the thigh
Name the 5 main muscles if the posterior abdominal wall
quadratus lumborum, psoas major, psoas minor, iliacus, diaphragm (posterior parts
Where do the 5 main muscles of the posterior abdominal wall sit
The psoas major and minor sit medially. The iliacus sits inferiorly. The diaphragm sits at the top, superiorly. The quadratus lumborum sits posteriorly and laterally.
Where does the psoas major attach to the vertical bodies
T12-L5, infront of the transverse process
Where does the psoas major insert
lesser trochanter of the femur
What is the function of psoas major
. It flexes the thigh at the hip joint. Can also flex the vertebra in the supine position.
What innervates psoas major
anterior rami of spinal nerves L1-L3
Where is psoas major in relation to psoas minor
psoas minor sits on top of major
Where does psoas minor originate
bodies of T12-L1
Where does psoas minor insert
inserts on the pectineal line and the iliopubic emin
What innervates psoas minor
anterior rami of L1
What i the function of psoas minor
Acts as a weak flexor for the vertebral column
Where does iliacus sit
in the iliac fossa
Where does iliacus insert
passes under inguinal ligament to insert on lesser trochanter of femur
What is the function of iliacus
It flexes the thigh at the hip joint
What innervates iliacus
femoral nerve
Where does quadratus lumborum originate
on the iliac crest and on the transverse process of lumbar vertebra L5 and the iliolumbar ligament
What is the iliolumbar ligament
connects the lumbar vertebra to the inside of the ilium
Where does quadratus lumborum insert
onto the transverse process of L1-L4 and onto the inferior margin of the 12th rib
What is the function of quadratus lumborum
Laterally flexes the spine and depress the rib
What innervates quadratus lumborum
anterior rami of T12 and L1-L4 spinal nerves
What does the diaphragm line
the inferior thoracic apeture
How is the diaphragm attached to lumbar vertebra
by crura
What innervates the diaphragm
phrenic nerve
Where does psoas major run
It runs down, across the ala of the sacrum, across the sacroiliac joint and along the pelvic brim
How does iliopsoas form
The medial fibres of iliacus and the lateral fibers of psoas major join, forming a single muscle belly (the iliopsoas)
What covers iliopsoas
iliopsoas fascia which is covered by peritoneum
What is the sacral promontory
marks the beginning of the pelvic inlet
Where are the kidneys located
in front of the 11th and 12th ribs
Where is the left renal vein
crosses in front of the aorta, just below the origin of the superior mesenteric artery
Where does the right renal artery pass
passes steeply backwards to reach the right kidney.
Where do the renal arteries arise
just below the superior mesenteric artery, and pass sharply backwards to reach the kidneys
Where do the kidneys lie
on each side of the great midline prominence
What enters the kidney hilum (anterior to posterior)
renal vein, renal artery and renal pelvis
What does the renal pelvis become continuous with
the ureter
What is the renal sinus
At the hilum, the surface of the kidney is rolled inward, creating a deep oval pocket
What happens in the renal sinus
the artery and vein divide into numerous branches
What forms the renal pelvis
is formed by a range of broad drainage channels, each one is called a caylx
What does each major calyx do
branch into several minor ones
Hoe does each minor calyx end
in a trumpet like widening - attaches to the surface of the kidney that faces in towards the renal sinus
At the end of each calyx what happens to the kidney
the solid tissue of the kidney projects inwards into a mound/ridge called a papilla
What is the solid tissue of the kidney called
renal parenchyma
What is the medulla continuous with
each papilla
Is the cortex inner or outer
outer
What happens towards the tip of each papilla in the kidney
the collecting tubules converge and open into the calyces
How long are uretrs
25-30cm long
where do the ureters pass
Pass over the pelvic brim at the bifurcation of the common iliac arteries
Where are the 3 sites that kidney stones can block ureters
Site 1 – at the junction of the ureters and renal pelvis. Site 2 – where the ureters cross the pelvic brim. Site 3 – during their passage through the wall of urinary bladder.
Where do the adrenal glands lie
just above the kidney
Where does the inferior vena cava lie in relation to the adrenal glands
just in front of the right adrenal gland
Where does the left adrenal gland lie
in front of the upper part of the left kidney close to the left crus of the diaphragm
What is the outer part of the adrenal gland called
cortex
What does the cortex of the adrenal gland secrete
corticosteroids
What is the darker inner layer of the adrenal gland called
medulla
What does the medulla of the adrenal gland secrete
adrenaline and noradrenaline
What is the shape of the right adrenal gland
pyramidal shape
What is the shape of the left adrenal gland
crescentic shaped
What is the superior blood supply to the adrenal gland
inferior phrenic artery
What is the middle blood supply to the adrenal gland
aorta
What is the inferior blood supply to the adrenal gland
renal artery
What is the diaphragm
A double-domed, musculotendinous partition that separates the thoracic and abdominal cavities.
What is the central tendon of the diaphragm called
aponeurotic part
Where does the right crura pass
arises from the anterior surfaces of the bodies and intervertebral discs of the lumbar vertebrae (specifically L1-L3). It ascends to attach to the central tendon of the diaphragm. The right crus passes behind the esophagus as it ascends.
Where does the left crura pass
arises from the bodies and intervertebral discs of the upper two or three lumbar vertebrae (L1-L2 or L1-L3) and ascends to attach to the central tendon of the diaphragm. The left crus also passes behind the esophagus as it ascends.
What is the median arcuate ligament
The median arcuate ligament is a fibrous band that arches over the aorta and originates from the sides of the diaphragmatic crura. It forms the superior border of the aortic hiatus, a passageway through which the aorta, thoracic duct, and azygos vein pass as they traverse between the chest and abdomen.
What is the medial arcuate ligament
he medial arcuate ligament is also known as the “crura diaphragmatis” or “lumbar arch.” It is formed by the thickened inferior border of the diaphragm near the crura. The medial arcuate ligament extends from the sides of the vertebral bodies of the first and second lumbar vertebrae (L1 and L2) to the sides of the aorta. It forms part of the posterior boundary of the aortic hiatus.
What is the lateral arcuate ligament
The lateral arcuate ligament is the least well-defined of the three arcuate ligaments. It is a thin fibrous band that stretches from the tips of the transverse processes of the lumbar vertebrae to the psoas major muscle and the quadratus lumborum muscle. The lateral arcuate ligament contributes to the formation of the lateral boundary of the aortic hiatus.
Where is the caval opening
T8
What passes through the caval openung
IVC and right phrenic nerve
What level is the oesophageal opening
T10
What passes through the osophageal opening
oesophagus, vagal trunks and oesophageal branches of left gastric vessels
Where is the aortic opening
T12
What passes through the aortic opening
Aorta, thoracic duct (sometimes azygous vein and hemiazygos vein)
What provides the sensory innervation of the diaphragm
Phrenic nerve (mostly), peripheral part – lower six or seven intercostal nerves and subcostal nerves.
