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Abdomen > Posterior Abdominal Wall and Lumbar Plexus > Flashcards

Posterior Abdominal Wall and Lumbar Plexus Flashcards

1
Q

What are the three layers of the Thoracolumbar Fascia? Which is the layer that covers the quadratus lumborum?

A

Anterior, Middle and Posterior layer.

It is the anterior layer that covers the quadratus lumborum

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2
Q

Which layer of fascia covers the Psoas Major muscle? What is it’s clinical correlation

A

Psoas fascia

Can get inflammatory collections from spinal cord and track down to groin where it is thinnest

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3
Q

What is the fascia that is continuous with the Psoas fascia?

A

Iliac Fascia

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4
Q

What is the fascia that covers the kidney and associated areas? Name the exact areas that it covers.

A

Peri-renal fascia

Bi-laminated fascia over:
Kidneys
Suprarenal gland
Upper ureter
Fat
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5
Q

Which is the fascia in the thoracolumbar region that fuses with the Transversalis Fascia?

A

Lateroconal fascia (this is the lateral aspect of peri-renal fascia)

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6
Q

Which are the two muscles that form the conjoined tendon?

A

Psoas Major and Iliacus

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7
Q

What is the origin and insertion of the Psoas Major

A

Origin: Transverse processes of T12-L5

Insertion: Lesser trochanter of femr (along with Iliacus

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8
Q

What are the major relations of the psoas Major?

A

Lies anterior to lumbar plexus

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9
Q

What is the innervation of the Psoas Major

A

Femoral Nerve (anterior br. of L2-L4)

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10
Q

What are the relations of the Psoas Minor

A

Inferolateral to sides of T12-L5 bodies

Anterior to Psoas Major

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11
Q

What is the origin and insertion of the Psoas Minor

A

Origin: Bodies of T12 and L1

Insertion: Pectineal Line (Pectin Pubis)

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12
Q

What is the innervation of the Psoas Minor

A

Anterior rami of L1

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13
Q

What are the relations of the Iliacus Muscle

A

Lateral to the inferior part of the Psoas Major

In the Iliac Fossa

Forms conjoined tendon along with Psoas Major - which is deep to Inguinal Ligament

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14
Q

What is the innervation of the Iliacus

A

Femoral Nerve (L2-L4)

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15
Q

What is the origin of the Quadratus Lumborum

A

From the Transverse processes of the Lumbar vertebrae and 12th rib

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16
Q

What are the relations of the Quadratus Lumborum

A

Lateral to superior part of Psoas Major

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17
Q

What is the innervation of the Quadratus Lumborum

A

Anterior branches of T12-L4

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18
Q

What is the action of the Psoas Major

A

Flexes the thigh

Flexes vertebral column laterally

Helps to balance the trunk

Helps to flex trunk when sitting

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19
Q

What is the action of the Iliacus

A

Flexes thigh

Stabilises hip joint

20
Q

What is the action of Quadratus Lumborum

A

Extends and laterally flexes vertebral column

Fixes 12th rib during inspiration

21
Q

At what level does the abdominal aorta bifurcate into left and right common iliac arteries?

A

L4

22
Q

What are the branches of the adominal aorta in the anterior midline? What are the levels?

A 
Celiac (T12)
Superior Mesenteric (L1)
Inferior Mesenteric (L3)
23
Q

What are the branches of the abdominal aorta laterally? What are their levels?

A

Suprarenal (L1)
Renal (L1)
Gonadal - Testicular or Ovarian (L2)

24
Q

What are the branches of the abdominal aorta in the posterolateral plane? What are their levels?

A 
Middle Sacral (L4)
Inferior Phrenic (T12)
Lumbar (L1-L4)
25
Q

At what level is the union of the common iliac veins? What do they form?

A

L5

Form Inferior vena cava

26
Q

Where does the median sacral vein drain?

A

Into the left iliac vein

27
Q

What are the plexuses that ANS travel through to get to the Abdominal Viscera

A

Coeliac Plexus
Superior and Inferior Mesenteric Plexuses
Hypogastric Plexus

28
Q

What are the relations of the Hypogastric Plexus

A

Travels with the Internal Iliac artery and Inferior Mesenteric Artery

29
Q

What are the nerves that supply the Hypogastric Plexus

A

Sympathetic verves from T10-L2

Parasympathetic Plevic Splanchnic nerves from S2-S4

30
Q

What are the main nerves supplying the parasympathetic and sympathetic components of the Abdominal Viscera

A

Sympathetic:

  • Thoracic Splanchnic (Greater, Lesser and Least)
  • Lumbar Trunk

Parasympathetic:

  • Vagus (ant. and post. trunks)
  • Pelvic splanchnic nerves
31
Q

Describe the main visceral plexus of the Abdomen

A

Lumbar plexus

From ant. primary rami of L1-L4

Deep to and within Psoas Major

32
Q

What are the branches of the Lumbar Plexus and what forms them?

A

Iliohypogastric - L1

Ilioinguinal - L1

Genitofemoral -L1 and L2

Lateral cutaneous n. of the thigh - Post. div. of L2-L3

Obturator - ant. div. of L2-L4

Femoral - post. div. of L2-L4

33
Q

Which branch of the Lumbar plexus communicates with the lumbosacral trunk

A

L4

34
Q

What are the Ligaments of the Posterior part of the diaphragm and their respective relations?

A

Median arcuate Ligament:

  • T12
  • Fibro-osseous tunnel

Medial arcuate ligament:

  • Arch over Pdoas Major
  • From median lig. to tip of L1 Transverse Process

Lateral arcuate ligament:

  • Over quadratus lumborum
  • From tip of L1 transverse process to tip of 12th rib
35
Q

What are the levels of the crura of the diaphragm

A

Rt. crus: L1-L3

Lt. crus: L1-L2

36
Q

What passes through the aortic opening of the diaphragm? What level is this

A

T12

Aorta
Thoracic duct
Left and right ascending Lumbar Vessels

37
Q

What passes through the oesophageal opening? What level is this?

A

T10

Oesophagus
Anterior and Posterior Vagal Trunks

38
Q

What passes through the Caval Opening? What level is this?

A

T8

IVC
Rt. Phrenic Nerve

39
Q

How do the Thoracic Splanchnic nerves pass through the diaphragm?

A

Through crura

40
Q

How do the Sympathic trunks pass through the diaphragm

A

Through medial arcuate ligament.

41
Q

How do the subcostal nerves pass through the diaphragm

A

Through the Later arcuate lig.

42
Q

How do the branches of the left phrenic nerve pass through the diaphragm?

A

Through the left dome of the diaphragm

43
Q

How do the sup. epigastric vessels and lymphatics pass through the diaphragm?

A

Between diaphragmic attachments to the Xiphoid and 7th costal cartilage

44
Q

How do the Intercostal neurovascular bundles pass through the diaphragm? Which ones are they?

A

7th - 12th neurovascular bundles

Pass between costal slips of origin of diaphragm

45
Q

What is the arterial supply to the diaphragm?

A

Superior surface:

  • Pericardiacophrenic aa
  • Musculophrenic aa.
  • —-Both are branches of the Internal thoracic artery—–

Inferior surface:

  • Inferior Phrenic arteries
  • —-First branches of the Abdominal Aorta—–
46
Q

What is the venous drainage of the diaphragm?

A

Superior surface:

  • Pericardiacophrenic vv
  • Musculophrenic vv
  • —-Both are branches of the Internal thoracic vein—–
  • Superior phrenic v. on right (drains into SVC)

Inferior surface:
-Inferior Phrenic vv.

Abdomen (10 decks)

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