Posterior Abdominal Wall and Respiratory Diaphragm

Question 1

psoas major m

Answer 1

inn - L2,L3, L4

action - bilaterally flexes thigh at the hip, unilaterally side bends trunk to the same side

Question 2

illiacus m

Answer 2

inn - femoral n

actions - plexus thigh at hip

Question 3

pasoas minor m

Answer 3

inn - L1 and L2
actions - depresses 12th rib, fixes 12th rib during deep inspiration, assists with trunk extension, side-bends trunk to same side

Question 4

quadratus lumborum m

Answer 4

inn - T12-L4

actions - extends and laterally flexes vertebral column, fixes rib 12 during inspiration

Question 5

psoas syndrome

Answer 5

lumbosacral pain
difficultly standing up straight
pain in the contralateral gluteal region
radiation of pain down the lower extremity
may mimic herniated disk

Question 6

respiratory diaphragm

Answer 6

R and L domes w/ depression (for heart) between them
when relaxed superior surface extends up as fas as 5th rib
boundaries - xiphisternal joint, costal margin, body of T 12

Question 7

Sternal origin of central tendon

Answer 7

R and L muscular slits that originate on posterior surface of xiphoid

Question 8

right crus

Answer 8

longer, L1-L3

forms the muscular esophageal hiatus

Question 9

left crus

Answer 9

shorter, L1 & L2

more lateral

Question 10

caval opening

Answer 10

T8, in central tendon

IVC, branches of the R phrenic n, lymphatic from liver

Question 11

esophageal hiatus

Answer 11

T10, formed and encircled by fibers of the R crus transmits

esophagus, anterior and posterior vagal trunks esophageal branches of left gastric a.

Question 12

aortic hiatus

Answer 12

T12, behid the junction of the R and L crura

aorta, thoracic duct, azygous vien

Question 13

sternocostal hiatus

Answer 13

located b/w sternal and costal parts of diaphragm
weak spot with potential for herniation
superior epigastic vessels

Question 14

Median arcuate ligament

Answer 14

connects the two crura anterior to the aortic hiatus

aortic hiatus

Question 15

medial arcuate ligament

Answer 15

fascial thickening over the superior part of the psoas major
extends from lateral part of body of L1 or L2 to the transverse process of same vertebra
gap for psoas major m and sympathetic trunk

Question 16

lateral arcuate ligament

Answer 16

fascial thickening over the superior part of the quadratus lumborum
extends from L1 transverse process to the tip of rib 12
gap for quadratus lumborum and supcostal n and vessels

Question 17

parasternal hernias

Answer 17

sternocostal triangle

located b/w the sternal and costal parts of the diaphragm

Question 18

pleuroperitoneal hernias

Answer 18

lumbocostal triangle

located b/w the 12th rib and diaphragm

Question 19

congenital diaphragmatic hernia

Answer 19

failure of pleuroperitoneal membranes to fuse with other components of the diaphragm
respiratory distress and cyanosis in the 1st minutes or hours of life
unusually flat abdomen

Question 20

Superior blood supply to diaphragm

Answer 20

pericardiacophrenic a - internal thoracic a.
musculophrenic a - internal thoracic a.
superior phrenic a - descending a.

Question 21

Inferior blood supply to diaphragm

Answer 21

inferior phrenic a
right - passes posterior to IVC
left - passes posterior to esophagus

Question 22

Motor innervation of the diaphragm

Answer 22

phrenic n (C3, C4, C5)
some branches run with inferior phrenic a
only motor innervation

Question 23

Sensory innervation of the diaphragm

Answer 23

central portion (central tendon) - phrenic n. 
Peripheral portion - intercostal n. T9-11

Question 24

superior lymphatics to diaphragm

Answer 24

anterior - anterior diaphragmatic nodes - parasternal

posterior - posterior diaphragmatic nodes - mediastinal nodes

Question 25

inferior lymphatics to diaphragm

Answer 25

celiac nodes | superior lumbar nodes

Question 26

costal origin of central tendon

Answer 26

muscular spits that originate from deep surfaces of lower 6th ribs and interdigitate with transversus abdominis

Question 27

lumbar origin of central tendon

Answer 27

arises from crura and arcuate ligaments

Question 28

common iliac nodes

Answer 28

lymph from the lower limbs, perineum, and gluteal region via the inguinal nodes drain into the aortic nodes

Question 29

aortic (lumbar) lymphatic trunks

Answer 29

drainage from the lower limbs, perineum, and gluteal region via the common iliac nodes directly - posterior abdominal wall, kidney, ureters, gonads, uterus, urine tubes indirect - IM nodes drains to cisterna chyli (L1 & L2)

Question 30

visceral lymphatics

Answer 30

``` drain lymph from the digestive system and associated glands IM nodes lateral aortic nodes SM nodes Celiac nodes ```

Question 31

cisterna chyli

Answer 31

``` dilation at the end of the thoracic duct drainage from L and R lumbar trunks the intestinal trunk descending thoracic lymph trunks ```

Question 32

celiac lymph

Answer 32

liver, stomach, spleen, pancreas, uper duodenum

Question 33

superior mesenteric lymph

Answer 33

lower duodenum, jejunum, ileum, colon

Question 34

inferior mesenteric lymph

Answer 34

colon

Question 35

internal iliac lymph

Answer 35

lower rectum to anal canal above pectinate line, bladder, vagina, prostate

Question 36

para-aortic lymph

Answer 36

testes, ovaries, kidneys, uterus

Question 37

superficial inguinal lymph

Answer 37

anal canal below pectinate line, most skin below umbilicus, scrotum

Question 38

deep inguinal lymph

Answer 38

lower extremity

Question 39

greater sac

Answer 39

accessed by incision to the ant abdominal wall

Question 40

lesser sac

Answer 40

post to stomach and lesser omentum

Question 41

supracolic compartment

Answer 41

stomach, liver, spleen

Question 42

infracolic compartment

Answer 42

SI, ascending and descending colon | further divided by the mesentery of the SI to the R/L infracolic spaces

Question 43

paracolic gutters

Answer 43

areas b/w lateral aspects of the ascending and descending colon and posterior abdominal wall allows for free communication b/w the supracolic and infracolic compartments

Question 44

phrenicolic ligament

Answer 44

prevents spread of fluid superiorly