Posterior Abdominal Wall Flashcards
What is the origin of psoas major?
inferior border of T12 to upper border of L5 - vertebral bodies, vertebral discs and medial ends of transverse processes
What is the insertion of psoas major?
Lesser trochanter of the femur (with iliacus)
What is the action of psoas major?
Flexor of the hip/ flexor of the trunk
Where are the lumbar arteries and veins in relation to psoas?
Behind psoas
Where is the lumbar plexus in relation to psoas?
Within psoas
Where is the sympathetic trunk in relation to psoas?
Anterior surface of psoas
What is the origin of psoas minor?
T12 and L1
What is the insertion of psoas minor?
blends with periosteum of pelvis
What is the origin/insertions of quadratus lumborum?
12th rib, iliac crest, tips of transverse processes
What is the action of quadratus lumborum?
lateral flexor of the spine
What is the origin of iliacus?
Iliac fossa
What is the insertion of iliacus?
Lesser trochanter of femur with psoas
What are the 3 layers of the thoracolumbar fascia?
Anterior, middle and posterior - anterior and middle are only in the thoracolumbar region
Where do the 3 layers of the thoracolumbar fascia meet?
Along the line of the 12th rib
Where does the anterior layer of thoracolumbar fascia originate?
The tip of the transverse process
Where does the middle layer of the thoracolumbar fascia originate?
The tip of the transverse process
Where does the posterior layer of the thoracolumbar fascia originate?
the tip of the spinous process
What is the space between the anterior and middle layers of the thoracolumbar fascia?
The anterior compartment - contains quadratus lumborum
What is the space between the middle and posterior layers of the thoracolumbar fascia?
The posterior compartment - contains erector spinae
What is a psoas abscess?
A lump on the thigh which has tracked down from the spine via psoas (from TB in the spine)
At what level are the kidneys?
T12 to L3
Which rib are the kidneys in front of?
The 12th rib
Which kidney is lower?
the right
Why does the kidney move with respiration?
Because it is associated with the diaphragm
What are the dimensions of the kidney?
10cm long, 5cm wide, 2.5cm thick
What is the shape of the right adrenal gland?
Pyramidal
What is the shape of the left adrenal gland?
crescent shaped (on superomedial aspect of kidney)
What envelopes the kidney?
A fibrous capsule, perirenal fat and perirenal fascia
What is on the inside of the kidney?
An outer cortex and an inner medulla
In which direction does the hilum of the kidney face?
Anteromedially
What is the order of structures entering the hilum from front to back?
Renal vein, renal artery, renal pelvis
What is the renal sinus?
A space just inside the hilum which is full of fat which embeds the structures entering the hilum
What do the renal arteries branch off?
The abdominal aorta?
How does the right renal artery get past the IVC to get to the kidney?
By going behind the IVC
What does the renal artery divide into?
5 segmental arteries
Why is there sometimes an additional renal artery?
Because during development the blood supply changes as the kidney changes position on the posterior abdominal wall - one of the earlier arteries may persist
Where do the renal veins drain into?
The IVC
How does the left renal vein get past the aorta to get to the IVC?
By going on top of the aorta
Which artery hooks over the top of the left renal vein?
superior mesenteric artery
How many major calyces unite to form the renal pelvis?
2-3
How many minor calyces unite to form a major calyx?
2-3
How many medullary pyramids do each minor calyx collect from?
1
Which muscle does the ureter relate to?
Psoas major
What site do you use radiologically to map the descent of the ureters?
The tips of the transverse processes
What are the three sites of narrowing of the ureter?
At the beginning where it becomes the ureter, at the middle where it goes over the pelvic brim at at the end where it enters the bladder
