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Gross Anatomy Block 2 > Posterior Abdominal Wall > Flashcards

Posterior Abdominal Wall Flashcards

1
Q

5 muscles of the posterior abdominal wall

A

Psoas major, quadratus lumborum, transversus abdominis, iliacus, and posterior part of diaphragm

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2
Q

Psoas

Origin
Insertion
Innervation
Action

A

Origin: Transverse process of T12-L5

Insertion: lesser trochanter of femur

Innervation: lumbar plexus

Action: flexes thigh (or trunk towards thigh if thigh is fixed - sitting up from bed)

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3
Q

Quadratus lumborum

Origin
Insertion
Innervation
Action

A

Origin: iliolumbar ligament, iliac crest, transverse processes of lower lumbar

Insertion: 12th rib

Innervation: lumbar plexus

Action: fixes 12th rib during inspiration, depresses it during forced expiration, laterally flexes vertebral column to same side

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4
Q

Iliacus

Origin
Insertion
Innervation
Action

A

Origin: iliac fossa

Insertion: lesser trochanter of femur

Innervation: femoral nerve

Action: same as psoas

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5
Q

Clinical relation to these muscles and tuberculosis

A

Advanced tuberculous can have a psoas abscess (above and below right inguinal ligament)

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6
Q

What is on the left side of the abdominal aorta

What is on the right side

A

Left: left sympathetic trunk

Right: IVC, beginning of azygos vein, and cisterna chyli

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7
Q

Where does the abdominal aorta split?

What does it split into?

A

L4

Two common iliac arteries

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8
Q

~3 anterior visceral branches of the abdominal aorta

A

Celiac artery SMA, and IMA

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9
Q

~3 lateral visceral branches of abdominal aorta

A

Suprarenal artery, renal artery, and testicular/ovarian artery

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10
Q

Five lateral abdominal wall branches (4 are the same)

A

Inferior phrenic artery and 4 lumbar arteries

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11
Q

3 terminal branches of abdominal aorta

A

2 common iliac arteries and median sacral artery

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12
Q

Where does each of the common iliac arteries end (by dividing into)?

A

End in front of SI joint by dividing into external and internal iliac arteries

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13
Q

What is lateral to the common iliac arteries?

What is anterior to the common iliac arteries

A

Psoas muscle

Ureters

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14
Q

External iliac artery gives off what two branches?

A

Deep circumflex iliac and inferior epigastric

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15
Q

Where does the inferior epigastric artery arise?

Where does the deep circumflex iliac artery arise?

A

Just above the inguinal ligament; runs upward and medially to rectus sheath

Arises close to inferior epigastric but runs upwards and laterally to ASIS

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16
Q

Internal iliac artery branches into?

These branches supply what 4 structures

A

Anterior and posterior divisions

Pelvic viscera, perineum, pelvic walls and buttocks

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17
Q

How is the inferior vena cava formed inferiorly?

What vertebral level?

What vertebral level does it pierce the central tendon of diaphragm?

A

By union of the common iliac veins (behind the right common iliac artery)

L5

T8

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18
Q

~ most of the names of the veins are same as arteries

Tributaries: (meaning veins that drain into the IVC)

  1. Two anterior branches
  2. Three lateral visceral branches
  3. Five lateral abdominal wall
  4. Three veins of origin
A
  1. Right and left hepatic veins
  2. Right suprarenal artery (left drains into left renal vein), renal veins, and right gonadal vein
  3. Inferior phrenic vein and 4 lumbar veins
  4. 2 common iliac veins and median sacral vein
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19
Q

What provides collateral circulation of the SVC and IVC (and give location of where on the SVC or IVC blockages would occur to get this collateral circulation)

A

Posterior abdominal wall veins

Below entrance of azygos vein and below the renal veins

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20
Q

Name the 4 veins of the posterior abdominal wall

A

Inferior mesenteric vein, superior mesenteric vein, splenic vein and portal vein

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21
Q

Inferior mesenteric vein

  1. Begins where, and is named what at this point?
  2. Course?
A
  1. Halfway down the anal canal as superior rectal vein
  2. Passes up the posterior abdominal wall on the left side of the inferior mesenteric artery and duodenojejunal flexure. Joines the SPLENIC vein behind the pancreas
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22
Q

Splenic vein

  1. Where does it begin and what two veins is it joined by?
  2. Course?
A
  1. Hilum of the spleen, joined by short gastric and left gastroepiploic veins
  2. Passes to the right within the splenicorenal ligament and runs behind the pancreas; joins superior mesenteric veins behind the neck of the pancreas to form the portal vein
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23
Q

Superior mesenteric vein:

  1. Where does it begin and where does it run?
  2. What two veins does it receive?
A
  1. Begins at ileocecal junction, runs up the right side of superior mesenteric artery and passes in front of 3rd part of duodenum and behind neck of pancreas, where it joins splenic vein to form portal vein
  2. Inferior pancreaticoduodenal vein and right gastroepiploic vein
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24
Q

Portal vein

  1. Formed by the union of what two veins? Where?
  2. Course?
  3. What happens when the portal vein enters the liver?
A
  1. Splenic vein and superior mesenteric vein behind the neck of the pancreas
  2. Ascends to the right behind the first part of duodenum and enters the lesser omentum, to the porta hepatis where it divides into right and left terminal branches
  3. Breaks up into sinusoids from which blood passes into the hepatic veins that join the IVC
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25
Q
  1. Portal vein drains blood from abdominal part of GI tract from where to where?
  2. Also drains blood from what 3 organs?
A
  1. From lower 1/3 of esophagus to halfway down the anal canal
  2. Spleen, pancreas and gallbladder
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26
Q

6 tributaries of the portal vein

A

Splenic vein, inferior mesenteric vein, superior mesenteric vein, left gastric vein, right gastric vein, and cystic vein

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27
Q

Name the 3 preaortic lymph nodes

They drain the GI tract from where to where

What 4 organs do they drain as well

A

Celiac, superior mesenteric and inferior mesenteric lymph nodes

From lower 1/3 of esophagus to halfway down the anal canal (same as portal vein)

Spleen, pancreas, gallbladder, and greater part of liver

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28
Q

Lateral aortic lymph nodes drain?

A

Kidneys, gonads, abdominal walls, and common iliac nodes

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29
Q

Where is the lumbar plexus formed? What is it formed from?

A

In the psoas muscle, from anterior rami of upper 4 lumbar nerves

30
Q

7 branches of the lumbar plexus

A 
Iliohypogastric nerve
Ilioinguinal nerve
Lateral cutaneous nerve of the thigh
Femoral nerve
Obturator nerve
Genitofemoral nerve
4th lumbar root of the lumbosacral trunk
31
Q

Which branches emerge from the lateral border of the psoas?

Medial border?

A

Iliohypogastric, ilioinguinal, lateral cutaneous nerve of the thigh, and femoral nerve are lateral

Obturator, 4th lumbar root of lumbosacral trunk

Genitofemoral is anterior to psoas

32
Q

Lumbar plexus

  1. What comes off of L1
  2. What do these nerves supply?
A
  1. Iliohypogastric and ilioinguinal
  2. Hypo- skin of lower part of abdominal wall
    Ilioinguinal- passes through inguinal canal to supply skin of groin and scrotum/labium majus
33
Q

Lumbar plexus

  1. What comes off of L2 and L3
  2. Where does it run
  3. What does it supply
A
  1. Lateral cutaneous nerve of the thigh
  2. Crosses iliac fossa and enters thigh behind the lateral end of the inguinal ligament
  3. Skin over lateral surface of thigh
34
Q

Lumbar plexus

  1. What nerves come from L2-4

~answer following questions about the larger one from answer 1~

  1. Where does it run
  2. What does it supply in the abdomen?
A
  1. Femoral (largest branch) and obturator nerve
  2. Down/lateral between psoas and iliacus. Enters thigh behind inguinal ligament and lateral to femoral vessels/sheath
  3. Iliacus muscle
35
Q

Lumbar plexus

Obturator nerve:

  1. Course?
A
  1. Emerges from medial border of psoas (at brim of pelvis in front of SI joint but behind iliac vessels), leaves pelvis by passing through obturator foramen into the thigh
36
Q

Significance of the 4th lumbar root of lumbosacral trunk?

A

It takes part in formation of sacral plexus

37
Q

Lumbar plexus:

  1. What nerve emerges from L1-2
  2. Splits into two branches: what do each supply
A
  1. Genitofemoral nerve
  2. Genital branch- enters spermatic cord and innervates cremaster muscle
    Femoral branch- supplies small area of skin of thigh; its a nervous pathway involved in the cremasteric reflex
38
Q
  1. Where does the abdominal part of the sympathetic trunk run?
  2. Locations of right and left sympathetic trunks
A
  1. Medial border of psoas on bodies of lumbar vertebrae, passes behind common iliac vessels to get into the pelvis
  2. Right lies behind right border of IVC; left lies close to left border of aorta
39
Q

Sympathetic trunk:

  1. White rami communicantes function?
  2. What do they contain?
A
  1. To join the first two ganglia to the first two lumbar spinal nerves
  2. Preganglionic nerve fibers and afferent sensory nerve fibers
40
Q
  1. Function of gray rami communicantes

2. What do they contain

A
  1. Join each ganglion to corresponding lumbar spinal nerve

2. Postganglionic fibers (to blood vessels, sweat glands, arrrector pili muscles)

41
Q

Sympathetic trunk branches:

Superior hypogastric plexus contains?

Where is it located

A

ONLY sympathetic fibers (no parasympathetic)

In front of common iliac vessels into the pelvis

42
Q

Aortic plexus is formed from?

A

Arteries that come off the anterior abdominal aorta (celiac plexus, mesenteric plexuses..)

43
Q

Ganglia of the celiac plexus contain?

A

There are mainly two celiac ganglia that receive the greater and lesser splanchnic nerves (preganglionic sympathetic)

Also contain postganglionic branches and parasympathetic vagal fibers

44
Q

Inferior mesenteric plexus receives?

A

Parasympathetic fibers from the sacral parasympathetic

45
Q

Retroperitoneal space is located behind?

A

Parietal peritoneum

46
Q

Runs from where to where

A

Rib 12/T12 to sacrum/iliac crests

47
Q

3 muscles that form the floor/posterior wall of retroperitoneal space?

What is located anterior to these muscles?

A

(From medial to lateral):
Psoas, quadratus lumborum, origin of transversus abdominis

Fascia/bed for suprarenal glands, kidneys, parts of ascending/descending colon, and duodenum

48
Q

1 organ and 2 vessels not previously mentioned that are also located in retroperitoneal space?

A

Ureters and renal and gonadal blood vessels

49
Q

Function of kidneys

A

Major role in controlling water/electrolyte balance and maintaining acid-base balance of blood

50
Q

The kidneys are uneven, why?

A

Right is slightly lower because of the large size of the right lobe of the liver

51
Q

When diaphragm contracts, how do kidneys move

52
Q

Hilum of kidney extends into

What runs through the hilum of kidney (5)

A

A large cavity called the renal sinus

Renal vein, 3 branches of renal artery, ureter, lymph vessels and sympathetic fibers

53
Q

4 coverings of the kidneys from deep to superficial

A
  1. Fibrous capsule
  2. Perirenal fat
  3. Renal fascia (encloses kidneys and suprarenal glands)
  4. Pararenal fat (part of retroperitoneal fat)
54
Q

3 nerves that run lateral to the kidney

A

Subcostal nerve, iliohypogastric nerve and ilioinguinal nerve

55
Q

5 arteries that give blood supply to the kidneys

A

Renal artery, lobar arteries, interlobar arteries, arcuate arteries, and interlobular arteries

56
Q

Renal artery

  1. Arises from
  2. Divides into __ that go where
A
  1. Aorta at L2

2. Divides into 5 segmental arteries that enter hilum of kidney

57
Q

Lobar arteries

  1. Arise from
  2. Gives off?
A
  1. Each segmental artery from renal artery (one for each renal pyramid)
  2. 2 or 3 interlobar arteries
58
Q

Interlobar arteries

  1. Run toward?
  2. Branches into what arteries, where?
A
  1. Cortex on each side of renal pyramid

2. Branches into arcuate arteries at the junction of the cortex and medulla (which arch over base of pyramids)

59
Q

Arcuate arteries

  1. Branch off into
  2. Where do these branches go
A
  1. Interlobular arteries

2. Ascend in the cortex

60
Q

Interlobular arteries

What arises from these?

A

Afferent glomerular arterioles

61
Q

Nerve supply of kidneys?

A

Renal sympathetic plexus (spinal nerves T10-12)

62
Q

Venous drainage of kidneys

A

Renal vein -> IVC

63
Q

Lymph drainage of the kidneys

A

Lateral aortic lymph nodes (around origin of renal artery)

64
Q

What is the renal pelvis

What does it receive

A

Funnel shaped, expanded upper end of ureter

Major calyces

65
Q

Ureter runs in between

A

Parietal peritoneum and psoas

66
Q

Blood supply of the ureter

A

Upper end: renal artery
Middle: gonadal arteries
Pelvis portion: superior vesical artery

~venous drainage is veins that correspond to arteries

67
Q

Lymph drainage of the ureters?

A

Lateral aortic and iliac nodes

68
Q

Nerve supply of ureters

A

Renal, gonadal, and hypogastric plexuses

Afferent fibers travel with sympathetic nerves and enter spinal cord at L1-2

69
Q

What separates suprarenal glands from the kidney

A

Perirenal fat

70
Q

Blood supply of suprarenal glands (3 arteries; 1 vein)

A

Inferior phrenic artery, aorta, and renal artery

Venous drainage: single vein that emerges from hilum of each gland and drains into IVC (on right) and renal vein (on left)

71
Q

Lymph drainage of the suprarenal glands

A

Lateral aortic nodes

72
Q

Nerve supply of suprarenal glands

A

Preganglionic sympathetic fibers derived from splanchnic nerves (most of the nerves end in the medulla of the gland)

Gross Anatomy Block 2 (8 decks)

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