Transcript Posterior abdominal wall and retroperitoneum

In the name of God
Posterior abdominal wall
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consists of:
fasciae, muscles and their vessels and spinal nerves.
& several viscera :
kidneys, suprarenal (adrenal) glands, pancreas, ureters
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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
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• Iliac fossa
• Last ribs
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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.
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Muscles:
PSOAS MAJOR
• Origion:
transverse processes of lumbar
vertebrae I-V.
• Insertion
lesser trochanter of the femur.
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Psoas minor
• Origion:
the last thoracic and first
lumbar vertebrae.
• Insertion:
iliopectineal eminence.
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Iliacus
• Origion:
iliac fossa on the interior side of
the hip bone
• Insertion:
• lesser trochanter of the femur
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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.,
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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.
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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.
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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
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Diaphragm
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Blood supply
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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.
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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
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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.
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Relation of kidney( ant.)
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Relation of kidney( pos.)
Diaphragm
Transversus abdominis
Quadratus lumborum
Psoas major
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Renal fascia or Gerota's fascia
Ant. Layer of renal
fascia(fascia of Toldt)
lateroconal fascia
Pos. Layer of renal
fascia(Zuckerkandl's fascia))
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kidney
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Subdivisions:
Cortex.
Medulla with renal
pyramids
Pelvis
major and minor
calyces (calyx)
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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
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Ureter
• is a continuation of the pelvis.
• Descends retroperitoneally on the
anterior surface of the psoas major.
• Passes anterior to bifurcation of
common iliac.
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Blood supply of ureters
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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
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Venous drainage:
Right suprarenal vein to inferior vena cava.
Left suprarenal vein to renal vein.
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‫‪Dr. Maria Zahiri‬‬
‫شاد و سالمت باشید‬