Posterior Abdominal Wall: Week 1

Question 1

Diaphragm→ originates @ __, costal margin, quadratus lumborum and __(medial & lateral arcuate ligaments, vertebral bodies L1-3)

Answer 1

xiphoid process, psoas fascia

Question 2

Diaphragm–> insertion @ ___ of the diaphragm

Answer 2

central tendon

Question 3

Diaphragm –> innervated by __ (C3-5)

Answer 3

phrenic nerve

Question 4

Diaphragm –> function = __ vertical diameter of thoracic cavity

Answer 4

increases

Question 5

Psoas major originates
@ vetebral bodies, __ __, and transverse processes of T12 to L4

Answer 5

IV discs

Question 6

Psoas major inserts @

Answer 6

lesser trochanter of femur

Question 7

Psoas major is innervated by the …

Answer 7

ventral rami of L1 to L3/4

Question 8

Psoas major function is flexion of __ at hip joint and flexion of trunk __ & __

Answer 8

thigh, forward, lateral

Question 9

Quadratas Lumborum origin @ Transverse process of L5, __, and __

Answer 9

iliolumbar lig, iliac
crest

Question 10

Quadratus Lumborum inserts @ __, and Rib 12

Answer 10

L1-4 Transverse processes

Question 11

Quadratus Lumborum innervated by Ventral rami of __, L1 to L4

Answer 11

T12

Question 12

Quadratus Lumborum function is __ & __ Rib 12. Some lateral bending as well.

Answer 12

Depression, stabilizing

Question 13

Psoas minor originates @ __ and IV discs of T12 and __

Answer 13

vetebral bodies, L1

Question 14

Psoas minor inserts @ __ of pelvic brim and iliopubic eminence

Answer 14

Pectineal line

Question 15

Psoas minor is innervated by …

Answer 15

L1 ventral ramus

Question 16

Psoas minor function weak __ of lumbar region

Answer 16

flexion

Question 17

Iliacus originates @ upper __ of iliac fossa, __ and iliolumbar ligament, upper lateral sacrum

Answer 17

2/3rds, anterior sacroiliac

Question 18

Iliacus inserts @ __ __ with psoas major (iliopsoas m)

Answer 18

lesser trochanter

Question 19

Iliacus is innervated by…

Answer 19

femoral nerve (L2-4)

Question 20

Iliacus function is flexion of __ at hip joint

Answer 20

thigh

Question 21

3 Regions of the Diaphragm:

Answer 21

1. Sternal Part - Xiphoid process
2. Costal Part - Internal Surface of 7th-12th ribs
3. Lumbar part- Medial Arcuate Ligament & Lateral Arcuate Ligament

Question 22

Median Arcuate Ligament:

Answer 22

connects crura @ midline, arches anterior to the AORTA, completes the aortic hiatus

Question 23

Medial Arcute Ligaments (right & left):

Answer 23

arch from crus to transverse process of L1, arch anterior to the psoas major muscle

Question 24

Lateral arcuate ligament:

Answer 24

tendinous arch from transverse process of L1 to 12th rib, arches anterior to quadratus Lumborum muscle

Question 25

Aortic haitus (major opening):

Answer 25

Located @: At T12, posterior to median arcuate ligament Structures passing through: Aorta, Thoracic Duct, and sometimes azygos v.

Question 26

Esophageal hiatus:

Answer 26

located @: AT T10, within right crus Structures passing through: Esophagus, vagal trunks, esophageal vessels

Question 27

Caval opening:

Answer 27

Located @: At T8, in central tendon (Rt) Structures passing through: IVC, right phrenic nerve

Question 28

Motor (efferent) innervation of the Diaphragm

Answer 28

Phrenic n (C3-5) solely

Question 29

Sensory (afferent) innervation of the Diaphragm | from fascia lining the diaphragm

Answer 29

* Centrally: phrenic nerve * Periphery: Intercostal nn 7 – 11 and subcostal (T12)

Question 30

Blood supply of the Diaphragm superior surface

Answer 30

* Musculophrenic and pericardiophrenic aa from Internal thoracic * Superior phrenic from Thoracic aorta

Question 31

Blood supply of the Diaphragm inferior surface

Answer 31

Inferior phrenic aa from Abdominal Aorta

Question 32

Refer to Slide 18 for innervation of the posterior abdominal wall

Question 33

Arteries of the Posterior Abdominal Wall

Answer 33

**ABDOMINAL** **AORTA** * Begins at T12 (aortic hiatus) * Ends at L4, bifurcating into two common iliac aa.

Question 34

Branches of PAW: branches of abdominal aorta

Answer 34

Branches of Abdominal Aorta * Parietal branches * Inferior phrenic aa (right & left) at T12 * Lumbar aa (4 pairs) * Median sacral a. (single artery) at L4 * Paired visceral branches * Middle suprarenal aa.(adrenal) at L1 * Renal aa(L1/2) * Gonadal aa(L2) * Unpaired visceral branches * Celiac a. at L1 * SMA at L1 * Inferior mesenteric a. at L3 ## Footnote Look at slide 15 for image

Question 35

Nerves of posterior abdominal wall

Answer 35

Lumbar plexus: contribution from ventral rami of L1 – L4 --> 50% receive contribution from T12

Question 36

Branches of Lumbar Plexus

Answer 36

* Iliohypogastric (L1) * Ilioinguinal (L1) * Genitofemoral (L1-2) * Lateral cutaneous nerve of the thigh (L2,3) * Femoral nerve (L2-4) * Obturator nerve (L2-4) ## Footnote slides 19-26

Question 37

Kidneys lie on __ abdominal wall and are fixed by __ posterior to peritoneum

Answer 37

posterior, retroperitoneal ## Footnote slide 31

Question 38

Kidney anterior relationships

Answer 38

Right kidney -->Heptorenal recess (Morrison's Pouch) [btwn Right Kidney and Liver] --> Diaphragm --> Lung | Right kidney is slightly lower ## Footnote Kidney most inferior to all other structures; slide 32

Question 39

Kidney posterior relationship ## Footnote slide 33

Answer 39

Diaphragm Quadratus lumborum m Transversus abdominis 11th & 12th ribs- left kidney 12th rib – right kidney Costodiaphragmatic recess Nerves: * Subcostal * iliohypogastric * ilioinguinal

Question 40

Kidney covering from outermost to innermost layer:

Answer 40

Pararenal fat Renal fascia Perirenal fat Fibrous capsule Kidney

Question 41

Kidney internal gross anatomy

Answer 41

renal cortex Major calyx renal medulla renal pyramids renal pelvis minor calyx renal papilla renal hilum ureter ## Footnote Slide 36

Question 42

Renal sinus

Answer 42

large, fat-filled cavity inside of the kidney that extends from the hilum ## Footnote slide 36

Question 43

Renal pelvis

Answer 43

is the upper expanded end of the ureter, located mostly in the renal sinus ## Footnote slide 37

Question 44

Constrictions (lodging of kidney stones) of the Ureters: Locations

Answer 44

Ureteropelvic Junction Cross Brim of Pelvic Inlet Vesicoureteric Junction | Slide 40