Posterior Abdominal Wall Flashcards
Psoas minor
Flex trunk weakly
Layers
Skin - superficial fascia (Camper’s) - muscles - endoabdominal fascia - extraperitoneal
Psoas major
Flex and externally rotate hip joint
Flex trunk
Iliacus
Flex and externally rotate hip joint
Flex trunk
Quadratus lumborum
Fixes rib during inspiration, contraction of diaphragm
Bend trunk to same side
Endoabdominal fascia
Iliopsoas and thoracolumbar fascia
Continuous with transversals fascia
Psoas fascia
Lies deep to posts major and minor
Thickens superiorly at medial arcuate ligament
Thoracolumbar fascia
Splits into three layers
Anterior = lines quadrates lumborum
Middle & posterior = wrap around erector spinae
Thickens superior at lateral arcuate ligament
Iliopsoas fascia
Irritation can be associated with inflammation of surrounding organs
Ex. lies under appendix on right
Psoas sign
Lie on side, extend thigh back
Positive if abdominal pain
Lumbar plexus
Formed by ventral rami
L1 iliohypogasric and ilioinguinal
L1-L2 genitofemoral
L2-L3 lateral cutaneous nerve of thigh
L2-L4 obturator nerve
L2-L4 femoral nerve
Iliohypogasric and ilioinguinal nerves
L1
Lateral to psoas
Genitofemoral nerve
L1-L2
Anterior to psoas
Lateral cutaneous nerve of thigh
L2-L3
Lateral to psoas
Obturator nerve
L2-L4
Medial to psoas
Femoral nerve
L2-L4
Lateral to psoas
Diaphragm
Separates abdomen from thorax
Crus of diaphragm
Left - L2, right to L3/L4 (longer)
Join at midline to form median arcuate ligament
Pierced by thoracic splanchnic nerves
Caval opening
T8
IVC, right phrenic
Esophageal hiatus
T10
Esophagus, vagal trunk
Aortic hiatus
T12
Aorta, thoracic duct, azygos vein
Sternocostal triangle
Small opening between sternal and costal attachments of diaphragm
Superior epigastric vessels pass
Blood supply of diaphragm
Superior phrenic
Inferior phrenic
Pericardiacophrenic
Musculophrenic
Nerves of diaphragm
Phrenic
Lower intercostal n
Hiatal hernia
Stomach produces through esophageal hiatus
Paraesophageal hiatal hernia
Fundus of stomach thru esophageal hiatus
Sliding hiatal hernia
Esophagus, cardia and fungus thru esophageal hiatus
Arteries of post abdominal wall
Celiac trunk
SMA
IMA
Suprarenal
Renal
Gonadal
Subcostal
Inferior phrenic
Lumbar
Veins of post abdominal wall
Receives less common iliac veins
Left inferior phrenic, suprarenal and gonadal veins join left renal vein
Lumbar veins drain into azygous and hemiazygous
Intercaval anastamosis
IVC
Common iliac
External iliac
Subclavian
Brachiocephalic
SVC
Lymph nodes of posterior abdominal wall
Celiac/SMA/IMA
Aortic
Common iliac
Internal and external iliac
Cisterna chyli
Sac at end of thoracic duct, drains into left venous angle