Posterior Abdominal Wall Flashcards

1
Q

name 6 components of the posterior abdominal wall

A
  • skeleton (5LV + IVD)
  • muscles
  • thoracolumbar fascia
  • aa (abdominal aorta + branches)
  • vv (inf vena cava + branches)
  • nn
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2
Q

name the muscles that make up the posterior abdominal wall

A
  • diaphragm
  • psoas maj
  • iliacus
  • quadratus lumborum
  • transversus abdominis
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3
Q

what is the primary muscle of respiration?

A

diaphragm

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4
Q

the diaphragm ____ during inspiration

A

descends

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5
Q

origins & insertion of diaphragm

A

O
- sternal: xiphoid process
- costal: internal surfaces of inf 6 costal cartilages
- lumbar: med + lat arcuate ligaments & L1-L3

I: central tendon

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6
Q

medial arcuate ligament travels from ____ to ____, and arches over ____

A
  • body of L1 to TP of L1
  • psoas major
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7
Q

lateral arcuate ligament travels from ____ to ____, and arches over ____

A
  • TP of L1 to 12th rib
  • quadratus lumborum
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8
Q

the right crus arises from ____

A

first 3-4 LV and IVDs

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9
Q

the right crus is ____ than the left crus

A

larger + longer

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10
Q

the left crus arises from ____

A

first 2-3 LV + IVDs

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11
Q

name 3 openings of the diaphragm and their spinal levels

A
  • caval opening (T8)
  • esophageal hiatus (T10)
  • aortic hiatus (T12)
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12
Q

what passes through the caval opening?

A

IVC
(opening in central tendon)

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13
Q

what passes through the esophageal hiatus?

A
  • esophagus
  • right & left vagal trunks
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14
Q

the esophageal hiatus forms the ____

A

right crus

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15
Q

what passes through the aortic hiatus?

A
  • aorta
  • thoracic duct
  • azygous & hemiazygous vv
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16
Q

the ____ is the opening posterior to the diaphragm

A

aortic hiatus

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17
Q

what forms the median arcuate ligament?

A

right & left crura unite in midline

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18
Q

what ligament forms the aortic hiatus?

A

median arcuate

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19
Q

arterial supply of diaphragm

A
  • thoracic aorta (sup phrenic aa)
  • internal thoracic aa (musculophrenic + pericardiophrenic aa)
  • abdominal aorta (inf phrenic aa)
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20
Q

venous drainage of diaphragm

A

veins mirror aa and drain into IVC

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21
Q

innervation of diaphragm

A
  • phrenic n (C3-C5): motor + sensory
  • lower 6-7 intercostal nn (T5-T11): sensory
  • subcostal n (T12): sensory
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22
Q

all motor innervation of the diaphragm comes from ____

A

phrenic n (C3-C5)
“keeps the diaphragm alive”

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23
Q

superior and inferior attachments of psoas major

A

sup:
- TPs of LV
- sides of T12-L5 bodies + IVDs

inf: lesser trochanter, femur

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24
Q

innervation of psoas major

A

ant rami of L1-L3

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25
Q

primary actions of psoas major

A
  • flex thigh (w iliacus)
  • flex trunk when sitting (w iliacus)
  • flex vertebral column laterally
  • balance trunk
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26
Q

superior and inferior attachments of iliacus

A

sup:
- sup 2/3 iliac fossa
- ala of sacrum
- ant sacroiliac ligaments

inf:
- lesser trochanter of femur & diaphysis inf to trochanter
- psoas maj tendon

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27
Q

innervation of iliacus

A

femoral n (L2-4)

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28
Q

primary action of iliacus

A

with psoas major, flexes thigh + stabilizes hip joint

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29
Q

superior & inferior attachments of quadratus lumborum

A

sup:
- medial 1/2 of 12th rib inf border
- tips of lumbar TPs

inf:
- iliolumbar lig
- internal lip of iliac crest

30
Q

innervation of quadratus lumborum

A
  • ant rami T12 (subcostal n)
  • lumbar plexus (L1-4)
31
Q

primary action of quadratus lumborum

A
  • extend & laterally flex vertebral column
  • fix rib 12 during inspiration
32
Q

the abdominal aorta descends anterior to vertebral bodies of ____ to ____

A

T12 - L4

33
Q

veins of the posterior abdominal wall drain directly into the ____, except for which veins?

A

IVC
left gonadal & left suprarenal vv

34
Q

where does the inferior vena cava begin?

A

at L5 to right of midline

35
Q

vertebral level of celiac trunk

A

T12

36
Q

vertebral level of SMA

A

L1

37
Q

vertebral level of renal arteries

A

L1

38
Q

vertebral level of gonadal arteries

A

L2

39
Q

vertebral level of IMA

A

L3

40
Q

vertebral level of aortic bifurcation

A

L4

41
Q

vertebral level of lumbar arteries

A

L1-L5

42
Q

vertebral level of median sacral artery

A

L4

43
Q

what forms cisterna chyli?

A

convergence of lumbar lymphatic trunk, intestinal lymph trunks, and descending thoracic trunks

44
Q

all lymph from the lower 1/2 of the body drain into ____

A

cisterna chyli

45
Q

location of cisterna chyli

A
  • ant to L1-L2 vertebral bodies
  • between IVC and abdominal aorta
46
Q

the subcostal nerve runs along the anterior surface of what muscle?

A

quadratus lumborum

47
Q

the lumbar plexus is composed of anterior rami of ____

A

L1-L4

48
Q

nerves of the lumbar plexus pass through ____ after nerve roots exit the spine

A

psoas major

49
Q

name the nerves of the lumbar plexus

A
  • ilioinguinal & iliohypogastric nn (L1)
  • genitofemoral n (L1-2)
  • lateral femoral cutaneous n (L2-3)
  • femoral n (L2-4)
  • obturator n (L2-4)
  • lumbosacral trunk (L4-5)
50
Q

function of ilioinguinal & iliohypogastric nerves

A

sensory & motor to anterior abdominal wall mm

51
Q

function of genitofemoral nerve

A
  • sensory to upper medial thigh
  • motor to cremaster m
52
Q

function of lateral femoral cutaneous n

A

sensory to lateral upper thigh

53
Q

function of femoral n

A

sensory & motor to ant thigh (quads)

54
Q

function of obturator n

A

sensory & motor to medial thigh (adductors)

55
Q

function of lumbosacral trunk

A

contribute to sacral plexus

56
Q

sympathetic innervation of GI tract to left colic flexure

A
  • greater splanchnic n (T5-9/10)
  • lesser splanchnic n (T10-11)
  • least splanchnic n (T12)
57
Q

sympathetic innervation of left colic flexure to rectum

A

lumbar plexus (L1-3)

58
Q

parasympathetic innervation of GI tract to left colic flexure

A

vagus n from vagal plexuses

59
Q

parasympathetic innervation of left colic flexure to rectum

A

pelvic splanchnic nn (S2-S4)

60
Q

spinal level of spleen innervation

A

T6-T8

61
Q

spinal level of stomach, duodenum, liver, gallbladder, & pancreas innervation

A

T6-T9

62
Q

spinal level of jejunum & ileum innervation

A

T8-T10

63
Q

spinal level of suprarenal gland innervation

A

T6-L2

64
Q

spinal level of kidney innervation

A

T10-L1

65
Q

spinal level of cecum, appendix, & ascending colon innervation

A

T10

66
Q

spinal level of transverse colon innervation

A

T11

67
Q

spinal level of descending colon innervation

A

T12-L2

68
Q

spinal level of sigmoid colon & rectum innervation

A

S2

69
Q

the greater splanchnic nerve consists predominantly of ____ganglionic ____ fibers from ____

A

preganglionic sympathetic
T5-T10

70
Q

Name all the organs which receive sympathetic innervation from the greater splanchnic nerve

A
  • esophagus
  • stomach
  • liver
  • left colic flexure
  • small intestine, ascending colon, transverse colon
  • duodenum