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104 Theme 3 - Kidneys and Urinary Tract > The posterior abdominal wall > Flashcards

The posterior abdominal wall Flashcards

1
Q

Which bones make up the posterior abdominal wall?

A
  • Ribs (11 and 12)
  • Lumbar vertebrae
  • Sacrum
  • Ilia
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2
Q

What muscles make up the posterior abdominal wall?

A
  • Diaphragm
  • Quadratus Lumborum
  • Psoas Major (& Minor)
  • Iliacus
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3
Q

Where is the diaphragm attached to?

A

Attached to the costal margin and vertebrae

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4
Q

What is the diaphragm made up of?

A

Combination of skeletal muscle and the central tendon

Contains 3 hiatuses

  • T8, T10 & T12
  • Passage for the IVC, oesophagus and aorta
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5
Q

What is the neurovascular supply to the diaphragm?

A

Neurovascular supply:

  • Arteries & Veins - Superior and inferior phrenic vessels
  • Nerves
  • Phrenic (C3-5) - Motor

Intercostal (T5-11) & Subcostal (T12) - Sensory

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6
Q

Which structure passes through the diaphragmatic hiatus at T8?

A.Aorta

B.IVC

Oesophagus

A

B.IVC

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7
Q

Where is quadratus lumborum?

A

Lies posterior to the kidneys

Extends from iliac crest to Rib 12

-Also attached laterally to the transversus abdominis muscle

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8
Q

What is the role of quadratus lumborum?

A

Provide abdominal stability and causes lateral flexion

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9
Q

What is the neurovascular supply to quadratus lumborum?

A

Neurovascular supply:

  • Arteries & Veins - Lumbar vessels
  • Nerves - Lumbar (T12-L4)
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10
Q

Where is psoas major?

A

Psoas muscles originate at the lumbar vertebrae

Iliacus originates in the iliac fossa

Psoas maj. and min. converge inferiorly and can be known as Iliopsoas

All insert at the lesser trochanter femur and function as hip flexors

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11
Q

What is the neurovascular supply of the psoas and iliacus muscle?

A

Neurovascular supply:

  • Arteries & Veins - lumbar vessels
  • Nerves - Femoral (L2 - L4)
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12
Q

What major vasculature passes through the posterior abdominal wall?

A

Aorta - Enters abdomen at T12

Inferior Vena Cava - Enters abdomen at T8

Provide and drain blood from the abdomen, pelvis and lower limbs.

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13
Q

What are the 3 types of abdominal aorta branches?

A
  • Midline - Coeliac (T12), sup. mesenteric (L1) and inf. mesenteric (L3)
  • Parietal - Lumbar
  • Visceral - Renal and gonadal (L2)
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14
Q

Where does the abdominal aorta bifurcate?

A

Bifurcates into the common iliac vessels at L4/5

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15
Q

Whats the diagnosis?

A

Abdominal Aortic Aneurysm (AAA)

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16
Q

Whats the diagnosis?

A

Abdominal Aortic Aneurysm (AAA)

17
Q

Above what size is an abdominal aortic aneurysm considered at significant risk of rupture?

A.1cm

B.3.5cm

C.5.5cm

D.8cm

12.5cm

A

C.5.5cm

18
Q

What is the somatic innervation of the abdomen?

A
  • Voluntary movement (skeletal muscle)
  • Abdominal wall, intercostal, vertebral and intervertebral musculature
  • Sensation
  • Skin
19
Q

What is the abdominal somatic innervation provided by?

A

Provided by nerve plexuses:

  • Lumbar plexus (right)
  • Sacral plexus (left)
20
Q

What is the autonomic innervation of the abdomen?

A
  • Unconscious control
  • Blood vessels, sweat glands
  • Abdominal organs (digestive tract to control peristalsis etc.)
21
Q

What does autonomic innervation control?

A

Unconscious control of:

  • Organs
  • Smooth muscle
  • Sweat glands
22
Q

Which nerves are important in autonomic control of organs?

A

Splanchnic nerves are heavily involved in innervation of organs

-Namely for the adrenal glands and kidneys

23
Q

What are splanchnic nerves?

A

A classification of purely autonomic nerves

These nerves synapse to postganglionic neurones at specific central ganglia - the prevertebral ganglia.

24
Q

What are prevertebral ganglia?

A

Located anterior to the vertebral column and aorta

“Pre-” meaning before

Greater, lesser and least splanchnic nerves synapse at the coeliac and aorticorenal ganglion to innervate the suprarenal glands.

25
Q

Which splanchnic nerve innervates the kidneys?

A.Greater

B.Lesser

C.Least

D.Pelvic

Thoracic

A

C.Least

26
Q

What are the 3 catagories of abdominal pain?

A
  • Somatic
  • Well localised, sharp or stabbing
  • Felt in skin, muscle, fascia and parietal peritoneum
  • Visceral
  • Poorly localised, dull ache or throbbing
  • Caused by stretching, ischaemia or chemical damage
  • Referred
  • Felt elsewhere than the affected structure
27
Q

Where is referred pain from the stomach, appendix, gallbladder and parietal peritoneum felt?

A
  • Stomach: felt in skin of dermatomes T5-9
  • Appendix: T10 (umbilicus)
  • Gallbladder: T7-9
  • With parietal peritoneum involvement: C3,4
28
Q

Where would you feel referred pain from the diaphragm?

A.Forearm

B.Pectoral region

C.Perineum

D.Scalp

E.Shoulder

A

E.Shoulder

104 Theme 3 - Kidneys and Urinary Tract (13 decks)

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