Posterior Abdominal Wall Flashcards

1
Q

What is the origin and insertion of Psoas Major

A

Origin: Lateral aspect TP of T12-L5
Insertion: Lesser trochanterof femur

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2
Q

WHat is the innervation of Psoas Major?

A

L2-L4 (lumbar plexus)

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3
Q

What is the function of Psoas major?

A

Bilaterally flex thigh at hip.

Unilaterally: side-bend to same side

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4
Q

What is the orgin and insertion of Psoas Minor?

A

Origin: lateraal aspect of T12-L1
Insertion: superior pubic ramus at the distand end of pectinate line

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5
Q

What is the innervation of psoas minor?

A

L1-L2

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6
Q

What is the function of Psoas minor?

A

Depress rib 12 during inspiration. Fixes 12th rib (during inspiration)
Bilaterally assists with trunk extension
Unilaterally: side bend trunk to the same side

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7
Q

What are origin and insertion of Quadratus lumborum?

A

Origin: iliac crest and iliolumbar ligament.
Insertion: medial half of inferior border of 12th rib.

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8
Q

What is the innervation of quadratus lumborum M.?

A

T12-L4

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9
Q

What is the function of Quadratus lumborum:

A

Extends and laterally flexes vertebral column.

-Fixes Rib12 during inspiration

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10
Q

What is the lipsoas Test?

A

Patient lies on unaffected side and extend opposite thigh against resistance. It’s done to help with differential diagnosis. Becuase Psoas major and iliacus muscle have close relationship with many abdominal structures, injury to any of the abdominal strucutre may present with iliopsoas pain.

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11
Q

How does Psoas syndrome present?

A
  • Lumbosacral pain
    -difficulty standing up straight
    -pain in the contralaeral gluteal region
    -radiation of pain down the lower extremity (usually stops at knee)
    -may mimic herniated disk
    differential diagnosis could Appendicitis.
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12
Q

What are the three periphral origins that inset on the central tendon of the the respiratory diaphragm

A
  1. sternal origin
  2. costal origin
  3. vertebral origin
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13
Q

which crus forms the muscular esophageal hiatis?

A

The right crus of the aortia hiatus. The right crus is longer than the left.

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14
Q

What comes out of the caval opening of the respiratory diaphragm?

A
  1. IVC
  2. branches of right phrenic nerve
  3. lymphatics from liver
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15
Q

What comes through the esophageal hiatus?

A
  1. Esophagus
  2. Ant and Post vagal trunk
  3. Esophageal branches of Left gastric a.
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16
Q

What comes through the aortic hiatus?

A
  1. Aorta
  2. Thoracic duct
  3. azygos vein
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17
Q

What passes through the sternocostal hiatus?

A

Superior epigastric vessels.

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18
Q

What structure can you find at the opening of the median arcuate ligament:

A

aorta

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19
Q

What structure can you find at the opening of the medial arcuate ligament gap?

A

psoas major M

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20
Q

What structure can you find at the lateral arcuate ligament gap?

A

quadratus lumborum m.

21
Q

What causes diaphragmatic hernias?

A

Hernias occur when attachments becomes stretched or ligaments become loose

22
Q

Where is the site for parasternal hernias?

A

At the sternocostal triangle Located between the sternal costal parts of the diaphragm.

23
Q

Where do pleuroperitoneal hernias occur?

A

At the lumbocostal triangle, lcoated between the 12th rib and the diagram.

24
Q

How do congential diaphragmatic hernia present?

A

Respiratory distress and cyanosis in the first minutes or hours of birth.. May also show unusually flat abdomen.

25
Q

What is a possible cause of esophageal hiatal hernias?

A

Possibly due to weakening of the muscular portion of the diaphragm.

26
Q

In paraesophageal what part of the stomach moves up?

A

The fundus.

27
Q

Does gastric contents regurgitation occur with paraesophageal hiatal hernia ?

A

No.

28
Q

What parts of the stomach slides up in sliding hiatal hernia?

A

the cardia and the fundus

29
Q

What is a diagnostic tool for hiatal hernia?

A

Imaging, usually CT with barium Swallow.

30
Q

what are the blood supply to the superior surface of the diaphragm?

A

Pericardiacophrenic A.
Musculophrenic A
Superior Phrenic.

31
Q

What are the blood supply to the inferior surface of the diaphragm?

A

Inferior phrenic artery

32
Q

How do the ring and left inferior phrenic arteries run with relation to IVC and esophagus

A

The right passes posterior to IVC

the left passes posterior to esophagus.

33
Q

What is the motor innervation to the diaphragm?

A

Phrenic N.

34
Q

what is the sensory innervation to the diaphragm?

A

Central portion : phrenic

peripheral portion: intercostal N.

35
Q

what is the route of lymph flow on the superfior surface of the diaphragm?

A

Anterior diaphragm: anterior diaphragmatic nodes –> parasternal nodes
Posterior diagphragm: posterior diaphragmatic nodes –> mediastinal nodes.

36
Q

What lymph nodes do lymph flow to from the inferior surface of the diaphgram?

A

Celiac nodes and superior lumbar nodes.

37
Q

At what vertebral level is the thoracic duct formed

A

L1-L2

38
Q

What lymph trunks do lymp travel to from the body wall?

A

lumbar lymph trunks

39
Q

What lymph trunks does lymph from GI tract travel to?

A

intestinal lymph trunks

40
Q

The intestinal lymphatic trunk recieves lymphs from which nodes?

A

Celiac nodes, superior mesenteric nodes, lumbar nodes, inferior mesenteric nodes.

41
Q

The cisterna chyli receives lymph from which trunks?

A

intestinal lymphatic trunks and lumbar lymphatic trunks

42
Q

The inernal iliac receives lymph from what areas?

A

Lower rectum (above the pectinate line); bladder; vagina (middle 3rd) prostate.

43
Q

Where do para-aortic lymph node cluster receive lymph from?

A

testes; ovaries; kidneys; uterus

44
Q

Where do superficial inguinal receive lymph from?

A

anal canal (below the pectinate line) most skin below umbilicus; scrotum

45
Q

Where do lymph from lower extremity drain into?

A

deep inguinal lymph node cluster.

46
Q

What organs are located in the supracolic compartment?

A

Stomach, liver, spleen

47
Q

What structures are found in infracolic compartment?

A

Small intestine, ascending and descending colon.

48
Q

What space allows for the free communication between the supracolic and infracolic compartments?

A

Paracolic gutters, the area between lateral aspects of ascending and escending colon and the posterior badominal wall.

49
Q

On the left side of the abdomnical cavity, what prevents the spread of fluid superiorly from the left paracolic gutters?

A

phrenicocolic ligament