1. Posterior abdominal wall
Like a boss

2. Psoas major

3. Psoas minor
Arise from T 12 to L 1-5, intervertebral discs, transverse processes lumbar vert
Passes inferiorly along pelvic brim to anterior thigh, under inguinal ligament
Attaches to lesser trochanter of femur
Minor sometimes absent

4. Iliacus

5. Quadratus lumborum
Ribs 7 to iliac crest

6. Attachment for lateral arcuate ligament

7. Top Left: Axial CT
Top Right: Sagittal CT
BL: Ant. Abdomen
BR: Lateral Chest

8. Right crus
L1 – L3

9. Left crus
L1 – L2

10. Median, medial, lateral arcuate ligaments

11. Hiatuses: caval, aortic, esophogeal

12. Aortic hiatus

13. Sweet

14. Esophogeal hiatus

15. Kidney; a retroperitoneal Organ

16. Perinephric (perirenal) fat and paranephric (pararenal) fat
Must incise renal fascia to reach organ in procedures

17. Pararenal fat

18. Renal cortex and cortical columns

19. Renal medulla

20. Renal sinus

21. Renal papilla

22. Minor calyx

23. Major Calyx

24. Renal pelvis

25. Renal ureter Drainage of urine from kidneys to bladder
3 constriction points: ureteropelvic junction, ureter intersection with iliac vessels at pelvic brim, entrance point for ureters into bladder
Kidney stones can be lodged in these constrictions

26. Middle suprarenal artery

27. Renal artery

28. Inferior suprarenal artery

29. Lumbar arteries Usually 4 branches
Arise from posterior abdominal aorta

30. Common iliac arteries

31. Median sacral artery
Arises from posterior surface of abdominal aorta

32. Testicular arteries

33. Ovarian Arteries

34. Renal veins
Left renal vein longer and cross midline in front of abdominal aorta
Crosses behind superior mesenteric artery
Can be compressed by aneurysm in these two vessels

35. Suprarenal veins Right suprarenal- short, passes directly into IVC
Left suprarenal- passes inferiorly to renal vein

36. Ovarian/testicular veins

37. Inferior phrenic veins

38. Right subcostal vein

39. Ascending lumbar vein
Receives drainage from first and second lumbar veins
Connect common iliac, iliolumbar, lumbar veins with azygos, hemiazygos veins of thorax
Serves as important collateral channels between lower and upper parts of body if IVC becomes blocked

40. Intermesenteric plexus

41. Phrenic nerve

42. Subcostal nerve

43. Subcostal nerve

44. Iliohypogastric nerve
Arises from L1 along with ilio-linguinal
Laterla to psoas major

45. Iliohypogastric nerve

46. Ilio-inguinal
Arises from L1
Smaller, inferior to iliohypogastric

47. Genitofemoral nerve (genital branch- medial) (femoral branch- lateral)
Arises from anterior L1/2
Genital branch continues downward and enters inguinal canal through deep inguinal ring
Femoral branch enters femoral sheath, lateral to femoral artery

48. Obturator nerve
Anterior L2-4
Enters obturator canal

49. Lateral cutaneous nerve of thigh
Arises from L2-L3
Supplies skin of anterior and lateral thigh to level of knee

50. Lumbosacral trunk
Meeting of lumbar plexus and sacral plexus

51. Cisterna Chyli
Trunks from lumbar nodes and lumbar trunks form cisterna chyli
Lies to the right side of abdominal aorta at L1/2
Marks the beginning of thoracic duct

52. Lateral aortic (lumbar) nodes
Receive from body wall, kidneys (upper ureter), suprarenal glands, and testes/ovaries
(Middle portion ureters) common iliac nodes
(inferior portion ureters) external and internal iliac vessels

53. Thoracic duct
Recieves drainage from posterior abdominal region

54. Vertebrocostal trigone

55. QUIZ

56. 1.
Posas minor

57. 2.
Major calyx

58. 3.
Lumbar arteries

59. 4.
Identify the structure. What nerve arises from the lateral bifurcation of this main nerve? What nerve arises from the medial bifurcation of this main nerve?

60. 5.
All of the following drain into the the lateral aortic (lumbar) lymph nodes EXCEPT:
Body wall of posterior abdominal region
Upper portion of kidney ureters
Suprarenal glands
Spleen
Testes/ovaries
D- the spleen drains into its corresponding mesenteric node (celiac, superior or inferior mesenteric node)

61. 6.
Identify the structure (be specific). At which vertebral level does it penetrate the diaphragm?
Abdominal aorta
T12

62. 7. Identify the structure. What does it mark the beginning of?
Cisterna chyli
Thoracic duct

63. Ate.
Why is the Psoas major muscle sheath of greater importance than ANY OTHER muscle sheath?
Muscle and sheath arise from both the lumbar vertebrae BUT ALSO
the intervertebral discs; therefore, if infection (i.e. tuberculosis and
Salmonella discitis) occurs and spread  anterior and anterolateral
into psoas major sheath  may appear below inguinal ligament as a MASS!