Posterior Abdominal Wall Flashcards

1
Q

What are the 5 muscles of the posterior abdominal wall?

A
  • quadratus lumborum
  • psoas major
  • psoas minor
  • diaphragm
  • iliacus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q
A

red = quadratus lumborum

blue = psoas minor

green = psoas major

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q
A

green = psoas major

red = quadratus lumborum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the origin of quadratus lumborum?

A

inferior border of 12th rib, transverse process of lumbar vertebrae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the insertion of quadratus lumborum?

A

iliolumbar ligament, iliac crest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the action of quadratus lumborum?

A

fixes the 12th rib during inspiration, lateral flexion (and extension) of the vertebral column

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the nerve innervation quadratus lumborum?

A

T12-L4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the origin of psoas major?

A

transverse processes of lumbar vertbrae, vertberal bodies of T12-L4 and IV disks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the insertion of psoas major?

A

lesser trochanters

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What muscles fascia contributes to the lateral acurate ligament?

A

quadratus lumborum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the action of psoas major?

A

flexion of the thigh (with iliacus), flexion of the trunk when thigh is flexed and lateral flexion of the vertebral column

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the nerve innervation of psoas major?

A

L1-L3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the origin of psoas minor?

A

bodies of T12-L1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the insertion of psoas minor?

A

pectineal line and iliopectineal eminence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the nerve innervation of psoas minor?

A

L1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the action of psoas minor?

A

Similar to psoas major but weaker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the origin of iliacus?

A

iliac fossa, iliac crest, anterior sacroiliac ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the insertion of iliacus?

A

lesser trochanter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the action of iliacus

A

flexion of the thigh

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the nerve innervation of iliacus

A

femoral nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the space between the inguinal ligament and the hip bone divided by?

A

femoral sheath into muscular compartments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the femoral sheath an extension of?

A

transversalis fascia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What does the muscular compartment of the femoral sheath transmit?

A

psoas majot and iliacus muscles with femoral nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What does the vascular compartment of trhe femoral sheath transmit?

A

femoral vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Where is the femoral canal located?

A

medial to the vascular compartment of the femoral sheath is the femoral canal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the opening of the femoral canal?

A

femoral ring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the femoral canal bounded by?

A
  • inguinal ligament (anterior)
  • Lacunar ligmaent (medial)
  • Pectineus or pectineal ligament (posterior)
  • femoral vein (lateral)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the femoral canal closed by?

A

extraperitoneal tissue

29
Q

How common is femoral hernia in males compared to females?

A

20x more common in females

30
Q

Name a weak area associated with abdominal protursion of the abdominal organs into the femoral canal?

A

femoral ring

31
Q

What landmark can be used to differentiate between inguinal and femoral hernia?

A

pubic tubercle

32
Q

What is more common if there is a swelling inferior and lateral to the pubic tubercle

A

femoral hernia

33
Q

Where do spinal nerves arise from and where do they merge?

A

arise from segments of the spinal cord and merge as dorsal (posterior) sensory roots and ventral (anterior) motor roots

34
Q

What do sensory and motor roots combine to form?

A

mixed spinal nerve that passes through an intervertebral foramen and divides into a dorsal and ventral ramus

35
Q

What is a dermatome?

A

region or strip of skin supplied by a specific spinal nerve

36
Q

What is each spinal nerve named in relation to?

A

intervertebral foramen from which it emerges

37
Q

`what is a myotome?

A

the muscle or group of muscles supplied by a specific nerve

38
Q

What are the skin and muscles of the abdominal wall supplied by?

A

segments of the ventral rami of the spinal nerves T7-12 and L1

39
Q

How do the nerves pass in the abdomen?

A

pass infero-medially around the abdomen between internal oblique and transversus abdominis

40
Q

What type of cutaneous branches are there in the adbome?

A

posterior, lateral and anterior

41
Q

Dermatome T6-7

A

Epigastrium (referred pain from the stomach)

42
Q

Dermatome T10

A

umbilicus

referred pain from appendix, gonad and small intestine

43
Q

Dematome T12

A

pubic region

referred paun from lower colon, bladder and uterus

44
Q

How does the shingles rash present?

A

rash can form a band along the course of a nerve (dermatome)

only appears on one side of your body

45
Q

What are the abdominal wall muscles and skin supplied by?

A

T7-L1 spinal nerves

46
Q

What does L1 contribute to?

A

iliohypogastric and ilioinguinal nerves

47
Q

Where do nerves of the abdomen pass between?

A

internal oblique and transversus abdominis (2nd and 3rd layers)

48
Q

Why do nerves of abdomen enter the rectus sheath?

A

to supply rectus abdominis from medial to lateral

49
Q

What muscle does the iliohypogastric nerve pierce?

A

external oblique aponeurosis above the superifical inguinal ring

50
Q

What does the ilioinguinal nerve enter?

A

inguinal canal (but not through the deep inguinal ring) and emerges through the superifical ring

51
Q

What do the ilioinguinal and iliohypogastric nerves supply?

A

skin just above the inguinal ligament

inferior fibres of internal oblique and transverse abdominis

52
Q

Name the 7 nerves of the lumbar plexus

A
  1. Iliohypogastric (L1)
  2. Ilioinguinal (L1)
  3. Genitofemoral (L1,2)
  4. Lateral femoral cutaneous (L2, L3) - lateral cutaneous nerve of the thigh
  5. Obturator (L2,3,4)
  6. Femoral (L2,3,4)
  7. To lumbosacral trunk
53
Q
A
  1. Iliohypogastric (L1)
  2. Ilioinguinal (L1)
  3. Genitofemoral (L1,2)
  4. Lateral femoral cutaneous (L2, L3) - lateral cutaneous nerve of the thigh
  5. Obturator (L2,3,4)
  6. Femoral (L2,3,4)
  7. To lumbosacral trunk
54
Q

What are the 7 main arteries that supply the posterior abdominal wall?

A
  1. intercostal arteries
  2. lumbar arteries
  3. superior epigastric arteries
  4. inferior epigastric arteries
  5. superifical epigastric arteries
  6. superifical circumflex iliac arteries
  7. deep circumflex arteries
55
Q
A
  1. intercostal arteries
  2. lumbar arteries
  3. superior epigastric arteries
  4. inferior epigastric arteries
  5. superifical epigastric arteries
  6. superifical circumflex iliac arteries
  7. deep circumflex arteries
56
Q

Where do lumbar arteries originate from and how many of them are there?

A

4 pairs

branches of the abdominal aorta

57
Q

Where do inferior epigastric arteries branch from and what canal do they enter?

A

branch of external iliac

on the medial side of the deep inguinal ring

enter the rectus sheath and ascend behind rectus adbominis

58
Q

What are the superifical epigastric arteries a branch of?

A

femoral artery

59
Q

What are the superifical circumflex iliac arteries a branch from?

A

femoral artery

60
Q

What are deep circumflex arteries a branch of? And how does it run?

A

external iliac artery

runs laterally, parallel to the inguinal ligament

61
Q

Where do the veins of the posterior abdominal wall radiate from?

A

umbilicus

62
Q

What veins can drain into the saphenous vein rather than the femoral?

A

superifical epigastric and superifical circumflex iliac

63
Q

What connects the venous systen through the umbilicus to the portal veuins of the liver?

A

paraumbilical veins

64
Q

Anterior lymph drainage above the umbilicus?

A

anterior axillary

65
Q

Anterior lymph drainage below the umbilicus

A

superifical inguinal

66
Q

posterior lymph drainage above iliac crests

A

posterior axillary lymph nodes

67
Q

posterior lymph drainage below iliac crests

A

superifial inguinal lymph nodes

68
Q

deep lymph drainge

A

lymph from the deep abdominal wall is drained by vessels alongside the epigastric vessels

superior = parasternal ⇒ mediastinal

inferior = external iliac ⇒ para-aortic

69
Q
A