Posterior Abdominal Wall & Diaphragm Quiz
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Questions and Answers

Which muscle is primarily responsible for assisting in trunk flexion?

  • Erector spinae
  • Quadratus lumborum
  • Psoas major (correct)
  • Iliacus

What does the median arcuate ligament contain?

  • Aorta and thoracic duct (correct)
  • Quadratus lumborum
  • IVC
  • Psoas major

Where does the esophagus pass through the diaphragm?

  • T8
  • T10 (correct)
  • L1
  • T12

What is a common symptom of a psoas abscess?

<p>Severe pain during thigh flexion (C)</p> Signup and view all the answers

Which structure is primarily formed by the septum transversum in the diaphragm?

<p>Central tendon (D)</p> Signup and view all the answers

Which of the following pairs does NOT correctly represent the origin of paired branches of the abdominal aorta?

<p>Renal arteries - LV1 (C)</p> Signup and view all the answers

What complication arises from a failure of the pleuroperitoneal fold to close the canal?

<p>Congenital diaphragm hernia (B)</p> Signup and view all the answers

Which structure passes through the caval opening at T8?

<p>IVC (B)</p> Signup and view all the answers

Which muscle assists primarily in lateral flexion of the trunk?

<p>Quadratus lumborum (B)</p> Signup and view all the answers

What is Nutcracker syndrome associated with?

<p>Compression of the left renal vein (A)</p> Signup and view all the answers

What is the most likely cause of intermittent intestinal pain after eating related to SMA syndrome?

<p>Compression of the duodenum between the SMA and aorta (D)</p> Signup and view all the answers

Which statement best describes a complication associated with an abdominal aortic aneurysm (AAA)?

<p>It may cause fatal outcomes if ruptured. (D)</p> Signup and view all the answers

In May-Thurner syndrome, which structure is compressed leading to lower limb symptoms?

<p>Left common iliac vein by the right common iliac artery (B)</p> Signup and view all the answers

Which lymphatic channels are responsible for collecting lymph from the GI tract and accessory organs?

<p>Pre-aortic nodes (C)</p> Signup and view all the answers

What is a characteristic feature of the lumbar sympathetic trunks?

<p>They are flat ganglia difficult to distinguish. (C)</p> Signup and view all the answers

Which of the following nerves provides motor innervation to the cremasteric muscle?

<p>Genital branch of the genitofemoral nerve (B)</p> Signup and view all the answers

In the context of venous blockage, what role do ascending lumbar veins play?

<p>They provide collateral circulation if the IVC is obstructed. (A)</p> Signup and view all the answers

Which nerves are responsible for innervating the skin of the proximal lateral thigh?

<p>Lateral femoral cutaneous nerve (C)</p> Signup and view all the answers

What is the purpose of IVC filters in clinical practice?

<p>To prevent the passage of DVT clots into the heart/lungs (A)</p> Signup and view all the answers

Which channel marks the beginning of the thoracic duct?

<p>Cisterna chyli (D)</p> Signup and view all the answers

Which muscle originates from the iliac fossa of the pelvis and assists in trunk flexion?

<p>Iliacus (A)</p> Signup and view all the answers

What structure is associated with the left crus of the diaphragm?

<p>Aorta (B)</p> Signup and view all the answers

Which of the following statements regarding the diaphragm's development is true?

<p>It develops from myocytes from somites C3-C5. (C)</p> Signup and view all the answers

What is the clinical significance of a hiatal hernia?

<p>It occurs due to weakness near the esophageal hiatus. (C)</p> Signup and view all the answers

Which of the following is a consequence of psoas abscess?

<p>Accumulation of pus between the psoas muscle and its fascia (A)</p> Signup and view all the answers

What arteries emerge near the superior mesenteric artery (SMA)?

<p>Middle suprarenal arteries (B)</p> Signup and view all the answers

Which structure passes through the esophageal hiatus at TV10?

<p>Esophagus (B)</p> Signup and view all the answers

What is one of the significant components of the median arcuate ligament?

<p>Aorta (A)</p> Signup and view all the answers

Which condition is characterized by compression of the 3rd part of the duodenum, causing intermittent intestinal pain?

<p>SMA syndrome (A)</p> Signup and view all the answers

What is a potential consequence of an abdominal aortic aneurysm if it ruptures?

<p>Fatal hemorrhage (B)</p> Signup and view all the answers

In May-Thurner syndrome, which two structures are primarily involved in the compression leading to symptoms?

<p>Left common iliac vein and right common iliac artery (C)</p> Signup and view all the answers

Which lymphatic channel is responsible for receiving lymph from the renal and suprarenal glands?

<p>Para-aortic channel (D)</p> Signup and view all the answers

Which nerve roots contribute to the formation of the femoral nerve?

<p>L2-L4 (D)</p> Signup and view all the answers

What is the primary role of ascending lumbar veins in the context of IVC blockage?

<p>Provide collateral circulation (D)</p> Signup and view all the answers

What is the primary clinical indication for performing a retroperitoneal lymph node dissection (RPLND)?

<p>Cancerous lymph nodes (B)</p> Signup and view all the answers

Flashcards

Posterior Abdominal Wall Muscles

Muscles posterior to the abdominal organs, involved in trunk and limb movement.

Psoas Major Function

Flexes the trunk and thigh, originating from the lumbar vertebrae and attaching to the femur.

Diaphragm Anatomy

Muscular partition that separates the thoracic and abdominal cavities; has crura and tendinous arches.

Diaphragm Crura

Muscle bundles of the diaphragm attached to the lumbar vertebrae, Right and Left (crura).

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Esophageal Hiatus

Opening through the diaphragm for the esophagus; contains vagal trunks, blood vessels.

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Caval Opening

Opening for the inferior vena cava (IVC) at T8 through the diaphragm.

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Abdominal Aorta Branches

Aorta has paired and unpaired branches supplying the abdominal organs (e.g., celiac trunk, renal arteries).

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Congenital Diaphragmatic Hernia

A birth defect where the diaphragm does not close properly, allowing abdominal organs to enter the chest.

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Psoas Abscess

Pus accumulation between the psoas muscle and its fascia, causing pain, fever, and weight loss.

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Nutcracker Syndrome

Compression of the left renal vein, often due to the abnormal positioning of arteries.

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SMA syndrome cause

Compression of the third part of the duodenum between the superior mesenteric artery (SMA) and the aorta.

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AAA (Abdominal Aortic Aneurysm)

A bulge or swelling in the abdominal aorta, potentially fatal if it ruptures.

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IVC location

The inferior vena cava (IVC) lies to the right of the abdominal aorta, forming from the merging of the two common iliac veins.

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May-Thurner Syndrome

Compression of the left common iliac vein by the right common iliac artery.

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Cisterna chyli

The beginning of the thoracic duct, formed by the convergence of abdominal lymphatic trunks.

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Pre-aortic lymph nodes

Lymph nodes along the abdominal aorta, receiving lymph from the GI tract and accessory organs.

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Para-aortic lymph nodes

Lymph nodes lateral to the aorta and IVC, receiving lymph from the body wall and other organs

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Retroperitoneal lymph node dissection (RPLND)

Surgical removal of cancerous retroperitoneal lymph nodes. Can be done open or laparoscopically.

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Subcostal nerve dermatome

Sensory area of the subcostal nerve, covering the suprapubic region

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Genitofemoral nerve

Nerve with parts that provide motor & sensory function to the groin, scrotum and thigh.

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Diaphragm Function

The main muscle involved in breathing, separating the chest cavity from the abdomen.

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Diaphragm Openings

Specialized holes in the diaphragm that allow structures like the esophagus and major vessels to pass through.

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SMA Syndrome

Compression of the third part of the duodenum between the superior mesenteric artery (SMA) and the aorta, leading to intermittent pain after eating.

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Abdominal Aortic Aneurysm (AAA)

Bulging or swelling of the abdominal aorta, often fatal if it ruptures.

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Inferior Vena Cava (IVC) Location

The IVC lies to the right of the abdominal aorta, formed by the convergence of the two common iliac veins.

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Study Notes

Posterior Abdominal Wall & Diaphragm

  • Musculoskeletal framework supports abdominal GI tract, liver, pancreas, spleen, and muscles moving trunk/limbs.
  • Ribs XI & XII, iliac crest and fossa, bodies/transverse processes of LV1-LV5, ala of sacrum form bony structures.
  • Muscles:
    • Erector spinae help with trunk extension.
    • Psoas minor (TV12-LV1) and major (TV12-LV4) assist with trunk & thigh flexion.
    • Iliacus (iliac fossa) assists with trunk/thigh flexion.
    • Quadratus lumborum (rib 12 & TV12-LV5) aids in lateral flexion.
  • Psoas abscess: pus between psoas muscle & fascia, causing pain during thigh flexion, fever, weight loss, and malaise.
  • Diaphragm:
    • Two crura (R: LV1-LV3, L: LV1-LV2) connected midline.
    • Three tendinous arches: median (aorta, thoracic duct), medial (psoas major, sympathetic trunk), lateral (quadratus lumborum).
    • Esophageal hiatus (TV10): esophagus, vagal trunks, esophageal branches pass through.
    • Caval opening (T8): inferior vena cava (IVC), R phrenic nerve, L phrenic nerve, azygos/hemiazygos veins, thoracic splanchnics pass through.
  • Developmental considerations regarding diaphragm development.
  • Congenital diaphragm hernia: failure to close pleuroperitoneal fold, allowing gut to enter thorax.

Clinical Correlations

  • Hiatal hernia: weakened diaphragm near esophageal hiatus permits stomach passage into thorax.
  • Abdominal aorta:
    • Unpaired branches: celiac trunk (TV12), superior mesenteric artery (SMA, LV1), inferior mesenteric artery (IMA, LV3).
    • Paired branches: inferior phrenic, middle suprarenal, renal, gonadal (~LV2), lumbar (4 pairs, LV1-LV4).
    • Nutcracker syndrome: L renal vein compression by SMA/aorta causes flank pain, blood in urine, and L-sided varicocele.
    • SMA syndrome: 3rd part duodenum compression by SMA/aorta causes intestinal pain, often after eating.
  • Abdominal aortic aneurysm (AAA): abdominal aorta bulge/swelling, often fatal if ruptured.
  • Inferior vena cava (IVC): lies Right to the Abdominal Aorta; Tributaries include common iliac, lumbar, R gonadal, renal, R suprarenal, inferior phrenic, & hepatic veins.
  • Clinical correlations related to IVC filters and May-Thurner syndrome.

Abdominal Lymphatics & Nerves

  • Abdominal lymphatics: 2 channels converge at the R posterior surface of the aorta near LV1-LV2.
  • Pre-aortic channel: receives lymph from GI tract & other accessory organs (liver, gallbladder, pancreas, spleen).
  • Para-aortic channel: receives lymph from body wall, kidneys, suprarenal glands, and testes/ovaries.
  • Retroperitoneal lymph node dissection (RPLND): open or laparoscopic surgeries to clear cancerous retroperitoneal lymph nodes.
  • Nerves: important lumbar plexus nerves include subcostal, iliohypogastric, ilioinguinal, genitofemoral, femoral, and obturator.
  • Iliohypogastric & ilioinguinal, from L1, innervate anterior abdominal wall and scrotum.
  • Genitofemoral from L1-L2, provides motor and sensory innervation.
  • Femoral, from L2-L4, is lateral to psoas major & innervates lateral proximal thigh
  • Obturator, from L2-L4, is medial to psoas major & innervates medial thigh

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Lecture 75: Gross Anatomy - Posterior Abdominal Wall & Diaphragm PDF

Description

Test your knowledge on the musculoskeletal framework, muscle functions, and anatomical structures of the posterior abdominal wall and diaphragm. This quiz covers key concepts related to the support of abdominal organs and related conditions like psoas abscess. Enhance your understanding of physiology and anatomy with these focused questions.

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