Atlas of Human Anatomy by Netter

(Darren Dugan) #1

Inferior phrenic arteries
Lumbar arteries (four pairs)
Unpaired parietal branch: Median sacral artery arising just above aortic bifurcation
Veins of the posterior abdominal wall (Section 4-6: Abdomen-Visceral Vasculature)
Inferior vena cava (IVC)
Formed from union of common iliac veins
Begins anterior to body of L5 and passes through the diaphragm at T8.
Its tributaries follow branches of aorta
Exceptions:
a. Left gonadal vein drains to left renal vein
b. Left suprarenal vein drains to left renal vein
Blood from abdominal viscera
Drains via portal system and liver
Reaches IVC through the hepatic veins
Ascending lumbar veins
Drain to azygos/hemiazygos veins and thence to superior vena cava (SVC)
Forms an anastomosis between IVC and SVC.
Lymphatics of the posterior abdomen
Common iliac nodes
Receive lymph from the external and internal iliac nodes
Drain to lumbar (para-aortic) nodes
Lumbar (para-aortic) nodes
Receive lymph from the posterior abdominal wall, descending colon, kidneys, ureters, testes/ovaries, uterus, uterine tubes
Efferent vessels form the lumbar lymphatic trunks
Preaortic nodes
Receive lymph from the digestive tract, liver, spleen, and pancreas
Efferent vessels form the intestinal lymphatic trunks
Nerves of the posterior abdominal wall (Section 4-7: Abdomen-Innervation)
Somatic nerves
Subcostal nerves
a. Ventral primary rami of T12
b. Arise in the thorax
c. Run inferiorly on surface of quadratus lumborum
d. Supply external abdominal oblique and skin of anterolateral abdominal wall
Lumbar nerves
a. Dorsal and ventral primary rami of lumbar spinal nerves
b. Dorsal rami supply muscles and skin of back
c. Ventral rami pass into substance of psoas major muscle and form lumbar plexus
Nerves of lumbar plexus
Ilioinguinal and iliohypogastric nerves (L1)
a. Enter abdomen posterior to medial arcuate ligament
b. Pierce transverse abdominus near anterior superior iliac spine (ASIS)
c. Supply skin of suprapubic and inguinal regions
Genitofemoral nerve (L1/2)
a. Emerges from anterior surface of psoas muscle
b. Runs inferiorly deep to fascia
c. Divides into genital and femoral branches
Lateral femoral cutaneous nerve (L2/3)
a. Emerges from lateral aspect of psoas muscle
b. Runs inferiorly on iliacus
c. Enters thigh posterior to inguinal ligament and medial to ASIS
Obturator nerve (L2-L4)
a. Emerges from medial border of psoas
b. Descends through pelvis to obturator canal
c. Supplies muscles and skin of medial thigh
Femoral nerve (L2-L4)
a. Emerges from lateral border of psoas
b. Innervates iliacus
c. Passes beneath inguinal ligament on surface of iliopsoas muscle
d. Innervates muscles of anterior thigh
Lumbosacral trunk (L4/5)
a. Descends over ala of sacrum into pelvis
b. Joins in formation of sacral plexus
Autonomic nerves
Thoracic splanchnic nerves
a. Greater (T5-T9), lesser (T10-T11) and least (T12) thoracic splanchnic nerves
b. Convey presynaptic sympathetic fibers to celiac, superior mesenteric, and aorticorenal sympathetic ganglia
Lumbar splanchnic nerves
a. Rise of abdominal sympathetic trunks
b. Three to four in number
c. Convey presynaptic sympathetic fibers to inferior mesenteric, intermesenteric, and superior hypogastric plexuses
Prevertebral sympathetic ganglia
a. Celiac
b. Superior mesenteric
c. Inferior mesenteric
d. Aorticorenal
Parasympathetic fibers
a. Preganglionic
b. From anterior and posterior vagal trunks and pelvic splanchnic nerves

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