BMS 590 ABD 4: Posterior Abdominal Wall, Kidneys & Adrenal Glands

What are the 5 components of the posterior abdominal wall:

5 lumbar vertebrae

Muscles

Diaphragm (superior)

Fascia

Lumbar plexus

Fat, nerves, vessels, LNs

MD LFLF

How many Lumbar verterbrae are part of the Posterior Abdominal Wall?

5 Lumbar verterbrae

List the muscles of the Posterior Abdominal Wall: (5)

Psoas

Quadratus lumborum

Iliacus

Transversus abdominis

Oblique muscles

PO QuIT

The Deep (_________) fascia lies between the parietal peritoneum and the muscles and is continuous with the _________ fascia

Endoabdominal fascia

transversalis

List the 3 Fascia of the Posterior Abdominal Wall

Psoas fascia

Thoracolumbar fascia

Quadratus lumborum fascia

PTQ

The psoas fascia surrounds the __________ muscle and is attached medially to the lumbar vertebrae and ________.

Psoas Major

Pelvic Brim

The psoas fascia thickens to form the ___________________ and is continuous with the quadratus lumborum and thoracolumbar fascias (the other two)

medial arcuate ligament MAL

PMAL

The Thoracolumbar fascia is the extensive fascia that is attached to the _____________ and envelopes the _______________muscles (in a similar manner to the rectus sheath)

Vertebral column

Deep back

Thoracolumbar fascia is thinner in the _________ than in the ________ area?

thorax

Lumbar

In the lumbar region, Thoracolumbar fascia attaches laterally to the_____, ______, and ______ muscles?

IO, TA, and latissimus dorsi m.

The Quadratus lumborum fascia is the anterior layer of the ____________________ that covers the quadratus lumborum muscle

thoracolumbar fascia

The Quadratus lumborum fascia thickens to form the ______________.

Lateral Arcuate ligament

Q LAL

The Psoas major m. is lateral to the _____________________ and functions to flex the ______ or trunk AND help us sit up.

lumbar vertebrae

Thigh

The Psoas major muscle is innervated by which nerves?

Anterior rami of L1 - L3

The Iliacus m. is lateral to the inferior part of psoas major and its tendons join those of the psoas major to form the _______ (chief flexor of the thigh).

Iliopsoas

The Iliacus muscle is innervated by which nerve?

Femoral nerve (L2 - L4)

The Iliacus muscle flexes the thigh and stabilizes the _______.

hip joint

The Quadratus lumborum is lateral to the superior part of the psoas major and forms the __________

Kidney bed

The Quadratus lumborum is innervated by which nerves?

Subcostal nerve and L1 - L4 nerves

Which muscle of the Posterior abdominal wall extends and laterally flexes the vertebral column?

Quadratus lumborum

The Abdominal aorta begins at the ____________ (level of T12) and ends at the level of L4, where it divides into Right and Left _____________

Aortic hiatus

common iliac arteries

List the branches of the Abdominal Aorta

Inferior phrenic artery

Middle suprarenal artery

Renal artery

Gonadal artery

Lumbar artery

Celiac trunk artery

Superior mesenteric artery

Inferior mesenteric artery

Common iliac artery

GRIM SLICC

Name the paired branches of the Abdominal aorta that supply the inferior surface of diaphragm

Inferior phrenic artery

Name arteries that are direct paired branches of the Abdominal aorta that supply the adrenal glands

Middle suprarenal artery

Name the paired branches of the Abdominal aorta that supply the kidneys

Renal artery

Name the paired branches of the Abdominal aorta that supply the gonads

Gonadal artery

Name the paired branches of the Abdominal aorta that supply the abdominal wall

**4 pairs of these**

Lumbar artery

Name the unpaired branches of the Abdominal aorta that supply the foregut, and associated organs

Celiac trunk

Name the unpaired branches of the Abdominal aorta that supply the midgut

Superior mesenteric artery

Name the unpaired branches of the Abdominal aorta that supply the hindgut

Inferior mesenteric artery

Name the branches of the Abdominal aorta that are bifurcation of aorta, at L4 level

Common iliac artery

Which 3 branches of the Abdominal aorta are the main suppliers of the GI?

Celiac trunk (foregut)

Superior mesenteric artery (midgut)

Inferior mesenteric artery (hindgut)

True or False: the Left Renal vein is larger than the Right Renal vein

True

Why is the Left Renal vein larger than the right Renal vein?

Because the Inferior Vena Cava is shifted more to the right in the abdomen.

Where does the Left Gonadal vein return back to?

Left Renal vein

True or False: the Left gonadal (testicular/ovarian) vein returns back to the Left Renal vein instead of directly to the Inferior Vena Cava

True

True or False: the Left Renal vein is longer/larger than the right Renal vein.

True

Name the largest vein in the body that begins anterior to L5 by the union of the common Iliac veins inferior to aortic bifurcation

Inferior Vena Cava

Name the vein that drains the liver

Hepatic vein

Name the veins that drain the inferior surface of the diaphragm

Inferior phrenic veins

Which vein drains the Right suprarenal gland?

Right suprarenal vein

Name the vein that drains the Right testis or Right ovary

Right gonadal vein

Which veins drains the kidneys?

Renal veins

Which 2 veins drain into the Left renal vein also, whereas their arterial counterparts originate directly from the abdominal aorta?

Left Gonadal vein

Suprarenal vein

Name the vein that drains the testis or ovary, but drains into the Left renal vein

Left gonadal vein

Name the vein that drains the Left suprarenal gland

Left suprarenal vein

Name the veins that drains the abdominal wall

Lumbar veins

Name the vein (that is located in the pelvis region) that drains the legs

Common iliac veins

Name the nerve that innervates the muscles of the anterolateral abdominal wall and skin on side of the hip and runs runs inferolaterally on the anterior surface of the quadratus lumborum muscle:

Subcostal nerve (T12)

Somatic innervation (muscles and skin) of the Posterior Abdominal wall is performed by which nerves?

Subcostal nerve (T12)

Iliohypogastric nerve (L1)

Ilioinguinal nerve (L1)

Genitofemoral nerve (L1 - L2)

Lateral cutaneous nerve of the thigh (L2 - L3)

Femoral nerve (L2 - L4)

Obturator nerve (L2 - L4)

Lumbosacral trunk (L4 - L5)

O GLLIIFS

The Lumbarplexus is comprised of which nerves?

Iliohypogastric nerve (L1)

Ilioinguinal nerve (L1)

Genitofemoral nerve (L1 - L2)

Lateral cutaneous nerve of the thigh (L2 - L3)

Femoral nerve (L2 - L4)

Obturator nerve (L2 - L4)

Lumbosacral trunk (L4 - L5)

O GLLIIF

Name the nerves that runs inferolaterally on the anterior surface of the quadratus lumborum muscle

- is part of the Lumbarplexus

Iliohypogastric nerve (L1) and Ilioinguinal nerve (L1)

The Iliohypogastric nerve (L1) innervates which 2 muscles?

Internal Oblique muscles

Transverse Abdominis muscles

What does the Ilioinguinal nerve (L1) innervate?

Internal Oblique muscle

Transverse Abdominis muscle

Mons pubis

Anterior scrotum/labia majora

Name the nerve that pierces the psoas major and runs inferiorly on its anterior surface

Genitofemoral nerve (L1 - L2)

What is the branch of the genitofemoral nerve that innervates the skin on the anterior thigh? (sensory)

- part of Lumbarplexus

Femoral branch of Genitofemoral nerve (L1 - L2)

The Genital branch of the genitofemoral nerve that innervates the ___________ in males and the skin on _______________ in females?

- part of the Lumbarplexus

Males: cremaster muscle and skin of scrotum

Females: skin on mons pubis and labia majora

Name the 2 branches of the Genitofemoral nerve (L1 - L2)

Femoral and Genital branch

Name the nerve that runs inferolateral on the iliacus muscle and enters the thigh deep to the inguinal ligament

Lateral cutaneous nerve of the thigh (L2 - L3)

Name the nerve that innervates the skin on the anterolateral surface of the thigh (sensory)

Lateral cutaneous nerve of the thigh (L2 - L3)

What does the Lateral cutaneous nerve of the thigh (L2 - L3) innervate?

Skin on the anterolateral surface of the thigh

Name the nerve that emerges from lateral border of psoas major muscle and passes to the thigh deep to the inguinal ligament

Femoral nerve (L2 - L4)

What does the Femoral nerve (L2 - L4) innervate?

Iliacus muscle

Muscles of anterior compartment of thigh (flexors of hip and extensors of knee)

Name the nerve that emerges from the medial border of the psoas major muscle and passes through the obturator foramen to the medial thigh

Obturator nerve (L2 - L4)

The Obturator nerve (L2 - L4) innervates which structures?

muscles of the medial compartment of thigh (hip adduction)

This group of nerves descends into the pelvis to contribute to the sacral plexus

Lumbosacral trunk (L4 - L5)

Which 2 nerve groups merge to form the Sciatic nerve?

Lumbosacral Trunk

Sacral nerves

Sympathetic innervation of the Posterior Abdominal wall is performed by which nerves?

Lower thoracic splanchnic nerves

Lumbar splanchnic nerves (L1 - L3)

The Lower thoracic splanchnic nerves is comprised of which 3 nerves?

Greater (T5 - T10) splanchnic nerve

Lesser (T10 - T11) splanchnic nerve

Least (T12) splanchnic nerve

The Lower thoracic splanchnic nerves convey presynaptic fibers to which ganglia?

Celiac ganglia

Superior mesenteric ganglia

Aorticorenal ganglia

Which ganglia corresponds to the Greater (T5 - T10),

Lesser (T10 - T11), and Least (T12) splanchnic nerves respectively?

Celiac ganglia

Superior Mesenteric ganglia

Aorticorenal ganglia

Name the sympathetic nerves that originate from the medial portion of the abdominal SP trunk at the level of L1-L3

Lumbar splanchnic nerves (L1 - L3)

The Lumbar splanchnic nerves (L1 - L3) convey presynaptic fibers to which ganglia?

Inferior mesenteric plexus

Superior hypogastric plexus

Which general regions of the GI tract do the Greater, Lesser, and Least splanchnic nerves innervate?

Foregut

Midgut

Kidneys

Parasympathetic innervation of the Posterior Abdominal wall is performed by which nerves?

Anterior and posterior vagal trunks

Pelvic splanchnic nerves

The Pelvic splanchnic nerves take over after the _________ nerve at which area/point in the body?

Vagus nerve

Left colic flexure

Anterior and posterior vagal trunks innervate everything up to which point?

the GI tract as far down as the left colic (splenic) flexure

Name the parasympathetic nerves that originate from the anterior rami of spinal nerves S2- S4

Pelvic splanchnic nerves

Which parasympathetic nerves convey presynaptic fibers to the inferior hypogastric plexus, and supplies the GI tract inferior to the left colic flexure

Pelvic splanchnic nerves

The Pelvic splanchnic nerves conveys presynaptic fibers to the _________ ____________ plexus.

Inferior Hypogastric plexus

The Sacral region has 2 sets of autonomic nerves, sacral and pelvic splanchnic.

Which is parasympathetic and which is sympathetic?

sympathetic = sacral splanchnic

parasympathetic = pelvic splanchnic

____________ _____________ plexuses are comprised of nerve networks of SP and PSP fibers, surrounding the abdominal aorta and its major branches.

Abdominal autonomic plexuses

Of the Abdominal autonomic plexuses, which are interconnected?

Celiac, superior mesenteric, and inferior mesenteric plexuses are interconnected

Abdominal autonomic plexuses are comprised of nerve networks of _____________ and ______________ fibers.

Sympathetic and Parasympathetic fibers

List the Abdominal autonomic plexuses

Celiac ganglia and plexus

Superior mesenteric ganglia and plexus

Inferior mesenteric ganglia and plexus

Aorticorenal ganglion and renal plexus

Superior hypogastric plexus

Inferior hypogastric plexus

Name the nerve plexus/ganglia that is located around the origin of the celiac trunk

Celiac ganglia and plexus

The Celiac ganglia and plexus is comprised sympathetically and parasympathetically of which nerves?

SP: greater & lesser splanchnic nerve

PSP: vagus nerve

The Celiac ganglia and plexus is responsible for the innervation of which organs/structures?

Liver

Gallbladder

Stomach

Spleen

Pancreas

Proximal part of duodenum

The Liver, Gallbladder, Stomach, Spleen, Pancreas, and Proximal part of the duodenum are innervated by which ganglia/plexuses?

Celiac ganglia and plexus

Name the nerve plexus/ganglia that is located around the origin of Superior Mesenteric Artery

Superior mesenteric ganglia and plexus

The Superior mesenteric ganglia and plexus is comprised sympathetically and parasympathetically of which nerves?

SP: lesser & least splanchnic nerve

PSP: vagus nerve

The Superior mesenteric ganglia and plexus is responsible for the innervation of which organs/structures?

Head of pancreas

Distal duodenum

Jejunum

Ileum

Cecum

Ascending and transverse colon

The Head of pancreas, Distal duodenum, Jejunum, Ileum, Cecum, and Ascending and transverse colon are innervated by which ganglia/plexuses?

Superior mesenteric ganglia and plexus

Name the nerve plexus/ganglia that is located around the origin of Inferior Mesenteric Artery

Inferior mesenteric ganglia and plexus

The Inferior mesenteric ganglia and plexus is comprised sympathetically and parasympathetically of which nerves?

SP: lumbar splanchnic (L1 - L3)

Mixed SP & PSP: superior mesenteric & superior hypogastric plexuses

True or False: the Inferior mesenteric ganglia and plexus is not partially mixed sympathetically and parasympathetically

True

The Inferior mesenteric ganglia and plexus is mixed SP and PSP.

- which plexuses are a part of this 'mixing'?

Superior mesenteric plexus

Superior hypogastric plexus

The Inferior mesenteric ganglia and plexus innervates which organs/structures?

Descending colon

Sigmoid colon

Upper rectum

The Descending colon, Sigmoid colon, and Upper rectum are innervated by which ganglia/plexuses?

Inferior mesenteric ganglia and plexus

Name the nerve plexus/ganglia that is located around the origin of the renal artery

Aorticorenal ganglion and renal plexus