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33 Cards in this Set
- Front
- Back
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describe the difference in pain sensation between primary and secondary retroperitoneal structures |
primary: have specific, sharp, localized pain sensation secondary: keep nerves/blood supply from visceral peritoneum, just pushed back (still dull, unspecific) vagus and splanchnic etc. |
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describe the musculature of the anterior body wall and their fascia connections |
rectus abdominus, surrounded by rectus sheath (depending on what level in the body) external abdominal oblique: aponeurosis anterior, meets latissimus dorsi posterior internal abdominal oblique and transversus abdominis fascia posterior splits around erector spinae, attaches to transverse process and spinous process (thoracolumbar fascia sheath) |
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describe the psoas major and minor |
major: just lateral to vertebral column, anchors to lumbar vertebrae to lesser trochanter of the femur. contracts to lift thigh minor: (present in 50% of people) directly anterior to psoas major into pelvis (spinal flexure slightly) |
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describe the iliacus muscle |
another thigh flexor attaches to iliac crest broad, curved attaches to lesser trochanter of femur, 'fuses' with psoas down more posterolateral than psoas |
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describe the quadratus lumborum |
vaguely quadratic shape attaches to rib, vertebral column and iliac crest (posterior wall) lateral flexor side to side |
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describe the diaphragm (from a posterior abdominal wall context) |
extends far down, injuries to lower abdomen can still result in pneumothorax
central aponeurosis (IVC goes through central tendon) esophagus passes through muscle lateral arcuate ligament: quadratus lumborum attachment medial arcuate ligament: psoas major attachment median arcuate ligament: aorta passes through (left and right crus) |
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describe the innervation of the posterior abdomen |
ventral primary rami thoracic: subcostal lombar sacral |
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describe the organization of the lumbar nerves |
lumbar plexus: communication between branches |
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describe the subcostal nerve |
'part' of the lumbar plexus, under the 12th rib, technically thoracic |
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describe the iliohypogastric nerve |
first nerve to branch innervates abdomen superior to inguinal ligament penetrates psoas major |
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describe the ilioinguinal nerve |
splits off iliohypogastric, or single nerve innervates inguinal region and tissue around pubic symphysis penetrates psoas major |
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describe the lateral cutaneous nerve of the thigh |
innervates anterolateral skin regions of the thigh 3rd nerve down on lateral border of psoas major across surface of iliacus muscle down into thigh |
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describe the femoral nerve |
innervates muscle of anterior compartment of thigh 4th nerve down on lateral border of psoas major thick nerve, more important |
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describe the genitofemoral nerve |
innervates skin of genitals and femoral region exits directly out of anterior surface of psoas |
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describe the obturator nerve |
only nerve on medial side of psoas major through opturator foramen of pelvis innervates muscles of the medial compartment of the thigh |
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describe the general principle of aortic branching in the abdomen |
unpaired anterior branch to viscera (celiac, superior mesenteric, inferior mesenteric) paired laterally to glands (suprarenal, renal, testicular) paired posterior to body wall (phrenic, lumbar, median sacral) bifurcates at L4 |
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describe the unpaired anterior branches of the aorta |
celiac trunk ~T12 to foregut superior mesenteric artery ~L1 to midgut inferior mesenteric artery ~L3 to hindgut |
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describe the branches of the celiac artery |
common hepatic artery to liver (proper hepatic, left and right hepatic) and right gastric artery and pancreatic-duodenal/right gastroomental left gastric artery (to lesser curvature of stomach) splenic artery (to spleen, short gastric and left gastroomental artery in greater curvature) |
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describe the blood supply to the pancreas |
grabs blood supply from everything nearby branches of splenic artery, gastroduodenal artery, superior mesenteric |
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describe the branches of the superior mesenteric artery |
intestinal arteries (many to small intestines) middle colic artery (to transverse colon) continues to marginal, anastamose with inf. right colic artery (to ascending colon) iliocolic artery (to ileum and ascending colon) |
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describe the branches of the inferior mesenteric artery |
sigmoidal arteries (many to sigmoid colon) left colic artery (to descending colon) superior rectal artery (to rectum) |
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define the critical point |
region between last sigmoidal artery and superior rectal artery where no anastomosing supply is available for rectum if damaged |
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describe the paired lateral arteries |
renal arteries (to kidneys) gonadal arteries (to testis/ovaries) middle suprarenal arteries (to adrenal glands) |
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describe the paired posterior arteries |
inferior phrenic arteries (to inferior surface of diaphragm, at aortic hiatus) lumbar arteries (at each vertebral level, supply posterior wall and body wall, like intercostals) median sacral artery (posterior at iliac bifurcation, supplies sacrum) |
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define an abdominal aortic compression |
emergency last resort slow/stop pelvic hemorrhage compress abdominal aorta against vertebral column |
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describe an abdominal aortic aneurism |
intrinsically weaker aorta, less elastin calcifies easily higher risk of aneurism, potential rupture |
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generally review the portal blood system |
intestinal capillaries--> small veins--> larger veins--> portal vein--> liver (portal vein branches)--> intrahepatic veins --> smaller veins--> liver capillaries (sinusoids)--> small veins (central veins)--> large veins (hepatic veins)--> IVC--> right heart |
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describe the venous drainage of the body wall |
similar to arteries unpaired anterior to viscera (return via portal) paired laterally to organs (return to IVC through renal veins, gonadal veins, suprarenal veins) paired posterior to body wall (return to IVC OR azygos/hemiazygos [left and right ascending lumbar veins=bypass]) |
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describe effects of portal hypertension |
backpressure in liver
expansions of veins in intestines, esophagus, anorectal backs all the way up to umbilical vein! Varices |
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describe the lymphatic return |
lower limbs and intestines comes to cisterna chyli, to thoracic duct |
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describe the organs of the posterior abdominal wall |
kidneys- lateral to psoas major, halfway along diaphragm suprarenal gland- superior to kidney |
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what do you find anterior to the right kidney |
suprarenal gland liver duodenum colon small intestine |
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what do you find anterior to the left kidney |
suprarenal gland stomach spleen pancreas small intestine colon |
