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Anatomy

Abdomen

Question 46 of 180

The quadratus lumborum muscle contributes to which of the following movements:

Answer:

The quadratus lumborum muscles depress and stabilise the twelfth ribs and contribute to lateral bending of the trunk. Acting together, the muscles may extend the lumbar part of the vertebral column.

Posterior Abdominal Wall Muscles

The most important muscles of the posterior abdominal wall are the psoas major, the iliacus and the quadratus lumborum which each possess a strong fascial covering. Associated with the psoas major muscle is the psoas minor muscle, which is sometimes absent.

Table: Function and Innervation of the Posterior Abdominal Wall Muscles

Muscle Extent Function Innervation
Psoas major Originates from vertebrae T12 – L5, covers anterolateral bodies of lumbar vertebrae and fills in spaces between vertebral bodies and transverse processes, passes inferiorly along pelvic brim and attaches distally to lesser trochanter of femur Flexes thigh at hip joint when trunk is stabilised, flexes trunk against gravity when body is supine Anterior rami L1 – L3
Quadratus lumborum Fills space between rib 12 and iliac crest on both sides of vertebral column, overlapped medially by psoas major muscle, lies medial to transversus abdominis muscle Depresses and stabilises twelfth rib, contributes to lateral bending of trunk Anterior rami of T12 and L1 – L4
Iliacus Fills iliac fossa on each side before passing inferiorly to join with psoas major muscle and attach distally to lesser trochanter of femur Flexes thigh at hip joint when trunk is stabilised, flexes trunk against gravity when body is supine Femoral nerve (L2 – L4)

Psoas Major

The psoas major originates from the lateral bodies of, the transverse processes of and the intervertebral discs between the T12 and L1 - L5 vertebrae, essentially covering the anterolateral surface of the bodies of the lumbar vertebrae and filling in the spaces between the vertebral bodies and the transverse processes. It passes inferiorly along the pelvic brim and continues into the anterior thigh to attach to the lesser trochanter of the femur.

The psoas major flexes the thigh at the hip joint when the trunk is stabilised and flexes the trunk against gravity when the body is supine.

It is innervated by the anterior rami of nerves L1 - L3.

The lumbar plexus forms within the psoas major muscle, anterior to its attachment to the transverse process of the lumbar vertebrae.

Quadratus Lumborum

The quadratus lumborum muscles essentially fill the space between rib 12 and the iliac crest on both sides of the vertebral column. They are overlapped medially by the psoas major muscles and along their lateral borders are the transversus abdominis muscles.

The quadratus lumborum muscles depress and stabilise the twelfth ribs and contribute to lateral bending of the trunk. Acting together, the muscles may extend the lumbar part of the vertebral column.

They are innervated by the anterior rami of T12 and L1 - L4.

Iliacus

The iliacus muscle fills the iliac fossa on each side, before passing inferiorly to join with the psoas major muscle (forming the iliopsoas muscle) and attach to the lesser trochanter of the femur.

Like the psoas major, the iliacus flexes the thigh at the hip joint when the trunk is stabilised and flexes the trunk against gravity when the body is supine.

It is innervated by branches of the femoral nerve.

Muscles  of the Posterior Abdominal Wall. (Image by OpenStax College [CC BY 3.0 (https://creativecommons.org/licenses/by/3.0)], via Wikimedia Commons)

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  • Biochemistry
  • Blood Gases
  • Haematology
Biochemistry Normal Value
Sodium 135 – 145 mmol/l
Potassium 3.0 – 4.5 mmol/l
Urea 2.5 – 7.5 mmol/l
Glucose 3.5 – 5.0 mmol/l
Creatinine 35 – 135 μmol/l
Alanine Aminotransferase (ALT) 5 – 35 U/l
Gamma-glutamyl Transferase (GGT) < 65 U/l
Alkaline Phosphatase (ALP) 30 – 135 U/l
Aspartate Aminotransferase (AST) < 40 U/l
Total Protein 60 – 80 g/l
Albumin 35 – 50 g/l
Globulin 2.4 – 3.5 g/dl
Amylase < 70 U/l
Total Bilirubin 3 – 17 μmol/l
Calcium 2.1 – 2.5 mmol/l
Chloride 95 – 105 mmol/l
Phosphate 0.8 – 1.4 mmol/l
Haematology Normal Value
Haemoglobin 11.5 – 16.6 g/dl
White Blood Cells 4.0 – 11.0 x 109/l
Platelets 150 – 450 x 109/l
MCV 80 – 96 fl
MCHC 32 – 36 g/dl
Neutrophils 2.0 – 7.5 x 109/l
Lymphocytes 1.5 – 4.0 x 109/l
Monocytes 0.3 – 1.0 x 109/l
Eosinophils 0.1 – 0.5 x 109/l
Basophils < 0.2 x 109/l
Reticulocytes < 2%
Haematocrit 0.35 – 0.49
Red Cell Distribution Width 11 – 15%
Blood Gases Normal Value
pH 7.35 – 7.45
pO2 11 – 14 kPa
pCO2 4.5 – 6.0 kPa
Base Excess -2 – +2 mmol/l
Bicarbonate 24 – 30 mmol/l
Lactate < 2 mmol/l

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