Posterior abdominal wall

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In the name of God

Dr. Maria Zahiri

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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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.

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Muscles:

PSOAS MAJOR

• Origion:transverse processes of lumbar

vertebrae I-V.

• Insertionlesser 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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Dr. Maria Zahiri

Quadratus lumborum

Origin: from the lower border of the last ribby four small tendons from the apices of the transverse processes of the upper four lumbar vertebraeInsertion: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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Dr. Maria Zahiri

Blood supply

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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.

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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 vertebraeThe anterior layer covers quadratus lumborum

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Dr. Maria Zahiri

Urinary SystemKidneys:

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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lateroconal fascia

Renal fascia or Gerota's fasciaAnt. Layer of renal

fascia(fascia of Toldt)

Pos. Layer of renal fascia(Zuckerkandl's

fascia))

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Dr. Maria Zahiri

kidneySubdivisions:

• 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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Dr. Maria Zahiri

Venous drainage:

Right suprarenal vein to inferior vena cava.Left suprarenal vein to renal vein.

Dr. Maria Zahiri

Dr. Maria Zahiri

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