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GI-Midterm > Posterior Abdominal Wall & Resp Diaphragm-1-11-16 > Flashcards

Posterior Abdominal Wall & Resp Diaphragm-1-11-16 Flashcards

1
Q

What is the proximal attachment for Psoas major m.?

What is the distal attachment for Psoas major m.?

What is its innervation?

What is its Actions?

A

Lateral aspects & transverse processes of T12-L5

Lesser trochanter of femur (via common tendon w/ iliacus m.

L2-L4 (via lumbar plexus)

Bilaterally: flex thigh at hip; Unilaterally: sidebends trunk to same side

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2
Q

What is the proximal attachment of Iliacus m.?

What is the distal attachment of Iliacus m.?

Innervation?

Actions?

A

Iliac fossa of pelvis

Lesser trochanter of femur (via common tendon w/ Psoas major m.)

Femoral n.

Flex thigh at hip

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3
Q

What is the proximal attachment for Psoas Minor m.?

What is the distal attachment for Psoas minor m.?

Innervation?

Actions?

A

Lateral aspects of T12-L1

Pectineal line (superior pubic ramus)

L1 and L2

Depresses 12th rib
FIXES 12th RIB (DURING DEEP INSPIRATION)
Bilaterally: assists with trunk extension
Unilaterally: side-bends trunk to same side

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4
Q

What is the proximal attachment for Quadratus lumborum m.?

What is the distal attachment for Quadratus lumborum m.?

Innervation?

Actions?

A

Iliac crest and Iliolumbar ligament

Medial half of inferior border of 12th rib & tips of lumbar TP

T12-L4

Extends and laterally flexes vertebral column
Fixes Rib 12 during inspiration

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5
Q

A patient presents with pain in the lower back (lumbosacral region) and has a difficult time standing up straight. The pain radiates down the lower extremity and stops at the knee. What does this patient likely have?

A

Psoas syndrome

May mimic herniated disk

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6
Q

Where does the right renal artery branch off of the aorta relative to the IVC?

A

Right renal a. Goes behind the IVC

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7
Q

What are the borders of the respiratory diaphragm?

A

Xiphisternal joint
Costal margin
Vertebral body of T12 (Right and left domes; Superior surface can extend to 5th rib)

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8
Q

What are the peripheral origins that insert onto the central tendon of the diaphragm?

A

Sternal origin
Costal origin
Vertebral origin

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9
Q

The right and left crus meet to form and surround this hiatus:

A

Aortic hiatus

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10
Q

What comes out of the Caval opening at T8?

A

IVC
Branches of Right Phrenic n.
Lymphatics from liver

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11
Q

What comes out of the Esophageal hiatus at T10?

A

Esophagus
Anterior and Posterior Vagal trunks
Esophageal branches of Left gastric a.

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12
Q

What comes out of the Aortic hiatus at T12?

A

Aorta
Thoracic duct
Azygous vein

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13
Q

What comes out of the Sternocostal hiatus of the respiratory diaphragm?

A

Superior epigastric vessels

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14
Q

This ligament is a gap for Psoas Major muscles and sympathetic trunk:

A

Medial Arcuate

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15
Q

This ligament creates an opening for the aortic hiatus (connects the 2 crura anterior to the aortic hiatus):

A

Median Arcuate

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16
Q

This ligament creates a gap for Quadratus lumborum muscle and subcostal nerves and vessels:

A

Lateral Arcuate

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17
Q

Where do diaphragmatic hernias usually occur?

A

The left side due to protection of the right hemidiaphragm by the liver

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18
Q

A patient comes in to your office with a diaphragmatic hernia in the sternocostal triangle of the respiratory diaphragm. What type of hernia is this?

A

Parasternal hernia-In the sternocostal triangle (anterolateral gap) located between the sternal and costal parts of diaphragm

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19
Q

A patient comes in to your office with a diaphragmatic hernia in the lumbocostal triangle region of the respiratory diaphragm. What type of hernia is this?

A

Pleuroperitoneal hernia-In the lumbocostal triangle located between the 12th rib and the diaphragm

20
Q

A neonate has gone into respiratory stress and is cyantoic within minutes after being born and presents with an unusually flat abdomen. His pleuroperitoneal membranes had failed to fuse with the other components of the diaphragm. What is the likely diagnosis?

A

Congenital diaphragmatic hernia

21
Q

What type of hernia is characterized by the fundus of the stomach extending through the esophageal hiatus and usually does NOT present with regurgitation of gastric contents?

A

Paraesophageal hiatal hernia

22
Q

What type of hernia is characterized by the abdominal esophagus, cardia, and fundus of the stomach sliding superiorly into the thorax?

A

Sliding hiatal hernia

23
Q

What is the blood supply to the superior surface of the diaphragm?

A

Pericardiophrenic a.
Musculophrenic a.
Superior phrenic a.

24
Q

What is the blood supply to the inferior surface of the diaphragm?

A

Inferior Phrenic a.:

Right inferior phrenic a. –> passes posterior to IVC
Left inferior phrenic a. –> passes posterior to esophagus

25
Q

What is the motor innervation to the diaphragm?

A

Phrenic n. –> C3-C5

Some branches run with the inferior phrenic a.

26
Q

What is the sensory innervation of the diaphragm

A

Central portion (central tendon): Phrenic n.

Peripheral portion: Intercostal n.

27
Q

Where do the anterior diaphragmatic nodes drain?

A

Anterior diaphragmatic nodes –> PARASTERNAL NODES

28
Q

Where do the posterior diaphragmatic nodes drain?

A

Posterior diaphragmatic nodes –> MEDIASTINAL NODES

29
Q

Where does the lymph of the inferior surface of the diaphragm drain?

A

Celiac nodes

Superior lumbar nodes

30
Q

Describe lymphatic drainage from the Lower extremity, perineum, and gluteal region:

A

Travels through abdomen –> Thoracic duct (forms L1-L2)

31
Q

Describe lymphatic drainage from the body wall:

A

Lumbar lymphatic trunks –> Thoracic duct

32
Q

Describe lymphatic drain of the GI tract:

A

Enters intestinal lymph trunks –> Thoracic duct

33
Q

Which lymph nodes drain into the Intestinal Lymphatic Trunk?

A

Celiac nodes
Superior Mesenteric nodes
Lumbar nodes
Inferior Mesenteric nodes

34
Q

This dilation at the end of the thoracic duct collects lymph from intestinal lymphatic trunks and lumbar lymphatic trunks. It is also a Retroperitoneal structure (posterior to aorta around L1-L2):

A

Cisterna Chyli

35
Q

List the area drained from the Celiac nodes:

A

Liver, stomach, spleen, pancreas, upper duodenum

36
Q

List the area drained from the superior mesenteric nodes:

A

Lower duodenum, jejunum, ileum, colon up to the splenic flexure

37
Q

List the areas drained by the inferior mesenteric nodes:

A

Colon from splenic flexure to upper rectum

38
Q

List the areas drained by the internal iliac nodes:

A

Lower rectum to anal canal (above pectinate line), bladder, vagina (middle 1/3), prostate

39
Q

List the areas drained by the para-aortic nodes

A

Testes, ovaries, kidneys, uterus

40
Q

List the areas drained by the superficial inguinal nodes:

A

Anal canal (below pectinate line), most skin below umbilicus, scrotum

41
Q

List areas drained by the deep inguinal nodes:

A

Lower extremity

42
Q

Which organs are within the supracolic compartment?

A

Stomach, liver, spleen

43
Q

Which organs are within the infracolic compartment?

A

SI and ascending and descending colon

Further divided by the mesentery of the SI into right and left infracolic spaces

44
Q

These are the areas between lateral aspects of ascending and descending colon and the posterior abdominal wall and allows for free communication between the supracolic and infracolic compartments

A

Paracolic gutters

45
Q

This ligament prevents the spread of fluid superiorly:

A

Phrenicocolic ligament

46
Q

What are the Posterior abdominal wall muscles?

A

Psoas minor
Psoas Major
Quadratus lumborum
Iliacus

GI-Midterm (11 decks)

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