Posterior Abdominal Wall

Question 1

Iliacus m. Innervation?

Actions?

Answer 1

Femoral n.

Flex thigh at hip

Question 2

Psoas minor innervation?

Action?

Answer 2

L1 and L2

Depress 12th rib and fix 12th rib during DEEP inspiration
Bilaterally assist w/trunk extension
Unilaterally side bend trunk to same side

Question 3

Quadratus lumborum m. Innervation?

Actions?

Answer 3

T12-L4

Extend and laterally flex vertebral column
Fixes 12th rib during inspiration

Question 4

What is the iliopsoas test?

Answer 4

Pt lies on unaffected side and extend opposite thigh against resistance

Question 5

What is the is the presentation of psoas syndrome?

What may it mimic?

Answer 5

Lumbosacral pain, difficulty standing up, pain in gluteal region, pain radiation down to lower extremity

Herniated disk

Question 6

Where does the right renal artery travel in relation to the IVC?

Answer 6

Posterior to it

Question 7

What peripheral origins insert on the central tendon of the respiratory diaphragm?

Answer 7

Sternal
Costal
Vertebral origins

Question 8

Where do the right and left crus of the diaphragm meet?

Answer 8

Aortic hiatus

Question 9

Describe the Right crus?

What does it form?

Answer 9

Longer

Forms the muscular esophageal hiatus

Question 10

Describe the left crus

Answer 10

Shorter, more lateral

Question 11

What is the vertebral level of the caval opening?

What comes out?

Answer 11

T8

IVC, Right phrenic nerve, lymphatics from liver

CLIPR (caval lymphatics IVC phrenic (R))

Question 12

Vertebral level of esophageal hiatus?

What comes out?

Answer 12

T10

Esophagus, ant. And post. Vagal trunks, esophageal branches of left gastric A.
VEEL Vagal trunks, esophagus, esophageal arteries (left gastric)

Question 13

Vertebral level of aortic hiatus?

What comes out?

Answer 13

T12

Aorta, thoracic duct, azygos vein
ATA boy

Question 14

What comes out of the sternocostal hiatus?

Answer 14

Superior epigastric vessels

Question 15

What does the median arcuate ligament form?

Answer 15

Aortic hiatus

Question 16

What does the medial arcuate ligament form?

Answer 16

Gap for psoas major

Question 17

What does the lateral arcuate ligament form?

Answer 17

Gap for quadratus lumborum

Question 18

Where do diaphragmatic hernias normally occur?

Why?

Answer 18

Left side

Protection of right hemidiaphragm by the liver

Question 19

Where does a parasternal hernia occur?

Answer 19

Sternocostal triangle

Question 20

Where does a Pleuroperitoneal hernia occur?

Answer 20

Lumbocostal triangle (bw 12th rib and diaphragm)

Question 21

What is the etiology of a congenital diaphragmatic hernia?

Presentation?

Answer 21

Failure of Pleuroperitoneal membranes to fuse with other components of the diaphragm

Respiratory distress and cyanosis, flat abdomen

Question 22

What arteries supplie the superior surface of the diaphragm?

Answer 22

Pericardiacophrenic
Musculophrenic
Superior phrenic

Question 23

What arteries supply the inferior surface of the diaphragm?

Answer 23

Inferior phrenic a
Right side -> post to IVC
Left side -> post to esophagus

Question 24

What is the motor innervation of the diaphragm?

What may some branches run with?

Answer 24

Phrenic n. (C3,4,5,)

Inferior phrenic a.

Question 25

Sensory innervation to diaphragm? | Central and peripheral portions

Answer 25

Central -> phrenic n. Peripheral -> intercostal n.

Question 26

What is the lymphatic drainage to superior surface of the diaphragm, anterior? Posterior?

Answer 26

A: parasternal nodes P: mediastinal nodes

Question 27

What is the lymphatic drainage to inferior surface of the diaphragm?

Answer 27

Celiac nodes | Superior lumbar nodes

Question 28

What drain to the thoracic duct? Where does it form?

Answer 28

Body wall, gi tract, lower extremity, perineum, gluteal region L1,L2

Question 29

What drains to the intestinal lymphatic trunk?

Answer 29

Celiac nodes, SM nodes, lumbar nodes, IM nodes SLIC nodes

Question 30

What is the cisterna chyli? Where does it collect lymph from?

Answer 30

Dilation at the end of the thoracic duct Intestinal lymphatic and lumbar lymphatic trunks

Question 31

Where is the cisterna chyli located?

Answer 31

Posterior to aorta, L1-2

Question 32

What does the para-aortic LN cluster drain?

Answer 32

Testes, ovary, kidney, uterus

Question 33

What does the Superficial inguinal LN cluster drain?

Answer 33

Scrotum, anal canal below Pectinate line, skin below umbilicus

Question 34

What does the deep inguinal LN cluster drain?

Answer 34

Lower extremity

Question 35

What does the Celiac LN cluster drain?

Answer 35

Liver, stomach, spleen, pancreas, upper duodenum

Question 36

What does the internal iliac LN cluster drain?

Answer 36

Lower rectum to anal canal (above Pectinate line) | Bladder, vagina, prostate

Question 37

What does the SM LN cluster drain?

Answer 37

Lower duodenum, Jejunum, ileum, colon

Question 38

What does the IM LN cluster drain?

Answer 38

Colon from splenic flexure to upper rectum

Question 39

What prevents the spread of fluid superiorly in the peritoneal cavity?

Answer 39

Phrenicolic ligament located on the left side

Question 40

What allows for free communication between the supracolic and infra colic compartments?

Answer 40

Paracolic gutters

Question 41

What is the innervation of Psoas Major m.? Actions?

Answer 41

L2-4 Flex thigh at hip Unilaterally side bend to same side