Posterior wall Of Abdomen Flashcards
The para vertebral gutters are where
Either side of the lumbar vertebral column
Posterior abdominal wall is composed of what
Five lumbar vertebrae Diaphragm Thoracolumbar fascia Lumbar plexus Posterior abdominal muscles - psoas - quadratus lumborum - iliacus - transverse abdominal - lateral oblique muscles
The deepest part of the para vertebral gutters is occupied by what
The kidneys
What lies in the anteriorly protruding vertebral column
The abdominal aorta
In lean individuals where is the abdominal aorta
Close to the anterior abdominal wall
What covers the posterior abdominal wall
A continuous layer of endoabdominal fascia
The psoas facia covers what
Psoas major
What is very long and foes all the way to the femur
The psoas fascia
What is thick and strong in the lumbar region and thin and transparent in the region where it covers the thoracic parts of the deep muscle
Thoracic bar fascia
the anterior layer of the thoracolumbar fascia covers what
Quadratus lumborum
When the following of these are diseased what happens what follows
Pancreas Lumbar lymph nodes Ureters Cecum Sigmoid colon
Movement of the iliopsoas is painful
Iliopsoas test
Having someone lie on their side and push their leg against the resistance of a hand, if pain occurs intra- abdominal inflammation may be present
Inflamed appendix- right psoas pain
What may cause spasm of the iliopsoas as a protective reflex
Disease of the intervertebral and sacral joints
Tb of vertebral column is what
Very common
Hematogenous spread
Infection spreading through the blood to the vertebrae
An abscess form TB in the lumbar region can do what
Spread from the vertebrae into the psoas sheath where it can make a psoas abscess
Pus from a psoas access usually surfaces where
In the thigh
What is another way that pus can reach the psoas sheath
By passing from the posterior part of the manubrium when the thoracic vertebrae is diseased
The posterior abdominal wall has what kind of nervous system
Autonomic and somatic
Partial lumbar sympathectomy
When the surgeon splits the muscles of the anterior abdominal wall and moves the peritoneum medically and exposes the edge of the psoas major
The relationship of the sympathetic trunk to the aorta and Ivc can make these large vessels do what
Be vulnerable to injury during lumbar sympathectomy
The lumbar plexus nerve network is composed of what
Anterior rami l1-l4
Femoral nerve
L2-l4 comes from the lateral border of the psoas major
Obturator nerve
L2-l4 from the medial border of the psoas major and goes to the lesser pelvis
What passes over the ala(wing) of the sacrum and descends to the pelvis to form the sacral plexus with anterior rami s1-s4
Lumbosacral trunk
What nerves run superior and parallel to the Iliad crest and pierce the transverse abdominal near the anterior superior iliac spin (Asia)
Ilioinguinal
Iliohypogastric
What nerve perches the psoas major and runs inferiority on its anterior surface
Genitofemoral nerve
Which nerve runs along the iliacus and enters the thigh deep to the inguinal ligament
Lateral femoral cutaneous nerve
What nerve is only present 10% of the time
Accessory Obturator nerve
Length of abdominal aorta
13cm
Abdominal aorta begins where
At the abdominal hiatus in the diaphragm (t12) and ends at the level of L4 because it divides into right and left
Just before leaving the abdomen the external iliac artery gives rise to what
Deep circumflex a. And inferior epigastric a.
Since the aorta lies posterior to the pancreas and sto,ach what in these organs could cause pulsation of the aorta
A tumor
Deep palpating of the mid abdomen can detect what
Aneurysm
What is associated with acute rupture of an abdominal aortic aneurysium?
Severe pain in the abdomen or back
Acute ruptures aneurysm of the aorta have what percent of fatality if not detected
90% because of heavy blood loss
In small children or thin people you can press on the inferior part of the abdomen to do what
Stop bleeding in the lower limbs or pelvis
The site of aortic bifurcation is indicated where
Just left of the midpoint of the line joining the highest points of the lilac crest
There are how many collateral routes for blood to return to the heart if the Ivc is blocked
3
- inferior epigastric vein
- superior epigastric vein
- thoracoepigastric vein
What is fairly common and can occur inferior to the renal veins
Left Ivc
During development these veins should have disappeared
Where are the lymphatic vessels in the posterior abdominal wall
On aorta, Ivc, and iliac vessels
Where do the common iliac lymph receive lymph from
External and interns
Iliac lymph nodes
Whree does the inferior end of the thoracic duct lie
Anterior to the bodies of l1-l2
What part of the thoracic duct varies greatly in size
The chyle cisterns
All the lymph from the lower part of the body converges and goes to where
Thoracic duct
What does the thoracic duct ascend thorough
The aortic hiatus in the diaphragm
The thoracic duct ends when it enters where
At the junction of left subclavian vein and internal jugular vein
