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GI Final > Posterior Abdominal Wall > Flashcards

Posterior Abdominal Wall Flashcards

1
Q

Posterior Abdominal Wall Components (6)

A
  • Lumbar Vertebrae and IV discs
  • Wall muscles
  • diaphragm
  • fascia
  • Lumbar plexus
  • fat, nerves, vessels
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2
Q

Muscular Floor

A
  1. Psoas Major and Minor
  2. Iliacus
  3. Quadratus Lumborum
  4. Diaphragm
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3
Q

Psoas Abscess

  • describe
  • symptoms
A

Infection deep to psoas fascia

Symptoms

  • back or flank pain
  • fever
  • inguinal mass
  • limp
  • anorexia
  • weight loss
  • lower abdominal pain exacerbated by extending limb
    • “psoas sign”
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4
Q

Fascia (3)

A

1) Median arcuate ligament
2) Medial arcuate ligament
3) lateral arcuate ligament

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5
Q

Median arcuate ligament

A

tendonous arch of the crura of the diaphragm

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6
Q

Medial arcuate ligament

A

fascial thickening of the psoas fascia

-lateral to the median arcuate ligament

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7
Q

Lateral arcuate ligament

A

thickening of fascia lining the quadratus lumborum

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8
Q

Diaphragm components

A
  • Muscular part
  • Central tendon
  • Crura
  • Apertures
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9
Q

Muscular part of Diaphragm

- components (3)

A

1) Sternal part: may not be present, attaches to xiphoid
2) Costal Part: attached to inferior 6 costal cartilages
3) Lumbar part: attaches to medial and lateral arcuate ligament

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10
Q

Crura of diaphragm

- components

A

Right Crus
- larger and longer (L3-L4)

Left Crus
- L2-L3

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11
Q

Apertures of diaphragm

- components (3)

A

1) Cavil Opening
- located at T8
- IVC and R. phrenic N.
2) Esophageal Hiatus
- located at T10
- esophagus
- anterior and posterior vagal trunks
3) Aortic Hiatus
- located at T12
- aorta, thoracic duct, and sometimes the azygos and hemi-azygos veins

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12
Q

Aorta Vertebral Level

A

T12-L4

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13
Q

Celiac Vertebral Level

A

T12

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14
Q

SMA Vertebral Level

A

L1

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15
Q

Renal Vertebral Level

A

L1/L2

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16
Q

Gonadal Vertebral Level

A

L2

17
Q

IMA Vertebral Level

A

L3

18
Q

Bifurcation Vertebral Level

A

L4

19
Q

Body of pancreas and splenic vein Vertebral Level

A

L1 and L2

20
Q

Left renal vein Vertebral Level

A

L2

21
Q

Horizontal part of duodenum Vertebral Level

A

L3

22
Q

Coils of the intestine Vertebral Level

A

Lower than L3

23
Q

Adrenal Glands

  • Component
  • Relationship to what’s around it
A

Right Adrenal Gland
- inferior to right crus, superior to right kidney, lateral to IVC, posterior and lateral to liver

Left Adrenal Gland
- inferior to left crus, posterior to spleen, posterior to stomach, posterior to pancreas, and superior to left kidney

24
Q

Adrenal Glands

- blood suplly

A

Superior (from inferior phrenic A), middle (from aorta), inferior (from renal) suprarenal arteries

Veins

  • right suprarenal vein to IVC
  • left suprarenal vein to left renal vein to IVC
25
Q

Adrenal Glands

- innervation

A

Preganglionic sympathetics from T6-L2

Celiac plexus and splanchnic nerves

26
Q

Kidney Relationships

A

Posterior: Muscular floor

  1. diaphragm
  2. psoas major m
  3. quadratus lumborum m
  4. transversus abdominis m

Anterior:

  1. Right Kidney (1/2 inch below left kidney)
    - liver duodenum, ascending colon
  2. Left Kidney (T12-L3)
    - stomach, spleen, pancreas, jejunum, descending
27
Q

Ureter Relationships

A

Posterior to ductus deferens (males)

posterior to uterine artery ( female)

28
Q

Ureter Constriction points

A

1) ureteropelvic junction
2) crossing external iliac artery and/or pelvic brim
3) Ureter enters bladder wall

29
Q

Renal Pelvis

A

flattened, funnel shaped, expansion of ureter
- receives 2-3 major calices, each of which divides into 2-3 minor calices

  • each minor calyx is indented by renal papilla, the apex of the renal pyramid
30
Q

Posterior Abdominal Wall Lymphatics

A

1) Celiac, superior and inferior mesenteric nodes: lymph from alimentary tract, liver, spleen, and pancrease
2. Lumbar lymph nodes (caval and aortic) posterior abdominal wall, kidneys, ureters, testes or ovaries, uterus and uterine tubes

31
Q

Lumbar Plexus components

A

1) Iliohypogastric
2) Ilioinguinal
3) Genitofemoral
4) Lateral cutaneous nerve of thigh
5) Obturator
6) Femoral

32
Q

Iliohypogastric nerve

  • spinal segment
  • motor function
  • sensory function
A

L1

Motor
- IO and TA

Sensory

  • skin of pubis
  • posterolateral gluteal skin
33
Q

Ilioinguinal nerve

  • spinal segment
  • motor function
  • sensory function
A

L1

Motor
-IO and TA

Sensory
-skin in upper medial thigh, penis, scrotum , mons pubis, labium majus

34
Q

Genitofemoral Nerve

  • spinal segment
  • motor function
  • sensory function
A

L1, L2

Motor

  • Genital branch of male
  • cremasteric muscle

Sensory

  • Genital branch- skin of scrotum, mons pubis, labium majus
  • Femoral branch- skin of upper anterior thigh
35
Q

Lateral cutaneous nerve of thigh

  • spinal segment
  • motor function
  • sensory function
A

L2, L3

Motor: N/A

Sensory
- skin of anterior and lateral thigh to the knee

36
Q

Obturator nerve

  • spinal segment
  • motor function
  • sensory function
A

L2-L4

Motor:

  • obturator externus
  • pectineus
  • muscles in medial compartment of thigh

Sensory:
-skin of medial aspect of thigh

37
Q

Femoral Nerve

  • spinal segment
  • motor function
  • sensory function
A

L2-L4

Motor:

  • Iliacus
  • Pectineus
  • muscles in anterior compartment of thigh

Sensory
- skin of anterior thigh and medial surface of leg

GI Final (15 decks)

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