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NME > The Posterior Abdominal Wall > Flashcards

The Posterior Abdominal Wall Flashcards

1
Q

Bones of the posterior abdominal wall (5):

A
  • lumbar vertebrae (L1-5)
  • iliac crest
  • ribs 11-12
  • iliac fossa
  • sacral ala and promontory
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2
Q

Bones of the posterior abdominal wall:

A
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3
Q

Muscles of the posterior abdominal wall(5):

A
  • Psoas major
  • Psoas minor (if present)
  • Quadratus lumborum
  • diaphragm
  • iliacus
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4
Q

Muscles of the posterior abdominal wall:

A
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5
Q

Psoas abscess

A

deepest muscle, site of transmitted infection

Prevent in legs as swelling & pain

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6
Q

Bones, muscles, fascia of the posterior abdominal wall:

A
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7
Q

What structures pierce the diaphragm at T8?

A
  • IVC
  • right phrenic nerve
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8
Q

What structures pierce the diaphragm at T10?

A
  • oesophagus
  • vagal trunks
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9
Q

What structures pierce the diaphragm at T12?

A
  • aorta
  • thoracic ducts
  • azygous vein
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10
Q

arcuate ligaments

A

The connenction between right and left Crura covers the abdominal aorta is MEDIAN arcuate

Lateral to crura attaching the lumbar vertebrae is medial arcuate ligament through which psoas major muscles and sympathetic trunks pass

Lateral arcuate ligament passes over quadratus lumborum

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11
Q

crura

A

-Fix diaphragm to lumbar vertebra
- left is L1 &L2
- right is L1,L2,L3

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12
Q

Label the crura and central tendon.

A
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13
Q

Muscles of the posterior abdominal wall

A
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14
Q

State the names of the fascia of the posterior abdominal wall (3):

A
  • Psoaas fascia
  • Iliac fascia
  • Thoracolumbar fascia
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15
Q

psoas fascia

A

thickens superiorly to form the medial arcuate ligaments, continuous inferiorly with iliac fascia

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16
Q

Iliac fascia

A

overlays iliacus muscle

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17
Q

Thoracolumbar fascia (3):

A
  • anterior layer: quadratus lumborum fascia, thickens
    superiorly to form the lateral arcuate
    ligaments
  • middle layer: deep covering of erector spinae muscles
  • posterior layer: superficial covering of erector spinae
    muscles
18
Q

Fascia of the posterior abdominal wall

19
Q

Bones, muscles, fascia of the posterior abdominal wall:

20
Q

Imaging

21
Q

Ureters: Pathway:

A
  • from lateral to medial
  • over anterior surface of Psoas major muscle
22
Q

Ureters: Constrictions:

A
  • Pelviureteric junction (PUJ)
  • Pelvic brim (passes over the common iliac vessel
    bifurcation)
  • Vesicouteric junction (VUJ) (through the detrusor
    muscle/bladder muscle)
23
Q

Ureters: Potential Constrictions:

A
  • Male: ductus deferens (crosses superior to ureter)
  • Female: uterine artery (crosses over ureter in true
    pelvic cavity)
24
Q

The ureters

25
Q

The abdominal aorta:

A
  • begins from the aortic hiatus T12
  • branches:
    • unpaired visceral: coeliac trunk, SMA, IMA
    • paired visceral: renal, gonadal, middle adrenal
    • paired somatic: inferior phrenic, lumbar x4
    • unpaired somatic: median sacral artery

Terminal branch/bifurcation: right and left iliac arteries
at L4

26
Q

Abdominal aortic aneurysm

A

Very pulsaltile means AAA

27
Q

Abdominal Aorta

28
Q

Posterior abdominal wall arteries

29
Q

Inferior Vena Cava:

A
  • passes through the diaphragm through CAVAL hiatus
    T8
  • formed by the union of common iliac veins at L5

Tributaries:
- suprarenal veins (R direct into IVC, L into L renal
veins)
- Renal veins (Right and Left)
- Gonadal veins (R direct into IVC, L into L renal vein)

31
Q

Somatic (wall not visceral) (motor/sensory) innervation of the posterior abdominal wall:

A

Lumbar Plexus (6):
- iliohypogastric nerve (L1)**
- iliolingual nerve (L1)**
- genitofemoral nerve (L1-2)
- lateral cutaneous nerve (thigh) (L2-3)
- obturator nerve (L2-4)
- femoral nerve (L2-4)

32
Q

Somatic innervation of posterior abdominal wall:

33
Q

Autonomic innervation of viscera of posterior abdominal wall (secretomotor) (symp,para,enteric):

A

Sympathetic (extrinsic):
- Greater splanchnic (T5-9)
- Lesser splanchnic (T10-11)
- Least splanchnic (T12)
- Lumbar splanchnic (L2-4)
- Sacral splanchnic (S2-4)

Parasympathetic (extrinsic):
- Vagus (CNX)
- Pelvic splanchnic nerve (S2-4)

Enteric Nervous System (intrinsic)

34
Q

autonomic innervation of the viscera:

35
Q

Characteristics of somatic pain (3):

A
  • skeletal muscle, bones, connective tissue
  • sharp, localised pain
  • follow dermatome or cutaneous mapping
36
Q

Characteristics of visceral pain (4):

A
  • viscera of body cavities and vessels
  • dull, poorly localised pain
  • oftern rederred to dermatome
  • usually due to stretch, ischaemia, chemical irritation
39
Q

Pain: appendicitis:

A

visceral progress to somatic pain

NME (52 decks)

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