Posterior Abdominal Wall

Question 1

Answer 1

Question 2

What is the action of the psoas major?

Answer 2

Flexion of the thigh at the hip and lateral flexion of the vertebral colum

Question 3

What is the action of the psoas minor?

Answer 3

Flexion of the vertebral colum

Question 4

What is the action of the quadratus lumourum?

Answer 4

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

Question 5

What are the 3 main openings in the diaphragm?

Answer 5

Caval hiatus

Oesoohageal hiatus

Aortic hiatus

Question 6

What vertebral level do the openings in the diphragm occur?

Answer 6

Caval- T8

Oesophagel- T10

Aortic- T12

Question 7

Answer 7

Question 8

What opening does the thoracic duct pass through?

Answer 8

Aortic hiatus

Question 9

When does a hiatus hernia occur?

Answer 9

When the upper part of your stomach bulges throguh the diaphragm

Question 10

The aorta and IVC are the two major blood vessels which run on the posterior of the abdominal cavity. Which vessel sits most anteriorlly?

Answer 10

Above umbilicus aorta is more posterior but below umbilicus the aorta becomes more anterior

Question 11

Where does the foregut run from and to?

Answer 11

The foregut runs from the Oesophagus to the Duodenum- proximal to bile duct(including liver, gall bladder, spleen and pancreas)

Question 12

Where does the midgut run from and to?

Answer 12

The midgut runs from duodenum to the first two thirds of the transverse colon

Question 13

Where does the hindgut run from and to?

Answer 13

The hindgut runs from the last third of the transverse colon to the upper part of the anal canal.

Question 14

What does the celiac trunk supply?

Answer 14

The foregut

Comes off the abdominal aorta at T12

Question 15

What does the SMA supply?

Answer 15

The midgut

Comes off the abdominal aorta at L1

Question 16

What does the IMA supply?

Answer 16

The hindgut

Comess off the abdominal aorta at L3

Question 17

Answer 17

Question 18

What are the 3 branches of the celiac trunk?

Answer 18

Left gastric artery

Hepatic artery

Splenic artery

Question 19

Where do the renal arteries comes off the abdominal aorta?

Answer 19

L1

Question 20

At what vertebral level does the abdominal aorta divide into 2 common iliac arteries?

Answer 20

L5

Question 21

Answer 21

Question 22

Answer 22

Question 23

What vessels merge to form the IVC?

Answer 23

Common illiac vein

Question 24

At what vertebral level do the common iliac veins merge?

Answer 24

L5

Question 25

The portal vein is formed by the union of which 2 major veins of the abdominal cavity?

Answer 25

Splenic Vein Superior mesenteric Vein

Question 26

Where does the inferior mesenteric vein drain to?

Answer 26

Splenic vein

Question 27

What are the 2 drainage systems in the body?

Answer 27

The portal system and the systemic system

Question 28

What is a portal system?

Answer 28

Part of the systemic circulation, in which the blood draining from the capillary bed of one structure flows through larger vessels to supply the capillary bed of another structure before returning to the heart.

Question 29

Blood from the gut tube superior to the diaphragm and inferior to the pelvic floor drains via what?

Answer 29

Systemic venous system

Question 30

Blood from the abdominopelvic gastrointestinal tract drains via what?

Answer 30

Via the portal system to the liver.

Question 31

Where are the four sites of the portal-systemic anastomoses?

Answer 31

Eosophageal varicies Caput medusae Rectal varices Transjugular intrahepatic portosystemic shunt

Question 32

What is the clinical relevance of these sites of anastomoses?

Answer 32

When there is a blockage in the portal system, the portocaval anatomoses enable the blood to still reach the systemic venous circulation

Question 33

What is pre aortic?

Answer 33

. If a vessel comes out of the aorta anteriorly the drainage would be to ‘pre-aortic’ nodes at that level

Question 34

What is para aortic?

Answer 34

If the vessels protrude at either side of the aorta, then the nodes are called ‘para-aortic’ nodes.

Question 35

What does all lymph from the foregut structures drain to?

Answer 35

Pre-aortic nodes at T12

Question 36

What is the sympathetic nere supply of the abdomen?

Answer 36

Abdominopelvic splanchnic nerves (greater, lesser and least) Prevertebral sympathetic ganglia Abdominal aortic plexuses

Question 37

What is the parasympatjetic nerve supply of the abdomen?

Answer 37

Anterior and posterior vagal trunks (vagus nerve – 10^th Cranial nerve) Pelvic splanchnic nerves (S2, S3 and S4)

Question 38

What does parasympathetic and sympathetic do to GI secretion

Answer 38

Parasympathetic- Increases Sympathetic- Decreases

Question 39

What do parasympathetic and sympathetic do to peristalsis?

Answer 39

Parasympathetic- Increase Sympathetic- Decrease

Question 40

What do parasympathetic and sympathetic do to blood vessels?

Answer 40

Parasympathetic- Vasodilation Sympathetic- Vasoconstriction

Question 41

What is the effect of vagotomy on gastric secretion?

Answer 41

It markedly reduces gastric secretion

Question 42

What is the visceral pain refered to for foregut pain?

Answer 42

Epigastric

Question 43

What is the visceral pain refered to for midgut pain?

Answer 43

Umbilical region

Question 44

What is the visceral pain refered to for hindgut pain?

Answer 44

Suprapubic

Question 45

What does the lumbar plexus originate from?

Answer 45

Ventral rami of L1-L4

Question 46

What is the lumbar plexus formed within?

Answer 46

The psoas major muscles Its main branches emerge either lateral to, on the surface of or medial to the psoas major muscle

Question 47

What is the root of the illiohypogastric nerve?

Answer 47

L1

Question 48

What is the root of the illioingiinal nerve?

Answer 48

L1

Question 49

What is the root of the genitofemoral nerve?

Answer 49

L1, L2

Question 50

What is the root of the lateral cutanous nerve of the thigh?

Answer 50

L2, L3

Question 51

What is the root of the obturator nerve?

Answer 51

L2, L3, L4

Question 52

What is the root of the femoral nerve?

Answer 52

L2, L3, L4

Question 53

What are the identifying features of the iliohypogastric nerve?

Answer 53

Runs to iliac crest,across the quadratus lumbordum; perforates the transversus abdominus and divides into its terminal branches – Sensory Higher up and passes anterior to quaratus lumborum

Question 54

What are the identifying features of the ilioinguinal nerve?

Answer 54

After innervating the muscles of the abdominal wall, it passes through the superficial inguinal ring to innervate the skin of the genitalia & middle thigh – sensory

Question 55

WHat are the identifying features of trhe genitofemoral nerve

Answer 55

After leaving the psoas major, the nerve quickly divides into the genital branch and the femoral branch Pierces psoas major runs along anterior to it

Question 56

What are the identifying features of the lateral cutanous nerve of the thigh?

Answer 56

Purely sensory function; enters the thigh at the lateral aspect of the inguinal ligament, where it provides cutaneous innervation Runs inferolaterally on illiacus, and enters thigh deep to inguinal ligament. Medial to inguinal spine

Question 57

What are the identifying features of the obturator nerve?

Answer 57

Descends through psoas major and emerges from its medial border, then travelling posteriorly along the pelvic wall, towards the obturator foramen of the pelvis; medial part of the thigh Psoas major medial border- passes inferior to superior pubic ramus

Question 58

What are the identifying features of the femoral nerve?

Answer 58

Innervates the anterior thigh muscles that flex the hip joint and extend the knee and supplies cutaneous branches to the anteromedial thigh and the medial side of the leg & foot. Big boy. Lateral to psoas major and deep to inguinal ligament

Question 59

What is the arterial supply, lymoh drainage and refered pain of the foregut?

Answer 59

Celiac trunk Celiac nodes Epigastric

Question 60

What is the arterial supply, lymoh drainage and refered pain of the midgut?

Answer 60

SMA Prevertebral superior mesenteric nodes Umbilical

Question 61

What is the arterial supply, lymoh drainage and refered pain of the hindgut?

Answer 61

IMA Chyle cistern Suprapubic

Question 62

Answer 62