Posterior Abdominal Wall

Question 1

What are the four muscles of the posterior abdominal wall?

Answer 1

psoas major/minor, iliacus, quadratus lumborum, diaphragm

Question 2

where does the psoas major/minor and iliacus insert onto?

Answer 2

lesser trochanter of the femur

Question 3

what is the innervation of the psoas major/minor muscle?

Answer 3

anterior rami of L1-L3

Question 4

what is the innervation of the iliacus muscle?

Answer 4

femoral nerve (L2-L4)

Question 5

what is the origin of the quadratus lumborum muscle?

Answer 5

the iliolumbar ligament and the lip of the iliac crest

Question 6

what is the insertion of the quadratus lumborum muscle?

Answer 6

the medial half of the inferior surface of the 12th rib

Question 7

what is the innervation of the quadratus lumborum muscle?

Answer 7

anterior rami of T12, L1-L4

Question 8

what is the common presentation of a psoas abscess?

Answer 8

back or flank pain, fever, limp, inguinal mass; lower abdominal pain that is exacerbated by extending the thigh (psoas sign)

Question 9

what are some causes of a psoas abscess?

Answer 9

disease of organs (TB spread into the abdomen), cancers, or infections deep to psoas fascia

Question 10

what are the three ligaments of the posterior abdominal wall?

Answer 10

medial arcuate ligament, lateral arcuate ligament, median arcuate ligament

Question 11

what is the medial arcuate ligament?

Answer 11

fascial thickening of the psoas fascia

Question 12

what is the lateral arcuate ligament?

Answer 12

fascial thickening of the quadratus lumborum muscle

Question 13

what is the median arcuate ligament?

Answer 13

the tendinous arch of the crura of the diaphragm-crosses the aorta

Question 14

what are the unpaired arteries of the posterior abdominal wall?

Answer 14

celiac trunk, superior mesenteric artery, inferior mesenteric artery, median sacral artery

Question 15

where does the IVC begin?

Answer 15

anterior to L5 and to the right

Question 16

what are tributaries?

Answer 16

corresponding veins of paired visceral and parietal branches of the aorta

Question 17

where does the left gonadal vein empty into?

Answer 17

the left renal vein, which then empties into the IVC

Question 18

what are the three openings of the diaphragm?

Answer 18

the caval opening, the esophageal hiatus, and the aortic hiatus

Question 19

where is the caval opening located?

Answer 19

T8 level

Question 20

what goes through the caval opening?

Answer 20

the IVC and the right phrenic nerve

Question 21

where is the esophageal hiatus?

Answer 21

T10 level

Question 22

what goes through the esophageal hiatus?

Answer 22

the esophagus and the anterior and posterior vagal trunks

Question 23

where is the aortic hiatus?

Answer 23

T12 level

Question 24

what passes through the aortic hiatus?

Answer 24

aorta, thoracic duct, and sometimes the azygos and hemiazygos veins

Question 25

What are the three parts of the muscular diaphragm?

Answer 25

muscular portion, central tendon, and the crura

Question 26

what are the parts of the muscular portion of the diaphragm?

Answer 26

the sternal part, the costal part, and the lumbar (crural) part

Question 27

where does the costal part of the diaphragm attach?

Answer 27

to the inferior 6 costal cartilages- this is the largest portion

Question 28

which crura of the diaphragm is larger?

Answer 28

the right crus

Question 29

what arteries supply the superior side of the diaphragm?

Answer 29

the musculophrenic and the pericardiophrenic artery and the superior phrenic artery

Question 30

what do the musculophrenic and pericardiophrenic arteries branch off of?

Answer 30

the internal thoracic artery

Question 31

what does the superior phrenic artery branch off of?

Answer 31

the thoracic aorta

Question 32

what arteries supply the inferior side of the diaphragm?

Answer 32

the inferior phrenic artery and the intercostal branches for the peripheral diaphragm

Question 33

what does the inferior phrenic artery branch off of?

Answer 33

the abdominal aorta

Question 34

what causes a hiatal hernia?

Answer 34

weakening of the muscular diaphragm

Question 35

where are the kidneys located?

Answer 35

retroperitoneally- lying about T12-L3 level

Question 36

which kidney is lower?

Answer 36

the right one

Question 37

what is the renal hilum?

Answer 37

it is the entrance to the renal sinus

Question 38

posteriorly , where do the superior parts of the kidney lie?

Answer 38

deep to the 11th and 12th ribs

Question 39

posteriorly, where is the left kidney hilum located?

Answer 39

near the transpyloric plane

Question 40

posteriorly, where does the transpyloric plane run through the right kidney?

Answer 40

the superior pole of the right kidney

Question 41

posteriorly, where is the inferior pole of the right kidney located?

Answer 41

an index finger superior to the iliac crest

Question 42

what muscle lies posterior to the largest part of the kidney?

Answer 42

the quadratus lumborum

Question 43

what nerves are susceptible to damage if you are resecting the kidney?

Answer 43

the iliohypogastric nerve and the ilioinguinal nerve

Question 44

what is the layer of fat that is surrounding the kidney?

Answer 44

perinephric fat

Question 45

what is just outside of the perinephric fat?

Answer 45

the renal fascia

Question 46

what is just outside of the renal fascia?

Answer 46

paranephric fat

Question 47

what is found in the renal hilum?

Answer 47

the renal artery and the renal vein

Question 48

what is the space in the kidney that is filled with some of the perinephric fat called?

Answer 48

the renal sinus

Question 49

what is it called where the ureter expands into a funnel-like shape?

Answer 49

renal pelvis

Question 50

where does the renal pelvis collect urine from?

Answer 50

The major calyx

Question 51

what makes up the renal medulla?

Answer 51

renal pyramids

Question 52

what sits between the renal pyramids and makes up the renal cortex?

Answer 52

the renal columns

Question 53

what is found at the tips of the renal pyramids?

Answer 53

the renal papilla

Question 54

what does the ureter connect?

Answer 54

the renal pelvis to the bladder

Question 55

where are common potential sites of obstruction in the ureter?

Answer 55

the junction of the ureter with the renal pelvis, at the point of the crossing of the pelvic brim, and the point where the ureter enters the bladder wall

Question 56

what can be used to detect an obstruction of the ureter?

Answer 56

a pyelogram

Question 57

what is the blood supply to the suprarenal glands?

Answer 57

superior, middle, and inferior suprarenal arteries

Question 58

where are all the lymphatics of the posterior abdominal wall collected into?

Answer 58

the cisterni chyli

Question 59

what is the cisterni chyli the beginning of?

Answer 59

the thoracic duct

Question 60

where does the subcostal nerve come from?

Answer 60

the anterior rami of T12

Question 61

where does the iliohypogastric nerve come from?

Answer 61

the anterior rami of L1

Question 62

where does the ilioinguinal nerve come from?

Answer 62

the anterior rami of L1

Question 63

where does the genitofemoral nerve come from?

Answer 63

the anterior rami of L1 and L2

Question 64

where does the lateral femoral cutaneous nerve come from?

Answer 64

the anterior rami of L2 and L3

Question 65

where does the femoral nerve come from?

Answer 65

the anterior rami of L2, L3, and L4

Question 66

where does the obturator nerve come from?

Answer 66

the anterior rami of L2, L3, and L4

Question 67

where does the lumbosacral trunk come from?

Answer 67

L4 and L5

Question 68

what is the innervation of the suprarenal glands?

Answer 68

preganglionic sympathetic from T10-L1; celiac plexus and abdominopelvic splanchnic nerves