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GIGU test! > Posterior abdominal wall > Flashcards

Posterior abdominal wall Flashcards

1
Q

what are the 4 muscles of the posterior abdominal wall and what are their innervations

A

Psoas Major and minor
-inn: anterior rami of L1-L3

Iliacus
-inn: femoral nerve L2-L4

Quadratus lumborum
-inn: anterior T12, L1-L4

Diaphram
-inn: C3-4-5

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2
Q

what is a Psoas Abscess?

A

Back or flank pain, fever,lump, inguinal mass

Causes:

  • diseases of organs (TB)
  • cancer
  • infections deep to psoas fascia

Lower abdominal pain exacerbated by extending the thigh (psoas sign)

mass in the psoas muscle

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3
Q

what are the three ligaments of the Posterior abdominal wall?

A

Median arcuate ligament:
-tendinous arch of the crua of the diaphragm that unites the right and left crua

Medial arcuate ligament

  • fascial thickening of the psoas fascia that spans the lumbar bodu and tip of the :1 transverse process
  • lateral to the medial arcuate ligament
  • psoas major found in it

Lateral arcuate ligament

  • fascial thickening of quadratus lumborum muscle running from L1 to the transverse process of the tip of the 12th rib
  • quadratus lumborum is found in here
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4
Q

Paired arteries of the Posterior abdominal wall?

A
  • Subcostal arteries
  • inferior phrenic arteries
  • suprarenal arteries
  • renal arteries (L2)
  • Gonadal arteries
  • lumbar arteries
  • Deep circumflex iliac arteries
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5
Q

What are the unpaired arteries of the Posterior abdominal wall?

A
  • Celiac trunk (T12)
  • superior mesenteric artery (L1)
  • inferior mesenteric artery (L3)
  • Median sacral artery (at bifurcation of the aorta)
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6
Q

What are the Veins of the posterior abdominal wall?

A

Inferior vena cava begins anterior to L5 and righ of medial plance that passes through the caval hiatus of the diaphragm

Paired visceral include the suparenal V, renal V, and gornadal V

Paired parietal branches include the inferior phrenic V, 3 and 4th lumbar vein, common iiac v

Ascending Lumbar V and azygous V connect the SVC and IVC

Venous return from abdominal viscera returns via portal system/hepatic vein

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7
Q

where does the right and left gonadal vein enter?

A

right gonadal vein enters the inferior vena cava

the left gonadal vein enters the left renal vein

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8
Q

What are the three Diaphragm Openings and what travels through them?

A

Caval opening at T8 level

  • IVC
  • right phrenic nerve

Esophageal hiatus at T10 level

  • esophagus
  • anterior and posterior vagal trunks

Aortic hiatus at T12

  • aorta
  • thoracic duct
  • azygous and hemiazygous veins sometimes
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9
Q

what makes up the Muscular Diaphragm

A

Muscular portion:

  • Sternal part attaches to xuphoid
  • costal part attaches to inferior 6 costal cartilages

Central tendon

Crua:

  • Right crus larger and longer some fibers will run on the left side (L3 to L4 vertebral bodies)
  • Left crus (L2-L3 vertebral bodies
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10
Q

What are the diaphragm arteries?

A

Superior side:

  • Musculophrenic and pericardiophrenic arteries (off internal thoracic a)
  • superior phrenic artery (off throacic aorta)

Inferior side

  • inferior phrenic a (off abdominal aorta)
  • intercostal branches for peripheral diaphragm
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11
Q

what are the two types of hiatal hernias?

A

Para-esophageal hiatal hernia:

  • pouch of peritoneum and stomach fundus extends through the esophageal hiatus usually anterior to esophagus
  • gastric regurgitation usually does not occur as cardiac portion is normal

Sliding hiatal hernia:

  • abdominal esophagus, cardiac, and portion of fundus extends through esophageal hiatus
  • regurgitation of stomach contents possible

both thought to be due to weakening of muscular diaphragm

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12
Q

Kidney location anterior aspect

A

Retroperitoneal lying at about T12-L3

Kidney lower on right side

suparenal glands lie above

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13
Q

kidney location posterior aspect

A

lies deep to 11th and 12 th ribs

left kidney hilum near transpyloric plane
-plane runs through the superior pole of right kidney

inferior pole of the right kidney is approximately index fingers breath superior to iliac crest

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14
Q

Nerves that travel in the posterior region near the kidney

A

Subcostal nerve (protected by the 12th rib)

illiohypogastric (L1)

Ilioinguinal (L1)

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15
Q

what are the three layers of the renal fat? and what is its purpose

A

Perinephric faft is adjacent to the kidney capsule and extends into the renal pelvis

renal fascia covers the fat enveloping the kidney and suprarenal gland

  • blends and ensheaths reneal vessels
  • superiorly continuous with inferior diaphragmatic fascia

Paranephric fat which is external to renal fascia

Fat allows for mobillity

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16
Q

Intrarenal anatomy

A 
Renal hilum
Renal sinus that is filled with fat
renal pelvis
renal calices
renal cortex
renal medulla
renal pyramids
renal columns
renal papilla
segmenta a/v
17
Q

Characteristics of the ureter, location, constrictions

A

Location:
-run inferiorly from renal pelvis passing over pelvic brim and along the lateral pelvic wall and running posterior to ductus deferens and uterine artery

Constrictions:

  • junction of ureter with renal pelvis
  • crossing the pelvic brim
  • entering bladder wall

Pyelogram: x ray of ureter enhanced with contrast media

18
Q

what is the innervation and blood supply of the suprarenal glands?

A

Blood supply:

  • superior, middle, inferior suprarenal arteries
  • veins

Innervation:

  • preganglionic sympathetic from T10-L1
  • celiac plexus and abdominopelvic splanchnic nerves
19
Q

what are the three main lymph nodes of the posterior abdominal wall? what do they drain?

A

Common iliac lymph nodes:

  • from external/internal iliac nodes
  • drain to the lumbar lymph nodes

Lumbar lymph nodes:

  • run along both sides of IVC and aorta
  • recieve from posterior wall and posterior pelvic wall and organs
  • form lumbar lymphatic trunks

Pre-aortic lymph nodes
-forming intestinal lymphatic trunks draining from alimentary tract, liver, spleeen, pancreas

all collected into cistern chyli which is the beginning of the thoracic duct

20
Q

what are the lumbar plexus nerves of the posterior wall and the associated spinal elements?

A
  • Subcostal T12
  • Illiohypogastric L1
  • Illioinguinal L1
  • Genitofemoral L1, L2
  • Lateral femoral cutaneous N (L2, L3)
  • Femoral N (L2,3,4)
  • Obturator N (L2,3,4)
  • lumbosacral trunk (L4,5)

GIGU test! (40 decks)

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