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Module 104: Theme 3 > Posterior abdominal wall > Flashcards

Posterior abdominal wall Flashcards

- Describe the bones and muscles that compose the posterior abdominal wall. - Describe the hiatuses within the diaphragm and the structures that pass through. - Describe the iliopsoas muscle. - Describe the course of the abdominal aorta and its main branches. - Describe the relationship of the abdominopelvic veins with respect to arteries. - Describe the relationship of the inferior vena cava to the aorta. - Describe the nerves supplying the abdominal walls. - Gain a basic knowledg

1
Q

Bones of the posterior abdominal wall

A

Ribs XI and XII

Sacrum

Ilia

Lumbar vertebrae

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2
Q

Diaphragm

  • Origin
  • Insertion
  • Action
  • Haitus
A

Origin:

  • Xiphoid process
  • Inferior 6 ribs
  • Crura and arcuate ligaments (lumbar)

Insertion:
Central tendon

Action:

  • Increases/decreases volume of thoracic and abdominal cavity
  • Central tendon prevents constriction of vessels at hiatus.

Hiatuses:

  • T8= IVC
  • T10= oesophagus
  • T12= aorta
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3
Q

Quadratus lumborum

  • Origin
  • Insertion
  • Action
A

Origin:

  • Iliac crest
  • Transverse process of LV

Insertion:

  • Inferior border of rib XII
  • Transverse process of LI to LIV

Action:

  • Lateral flexion of the trunk
  • Stabilises rib XII
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4
Q

Illiacus

  • Origin
  • Insertion
  • Action
A

Origin:

  • Iliac fossa
  • Upper lateral surface of sacrum

Insertion:
- Lesser trochanter of the femur

Action:
- Flexion of thigh at the hip

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5
Q

Psoas major

  • Origin
  • Insertion
  • Action
A

Origin:
- Lateral surface of TXII and Lumbar vertebrae

Insertion:
- Lesser trochanter of the femur

Function:
- Flexion of the thigh at the hip

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6
Q

Blood supply of the diaphragm

A

Superior and inferior phrenic arteries and veins

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7
Q

Blood supply the quadratus lumborum

A

Lumbar arteries and veins

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8
Q

Blood supply of the psoas major

A

Lumbar branch of iliolumbar artery.

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9
Q

Innervation of diaphragm

A

Phrenic nerve - C3-5
- All motor supply and sensory supply of central area

Intercostal and subcostal nerve supply the sensory nerves for the rest

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10
Q

Branches of the abdominal aorta

A

Paired lumbar at each vertebrae level

At T12:
Coeliac trunk
Middle suprarenal

L1:
Superior mesenteric

L2:
Renal arteries
Gonadal (paired)

L3:
Inferior mesenteric

L5:
Right and left common iliac

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11
Q

Branches of the inferior vena cava

A

L1:

  • Right suprarenal
  • Right and left renal

L2:
Right gonadal

L5:
Right and left common iliac

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12
Q

Abdominal aortic aneurysm

A

Ballooning of vessel
- More common below renal arteries

Usually caused by atherosclerosis weakening the wall overtime

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13
Q

Claudication

A

Pain in the leg caused by occlusion at the aortic bifurcation

Consequence:
- Impotence in males

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14
Q

Somatic nerves of the abdomen

  • Nerves
  • Control
  • Innervation
A

Lumbar plexus L1-4
- Gives motor and sensory supply

Allows voluntary muscle control and sensation.

Innervates:

  • Muscles of the anterior and posterior abdominal wall.
  • Joints
  • Skin
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15
Q

Sympathetic supply of the abdomen

A

Segmented structures like blood vessels in muscle and sweat glands:
- Sympathetic chain

Viscera:

  • Celiac, superior and inferior mesenteric ganglion
  • pre vertebral ganglia: nerves from spinal cord that bypass sympathetic chain to synapse at viscera.
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16
Q

Parasympathetic supply of the abdomen

A

Vagus nerve [CNX]:
- Foregut and midgut

Pelvic splanchnic [S2-4]:
- Hindgut

17
Q

Celiac ganglion

A

Collection of cell bodies around coeliac trunk- pre-vertebral ganglion

Fibers from sympathetic fibers Greater splanchnic nerves [T5-9] synapse here

Supplies the foregut

18
Q

Superior mesenteric ganglion

A

Collection of cell bodies around superior mesenteric artery: pre-vertebral ganglion

Fibers from the lesser splanchnic nerves [T10-11] synapse here.

19
Q

Inferior mesenteric ganglion

A

Collection of cell bodies around inferior mesenteric artery: pre-vertebral ganglion

20
Q

Aorticorenal ganglion

A

Collection of cell bodies where the lesser splanchnic nerve [T10-11] synpases at.

Supplies the kidneys and upper ureter

21
Q

Kidney nervous supply

A

Mainly supplied by the least splanchnic nerve [T12]

Least splanchnic nerve synapses at renal plexus.

22
Q

Innervation of adrenal glands

A

Innervated by the greater, lesser and least splanchnic nerves:
Synapse at celiac and aorticorenal ganglia

23
Q

Somatic abdominal pain

A 
Arises from:
Skin
Fascia
Muscle
Parietal peritoneum

This pain is localised and severe

24
Q

Visceral abdominal pain

A

Pain that arises from:

  • Abdominal organs
  • Mesentery
  • Visceral peritoneum

Caused by:

  • Stretching of mesentery or viscera
  • Impaired blood supply to viscus
  • Chemical damage to viscus

Type of pain:

  • Dull
  • Poorly localised
  • Midline
25
Q

Referred abdominal pain

A

When pain is felt at a location other than the site of origin
- Due to being supplied by the same/ adjacent segments of the spinal cord

Pain is produced by somatic or visceral structures

26
Q

Stomach referred pain

A

T5-9

27
Q

Appendix referred pain

A

T10

28
Q

Gallbladder referred pain

A

T7-9

Parietal peritoneum at C3-4

29
Q

Central diaphragm referred pain

A

C3-5

30
Q

Parietal diaphragm referred pain

A

T7-11

31
Q

Anterior abdominal wall referred pain

A

T7-12, L1

32
Q

Psoas major innervation

A

Femoral (L2-L4)

Module 104: Theme 3 (13 decks)

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