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Brett GI Midterm > 9 Posterior Abdominal Wall > Flashcards

9 Posterior Abdominal Wall Flashcards

1
Q

What is the origin of the psoas mm

A

Transverse processes and sides of vertebral bodies and intervertebral disks of T12-L5

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2
Q

What is the insertion of the psoas

A

Tendon to the lesser trochanter of femur

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3
Q

What is the innervation of the psoas mm

A

Anterior rami of L1-3

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4
Q

What is the origin of the illiacus

A

Superior 2/3s of iliac fossa, ala, anterior sacro-iliac ligaments

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5
Q

What is the insertion of the iliacus

A

Lesser trochanter and shaft below

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6
Q

What is the innervation of the iliacus

A

Femoral n (L2-4)

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7
Q

What is the origin of the quadratus lumborum

A

Medial half of inferior surface of 12th rib plus tips of lumbar ptp

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8
Q

What is the insertion of quadratus lumborum

A

Iliolumbar ligament and lip of iliac crest

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9
Q

What is the function of the quadratus lumborum

A

Helps fix 12th rib during deep inspiration

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10
Q

What is the innvervation of the quadratus lumborum

A

Anterior T12, L1-4

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11
Q

What does a psoas abscess cause

A

Back or flank pain, fever, limp, inguinal mass

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12
Q

What is the cause of a psoas abscess

A

Disease of organs (TB spread into abdomen)
Cancer
Infections deep to psoas fascia

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13
Q

How do you determine psoas abscesses

A

Lower abdominal pain exacerbated by extending thigh (psoas sign)

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14
Q

What is the median arcuate ligament

A

Tendinous arch of the crura of the diaphragm; unites R and L crura (where aorta pierces diaphram)

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15
Q

What is the medial arcuate ligament

A

Fascial thickening of psoas fascia; spanning lumbar body and tip of L1 transverse process

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16
Q

What is the lateral acruate ligament

A

Fascial thickening of quadratus lumborum m running from L1 tp to the tip of the 12th rib

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17
Q

What pierces through the diaphragm m

A

Esophagus and aorta

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18
Q

What are the unpaired A of the abdominal aorta

A

Celiac trunk (T12)
SMA (L1)
IMA (L3)
Medial sacral A

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19
Q

What are the paired A of the abdominal aorta

A 
Subcostal A
Inferior phrenic A
Suprarenal A
Renal A (L2)
Gonadal A (L2)
Lumbar A
Deep circumflex iliac A
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20
Q

Where does the IVC begin inferiorly

A

Anterior to L5 and right of midline

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21
Q

What are the paired tributaries of the IVC

A

Suprarenal V, renal V, gonadal V, inferior phrenic V, 3rd and 4th lumbar V, common iliac V

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22
Q

What goes through the diaphragm at T8

A

IVC and right phrenic N

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23
Q

What does through the diaphragm at T10

A

Esophagus and ant/post vagal trunks

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24
Q

What goes through the diaphragm at T12

A

Aorta
Thoracic duct
Sometimes azygos and hemiazygos V

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25
Q

Where is the R crus of the diaphragm

A

Larger and longer (L3-4 vertebral bodies)

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26
Q

Where is the L crus of the diaphragm

A

L2-3

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27
Q

What are the arteries superior to the diaphragm

A
  • Superior phrenic A (off thoracic aorta)

- Musculophrenic and pericardicophrenic A (off internal thoracic A)

28
Q

What are the arteries inferior to the diaphragm

A
  • Inferior phrenic A (off abdominal aorta)

- intercostal branches for peripheral diaphragm

29
Q

What are the types of hiatal hernias

A

Para-esophageal hiatal hernia

Sliding hiatal hernia

30
Q

What is a para-esophageal hiatal hernia

A

Portion of the fundus of the stomach herniates through the diaphragm

31
Q

With what hiatal hernia does regurgitation of the stomach occur

A

Sliding

32
Q

What is a sliding hiatal hernia

A

The cardia and part of the fundus slide superiorly through the esophageal hiatus

33
Q

Why are hiatal hernias thought to happen

A

Weakening of muscular diaphragm

34
Q

Where are the kidneys (level)

A

T12-L3, right kidney is lower

35
Q

What is the renal hilum

A

Entrance to renal sinus (where the A, V, N, and ureters come out)

36
Q

The left kidney hilum is near what plane

A

Transpyloric

37
Q

The transpyloric plane runs through what part of the right kidney

A

Superior pole

38
Q

Where is the inferior pole of the right kidney

A

Approximately index finger breadth superior to iliac crest

39
Q

What lies posterior to the largest part of the kidney

A

Quadratus lumborum m

40
Q

What nerves are posterior to the kidney

A

Subcostal (protected by 12th rib)
Iliohypogastric (L1) (superior to ilioinguinal)
Ilioinguinal (L1)

41
Q

What does the renal fascia surround

A

Kidney, adrenal gland, and perirenal fat

42
Q

What are the types of renal fat

A

Perinephric (perirenal) - covers kidney and suprarenal

Paranephric (pararenal) - external to renal fascia

43
Q

What is the renal fascia continuous with

A

Inferior diaphragmatic fascia

44
Q

What are the points of constriction of the ureter

A
  • Junction of urerter with renal pelvis
  • Crossing pelvic brim
  • Entering bladder wall
45
Q

What is an xray of the ureter

A

Pyelogram

46
Q

What supplies the kidney

A

Renal A which branch into segmental A

47
Q

What supplies the ureter

A
  • renal branches
  • gonadal branches
  • iliac branches
  • superior vesicular branches
  • pelvic branches
48
Q

Where is the right suprarenal gland

A

Lies near right crus of diaphragm, right kidney and IVC

49
Q

Where is the L suprarenal gland

A

Lies near L crus of diaphragm, spleen, stomach, pancreas, L renal

50
Q

What is the supply of the suprarenal gland

A

Superior, middle, inferior suprarenal A

51
Q

What is the innervation of the suprarenal gland

A

Preganglioninc sympathetic for T10-11

52
Q

What does the inferior suprarenal come off? Middle? Superior?

A

Inferior - Renal A
Middle - aorta
Superior - inferior phrenic A

53
Q

What path does lymph follow from the lower parts of the abdomen

A

Common iliac nodes (from external/internal iliac nodes) —> lumbar lymph nodes (runs along both sides of IVC and aorta) —> lumbar lymphatic trunks —> pre-aortic lymph nodes —> cisterni chyli (beginning of thoracic duct)

54
Q

What level is the subcostal N

A

T12; runs along margin of 12th rib

55
Q

What level are the iliohypogastric N and ilioinguinal N

A

L1; they can come out divided or divide shortly after

56
Q

What level is the genitofemoral N

A

L1,2; comes out on the psoas mm and runs medially

57
Q

What level is the lateral femoral cutaneous N

A

L2,3; beneath inguinal ligament and medial to ASIS

58
Q

What level is the femoral N

A

L2-4, it is the largest

59
Q

What level is the obturator N

A

L2-4

60
Q

What level is the lumbosacral trunk

A

L4,5

61
Q

What does the subcostal N innervate

A

EO

62
Q

What does the iliohypogastric N innervate

A

IO, TA, and posterolateral gluteal skin and skin in pubic region

63
Q

What does the ilioinguinal innervate

A

IO, TA, and skin in the upper medial thigh, and either the skin over the root of the penis and anterior scrotum or the mons pubis and labium majus

64
Q

What does the genitofemoral inneravate

A

Male cremasteric m

Genital branch - skin of anterior scrotum or skin of mons pubis and labium majus

Femoral branch - skin of upper anterior thigh

65
Q

What does the lateral cutaneous nerve of thigh innervate

A

Skin on anterior and lateral thigh to the knee

66
Q

What does the obturator n innervate

A

Obturator externus, pectineus, mm in the medial compartment of thigh

Skin on medial aspect of thigh

67
Q

What does the femoral n innervate

A

Iliacus, pectineus, mm in anterior compartment of thigh

Skin on anterior thigh and medial surface of leg

Brett GI Midterm (11 decks)

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