Posterior Abdominal Wall Flashcards

1
Q

Summarise the contents of the posterior abdominal wall

A
  • 5 lumbar vertebrate and IV discs, - IVC and aorta, - Paravertebral gutters (Muscles and kidneys)
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2
Q

Name the posterior abdominal wall muscles

A
  • Psoas major, - Psoas minor, - Iliacus, - Quadratus Lumborum - (diaphragm)
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3
Q

Name the origins and insertions of Quadratus Lumborum

A

O - Inferior boarder of 12th rib and the transverse processes of L1-4 vertebrae. I - Iliolumbar ligament and Iliac crest

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4
Q

Describe the action of Quadratus lumborum and its nerve innervation

A

Action - Pulls down the 12th rib which helps with the descent of the diaphragm in inspiration and lateral flexion. N - T12 to L4

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5
Q

Name the origins and insertions of psoas major

A

Origins - Transverse processes of lumber vertebrate, bodies of T12-L4 and the IV disks. Insertion - Lesser trochanter

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6
Q

Name the actions and innervation of psoas major

A

Action - Flexion of the thigh and trunk and lateral flexion of the vertebral column. N - L1 to L3

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7
Q

Name the origin, insertion and innervation of psoas minor

A

Origins - Bodies of T12 to L1, Insertions - Pectineal line and iliopectineal eminence. N - L1

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8
Q

Name the origins, insertions, action and innervation of Iliacus muscle

A

Origins - Iliac fossa, Iliac crest and anterior sacroiliac ligament. Inserts - Lesser trochanter, Action - Femoral flexion of the thigh, Innervation - Femoral nerve (L2-4)

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9
Q

What is the function of the femoral sheath and what is it continuous with?

A

It is a continuous with transversalis and iliac fascia. Its function is to separate the space between the inguinal ligament and hip bone into muscular and vascular compartments

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10
Q

What is the function of the muscular and vascular compartments?

A

Muscular compartment transmits psoas major, iliacus muscles and femoral nerve. Vascular - Transmits femoral vessels

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11
Q

Name the boundaries of the femoral canal

A

Anterior - Inguinal Ligament, Posterior - pectineus Medial - Lacunar ligament, Lateral - Femoral vein. It is then closed by extraperitoneal tissue

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12
Q

Explain why femoral hernias occur

A

The femoral ring is a weak area and so is often associated with abnormal protrusion of the abdominal organs into the femoral canal. Femoral hernias are more prone to strangulation than inguinal hernia

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13
Q

Why are femoral hernias more common in women?

A

Because the in men the inguinal canal is larger due to the spermatic cord and descent of the testies.

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14
Q

What are dermatomes and mytomes?

A

Dermatome - Strip of skin supplied by specific spinal nerve Myotome - Froup of muscle fibres supplied by a specific spinal nerve

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15
Q

What is the nerve supply of the abdominal wall?

A

T7 - L1 spinal nerves. They pass between internal oblique and transversus abdominis

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16
Q

Describe where referred pain is from when pain presents in the epigastrium, the umbilicus and the pubic region

A

T6-7 (epigastrium) - Pain from stomach and oesophagus. T10 (umbilicus) - Appendix, gonads and small intestine. T12 (pubic region) - Lower colon, bladder and uterus

17
Q

Describe the appearance of herpes zoster (shingles)

A

The rash can form a band along the course of a nerve/dermatome as the virus remains inactive in nerve cells. Reactivation of the virus causes shingles

18
Q

Label the branches of the lumbar plexus

A

1) Iliohypogastric (L1), 2) Ilioinguinal (L1), 3) Genitofemoral (L1,L2) 4) Lateral femoral cutaneous , 5) Obturator (L2,3,4), 6) Femoral (L2,3,4) 7) To lumbrosacral trunk

19
Q

Where does the lumbar plexus form and what does it supply?

A

It forms in the psoas major muscle and goes on to supply abdominal muscles and extensor and adductor compartments of the thigh

20
Q

Describe the arterial supply

A
  1. Intercostal arteries, 2. Lumbar arteries (branches of abdominal aorta) 3. Superior epigastric arteries (branch of ITA and descends behind rectus abdominis) 4. Inferior epigastric artery, 5. Superior epigastric artery. 6. Superficial circumflex iliac artery. 7. Deep circumflex iliac artery
21
Q

Describe the venous drainage of the abdomen

A

Veins radiate from the umbilicus. They eventually drain into femoral and external iliac veins inferiorly and the internal thoracic and axillary veins superiorly. Superficial epigastric and circumflex iliac drain to great saphenous

22
Q

Desribe the anterior superficial lymphatic drainage

A

Above umbilicus - Anterior axillary nodes. Below umbilicus - Superficial inguinal nodes

23
Q

Describe the posterior superficial lymphatic drainage

A

Above iliac crests - Posterior axillary nodes. Below iliac crests - Superficial inguinal nodes

24
Q

Describe the deep lymphatic drainage

A

Drain alongside epigastric vessels either superiorly to parasternal nodes then to mediastinal nodes or inferiorly to external iliac and then para-aortic nodes.

25
Q

Describe the presentation of psoas abscess

A

Infection passes into psoas muscle sheath and spreads within the muscle sheath. May appear as mass below inguinal lig

26
Q

What is Meralgia paresthetica

A

characterized by tingling, numbness and burning pain in the outer part of your thigh caused by compression of the lateral femoral cutaneous nerve