66. GA - Posterior Abdominal Wall & Diaphragm

Musculoskeletal structure posterior to abdominal organs (GI tract, liver, pancreas, spleen). Includes muscles for trunk and limb movement, bordered superiorly by the diaphragm. Contains retroperitoneal viscera (kidneys, ureters, suprarenal glands). A conduit for structures like aorta, IVC, lymphatics, and nerves.

Ribs 11 & 12, iliac crest & fossa, lumbar vertebrae (bodies & transverse processes L1-L5), and the upper margin (ala) of the sacrum.

There are 4 muscles in the posterior abdominal wall.

Organs behind the peritoneum (abdominal lining) including kidneys, ureters, and adrenal glands.

Major artery in posterior abdominal wall, supplying blood to the abdominal organs.

Major vein in posterior abdominal wall, returning blood to the heart.

Nerve network emerging from the posterior abdominal wall, innervating lower trunk and limbs

The diaphragm is a muscle in the upper abdomen. It's a dome-shaped muscle with a central tendon and circumferential muscles that anchor to the lumbar vertebrae.

The diaphragm plays a vital role in breathing. It moves to create pressure differences in the chest cavity. It also serves as the superior boundary of the abdominal cavity

Musculotendinous structures attaching the diaphragm to the lumbar vertebrae.

Ligaments that support the diaphragm, specifically found posterior to it.

The aorta enters the abdominal cavity at the level of the 12th thoracic vertebra (T12).

Branches from the aorta supplying the inferior surface of the diaphragm.

Opening in the diaphragm for the esophagus (food pipe).

Opening in the diaphragm through which the inferior vena cava (IVC) passes.

A muscle of the posterior abdominal wall, lying under the lateral arcuate ligament.

RetroPeritoneal Lymph Node Dissection; a surgical procedure to remove retroperitoneal lymph nodes, often used to treat testicular cancer.

A surgical approach to RPLND that involves a large incision from the sternum to the pubic bone. The surgeon accesses the lymph nodes by moving the peritoneum and abdominal contents.

A minimally invasive surgical approach to RPLND using small incisions and a laparoscope. This method offers less scarring and muscle damage compared to open RPLND.

A type of laparoscopic RPLND that uses robotic arms controlled by a surgeon. This approach may offer better precision and dexterity.

A birth defect where the pleuroperitoneal folds fail to close, causing abdominal organs to herniate into the chest cavity. This can affect lung development and lead to breathing issues.

A condition where part of the stomach protrudes through the esophageal hiatus (opening in the diaphragm for the esophagus) into the chest cavity. May be associated with GERD (acid reflux).

The abdominal aorta branches into unpaired arteries supplying GI structures (celiac, SMA, IMA) and paired arteries supplying non-GI structures (inferior phrenic, middle suprarenal, renal, gonadal, lumbar).

Occurs when the left renal vein is compressed between the abdominal aorta and the superior mesenteric artery (SMA). This can cause flank pain, hematuria (blood in urine), and left-sided varicocele.

Diaphragmatic hernia is a birth defect where the diaphragm doesn't form correctly, allowing organs to herniate into the chest. Hiatal hernia is a condition where part of the stomach protrudes through the esophageal opening in the diaphragm.

These are the septum transversum (forms central tendon), pleuroperitoneal folds (close pericardioperitoneal canals), posterior esophageal mesentery (forms crura), and peripheral rim (myocytes from C3-C5 somites).

The abdominal aorta enters the abdominal cavity posterior to the median arcuate ligament at the level of the 12th thoracic vertebra (TXII).

A structure that forms an arch over the aorta as it enters the abdomen. It helps to stabilize and support the aorta.

The abdominal aorta splits into the left and right common iliac arteries at the level of the 4th lumbar vertebra (LIV).

Compression of nearby structures can occur, leading to conditions like Nutcracker syndrome (compression of the left renal vein) and SMA syndrome (compression of the duodenum).

Compression of the third part of the duodenum between the superior mesenteric artery (SMA) and the aorta, causing intermittent abdominal pain, mainly after eating. More common in people with low body weight.

A bulging or weakened area in the abdominal aorta, the main blood vessel supplying the abdomen. Can rupture, leading to a life-threatening internal bleed.

The main vein in the abdomen, returning blood to the heart. It runs to the right of the aorta and is formed by the merging of the common iliac veins.

Veins that drain into the IVC, including common iliac veins, lumbar veins, gonadal veins, renal veins, suprarenal veins, inferior phrenic veins, and hepatic veins.

Long veins that provide collateral venous return (alternative blood flow) when the IVC is blocked. They connect the common iliac, iliolumbar, and lumbar veins with the azygos and hemiazygos veins.

A blood clot that forms in the deep veins of the legs or pelvis. Can potentially be fatal.

Devices placed in the IVC to prevent blood clots from traveling to the lungs.

People with lower body weight tend to have a longer, thinner mesentery. This allows the SMA to droop lower, increasing the chance of compressing the duodenum against the aorta.

A 3D imaging technique that combines X-ray images to create a detailed view of the inside of the body. Used to assess the size and shape of an AAA.

Calcium deposits form in the weakened walls of an AAA as the body tries to repair the damaged area, but this process can further weaken the vessel.