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anatomy - abdominal aorta > The posterior abdominal wall > Flashcards

The posterior abdominal wall Flashcards

1
Q

What are the bones of the posterior abdominal wall?

A

Lumbar vertebrae
Ribs 11/12
Ilia
Sacrum

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2
Q

What are muscles of the posterior abdominal wall?

A

Diaphragm
Quadratus lumborum
Iliacus
Psoas

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3
Q

What is the diaphragm anchored by?

A

Crura (left and right crus)

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4
Q

Purpose of the central tendon of the diaphragm

A

to not crush the structures that pass through the hiatus

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5
Q

What are the levels of the structures that pass through the hiatus?

A

IVC - T8
Oesophagus - T10
Aorta - T12

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6
Q

Location of the quadratus lumborum

A
  • Post to kidneys

- Superficially to the psoas major

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7
Q

Attachments of quadratus lumborum

A
  • It originates from the iliac crest and iliolumbar ligament
  • The fibres travel superomedially, inserting onto the transverse processes of L1-L4 and the inferior border of the 12th rib
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8
Q

What are the actions carried out by the quadratus lumborum?

A
  • Extension and lateral flexion of the vertebral column

- It also fixes the 12th rib during inspiration, so that the contraction of diaphragm is not wasted

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9
Q

What is the innervation of the quadratus lumborum?

A

Anterior rami of T12-L4 nerves

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10
Q

Location of the psoas major

A

The psoas major is located near the midline of the posterior abdominal wall, immediately lateral to the lumbar vertebrae

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11
Q

What are the attachments of the psoas major?

A

Originates from the transverse processes and vertebral bodies of T12-L5.

It then moves inferiorly and laterally, running deep to the inguinal ligament, and attaching to the lesser trochanter of the femur

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12
Q

What are the actions of psoas major?

A

Flexion of the thigh at the hip lateral flexion of the vertebral column

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13
Q

What is the innervation of the psoas major?

A

Anterior rami of L1-L3 nerves

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14
Q

Location of psoas minor

A

Is only present in 60% of the population. It is located anterior to the psoas major

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15
Q

Attachments of psoas minor

A

Originates from the vertebral bodies of T12 and L1 and attaches to a ridge on the superior ramus of the pubic bone, known as the pectineal line

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16
Q

What are the actions of the psoas minor?

A

Flexion of the vertebral column

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17
Q

What is the innervation of the psoas minor?

A

Anterior rami of the L1 spinal nerve

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18
Q

Location of the iliacus

A

The iliacus muscle is a fan shaped muscle that is situated inferiorly on the posterior abdominal wall

It combines with the psoas major to form the iliopsoas - the major flexor of the thigh

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19
Q

What are the actions of the iliacus?

A

Flexion of the thigh at the hip joint

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20
Q

What is the innervation of the iliacus?

A

Femoral nerve (L2 - L4)

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21
Q

What is the vein/artery that supplies the diaphragm?

A

Sup and inf phrenic

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22
Q

What is the vein/artery that supplies the quadratus lumborum?

A

Lumbar

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23
Q

Vein/artery for iliopsoas

A

Lumbar

24
Q

Innervation of diaphragm

A

Phrenic (C3-5)
Intercostal (T5-11)
Subcostal (T12)

25
Q

Innervation of quadratus lumborum

A

Lumbar (T12-L4)

26
Q

Innervation of iliopsoas

A

Femoral (L2-L4)

27
Q

What are the three midline vessels of the aorta?

A

Coeliac, SMA and IMA

28
Q

What are the paired parietal branches of the aorta?

A

Inferior phrenics, lumbars and middle sacral

29
Q

Examples of paired visceral branches of the aorta?

A

Renal and gonadal

30
Q

Where is an aneurysm more common in the aorta?

A

More common below renal arteries

31
Q

What can occlusion of the aortic bifurcation cause?

A

Claudication and impotence

32
Q

What does the somatic innervation in the abdomen innervate?

A

Somatic - Muscles of anterior/posterior abdominal wall, joints (eg intervertebral), skin etc

33
Q

What does the autonomic innervation in the abdomen innervate?

A

Autonomic - In segmented structures (blood vessels in muscle, sweat glands in skin etc)

  • In viscera, aka splanchnic (peristalsis of stomach, heart rate etc)
34
Q

Where do the somatic nerves for the abdomen originate from?

A

Lumbar plexus (L1-L4) - motor and sensory

Sacral plexus

35
Q

Where does the autonomic sympathetic nerve supply originate from?

A

Segmented – Sympathetic chain (paravertebral)

Viscera – Celiac, sup and inf mesenteric (prevertebral)

36
Q

Where does the autonomic parasympathetic nerve supply originate from?

A

vagus; pelvic splanchnic

37
Q

Where do the nerves for the prevertebral ganglia originate from?

A

Nerves originate in spinal cord and project to these ganglia bypassing the symp chain and from these to the viscera –> Splanchnic nerves

38
Q

What part of the spinal cord does the greater splanchnic nerve originate from?

A

T5-T9

39
Q

What part of the spinal cord does the lesser splanchnic nerve originate from?

A

T10-T11

40
Q

What part of the spinal cord does the least splanchnic nerve originate from?

A

T12

41
Q

What are the two types of abdominopelvic splanchnic nerves?

A

Lower thoracic splanchnic nerves

Lumbar splanchnic nerves

42
Q

What nerves are part of the lower thoracic splanchnic nerves?

A

Greater, lesser and least thoracic splanchnic nerves.

43
Q

What ganglia and plexuses do the lower thoracic splanchnic nerves pass through?

A

They pass through the diaphragm to send fibers to the celiac, aorticorenal, and superior mesenteric ganglia and plexuses

44
Q

Where do the lumbar splanchnic nerves start?

A

These nerves start at the abdominal sympathetic trunk

45
Q

What plexuses do the lumbar splanchnic nerves go through?

A

Join the intermesenteric, inferior mesenteric, and superior hypogastric plexuses

46
Q

What are the suprarenals innervated by?

A

Suprarenals are innervated by greater, lesser and least splanchnic nerve from the celiac and aorticorenal ganglia

Kidneys innervated mostly by fibres from the least splanchnic nerve

47
Q

What are the three types of abdominal pain?

A

Somatic, visceral and referred

48
Q

Where does the somatic abdominal pain arise from

A

Skin, fascia, muscle and parietal peritoneum

49
Q

What is the character of somatic abdominal pain

A

Precisely localised and severe

50
Q

Where does visceral abdominal pain arise from

A

Abdominal organs, mesenteries and visceral peritoneum

51
Q

What are the causes of visceral abdominal pain?

A

Stretching viscus or mesentery, impaired blood supply to viscus and chemical damage to viscus

52
Q

Describe the character of visceral abdominal pain

A

Dull and poorly localised
Pain is referred to midline(embryology)
Colic pain is a form of visceral pain

53
Q

What is referred pain?

A

Describes pain at a location other than site of origin stimulus but supplied by same or adjacent segments of the spinal cord

54
Q

What is the level that visceral pain arise from for the stomach?

A

T5-T9

55
Q

What is the level that visceral pain arise from for the appendix?

A

T10

56
Q

What is the level that visceral pain arise from for the gall bladder?

A

T7-9; but with parietal peritoneum involvement C3,4

57
Q

What are the nerves that pain signals from pleura or peritoneum of diaphragm or anterior abdominal wall reach the CNS via?

A

Central part diaphragm - phrenic C3-5

Peripheral diaphragm - intercostals T7-11

Anterior abdominal wall - T7-12 and L1

anatomy - abdominal aorta (10 decks)

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