Flashcards in Posterior Abdominal Wall and Lumbar Plexus Deck (46):
What are the three layers of the Thoracolumbar Fascia? Which is the layer that covers the quadratus lumborum?
Anterior, Middle and Posterior layer.
It is the anterior layer that covers the quadratus lumborum
Which layer of fascia covers the Psoas Major muscle? What is it's clinical correlation
Can get inflammatory collections from spinal cord and track down to groin where it is thinnest
What is the fascia that is continuous with the Psoas fascia?
What is the fascia that covers the kidney and associated areas? Name the exact areas that it covers.
Bi-laminated fascia over:
Which is the fascia in the thoracolumbar region that fuses with the Transversalis Fascia?
Lateroconal fascia (this is the lateral aspect of peri-renal fascia)
Which are the two muscles that form the conjoined tendon?
Psoas Major and Iliacus
What is the origin and insertion of the Psoas Major
Origin: Transverse processes of T12-L5
Insertion: Lesser trochanter of femr (along with Iliacus
What are the major relations of the psoas Major?
Lies anterior to lumbar plexus
What is the innervation of the Psoas Major
Femoral Nerve (anterior br. of L2-L4)
What are the relations of the Psoas Minor
Inferolateral to sides of T12-L5 bodies
Anterior to Psoas Major
What is the origin and insertion of the Psoas Minor
Origin: Bodies of T12 and L1
Insertion: Pectineal Line (Pectin Pubis)
What is the innervation of the Psoas Minor
Anterior rami of L1
What are the relations of the Iliacus Muscle
Lateral to the inferior part of the Psoas Major
In the Iliac Fossa
Forms conjoined tendon along with Psoas Major - which is deep to Inguinal Ligament
What is the innervation of the Iliacus
Femoral Nerve (L2-L4)
What is the origin of the Quadratus Lumborum
From the Transverse processes of the Lumbar vertebrae and 12th rib
What are the relations of the Quadratus Lumborum
Lateral to superior part of Psoas Major
What is the innervation of the Quadratus Lumborum
Anterior branches of T12-L4
What is the action of the Psoas Major
Flexes the thigh
Flexes vertebral column laterally
Helps to balance the trunk
Helps to flex trunk when sitting
What is the action of the Iliacus
Stabilises hip joint
What is the action of Quadratus Lumborum
Extends and laterally flexes vertebral column
Fixes 12th rib during inspiration
At what level does the abdominal aorta bifurcate into left and right common iliac arteries?
What are the branches of the adominal aorta in the anterior midline? What are the levels?
Superior Mesenteric (L1)
Inferior Mesenteric (L3)
What are the branches of the abdominal aorta laterally? What are their levels?
Gonadal - Testicular or Ovarian (L2)
What are the branches of the abdominal aorta in the posterolateral plane? What are their levels?
Middle Sacral (L4)
Inferior Phrenic (T12)
At what level is the union of the common iliac veins? What do they form?
Form Inferior vena cava
Where does the median sacral vein drain?
Into the left iliac vein
What are the plexuses that ANS travel through to get to the Abdominal Viscera
Superior and Inferior Mesenteric Plexuses
What are the relations of the Hypogastric Plexus
Travels with the Internal Iliac artery and Inferior Mesenteric Artery
What are the nerves that supply the Hypogastric Plexus
Sympathetic verves from T10-L2
Parasympathetic Plevic Splanchnic nerves from S2-S4
What are the main nerves supplying the parasympathetic and sympathetic components of the Abdominal Viscera
-Thoracic Splanchnic (Greater, Lesser and Least)
-Vagus (ant. and post. trunks)
-Pelvic splanchnic nerves
Describe the main visceral plexus of the Abdomen
From ant. primary rami of L1-L4
Deep to and within Psoas Major
What are the branches of the Lumbar Plexus and what forms them?
Iliohypogastric - L1
Ilioinguinal - L1
Genitofemoral -L1 and L2
Lateral cutaneous n. of the thigh - Post. div. of L2-L3
Obturator - ant. div. of L2-L4
Femoral - post. div. of L2-L4
Which branch of the Lumbar plexus communicates with the lumbosacral trunk
What are the Ligaments of the Posterior part of the diaphragm and their respective relations?
Median arcuate Ligament:
Medial arcuate ligament:
-Arch over Pdoas Major
-From median lig. to tip of L1 Transverse Process
Lateral arcuate ligament:
-Over quadratus lumborum
-From tip of L1 transverse process to tip of 12th rib
What are the levels of the crura of the diaphragm
Rt. crus: L1-L3
Lt. crus: L1-L2
What passes through the aortic opening of the diaphragm? What level is this
Left and right ascending Lumbar Vessels
What passes through the oesophageal opening? What level is this?
Anterior and Posterior Vagal Trunks
What passes through the Caval Opening? What level is this?
Rt. Phrenic Nerve
How do the Thoracic Splanchnic nerves pass through the diaphragm?
How do the Sympathic trunks pass through the diaphragm
Through medial arcuate ligament.
How do the subcostal nerves pass through the diaphragm
Through the Later arcuate lig.
How do the branches of the left phrenic nerve pass through the diaphragm?
Through the left dome of the diaphragm
How do the sup. epigastric vessels and lymphatics pass through the diaphragm?
Between diaphragmic attachments to the Xiphoid and 7th costal cartilage
How do the Intercostal neurovascular bundles pass through the diaphragm? Which ones are they?
7th - 12th neurovascular bundles
Pass between costal slips of origin of diaphragm
What is the arterial supply to the diaphragm?
-----Both are branches of the Internal thoracic artery-----
-Inferior Phrenic arteries
-----First branches of the Abdominal Aorta-----