Posterior wall and diaphragm

Question 1

What are the origins and insertion of the quadratus lumborum?

Answer 1

Originates on the iliac crest and 2-4 lumber transverse processes

Inserts on the 12th rib

Question 2

There are little gaps in the diaphragm called sternocostal triangles: what do they separate? what goes through them?

Answer 2

Superior epigastric vessels go through the sternocostal triangles

Sternocostal triangles separate the sternal portion from the costal portion

Question 3

What forms the esophageal hiatus and the suspensory ligament of the duodenum?

Answer 3

The right crus

Question 4

What is formed by the joining of the right and left crus?

Answer 4

Median arcuate ligament –> aortic hiatus

Question 5

Where is the medial arcuate ligament?

Answer 5

From the thickenings of the thoracolombar fascia to the psoas major muscle

Forms a fibrous arch that attaches to L1/L2

Question 6

Where is the lateral arcuate ligament?

Answer 6

From the transverse process of the first lumbar vertebrae to the 12th rib

Question 7

What is the blood supply to the posterior diaphragm?

Answer 7

Superior phrenic arteries…direct branches off the thoracic aorta

Question 8

What supplies the central area of the diaphragm?

Answer 8

The pericardiacophrenic arteries…branches of th internal thoracic arteries

Question 9

What supplies the periphery of the diaphragm?

Answer 9

Musculophrenic arteries…one of the terminal branches of the internal thoracic arteries

Question 10

What is the major source of blood to the diaphragm?

Answer 10

Inferior phrenic arteries…first branches of he aorta in the abdomen

Question 11

What is the primary venous flow from the diaphragm?

Answer 11

Inferior phrenic v –> suprarenal v –> renal v

Question 12

What is the motor innervation of the diaphragm?

Answer 12

Phrenic nerves…C3,4,5 keeps the diaphragm alive

Question 13

What is the afferent sensation of the diaphragm?

Answer 13

Phrenic nerve

Intercostal nerves

Question 14

Where is the cisterna chyli?

Answer 14

Between the aorta and right crus of the diaphragm…behind the median arcuate ligament

Question 15

What does the cisterna chyli drain into?

Answer 15

The thoracic duct

Question 16

What are tributaries of cisterna chyli?

Answer 16

Lumbar lymph trunks

Intestinal lymph trunks

Question 17

What are the 7 branches of the lumbar plexus from top to bottom?

Answer 17

Ilioinguinal and iliohypogstric (L1)
Genitofemoral (L1-2)
Lateral femoral cutaneous nerve (L2-3)
Obturator nerve (L2-4)
Femoral Nerve (L2-4)
Lumbosacral trunk (0.5 of L4 and L5)

Question 18

What does the lumbosacral trunk do?

Answer 18

Descends into pelvis to join 1st sacral nerve…helping form the sacral plexus