Posterior Abdominal Wall Flashcards
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What the possible consequence of a psoas abscess?
Damage to the lumbar plexus because it is found within the psoas major
List some of the problems that can be caused by the psoas.
- Low back pain
- Sacroiliac pain
- Sciatica
- Disc problems
- Spondylolysis
- Scoliosis
- Hip degeneration
- Knee pain
- Menstruation pain
- Infertility
- Digestive problems
- Pelvic tilt
- Leg length discrepancies
- Kyphosis
- Lumbar lordosis
Origin, blood supply and innervation to diaphragm
Blood supply: Inferior phrenic arteries
Innervation: Phrenic nerves (C3, C4, AND C5)
Origin: Sternal (@ xiphoid process)
Costal: At the lower six ribs
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The muscles of the diaphragm arise from somite level _____ to ___.
3;5
NOTE: The muscular fibers may be grouped according to their origins into three parts: sternal, costal, and lumbar
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Sphincter-like arrangement of the ________ acts as a “lower esophageal sphincter”
Right crus fibers
Lateral arcuate ligament
Runs from L1 transverse process to Rib 12
Medial arcuate ligament
Runs from L1 transverse process to L1 vertebral body
Median arcuate ligament
Unites left and right crura of diaphragm insertion: central tendon
What are the two parts of the adrenal gland? What is secreted by each, respectively?
-
Adrenal cortex
- Mineral corticoids
- Glucocorticoids
- Sex hormones
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Adrenal Medulla
- Epinephrine
- Norepinephrine
What three arteries supply the adrenal gland?
Right and left superior suprarenal arteries
- Branch of right and left inferior phrenic arteries
Right and left middle suprarenal arteries
- Branch of abdominal aorta
Right and left inferior suprarenal arteries
- Branch of renal artery
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Which organs have the greatest blood supply per gram of tissue?
Adrenal gland
Thyroid gland
Venous drainage of the adrenal glands is achieved via the ________.
Suprarenal veins
NOTE: The suprarenal veins may form anastomoses with the inferior phrenic veins
What the three constrictions of the ureters?
- Ureteropelvic junctions
- Pelvic inlet
- Entrance to bladder
What nerves make up the lumbar plexus?
Lumbar plexus (L1-L4)
- Iliohypogastric nerve
- Ilioinguinal nerve
- Genitofermoral nerve
- Lateral femoral cutaneous nerve
- Femoral nerve
- Obturator nerve
- Lumbosacral trunk
NOTE: The lumbar plexus constitutes the somatic nervous system
Components of the sympathetic trunk
- Lumbar splanchnic nerves
- Celiac plexus
- Superior mesenteric plexus
- Renal plexus
- Inferior meseneric plexus
- Aortic plexus
- Hypogastric plexus
NOTE: The sympathetic trunk constitutes the autonomic nervous system
Branches of the abdominal aorta
Unpaired
- Celiac trunk
- Superior mesenteric artery
- Inferior mesenteric artery
- Median sacral artery
Paired
- Inferior phrenic arteries
- Middle supra-renal arteries
- Renal arteries
- Gonadal arteries
- Lumbar arteries
- Common iliac arteries
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What is the significance of the azygos vein and its attachment points?
- The azygos vein is conencting to the systems of the superior and inferior vena cava and can provide an alternative path for blood to the right atrium when either the vena cava are blocked
What is the major function of the kidneys?
- Maintain blood purity by removing:
- Nitrogen compounds
- Urea
- Uric acid
- Creatinine
- Excessive ions thus maintaining electrolyte balance
- K+
- H+
- Toxins
- Nitrogen compounds
Where are the kidneys located?
- Retroperitoneal
- Right kidney is lower
- Between T12 and L3
Which nerves cross the the kidneys?
- Subcostal
- iliohypogastric
- Ilioinguinal
NOTE: Damage of the subcostal, iliohypogastric and ilioinguinal nerves during kidney transplant may result in paralysis of the lower abdominal wall and hernia
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What is the course of the ureters?
- Run posterioinferiorly on the lateral wall of the pelvis
- External to the parietal peritoneum
- Anterior to the internal iliac aa.
- They curve anteromedially to ender the posteriosuperior angle of the bladder
Nerves to the kidney and ureters arise from the ________.
Renal plexus
NOTE: The renal plexus consists of parasympathetic and sympathetic fibers. The plexus is supplied by fibers fro m the thorasic splanchnic n., mostly least splanchnic nerve.
How is a ureter stone passes?
Smooth muscle of the ureter produce intense peristaltic contractions.
NOTE: Dilation of the pelvis and calyces
What are the presentations of hydronephrosis due to congenital pelviureteric obstruction?
- Marked dilation of the renal pelvis
- The proximal 1/3 of the ureter was atrophic with a pinpoint microscopic lumen
- Patient presents with abdominal pain
Where is the kidney usually placed in cases of kidney donation?
Iliac Fossa
NOTE: It is often necessary to use a different blood supply. The renal artery is often connected to the external iliac artery in the recepent. The renal vein is often conencted to the external iliac vein in the recipient.
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Where is the bladder located in females?
Anterior and inferior to the uterus
Why does urinary frequency and urgency increase during pregnancy?
The enormous uterus limits the expansion of the bladder
What’s the difference between the internal and external uretheral sphincters?
Internal urethral sphincter
- Circular smooth muscle
External urethral sphinter
- Skeletal muscle
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The urethra passes through the ________ in males.
Prostate gland
*Prostate tumors may occlude the urethra
Benign prostate hypertrophy
- Enlargement of the inner part of the gland, most median lobe, by action of testosterione
- Swelling of the uvula, leads to compression of the internal urethral orifice, which leads to intermittent retention of urine
NOTE: This occurs mostly in aged men, where there is a frequency to urinate, however urine cannot be expelled
Why are females more prone to UTIs?
Becuae of the location of the urethra, proximal to the vagina, and the shortness of the urethra
