Posterior Abdominal Wall Flashcards
What is the primary muscle of respiration?
Diaphragm
What happens to the diaphragm during inspiration?
Descends
What is the sternal origin of the diaphragm?
Xiphoid process
What is the costal origin of the diaphragm?
Internal surfaces of inferior six costal cartilages
What is the lumbar origin of the diaphragm?
Medial and lateral arcuate ligaments and three superior lumbar vertebrae
What is the insertion of the diaphragm?
Central tendon
Where is the medial arcuate ligament?
Body of L1 to TP of L1, arching over psoas major
Where is the lateral arcuate ligament?
TP of L1 to 12th rib, arching over quadratus lumborum
Where is right crus of the diaphragm?
Arises from first three or four lumbar vertebrae and intervertebral disks
Where is left crus of the diaphragm?
Arises from first two or three lumbar vertebrae and intervertebral disks
Which crus of the diaphragm is larger and longer than the other?
Right crus is larger and longer than left crus
What is the caval opening of the diaphragm?
At what spinal level will it occur?
Opening in central tendon for inferior vena cava
Level of T8
What travels in the esophageal hiatus of the diaphragm?
At what spinal level will it occur?
Esophagus, right and left vagal trunks
Level of T10
Which hiatus of the diaphragm forms the right crus?
Esaphageal hiatus
Where is the aortic hiatus?
Which level of the spine is this?
Opening posterior to diaphragm at level of T12
What travels within the aortic hiatus of the diaphragm?
- Aorta
- Thoracic duct
- Azygos veins
- Hemiazygos veins
The right and left crura unite in the midline over the aortic hiatus to form…
median arcuate ligament
Which major arteries will supply the diaphragm?
- Thoracic aorta
- Internal thoracic arteries
- Abdominal aorta
Which branches of the thoracic aorta supply the diaphragm?
Superior phrenic arteries
Which branches of the internal thoracic arteries supply the diaphragm?
- Musculophrenic arteries
- Pericardiophrenic arteries
Which branches of the abdominal aorta supply the diaphragm?
Inferior phrenic arteries
Describe the venous drainage of the diaphragm
Veins mirror arteries and drain to IVC
Which nerve is responsible for both motor and sensory function of the diaphragm?
Phrenic nerve (C3-C5)
Which nerves innervate the diaphragm?
- Phrenic nerve (C3-C5)
- Lower 6-7 intercostal nerves (T5-T11)
- Subcostal nerve (T12)
What type of innervation will lower 6-7 intercostal nerves and subcostal nerve provide the diaphragm?
Sensory
Where is the superior attachment of psoas major?
- Transverse processes of lumbar vertebrae
- Sides of T12-L5 vertebral bodies and IVDs
Where is the inferior attachment of psoas major?
Lesser trochanter, femur
What is the innervation of psoas major?
Anterior rami of lumbar nerves L1-3
What are the primary actions of psoas major?
- Flexes thigh (with iliacus)
- Flexus trunk when sitting (with iliacus)
- Flexes vertebral column laterally
- Balances trunk
What are the superior attachments of iliacus?
- Superior two thirds of iliac fossa
- Ala of sacrum
- Anterior sacroiliac ligaments
What are the inferior attachments of iliacus?
- Lesser trochanter, femur and diaphysis inferior to trochanter
- Psoas major tendon
What is the innervation of iliacus?
Femoral nerve (L2-4)
What is the primary action of iliacus?
Acting with psoas major flexes thigh and stabilizes hip joint
What is iliopsoas?
What is its function?
Integration of inferior fibers of psoas major/minor with iliacus fibers
Major flexor of the thigh and hip stabilizer
What are the superior attachments of quadratus lumborum?
- Medial one half of 12th rib inferior border
- Tips of lumbar TPs