Posterior abdominal wall

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Presentation transcript:

Posterior abdominal wall In the name of God Posterior abdominal wall Dr. Zahiri

Dr. Maria Zahiri consists of: fasciae, muscles and their vessels and spinal nerves. & several viscera : kidneys, suprarenal (adrenal) glands, pancreas, ureters

lumbar vertebrae five vertebrae between the rib cage and the pelvis. Dr. Maria Zahiri lumbar vertebrae five vertebrae between the rib cage and the pelvis. They are the largest segments of the vertebral column The lumbar vertebrae help support the weight of the body, and permit movement

Dr. Maria Zahiri Iliac fossa Last ribs

Dr. Maria Zahiri

Muscles: PSOAS MAJOR Morphology: is a long fusiform muscle Location: Dr. Maria Zahiri Muscles: PSOAS MAJOR Morphology: is a long fusiform muscle Location: on the side of the lumbar region of the vertebral column and brim of the lesser pelvis. Junction: It joins the iliacus muscle to form the iliopsoas. In less than 50 percent of human subjects, the psoas major is accompanied by the psoas minor.

Muscles: PSOAS MAJOR Origion: Dr. Maria Zahiri Muscles: PSOAS MAJOR Origion: transverse processes of lumbar vertebrae I-V. Insertion lesser trochanter of the femur.

Psoas minor Origion: the last thoracic and first lumbar vertebrae. Dr. Maria Zahiri Psoas minor Origion: the last thoracic and first lumbar vertebrae. Insertion: iliopectineal eminence.

Iliacus Origion: iliac fossa on the interior side of the hip bone Dr. Maria Zahiri Iliacus Origion: iliac fossa on the interior side of the hip bone Insertion: lesser trochanter of the femur

Dr. Maria Zahiri

Quadratus lumborum Origin: from the lower border of the last rib Dr. Maria Zahiri Quadratus lumborum Origin: from the lower border of the last rib by four small tendons from the apices of the transverse processes of the upper four lumbar vertebrae Insertion: the internal lip of the iliac crest for about 5 cm.,

diaphragm is a dome-shaped musculofibrous septum Dr. Maria Zahiri diaphragm is a dome-shaped musculofibrous septum separates the thoracic from the abdominal cavity, Its peripheral part consists of muscular fibers that take origin from the circumference of the inferior thoracic aperture and converge to be inserted into a central tendon.

Dr. Maria Zahiri Part Origin The muscular fibers may be grouped according to their origins into three parts: Sternal: two muscular slips from the back of the xiphoid process. Costal: The inner surfaces of the cartilages and adjacent portions of the lower six ribs on either side, interdigitating with the Transversus abdominis. Lumbar: Aponeurotic arches, named the lumbocostal arches, and from the lumbar vertebrae by two pillars or crura. There are two lumbocostal arches, a medial and a lateral, on either side.

Crura and central tendon Dr. Maria Zahiri Crura and central tendon At their origins the crura(crus) are tendinous in structure The retrocrural area is the area behind the crus of the diaphragm. The central tendon of the diaphragm is a thin but strong aponeurosis situated near the center of the vault formed by the muscle

Dr. Maria Zahiri Diaphragm

Dr. Maria Zahiri

Dr. Maria Zahiri Blood supply

Dr. Maria Zahiri

Thoracolumbar fascia (lumbodorsal fascia Dr. Maria Zahiri Thoracolumbar fascia (lumbodorsal fascia Is a deep investing membrane covers the deep muscles of the back of the trunk It is made up of three layers, anterior, middle, and posterior. The anterior layer is the thinnest The posterior layer is the thickest. Two spaces are formed between these three layers of the fascia. Between the anterior and middle layer lies the quadratus lumboru muscle. The erector spinae muscle is enclosed between the middle and posterior layers.

to the spines of the lumbar and sacral vertebrae The middle layer Dr. Maria Zahiri The posterior layer to the spines of the lumbar and sacral vertebrae The middle layer is attached medially to the tips of the transverse processes of the lumbar vertebrae The anterior layer covers quadratus lumborum

Dr. Maria Zahiri

Dr. Maria Zahiri Urinary System Kidneys: Kidneys are retroperitoneal. Lie against posterior abdominal wall on either side of vertebral column. Generally lie adjacent to upper three lumbar vertebrae.

Relation of kidney( ant.) Dr. Maria Zahiri Relation of kidney( ant.)

Relation of kidney( pos.) Dr. Maria Zahiri Relation of kidney( pos.) Diaphragm Transversus abdominis Quadratus lumborum Psoas major

Renal fascia or Gerota's fascia Dr. Maria Zahiri Renal fascia or Gerota's fascia Ant. Layer of renal fascia(fascia of Toldt) lateroconal fascia Pos. Layer of renal fascia(Zuckerkandl's fascia))

Dr. Maria Zahiri

kidney Subdivisions: Cortex. Medulla with renal pyramids Pelvis Dr. Maria Zahiri kidney Subdivisions: Cortex. Medulla with renal pyramids Pelvis major and minor calyces (calyx)

Blood supply of kidney Right and left renal arteries: Dr. Maria Zahiri Blood supply of kidney Right and left renal arteries: Right is longer than the left. Extrahilar arteries Right and left renal veins: Left is longer than the right

Ureter is a continuation of the pelvis. Dr. Maria Zahiri Ureter is a continuation of the pelvis. Descends retroperitoneally on the anterior surface of the psoas major. Passes anterior to bifurcation of common iliac.

Blood supply of ureters Dr. Maria Zahiri Blood supply of ureters

Suprarenal (adrenal) glands: Dr. Maria Zahiri Suprarenal (adrenal) glands: Lie against posterior abdominal wall on superior poles of kidneys. Arterial supply: Superior suprarenal arteries: From inferior phrenic artery. Middle suprarenal artery: From abdominal aorta. Inferior suprarenal arteries: From renal artery

Dr. Maria Zahiri

Dr. Maria Zahiri Venous drainage: Right suprarenal vein to inferior vena cava. Left suprarenal vein to renal vein.

Dr. Maria Zahiri

Dr. Maria Zahiri شاد و سلامت باشید