Posterior Abdominal Wall Musculature (and Lymphatics)

Question 1

Psoas Major

Answer 1

• Origin:
  
  • Lateral aspects and transverse processes of vertebral bodies and discs of T12-L5
• Insertion:
  
  • Lesser trochanter of femur via common tendon with iliacus (iliopsoas tendon)
• Innervation:
  
  • L2,L3,L4 via lumbar plexus
• Action:
  
  • Flexes thigh at hip
  • with feet fixed flexes trunk at thigh (at the hip joint. Acting unilaterally side-bends trunk to same side

Question 2

Psoas Minor

Answer 2

• Origin:
  
  • Lateral aspects of bodies of T12 and L1, plus their intervening discs
• Insertion:
  
  • Pectineal line on superior ramus of pubis
• Innervation:
  
  • L1, (L2)
• Action:
  
  • Assists in extension and flexion of trunk
  • acting unilaterally side-bends trunk to same side

Question 3

What is the most lateral muslce of the posterior abdominal wall

Answer 3

Quadratus lumborum

Question 4

Quadratus lumborum

Answer 4

• Origin:
  
  • Iliac crest and iliolumbar ligament
• Insertion:
  
  • Medial half of inferior border of 12th rib
  • tips of lumbar transverse processes
• Innervation:
  
  • T12-L4
• Action:
  
  • Extends and laterally flexes vertebral column
  • fixes rib 12 during inspiration

Question 5

Iliacus

Answer 5

• Origin:
  
  • Iliac fossa of pelvis
• Insertion:
  
  • Lesser trochanter of femur via common iliopsoas tendon
• Innervation:
  
  • Femoral Nerve (L2,L3,L4)
• Action:
  
  • Flexes thigh at hip.
  • with lower limb fixed, flexes pelvis on thigh

Question 6

The superior surface of respiratory diaphragm extends upward as far as ____ rib

Answer 6

5th

Question 7

Boundaries of respiratory diaphragm

Answer 7

• Xiphisternal joint
• Costal margin
• Body of TV12

Question 8

Three peripheral orgins of the respiratory diaphragm inserts on central tendon

Answer 8

• Sternal origin
• Costal origin
• Lumbar origin

Question 9

posterior origins of diaphragm form ____ ligaments over posterior wall structures

Answer 9

arcuate

Question 10

The median arcuate ligament is over the ___

Answer 10

aorta

Question 11

The medial arcuate ligaments are over the

Answer 11

• psoas major
• Sympathetic trunks

Question 12

The lateral arcuate ligaments are over

Answer 12

• quadratus lumborum
• subcosta nerves, arteries, and veins

Question 13

Arcuate ligaments are also called

Answer 13

• lumbocostal arches
  
  • Median lumbocostal arch
  • medial lumbocostal arch
  • lateral lumbocostal arches

Question 14

The Vertebrocostal (lumbocostal) triangle is a potential site of what clinical significance

Answer 14

potential site for hernias

Question 15

Respiratory Diaphragm openings

Answer 15

• Aortic hiatus (T12)
  
  • aorta
  • thoracic duct
• Esophageal hiatus (T10)
  
  • esophagus
  • esophageal branches of left gastric artery
  • anterior and posterior Vagal trunks
  • lymphatics
• Vena Caval foramen (T8)
  
  • Inferior vena cava
  • terminal branches of right phrenic nerve
  • lymphatics from the liver
• Sternocostal hiatus
  
  • superior epigastric vessels

Question 16

Vessels of Diaphragm

Answer 16

• superior surface
  
  • pericardiacophrenic
  • musculophrenic
  • superior phrenic artery
• Inferior surface
  
  • inferior phrenic artery and vein
    
    • from celiac trunk or aorta, right passes posterior ot IVC, left posterior to esophagus, posterior branches give off superior suprarenal artery

Question 17

Nerves of Diaphragm

Answer 17

• Motor nerves
  
  • Phrenic nerve (C3,C4,C5)
  • branches run with inferior phrenic artery
• Sensory nerves
  
  • Phrenic nerve carries sensory nerves from central tendon
  • intercostal nerves carry sensory fibers from peripheral part

Question 18

Nerves of posterior abdominal wall

Answer 18

• Subcostal (T12)
• Iliohypogastric (T12)
• Ilioinguinal (L1)
• Lateral cutaneous nerve of thigh (L2,L3)
• Genitofemoral nerve (L1,L2)
• Femoral (L2-L4)

Question 19

Aortic bifurication is at what vertebral level

Answer 19

L4

Question 20

Sympathetic innervation of gut involves what two pathways

Answer 20

• Splanchnic
• Suprarenal

Question 21

which kidney is higher the left or right

Answer 21

the left

Question 22

After secretion, urine runs from ______ to minor calyses, to major calyses to the ___ and finally the ureter

Answer 22

After secretion, urine runs from renal papillae to minor calyses, to major calyses to the renal pelvis and finally the ureter