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Anatomy Posterior Abdominal Wall
KYCOM Block 2
145
Anatomy
Graduate
09/19/2012

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Term
what are the components of the posterior abdominal wall
Definition
lumbar vertebra, intervertebral discs, upper hip bone, psoas major, psoas minor, iliacus, quadratus lumborum, posterior transversus abdominis, lumbar diaphragm
Term
what is the origin of the quadratus lumborum
Definition
iliolumbar ligament and iliac crest
Term
what is the origiin and insertion of the iliolumbar ligament
Definition
from transverse process of L5/L4 to posterior iliac crest
Term
what is the insertion of the quadratus lumborum
Definition
border of 12th rub and transverse process of upper 4 lumbar
Term
what innervates quadratus lumborum
Definition
ventral rami of T12-L3/4
Term
what are the actions of the quadratus lumborum
Definition
flex rib 2 holding it down against traction of diaphragm, lateral flexion of lumbar spine
Term
what is the origin of the peripherial part of the diaphragm
Definition
margin of inferior thorasic aperature
Term
what is the peripherial part of the diaphragm made of
Definition
muscle
Term
what is the central part of the diaphragm made of
Definition
tendon
Term
what is the name of the central part of the diaphgram
Definition
central tendon
Term
what is the function of the central tendon
Definition
where muscle fibers insert
Term
what are the three parts of the diaphgram
Definition
sternal, costal, lumbar
Term
what part of the diaphgram is the smallest
Definition
sternal
Term
where do the sternal diaphragm fibers originate
Definition
posterior surface of xyphoid
Term
were do the costal diaphragm fibers originate
Definition
interal surface of lower ribs and their costal cartilages
Term
where does the lumbar diaphragm fivers originate
Definition
right crus, left crus, median acurate ligament
Term
what does the right crus attach to
Definition
vertebral bodies of L1-3/4 and the intervetebral discs
Term
what does the left crus attach to
Definition
vertebral bodies of L1-2/3 and the intervetebral discs
Term
what does the acurate ligament attach to
Definition
the medial borders of the right and left cura
Term
what does the acurate ligament cover
Definition
the anterior surface of the aorta
Term
what is the origin and insertion of the medial acurate ligament
Definition
body of L2 to tip of transverse process of L1
Term
what does the medial acurate ligament cover
Definition
anterior surface of psoas major muscle
Term
what is the origin and insertion of the lateral arcuate ligament
Definition
tip of transverse process of L1 to 12th rib
Term
what does teh lateral acurate ligament cover
Definition
anterior of the quadratus lumborum
Term
which dome of the diaphragm is higher, why
Definition
the right because of the liver on the left
Term
during expiration what rib level is the right done
Definition
upper border of rib 5
Term
during expiration what rib level is the left dome
Definition
lower border of rib 5
Term
on which side of the body does the diaphragm attach down the most
Definition
posterior
Term
what structures surround the aortic hiatus
Definition
body of T12, right and left cura, median acurate ligament
Term
what passes through the aortic haitus with the aorta
Definition
thoracic duct
Term
where is the aortic hiatus in relation to the diaphgram
Definition
posterior
Term
where is the esophageal hiatus on the diaphgram in relation to the aortic hiatus
Definition
anterior, superior, and slightly left of the aortic haitus
Term
what goes through the esophageal hiatus with the esophagus
Definition
anterior and posterior vagal trunks, esophageal branches of left gastric vessels
Term
where is the caval opening on the diaphgram in relation to the esophageal hiatus
Definition
anterior, superior and to the right, in the central tendon
Term
where do the splanchnic nerves pierce the diaphgram
Definition
cura
Term
where does the sympathetic trunk pierce the diaphgram
Definition
posterior to medial acurate ligament
Term
where do the terminal branches of the right phrenic nerve pierce the diaphgram
Definition
central tendon, immediatly to the right of the IVC
Term
where do the terminal branches of the left phrenic nerve pierce the diaphgram
Definition
muscle anterior to central tendon and close to apex of heart
Term
what is the sternal costal triangle
Definition
small gap between the sternal and costal origins of the diaphragm
Term
what does the sternal costal triangle transmit
Definition
superior epigastric vessels, lymph vessels
Term
what nerves supply the diaphragm
Definition
phrenic, ventral rami of C3-5
Term
what is the most important muscle in inspiration
Definition
diaphragm
Term
what are the functions of the diaphragm
Definition
inspiration, abdominal pressure holding, andominal evacuation, helps in weight liting by preventing flexion, thoracoabdominal pump
Term
what is the function of the thoracoabdominal pump
Definition
contraction and descent of the diaphragm increases intra abdominal pressure and decreases intro-thoracic pressure, helps blood in IVC to move up and into right atrium and lymph to thoracic duct
Term
what nerves does the lumbar plexus include
Definition
L1-3 and part of 4.
Term
what does the lumbar plexus supply
Definition
anterior abdominal wall, external genitalia, lower limbs
Term
if L4 isnt fully committed to the lumbar plexus, who is it cheating with
Definition
joins L5 to form the lumbosacral trunk in the sacral plexus
Term
what are the three branches of L1
Definition
iliohypograstric, ilioinguinal, lower branch that joins the genitofermoral
Term
what does the anterior division of the lumbar plexus include and form
Definition
L2, L3, and L4 form the obtuartor
Term
what does the posterior division of the lumbar plexus include and form
Definition
L2, L3, and L3 forming the femoral nerve
Term
what forms the lateral cutaneous nerve of the thigh (lateral femoral cutaneous nerve)
Definition
L2 and L2 of lumbar plexus
Term
what branches of the lumbar plexus form the lateral border of the psoas majow muscle
Definition
iliohypogastric, ilioinguinal, lateral femoral cutaneous, and femoral
Term
what branches of the lumbar plexus form the medial border of the psoas major muscle
Definition
obturator
Term
what branches of the lumbar plexus form the anterior border of the psoas major muscle
Definition
genitofemoral
Term
what type of peritoneal covering does the genitofemoral nerve have
Definition
retroperitoneal, descends behind the peritonieum
Term
what are the branches of the genitofemoral nerve
Definition
genital, femoral
Term
what does the genital branch of the genitofemoral nerve supply in males
Definition
cremaster muscle and skin of scrotum
Term
what does the genital branch of the genitofemoral nerve supply in females
Definition
joins round ligament and supplies skin of labium majus
Term
what does the femoral branch of the genitofemoral nerve supply
Definition
skin over upper part of femoral triangle
Term
how many ganglia are in the lumbar sympathetic trunk
Definition
3-5
Term
describe the path of the lumbar sympathetic trunk
Definition
medial border of psoas major on bodies of lumbar vertebra, passes posterior to common iliac vessels to become continous with acral part of sympathetic trunk. on the right is is posterior to the right of IVC on left it is adjacent to the left of aorta
Term
what are the branches of the lumbar sympathetic trunk (one side)recieves
Definition
recieves 2 branches of white communicating rami from lumbar spinal nerves
Term
what are the branches of the lumbar sympathetic trunk (one side)gives
Definition
one gray communicating rami to all lumbar spinal nerves
Term
what do the lumbar splanchnic nerves join
Definition
superior hypogastric plexuses
Term
what nerve fibers does the lumbar splanchnic nerves have
Definition
sympathetic (visceral motor) and visceral sensory fibers
Term
where is the aortic plexus located
Definition
anterior to abdominal aorta
Term
what does the aortic plexus recieve fibers from
Definition
thoracic splanchnic and lumbar splanchnic nerves
Term
what fibers leave the aortic plexus
Definition
vagus
Term
what prevertebral ganglia does the aortic plexus contain
Definition
celiac, aorticorenal, superior and inferior mesenteric
Term
what is the superior hypogastric nerve a continuation of
Definition
aortic plexus
Term
where does teh superior hypogastric nerve begin, then where is it located
Definition
at bifuraction of abdominal aorta, between right and left common iliac vessels and anterior to L5 and sacral promontory
Term
what vertrbra does the kidney line up with
Definition
T12-L3
Term
what kidney is lower, why
Definition
the right because of the liver on the left
Term
what are the functions of the kidney
Definition
excrete most waste of metabolism, control wanter and electrolyte balance, control acid-base balance, secrete blood pressure regulators and hematopoeisis
Term
what blood regulators does the kidney release
Definition
renin, erythropoietin
Term
what are the surfaces of the kidney
Definition
anterior and posterior
Term
what are the poles of the kidney
Definition
superior and inferior
Term
wha are the borders of the kidney
Definition
medial and lateral
Term
where is the kidney hilum located
Definition
medial border
Term
where does the kidney hilum lead to
Definition
renal sinus
Term
what structures are in the kidney hilum
Definition
renal vein, artery, renal pelvis, lymph, autonomic nerves
Term
what is the renal pelvis an extension of
Definition
the ureter
Term
what are the coverings of the kidney
Definition
perirenal fat, renal fascia, parareal fat
Term
what is the function of the coverings of the kidney
Definition
support them, hold them in place, apposition to neighboring organs
Term
what is the perirenal fat in contact with
Definition
kidney and suprarenal gland, extends through hilum into renal sinus
Term
what does the renal fascia cover
Definition
kidney, adrenal gland, and perirenal fat
Term
what does the pararenal fat cover
Definition
kidney, adrenal gland, perirenal fat, renal fascia. in contact with extraperitoneal fat
Term
what is touching the anteiror right kidney
Definition
liver, duodenum 2, r colic flexure, coils of si
Term
what is touching left anterior kidney
Definition
spleen, stomach, pancreas, left colic flexure, coils of si
Term
what is touching the posterior right kidney
Definition
psoas major, quadratu lumborum, transversus abdominis, diaphragm, 12th rib, subcostal, iliohypograstric, ilioinguinal
Term
what is touching the left posterior kidney
Definition
psoas major, quadratu lumborum, transversus abdominis, diaphragm, 12th rib, 11th rib, subcostal, iliohypograstric, ilioinguinal
Term
what are the layers of the renal parenchyma
Definition
cortex and medulla
Term
where are the renal pyramids located, how are they oriented
Definition
in the medulla, with their apex towards the renal sinus
Term
what seperates teh renal pyramids
Definition
renal columns
Term
what is the apex of the renal pyramid called
Definition
renal papilla
Term
where is the renal parenchyma located
Definition
surrounded by a fibrous capsule
Term
what perferate the renal papillae
Definition
colleting ducts
Term
where do collecting ducts drain urine
Definition
into minor calyces
Term
describe the path from minor calyces to ureter
Definition
minor calyces join > 2-3 major calyces > renal pelvis > tapers becoming continous with ureter
Term
what are the contents of the renal sinus
Definition
branches of the renal artery, tributaries of the renal vein, minor and major calyces, renal pelvis, lymph, autonomic nerves, adipose
Term
what is the ureter made of
Definition
muscle
Term
where does the ureter begin
Definition
abdomen as a continuation of the renal pelvis
Term
what is the ureter behind
Definition
psoas major and peritoneum
Term
at what point does the ureter turn forward to reach the base of the urinary bladder
Definition
ischial spine
Term
where may kidney stones be located
Definition
constrictions in the ireter: renal pelvis ureter junction, pelvic brim, where is pierces bladder
Term
what is the most narrow part of the ureter
Definition
where it pierces the bladder
Term
what is the pelvic brim
Definition
where the ureter crosses the bifrucation of the common iliac artery
Term
what touches the anterior right ureter
Definition
duodenum 2, right colic and ileocolic vessels, right ovarian and testicular vessels, lower mesentery of si, terminal ileum
Term
what touches the anterior of the left ureter
Definition
left colic vessels, left ovarian and testicular vessels, sigmoid colon and its mesentery
Term
what touches the posterior side ot the ureter
Definition
psoas major, genitofemoral nerve, bifurcation of the common iliac
Term
what shape is the right suprarenal gland
Definition
pyramidal
Term
what touches the anterior side of the adrenal gland
Definition
liver
Term
what is in front of the medial right adrenal gland
Definition
IVC
Term
what is the shape of the left adrenal gland
Definition
crescent
Term
what is anterior to the left adrenal gland
Definition
pancreas, lesser sac, stomach
Term
what does the adrenal cortex come from
Definition
mesoderm
Term
what does the adrenal medulla come from
Definition
ectoderm (neural crest cells)
Term
what hormones are secreted by the adrenal cortex
Definition
mineralcorticoids (aldosterone), glucocorticoids (cortisol), androgens
Term
what does aldosterone do
Definition
regulate clectrolyte and water balance
Term
what does cortisol do
Definition
regulate carbohydrate, protein, and fat metabolism
Term
what are androgens
Definition
sex hormones
Term
what does the adrenal medulla secrete
Definition
catecholamines (epinepherine)
Term
what arteries supply the adrenal glands
Definition
superior suprarenal arteries, midle suprarenal srtery, inferior suprarenal artery
Term
what is the superior suprarenal arteries a branch of
Definition
inferior phrenic a
Term
what is the middle suprarenal artery a branch od
Definition
paired visceral branch of abdominal aorta
Term
what is the inferior suprarenal artery a branch of
Definition
renal artery
Term
what vein drains the artery
Definition
single suprarenal vein
Term
what does the right suprarenal vein drain into
Definition
IVC
Term
what does the left suprarenal vein drain into
Definition
left renal vein
Term
what is the adrenal medulla innervated by
Definition
preganglionic sympathetic fibers
Term
what does the common iliac artery follow
Definition
psoas major
Term
where does the common iliac artery termiate
Definition
L5.S1 intervetebral disc level by dividing into internal and external iliac a
Term
what does the external iliac artery run along
Definition
medial border of psoas major
Term
where does the external iliac artery end
Definition
enters the thigh by passing under inguinal ligament to become femoral a
Term
what branches does the external iliac artery give off, where
Definition
inferior epigastric and deep circumflex iliac arteries, just before it becomes the femoral
Term
what forms the IVC, where
Definition
right and left common iliac veins, posterior to right common iliac a at L5
Term
when the IVC accends, where is it loacted in relation to the abdominal aorta and vertebra
Definition
right of aorta and anterior to vertebra
Term
what is the spot on the liver called where it passes
Definition
deep groove
Term
what branches of the IVC dont correspond to the branches of the aorta
Definition
unpaired visceral branches that correspond with unpaired visceral branches of the abdominal aorta and drain into the portal system
Term
what are the visveral tributaries of the IVC
Definition
r and l renal, r suprarenal, r ovarian/testicular, hepatic
Term
where does the left suprarenal vein drain into
Definition
left renal vein
Term
where does the left ovarian/testicular vein drin into
Definition
left renal vein
Term
describe the lumbar veins
Definition
connect to eachother before they enter the IVC by vertical anastomotic venous channels called ascending lumbar vein
Term
what are the parietal tributaries of the IVC
Definition
inferior phrenic veins, lumbar veins
Term
where does the median sacral vein terminate
Definition
left common iliac
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