Posterior wall

Question 1

Describe the posterior abdominal wall

Answer 1

Consists of

• five lumbar vertebrae and associated IV discs
• Posterior abdominal wall muscles, including the psoas, quadratus lumborum, iliacus, transverse abdominal and oblique muscles
• diaphragm which forms the superior
• Fascai
• Lumbar plexus
• Fat nerve vessels and lymph nodes

Question 2

Muscles of the posterior abdominal wall

Answer 2

• Psoas major
• Illiacus
• Quadratus lumborum

Question 3

Describe quadratus lumborum

Answer 3

Origin: medial half of inferior border of 12th ribs and tips of lumbar transverse processe

Inferior attachment: iliolumbar ligmanet and internal lip of iliac crest

Innervation: anterior branches of t12 and l1-4

Action: extends and laterally flexes vertebral column, fixes 12th rib during inspiration

Question 4

Discuss relations of the abdominal aorta

Answer 4

Anterior:

• Celiac plexus and ganglion
• body of the pancrease and splenic vein
• left renal veins
• horizontal part of the duodenum
• colis of small intestine

Posterior
-left lumbar vein

Right
-azygos, chyle cistern, thoracic duct right crus of diaphragm and right celiac ganglian

Left:

• left curs
• left celiac ganglian

Question 5

Describe the IVC

Answer 5

The largest vein in the body, valveless

Returns blood from the lower limbs and back, abdominal wall and abdominopelvic viscera back to the heart. Blood from the abdominal viscera pass through the portal system prior to entering the IVC

Begins at the level of L5 by the union of the common iliacs. Occur 2.5cm right of the median plane inferior to the bifurcation of the aorta

Ascends to the right of l3-l5, the aorta and the psoas major

Question 6

Describe the lymphatic of the posterior abdominal wall

Answer 6

Lymphatic and nodes lie along the aorta IVC and iliac vessels

The common iliac nodes receive lymph from the external and internal iliac lymph nodes. This then passes to the right and left lumbar lymph nodes

Lymph from the alimentary tract pass along the celiac, SMA and IMA to the prearotic lymph nodes

Efferents from these vessels form the intestinal lymphatic trunk these participate in the confluence of lymphatic trunks that give rise to the thoracic duct

The right and left lumbar lumph nodes lie on both sides of the IVC and Aorta. These receive lymph from the posterior abdominal wall, kidney ureters testes and ovaris uterus and uterine tubes. They also receive lymph from the descending colon, pelvic and lower limbs through the inferior mesenteric and common iliac lymph ndoes

Efferent lymphatic vessels from the alrge lumbar lyhmph nodes form the right and left lumbar lymphatic trunks

The inferior end of the thoracic duct lies anterior ot the bodies of the l1 and l2 vertebrae between the right crus of the diaphragm and the aorta. Begins with the convergence of the the main lymphatic ducts of the abdomen which can take the form of the chyle cistern. The convergence consists of

• left and right lumbar trunks
• intestinal lymph trunk and a pari of descending thoracic lymphatic trunks

Thoracic duct passes through the oesophageal hiatus and ends bye entering the venous system at the junction of the left subclavian and internal jugular veins