Posterior Abdominal Wall and Respiratory Diaphragm Flashcards Preview

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Flashcards in Posterior Abdominal Wall and Respiratory Diaphragm Deck (81):
1

4 Posterior abdominal wall muscles

Psoas major, psoas minor, quadratus lumborum, iliacus

2

Psoas major m proximal attachment

lateral aspect and transverse processes of vertebral bodies T12-L5

3

Psoas major distal attachment for psoas major

lesser trochanter of femur

4

Psoas major innervation

L2, L3, L4 via lumbar plexus

5

Psoas major actions

bilaterally flex thigh at high
unilaterally side bends trunk to same side

6

Iliacus proximal attachment

iliac fossa of pelvis

7

Iliacus distal attachment

lesser trochanter of femur

8

Iliacus innervation

femoral n

9

Iliacus actions

flexes thigh at hip

10

Psoas minor proximal attachment

lateral aspect of vertebral bodies of T12-L1

11

Psoas minor distal attachment

pectineal line

12

Psoas minor innervation

L1 and L2

13

Psoas minor actions

Fixes 12th rib during deep inspiration*
Bilaterally assist with trunk extension
Unilaterally side-bends trunk to same side

14

Quadratus Lumborum proximal attachment

iliac crest and iliolumbar ligament

15

Quadratus Lumborum distal attachment

medial half of inferior border of the 12th rub

16

Quadratus lumborum innervation

T12-L4

17

Quadratus lumborum actions

Flexes Rib 12 during inspiration
Extends and laterally flexes vertebral column

18

What organs do psoas major and iliacus m associate with

Kidney, ureter, cecum, sigmoid colon, pancreas, posterior abdominal nerves

19

Presentation of Psoas Syndrome

Lumbosacral pain, difficulty standing up, pain in contalteral gluteal region, radiation down lower extremity

20

Borders of the diaphragm

Xiphisternal Joint, Costal Margin, Vertebral body of T12, Right and Left domes,

21

3 peripheral origins insert on central tendon

Sternal origin, costal origin, 12th vertebral body origin

22

Where do the right and left crus meet?

aortic hiatus

23

Right crus vs left crus

Right crus is longer and medial and Left crus is shorter and more lateral

24

What vertebral level is the caval opening?

T8

25

What 3 things come out of the caval opening

Inferior phrenic, branches of R phrenic nerve, lymphatics from liver

26

What opening is at T10

esophageal hiatus

27

What 3 things are coming out of the Esophageal Hiatus

Esophagus, Anterior/Posterior vagal trunks, esophageal branches of L gastric artery

28

What opening is at T12

Aortic Hiatus

29

What 3 things are coming out of the aortic hiatus

Aorta, thoracic duct, azygous vein

30

What is coming out of the sternocostal hiatus

Superior Epigastric vessels

31

What do the posterior origins of the diaphragm form

the arcuate ligaments

32

What are the 3 arcuate ligaments

median, medial, lateral

33

What posterior abdominal wall structure does the median arcuate ligament form?

aortic hiatus

34

What posterior abdominal wall structure does the medial arcuate ligament form?

gap for Psoas Major m.

35

What posterior abdominal wall structure does the lateral arcuate ligament form?

gap for quadratus lumborum m.

36

How do diaphragmatic hernias occur

attachment become stretched or ligaments become loose

37

Why are diaphragmatic hernias more common on L side

protection of the right hemidiaphragm by the liver

38

Where do parasternal hernias occur

sterocostal triangle

39

Where is the sternocostal triangle located

between sternal and costal parts of diaphragm

40

What kind of hernia happens at the lumbocostal triangle

pleuroperitoneal hernia

41

Where is the lumbocostal triangle located

between 12th rib and diaphragm

42

How does a congenital disphragmatic hernia occur

failure of pleuroperitoneal membranes to fuse with other components of diaphragm

43

S/S of congenital diaphragmatic hernia

Respiratory distress and cyanosis in first minutes or hours of life

44

Two main types of hiatal hernias

Paraesophageal hernia
Sliding hernia

45

Paraesophageal hernia

no regurgitation, only stomach contents in hiatus

46

Sliding hernia

some regurgitation occurs, esophagus and stomach in hiatus

47

How to tell the difference between paraesophageal and sliding hernia on Xray

Barium swallow

48

Superior blood supply to diaphragm

pericaracophrenic, musculophrenic, superior phrenic artery

49

Inferior blood supply to diaphragm

Inferior phrenic artery

50

What does the R inferior phrenic artery pass by

posterior to IVC

51

What does the L inferior phrenic artery pass by

posterior to esophagus

52

Motor innervation to diaphragm

Phrenic Nerve- C3, C4, C5

53

Sensory innervation to central portion of diaphragm

phrenic n

54

Sensory innervation to peripheral portion of diaphragm

intercostal n

55

Superior surface lymphatics of diaphragm (anterior)

anterior diaphragm- anterior diaphragm nodes to parasternal

56

Superior surface lymphatics of diaphragm (posterior)

posterior diaphragm- posterior diaphragm nodes to mediastinal nodes

57

Inferior surface lymphatics of diaphragm

celiac nodes and superior lumbar nodes

58

3 things that drain into thoracic duct

lower extremity/perineum/gluteal region, body wall, GI tract

59

4 lymph nodes that drain into intestinal lymphatic trunk

celiac nodes, superior mesenteric nodes, lumbar nodes, inferior mesenteric nodes

60

What is the cisterna chyli

dilation at end of thoracic duct

61

What lymph drains into cisterna chyli

intestinal lymphatic trunks and lumbar lymphatic trunks

62

Is Cisterna chyli intraperitoneal or retroperitoneal

retroperitoneal

63

Where is the cisterna chyli located

posterior to aorta around L1-L2

64

Areas drained by celiac lymph nodes

liver, stomach, spleen, pancreas, upper duodenum

65

Areas drained by superior mesenteric lymph nodes

lower duodenum, jejunum, ileum, colon up to R colic flexure

66

Areas drained by inferior mesenteric lymph nodes

colon from splenic flexure to rectum

67

Areas drained by internal iliac lymph nodes

lower rectum to anal canal (above pectinate line), bladder, vagina, prostate

68

Areas drained by para-aortic lymph nodes

testes, ovaries, kidneys, uterus

69

Areas drained by superficial inguinal lymph nodes

anal canal (below pectinate line), most skin below umbilicus, scrotum

70

Areas drained by deep inguinal lymph nodes

lower extremity

71

Cell histo above pectinate line

simple columnar

72

Cell histo below pectinate line

stratified squamous

73

2 divisions of peritoneal cavity

greater sac and lesser sac

74

Other name for lesser sac

omental bursa

75

What divides the supracolic and infracolic compartments

transverse mesocolon

76

What is in the supracolic compartment

stomach, liver, spleen

77

What is in the infracolic compartment

small intestine, ascending and descending colon

78

What divides the infracolic compartment into R and L

THE mesentery of SI

79

What is a paracolic gutter

areas between lateral aspects of ascending and descending colon and posterior abdominal wall

80

What is the function of paracolic gutter

free communication between supracolic and infracolic compartment

81

What prevents the spread of fluid superiorly

phenicocolic ligament