Posterior Abdominal Wall Notes

Front 1

formation of sympathetic innervation to abdomen

Back 1

comes from the greater, lesser and least (abdominopelvic) splanchnic nerves and forms the celiac ganglion, which gives branches to aorticorenal ganglia, superior mesenteric and inferior mesenteric ganglia

Front 2

formation of parasympathetic innervation to abdomen

Back 2

vagus nerve, which comes from the left and right vagal trunks, becomes the anterior (left) and posterior (right) vagus at the stomach, innervates to all midgut derivatives, parasympathetic to the hindgut comes from the S2-S4 pelvic splanchnic nerves, which form a pelvic plexus

Front 3

abdominopelvic splanchnic nerves

Back 3

consists of the lower thoracic splanchnic nerves and the lumbar splanchnic nerves

Front 4

lumbar splanchnic nerves

Back 4

form the intermesenteric, inferior mesenteric and superior hypogastric plexuses

Front 5

celiac ganglion

Back 5

innervates the stomach, liver, gallbladder and pancreas

Front 6

aorticorenal ganglia

Back 6

innervates the kidneys and gonads

Front 7

superior mesenteric ganglia

Back 7

innervates the jejunum, ileum, cecum, ascending colon, transverse colon

Front 8

inferior mesenteric ganglia

Back 8

innervates the descending colon, rectum, sigmoid colon

Front 9

visceral afferent fibers

Back 9

convey pain sensations, accompany the sympathetic fibers and reflexes that accompany the parasympathetic fibers

Front 10

innervation levels of the foregut, midgut, and hindgut

Back 10

foregut-T6-T9
midgut-T8-T12
hindgut-T12-L2

Front 11

parasymphatetic

Back 11

consists of the anterior and posterior vagal trunks, pelvic splanchnic nerves, abdominal autonomic plexues, and the enteric parasympathetic ganglia

Front 12

pelvic splanchnic nerves

Back 12

convey presynaptic parasympathetic fibers to the inferior hypogastric plexus

Front 13

abdominal autonomic plexus

Back 13

form a pathway for the celiac, superior mesenteric and the inferior mesenteric plexus to be interconnected

Front 14

central tendon of the diaphragm

Back 14

the trifoliate central aponeurotic part of the diaphragm

Front 15

openings in the diaphragm

Back 15

from anterior to posterior, caval opening (T8, in the central tendon), esophageal hiatus (T10), aortic hiatus (T12)

Front 16

three parts of the muscular portion of the diaphragm

Back 16

sternal part, costal part, lumbar part (arises from two aponeurotic arches, the medial and lateral arcuate ligaments and the three superior lumbar vertebrae, forms right and left muscular crura that ascend to the central tendon)

Front 17

crura of the diaphragm

Back 17

musculotendinous bundles that arise from the anterior sufaces of the bodies of the superior three lumbar vertebrae, the anterior longitudinal ligament and the IV discs

Front 18

right crus

Back 18

larger and longer than the left crus, arises from the first 3 lumbar vertebrae, esophageal hiatus is found here

Front 19

left crus

Back 19

smaller than the right, arises from the first 2 lumbar vertebrae

Front 20

median arcuate line

Back 20

unites the right and left crura, forms the aortic hiatus

Front 21

medial arcuate line

Back 21

thickening of fascia coverin the psoas major

Front 22

lateral acruate line

Back 22

thickening of fascia covering the quadratus lumborum

Front 23

superior blood supply to the diaphragm

Back 23

pericardiophrenic, musculophrenic arteries, branches of the internal thoracic

Front 24

inferior blood supply to the diaphragm

Back 24

inferior phrenic arteries, although these are the first branches of the abdominal aorta, may be a branch off the celiac

Front 25

inferior blood drainage of the diaphragm

Back 25

inferior phrenic vein, right drains into the IVC, left has two branches (anterior to the IVC, posterior to the left suprarenal vein)

Front 26

lymphatic drainage of the diaphragm

Back 26

anterior and posterior diaphragmatic lymph nodes, posterior lymph node drains into the parasternal, posterior mediastinal and phrenic lymph nodes, anterior drains into the phrenic and superior lumbar lymph nodes

Front 27

innervation of the diaphragm

Back 27

right and left phrenic nerves (C3-C5)

Front 28

aortic hiatus

Back 28

does not pierce the diaphragm, is actually posterior to it, thus the blood flow is not affected by the diaphragm

Front 29

small apertures in the diaphragm

Back 29

sternocostal triangle (foramen)-small opening in the diaphragm between the sternal and costal attachments of the diaphragm, transmits lymphatics
at each crus there are small foramen for the greater and lesser splanchnic nerves

Front 30

psoas fascia

Back 30

covers the psoas major, attached medially to the lumbar vertebrae and pelvic brim, thickened superiorly to form the medial arcuate ligament, fuses medially with the qaudratus lumborum and thoracolumbar fascias

Front 31

thoracolumbar fascia

Back 31

surrounds the erector spinae muscles, has a posterior, middle and anterior layer

Front 32

quadratus lumborum fascia

Back 32

the anterior layer of the thoracolumbar fascia, covers the quadratus lumborum, thickens superiorly to form the lateral arcuate ligament, adherent inferiorly to the iliolumbar ligaments

Front 33

psoas major

Back 33

origin-transverse processes of lumbar vertebrae, contraction causes irritation of an inflamed appendix
insertion-lesser trochanter of femur
action-flexes thigh, balance the trunk
innervation-lumbar plexus via L2-L4

Front 34

quadratus lumborum

Back 34

origin-medial half of inferior border of 12th ribs, tips of lumbar transverse processes
insertion-iliolumbar ligament and internal lip of iliac crest
action-extneds and laterally flexes the vertebral column
innervation-T12, L1-L4

Front 35

subcostal nerve

Back 35

runs anterior to the quadratus lumborum

Front 36

lumbar plexus

Back 36

formed anterior to the lumbar transverse processes from L1-L4

Front 37

femoral nerve

Back 37

branch of the lumbar plexus, emerges from the lateral border of the psoas and innervates the iliacus passing deep to the inguinal ligament

Front 38

obturator nerve

Back 38

emerges from the medial border of the psoas major and passes into the lesser pelvis

Front 39

ilioinguinal and iliohypogastric

Back 39

arise from the anterior ramus of L1, enters posterior to the medial arcuate ligament

Front 40

genitofemoral nerve

Back 40

pierces the psoas major and runs inferiorly on its anterior surface, divides to the common and external iliac arteries into femoral and genital branches

Front 41

lateral femoral nerve

Back 41

runs inferolaterally on the iliacus and enters the thigh deep to the inguinal ligament

Front 42

branches of external iliac artery

Back 42

deep circumflex and inferior epigastric

Front 43

lymphatics in the posterior abdominal wall

Back 43

external and internal iliac lymph nodes -> common iliac lymph nodes or inferior mesenteric lymph node -> right and left lumbar lymph nodes

Front 44

right and left lumbar lymph nodes

Back 44

receive lymph from the posterior abdominal wall, kidneys, ureters, testes or ovaries, uterus and uterine tubes

Front 45

chyle cisternae

Back 45

thin-walled, sac of the inferior aspect of the thoracic duct, two lumbar trunks and one intestinal trunk, to get here must slit the right crus

Front 46

innervation of the bladder

Back 46

sympathetics from the hypogastric plexus innervate the involuntary sphincter, parasympathetics from the pelvic splanchnics (S2-S4) may cause urination (innervates the detrussor muscle)

Front 47

pudendal nerve

Back 47

can control the voluntary sphincter

Front 48

polar arteries of the kidney

Back 48

embryological, may be present in adults if it was not obliterated when the kidney became supplied by the renal arteries

Front 49

white rami

Back 49

enters the chain, only from T1-L2

Front 50

abdominal regions of the body

Back 50

right hypochondriac, right lateral (lumbar), right inguinal (groin), epigastric, umbilical, pubic

Front 51

transverse mesocolon

Back 51

divides the abdominal cavity into a supracolic compartment (stomach, liver, spleen) and infracolic compartment (small intestine and ascending and descending colon)

Front 52

prepyloric vein

Back 52

ascends over the pylorus to the right gastric vein, obvious in living persons

Front 53

anterior vagal trunk

Back 53

derived mainly from the left vagus nerve, runs toward the lesser curvature of the stomach, where it gives off hepatic and duodenal branches, leave the stomach to the heptoduodenal ligament

Front 54

posterior vagal trunk

Back 54

derived mainly from the right vagus nerve, gives off a celiac branch, runs to the celiac plexus

Front 55

sympathetic nerve supply of the stomach

Back 55

from T6-T9, pass to the celiac plexus through the greater splanchnic nerves

Front 56

renal fascia and the diaphragmatic fascia

Back 56

renal fascia is continuous with the fascia on the inferior surface of the diaphragm, primary attachment of the suprarenal glands is to the diaphragm

Front 57

level of the kidney

Back 57

T12-L3

Front 58

constriction points of the ureters

Back 58

1. at the junction sof the ureters and renal pelvis
2. where the ureters cross the brim of the pelvic inlet
3. during their passage through the wall of the urinary bladder

Front 59

arterial branches of the ureters

Back 59

renal arteries, gonadal arteries, abdominal aorta, iliac arteries (vesicular)

Front 60

fat in the adrenal gland

Back 60

perinephric

Front 61

suprarenal cortex

Back 61

derives from mesoderm and secretes corticosteroids and androgens, cause the kidney to retain sodium and water, INC blood volume and pressure

Front 62

suprarenal medulla

Back 62

nervous tissue permeated with capillaries, secrete epinephrine, activate the body to a flight of flight status

Front 63

venous drainage of the right suprarenal vein

Back 63

IVC

Front 64

venous drainage of the left suprarenal vein

Back 64

left renal vein

Front 65

lympathics of the kidney

Back 65

renal lymphatic vessels follow the renal veins and drain into the right and left lumbar lymph nodes

Front 66

lymphatics of the ureter

Back 66

middle part-drain into the common iliac lymph nodes
inferior part-drain into the external or internal iliac lymph nodes, then passes to the lumbar lymph nodes

Front 67

innervation of the kidney

Back 67

renal nerve plexus from the abdominopelvic splanchnic nerves

Front 68

innervation of the suprarenal gland

Back 68

from the celiac plexus and abdominopelvic splanchnic nerves