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
  
  • median arcuate ligament
    
    • over aorta
  • medial arcuate ligaments
    
    • over psoas major mm.
    • sympathetic trunks
  • Lateral arcuate ligaments
    
    • over quadratus lumborum mm.
    • subcostal nerve, artery, and vein

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) (only motor nerves of diaphragm)
    
    • 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
• The left kidney superior pole is at T11
• The right kidney superior pole is at T12

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

Question 23

Answer 23

Question 24

Question 25

Question 26

Answer 26

Question 27

Question 28

Question 29

Answer 29

Question 30

Question 31

Question 32

Question 33

Question 34

Question 35

Question 36

Question 37

Question 38

Answer 38

• Iliacus

Question 39

Answer 39

• Quadratus lumborum

Question 40

Answer 40

• Psoas Mino

Question 41

Answer 41

• Psoas Major