Posterior Abdominal Wall

Question 1

Deep circumflex iliac artery anastomoses with

Answer 1

Iliolumbar artery

Going around the internal crest of the iliac spine crest

Question 2

Psoas minor and major

And clinical condition

Answer 2

T12-L5 TP——> lesser trochanter
N: L1-L3 anterior rami
Can get infected due to (TB, cancer, infections in fascia that causes puss buildup) = Psoas Abscess
Sx: flank, back pain ,fever, limp, inguinal mass, *lower ABD pain when extending thigh)

Question 3

Iliacus

Answer 3

Superior Iliac fossa ——> lesser trochanter

N : Femoral N

Question 4

Quadratics Lumborum

Answer 4

Iliolmbar lig at lip of iliac crest——> lumbar TP and 12 rib

N: T12-L4 anterior rami

Question 5

Medial Arcuate Lig

Answer 5

Fascia over the psoas major (from L1 body to L1 TP)

Lateral to the median arcuate lig

Question 6

Lateral Arcuate Lig

Answer 6

Fascia thickening over the Quadratus Lumborum (L1 TP to 12th rib)

Question 7

Median Arcuate Lig

Answer 7

Tendon facia of crura of diaphragm over the Aorta
Unites the left and right crura
Esophagus in the esophagus hiatus is above it

Question 8

IVC begins at

Answer 8

L5 to the right of the midline
For venous return from ABD to the portal venous system (hepatic Vein)
Makes the Lumbar Veins

Question 9

Azygos vein + Lumber veins

Answer 9

Anastomoses to go thorax to make SVC

Question 10

Where does the LEFT Gonadal Vein drain into

Answer 10

Left renal vein ——> IVC (on right side)

The right gonadal ——> IVC directly

Question 11

Inferior mesenteric vein

Answer 11

Empty to portal vein to enter hepatic vein

Question 12

Hepatic Veins empty into what

Answer 12

IVC

Question 13

Caval Opening

Answer 13

T8
IVC goes through into the ABD cavity
Right Phrenic N goes through to the ABD cavity
*both go through diaphragm

Question 14

Esophageal Hiatus

Answer 14

T10
Esophagus
Ant + Post Vagal trunks
*both go through diaphragm

Question 15

Aortic Hiatus

Answer 15

T12 
Aorta 
Thoracic Duct
Sometimes Azygos and Hemiazygos 
* go behind diaphragm

Question 16

Esophageal hiatus pierces what

Answer 16

The right crura (from L1-L4) some from left of aortic hiatus

Question 17

Left crura

Answer 17

From L1-L3

Question 18

Superior arteries of the diaphragm

Answer 18

Musculaophrinic and Pericardiophrenic A(internal thoracic)

Superior Phrenic A (thoracic Aorta)

Question 19

Inferior arteries of the diaphragm

Answer 19

Inf. Phrinic (ABD Aorta)

Intercostal br —> peripheral diaphragm

Question 20

Hiatal Hernia

Para-Esophageal Hiatal Hernia

Answer 20

Peritoneum punch and fundus of stomach extends through the esophageal hiatus (anterior to esophagus)
= NO Gastric regurgitation (since normal cardiac portion)

Question 21

Hiatal Hernia

Sliding Hiatal Hernia

Answer 21

Abdominal esophagus, cardiac of stomach and some fundus of stomach extend through the esophageal hiatus
= Regurgitation does happen

Question 22

Cause of Hiatal Hernia

Answer 22

Weakening of muscular diaphragm

Large amount of ABD fat

Question 23

Renal Hilum

Answer 23

Entrance to renal sinus (where BV, renal pelvis, N are in kidney)

Question 24

Which side of the kidney is lower

Answer 24

Right side due to the Liver above it

Question 25

Transpyloric Plane crosses

Answer 25

Hilum of left kidney, superior pole of right kidney, pyloris of stomach

Question 26

Where is the inferior role of the right kidney

Answer 26

1 index finger breath above iliac crest

Question 27

Kidney of anterior to which ribs

Answer 27

11 and 12, which protects it

Question 28

Which muscles cover the kidney

Answer 28

``` Quadratus Lumborum Transversus Abdominius (some more lateral) Psoas Major (Some more medial) ```

Question 29

Which 2 nerves run posterior to the right kidney and you have to be careful if you are doing a procedure from the back Which nerve goes to the Quadratus Lumborum which protects most of the kidney

Answer 29

Iliohypogastric N + Ilioingual N Subcostal (protected by 12th rib, going inferior to it)

Question 30

Perinephric fat

Answer 30

Next to or right around kidney capsule (extends to renal pelvis) Internal to renal fascia

Question 31

Renal Fascia

Answer 31

Fat over kidney and suprarenal glands (around renal vessels, continuous with inferior diaphragmatic fascia)- around the hiatus

Question 32

Paranephric fat

Answer 32

External to renal fascia

Question 33

Location of Ureter

Answer 33

Inf of renal pelvic brim and sling lateral pelvic wall + posterior to ducts deferens (m) or uterine A (f)

Question 34

Potential sites of obstruction of uterus

Answer 34

1. Nuncio of ureteric and renal pelvis 2. Crossing pelvic brim 3. Entering bladder wall

Question 35

Pyelogram

Answer 35

X-ray of ureter enhanced with contrast media

Question 36

Where is the right suprarenal gland located

Answer 36

Near the right crus, right kidney , and IVC

Question 37

Location of Left Suprarenal Glands

Answer 37

Near left crus, spleen, stomach, pancreas, and left renal

Question 38

A and N to the suprarenal glands

Answer 38

A : superior middle inferior suprarenal arteries and veins N: preganglionic sympathetic from T11-L1, Celiac plexus and abdominopelvic Splanchnic nerves

Question 39

Common iliac lymph nodes from and to

Answer 39

From external and internal iliac nodes | Drain into the lumbar lymph nodes

Question 40

Lumbar lymph nodes to and form

Answer 40

From posterior wall and posterior pelvic wall and organs + lumbar lymphatic trunks Runs along both sides of IVC and aorta

Question 41

Pre-aortic lymph nodes to and form

Answer 41

Becomes intestinal lymph nodes FROM into alimentary tract, liver, spleen, pancreas DRAIN into Cisterni chyli (beginning of thoracic duct)