Posterior Abdominal Wall Flashcards
5 muscles of the posterior abdominal wall
Psoas major, quadratus lumborum, transversus abdominis, iliacus, and posterior part of diaphragm
Psoas
Origin
Insertion
Innervation
Action
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)
Quadratus lumborum
Origin
Insertion
Innervation
Action
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
Iliacus
Origin
Insertion
Innervation
Action
Origin: iliac fossa
Insertion: lesser trochanter of femur
Innervation: femoral nerve
Action: same as psoas
Clinical relation to these muscles and tuberculosis
Advanced tuberculous can have a psoas abscess (above and below right inguinal ligament)
What is on the left side of the abdominal aorta
What is on the right side
Left: left sympathetic trunk
Right: IVC, beginning of azygos vein, and cisterna chyli
Where does the abdominal aorta split?
What does it split into?
L4
Two common iliac arteries
~3 anterior visceral branches of the abdominal aorta
Celiac artery SMA, and IMA
~3 lateral visceral branches of abdominal aorta
Suprarenal artery, renal artery, and testicular/ovarian artery
Five lateral abdominal wall branches (4 are the same)
Inferior phrenic artery and 4 lumbar arteries
3 terminal branches of abdominal aorta
2 common iliac arteries and median sacral artery
Where does each of the common iliac arteries end (by dividing into)?
End in front of SI joint by dividing into external and internal iliac arteries
What is lateral to the common iliac arteries?
What is anterior to the common iliac arteries
Psoas muscle
Ureters
External iliac artery gives off what two branches?
Deep circumflex iliac and inferior epigastric
Where does the inferior epigastric artery arise?
Where does the deep circumflex iliac artery arise?
Just above the inguinal ligament; runs upward and medially to rectus sheath
Arises close to inferior epigastric but runs upwards and laterally to ASIS
Internal iliac artery branches into?
These branches supply what 4 structures
Anterior and posterior divisions
Pelvic viscera, perineum, pelvic walls and buttocks
How is the inferior vena cava formed inferiorly?
What vertebral level?
What vertebral level does it pierce the central tendon of diaphragm?
By union of the common iliac veins (behind the right common iliac artery)
L5
T8
~ most of the names of the veins are same as arteries
Tributaries: (meaning veins that drain into the IVC)
- Two anterior branches
- Three lateral visceral branches
- Five lateral abdominal wall
- Three veins of origin
- Right and left hepatic veins
- Right suprarenal artery (left drains into left renal vein), renal veins, and right gonadal vein
- Inferior phrenic vein and 4 lumbar veins
- 2 common iliac veins and median sacral vein
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)
Posterior abdominal wall veins
Below entrance of azygos vein and below the renal veins
Name the 4 veins of the posterior abdominal wall
Inferior mesenteric vein, superior mesenteric vein, splenic vein and portal vein
Inferior mesenteric vein
- Begins where, and is named what at this point?
- Course?
- Halfway down the anal canal as superior rectal vein
- 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
Splenic vein
- Where does it begin and what two veins is it joined by?
- Course?
- Hilum of the spleen, joined by short gastric and left gastroepiploic veins
- 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
Superior mesenteric vein:
- Where does it begin and where does it run?
- What two veins does it receive?
- 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
- Inferior pancreaticoduodenal vein and right gastroepiploic vein
Portal vein
- Formed by the union of what two veins? Where?
- Course?
- What happens when the portal vein enters the liver?
- Splenic vein and superior mesenteric vein behind the neck of the pancreas
- 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
- Breaks up into sinusoids from which blood passes into the hepatic veins that join the IVC
- Portal vein drains blood from abdominal part of GI tract from where to where?
- Also drains blood from what 3 organs?
- From lower 1/3 of esophagus to halfway down the anal canal
- Spleen, pancreas and gallbladder
6 tributaries of the portal vein
Splenic vein, inferior mesenteric vein, superior mesenteric vein, left gastric vein, right gastric vein, and cystic vein
Name the 3 preaortic lymph nodes
They drain the GI tract from where to where
What 4 organs do they drain as well
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
Lateral aortic lymph nodes drain?
Kidneys, gonads, abdominal walls, and common iliac nodes