L4 - Posterior Abdominal Wall & Diaphragm

Question 1

Posterior Abdominal Wall consists of how many lumbar vertebrae?

Answer 1

Five L1-L5

Question 2

Which muscles are associated with the posterior abdominal wall?

Answer 2

Quadratus Lumborum Psoas Major and minor Illiacus

Question 3

Quadratus Lumborum Muscle

Answer 3

Innervation : T12-L4 Action: Unilaterally Flexes the Trunk

Question 4

Psoas Major

Answer 4

Inf Attachment : along with the illacus muscle, lesser trochanter of femur

Innervation : ventral rami L1-L3

Action : Flexes thigh and trunk

Question 5

Illiacus Muscle

Answer 5

Inf attachment : Along with psoas major m, lesser trochanter of femur

Action : flexes thigh

Innervation : Femoral Nerve

Question 6

Which of these matches are INCORRECT?

• A. Psoas Major…Rami from T12-L4
• B. Quadratus Lumborum…Rami from T12-L4
• C. Iliacus…Femoral Nerve (L2-L4)
• D. Psoas Major…Rami from L1-L3

Answer 6

•A. Psoas Major…Rami from T12-L4

actually

L1-L3

Question 7

Quadratus Lumborum in relation to Psoas Major and Kidenys

Answer 7

Quadratus Lumborum:

• LATERAL to the Psoas Major
• POSTERIOR to the Kidney

Question 8

How is the skeletal muscle arranged around the central tendon? and what tissue is the central tendon made up of?

Answer 8

Question 9

IVC: # vertebrae?

Esophagus : # Vertebrae?

Aorta: # Vertebrae?

Answer 9

I ate 10 eggs at 12

IVC : 8

Esophagus : 10

Aorta : 12

Question 10

Whats muscle is under the medial arcuate ligament?

Answer 10

Psoas Major

Question 11

What muscle is under the lateral arcuate ligament?

Answer 11

Quadratus Lumborum Muscle

Question 12

What is under the median arcuate ligament?

Answer 12

Aorta

Question 13

The median arcuate ligament is made up of?

Answer 13

Left and Right Crus

Question 14

The right crus forms the ?

Answer 14

Esophageal hiatus

Question 15

Right phrenic nerve passes with?

Answer 15

IVC T8

Question 16

Vagus nerve passes with?

Answer 16

Esophagus T10

Question 17

Answer 17

Question 18

Innervation of the diaphragm from the phrenic nerve…spinal level?

Answer 18

C3,C4,C5 keeps you ALIVE

Question 19

Peripheral part of the Diaphragm

Supplied by?

Innervation?

Answer 19

Supplied by the body wall

and Intercostal nerves are the innervation which is important in reffered pain.

Question 20

Referred pain from the Diaphragm will present as?

Answer 20

Bc of its innervation from the cervical plexus irritation of the diaphragm is often felt as pain in the right or left shoulders

Question 21

Appendicitis reffered pain will present as?

Answer 21

Umbillicus Region

Question 22

Gall bladder reffered pain will present as?

Answer 22

Right shoulder

Question 23

Hiatial Hernia

Answer 23

Portion of the stomach in the thoracic cavity bc of a weak esophageal sphincter.

A loose RIGHT CRUS results in a hiatal Hernia because the right crus is makes up the esophageal sphincter!

Question 24

Which structure goes under the lateral arcuate ligament?

• A. Psoas Major Muscle
• B. Aorta
• C. Quadratus Lumborum Muscle
• D. Iliacus Muscle

Answer 24

•C. Quadratus Lumborum Muscle

Question 25

Blood supply of the Diagphragm Thoracic Surface?

Answer 25

Pericardiphrenic arteries Musculophrenic arteries Superior phrenic arteries

Question 26

Blood supply of the Diagphragm? Abdominal Surface:

Answer 26

Inferior Phrenic Arteries

Question 27

Lumbar Plexus : Remember the Date Mneumonic!

Answer 27

Interested in getting lunch on friday? Illihypogastiral L1 illioinguinal L1 Gentiofemoral L1 L2 Lateral Gentiofemora L2, 3 Obtruator Nerve L2-L4 Femoral Nerve L2-L4

Question 28

Accessory Obtruator Nerve, not everyone has this but know the Lumbar level and lumbarsacral trunk, what does it do and what level?

Answer 28

L3-L4 = Accessory Obtruator Nerve Lumbosacral = L4-L5, connects lumbar and sacral plexus

Question 29

Is the subcostal nerve part of the lumbar plexus?

Answer 29

Hell NO, but still on the posterior wall of the abdomen. and T-12

Question 30

Nerves in relation to Psoas Major: superior? Lateral? Medial?

Answer 30

Question 31

Female Inguinal Canal Contents :

Answer 31

Round Ligament of the Uterus Genital Branch of the Gentiofemoral Nerve Illioinguinal Nerve

Question 32

Male Inguinal Canal contents :

Answer 32

* Spermatic Cord * (Surrounded by the External Spermatic Fascia, Cremaster Muscle and Internal Spermatic Fascia) * Testicular Artery and Vein * Vas Deferens * Genital branch of the Genitofemoral nerve * Ilioinguinal Nerve

Question 33

Answer 33

Question 34

Answer 34

Question 35

Answer 35

Question 36

Posterior Abdominal Wall Nerves

Answer 36

Question 37

Which of the following supply the abdominal portion of the diaphragm? ## Footnote * A. Musculophrenic Arteries * B. Inferior Phrenic Arteries * C. Pericardiophrenic Arteries * D. Superior Phrenic Arteries

Answer 37

•B. Inferior Phrenic Arteries

Question 38

Kidneys are ALWAYS and lie at what level, what nerves are associated with the kidney?

Answer 38

Retroperitoneal Paravertebral gutters : T11-L3 •Subcostal, iliohypogastric and ilioinguinal nerves pass diagonally and laterally posterior to the kidneys

Question 39

Unpaired Arteries off of the Abdominal Aorta: Superior to Inferior:

Answer 39

Celiac Trunk SMA IMA Median Sacral Artery

Question 40

Right side of the abdomin:

Answer 40

IVC and Gonandal Vein draining into the IVC

Question 41

Left side of the abdomin:

Answer 41

* Left Side: * Aorta * Gonadal Vein draining into Left Renal Vein * Left Renal Vein * Superior to the Aorta * Inferior to SMA

Question 42

The right kidney is lower or higher in its positioning? and why?

Answer 42

Lower due to the liver

Question 43

Subcostal, illohypogastric, and ilioinguinal nerves all run posterior to the kidneys?

Answer 43

TRUE

Question 44

The three nerves that run posterior to the kindeys and anterior to the psoas major and quadratus lumborum muscle?

Answer 44

Question 45

Pararenal fat : Perirenal fat :

Answer 45

Outside of the Renal Fascia Inside the Renal Fascia ( On the Kidney)

Question 46

Which of the following is the correct order of the unpaired arteries off the abdominal aorta from superior to inferior? ## Footnote * A. SMA à IMA à Celiac Trunk à Median Sacral Artery * B. Celiac Trunk à SMA à Median Sacral Artery à IMA * C. Celiac Trunk à SMA à IMA à Median Sacral Artery * D. SMA à Median Sacral Artery à IMA à Celiac Trunk

Answer 46

•C. Celiac Trunk à SMA à IMA à Median Sacral Artery

Question 47

Paired Vessels off Abdominal Aorta :

Answer 47

* Inferior Phrenic Arteries * Suprarenal Arteries * Renal Arteries * Gonadal Arteries * Lumbar Arteries THE ADRENAL AND RENAL ARTERIES ARE PAIRED VESSELS OFF THE AORTA

Question 48

Renal Artery gives off __ branches that supply ___ lobes of the kindey.

Answer 48

5 branches, 5 lobes

Question 49

Answer 49

Question 50

Answer 50

Question 51

renal sinus?

Answer 51

Question 52

Answer 52

Question 53

Ureter Crosses over the ?

Answer 53

External Illiac Artery and Vein

Question 54

Ureter goes under the ?

Answer 54

Uterine Artery in Females Vas Deferens in Males

Question 55

Answer 55

Question 56

Answer 56

Question 57

Kidney Stones spinal level? How do patients feel?

Answer 57

Question 58

Right Adrenal lies ? Left Adrenal faces?

Answer 58

Question 59

Adrenal Blood Supply

Answer 59

Superior Middle Inferior Adrenal artieries

Question 60

Does the cortex have innervation? Is there parasympathetic innervation?

Answer 60

The greater splanchnic gives off fibers directly to the adrenal gland. These preganglionic sympathetics synapse directly on neural crest-derived cells in adrenal medulla. These chromaffin cells secrete epinephrine (80%) and norepinephrine (20%). The cortex has no innervation. There is no parasympathetic innervation.

Question 61

Answer 61

Question 62

Abdominal Aorta picture

Answer 62

Question 63

Gonadal vein on left side dumps into? Gonandal vein on right side dumps into?

Answer 63

Question 64

Answer 64

Question 65

Answer 65

Question 66

Answer 66

Question 67

Answer 67

Question 68

Answer 68

Question 69

Kidneys and testes drain into the ____ and other lump nodes in that region

Answer 69

Kidneys and testes drain into the paraaortic lymph nodes

Question 70

Chyle Cisternae -\> drains into?

Answer 70

Chyle Cisternae -\>Thoracic Duct -\>Left Subclavian Vein

Question 71

All of the venous drainage from the digestive organs and the spleen enter the \_\_\_\_ system to be carried to the \_\_\_\_.

Answer 71

All of the venous drainage from the digestive organs and the spleen enter the **portal** **venous system** to be carried to the **liver.**

Question 72

Portal-Caval Anastomoses The anastomoses of the portal venous drainage with the somatic (caval) venous drainage has important clinical significance. There are 3 main sites of anastomosis:

Answer 72

There are 3 main sites of anastomosis: 1. Esophageal veins 2. Paraumbilical veins 3. Veins of anal canals

Question 73

Whihc anastomoses site ias assoiciated with alcohol abuse and cirrhosis?

Answer 73

1. Esophageal veins 2. Paraumbilical veins