ABDOMEN#2

Dr.Bushra Haseeb
BDS, RDS
Demonstrator in the Dental Section , Azra Naheed Medical College
POSTERIOR ABDOMINAL WALL
• The posterior abdominal wall is a complex region of anatomy.
• It is formed by the:
1. Lumbar vertebrae
2. Pelvic girdle
3 Posterior abdominal muscles
4 Posterior abdominal wall fascia.

• Major vessels, nerves and organs are located on the inner surface of
the posterior abdominal wall.
LUMBAR VERTEBRAE
• The lumbar vertebrae are, in human
anatomy, the five vertebrae between the 
rib cage and the pelvis.
• They are the largest segments of the 
vertebral column 

• They are designated L1 to L5, starting at the

top.
• The lumbar vertebrae help support the
weight of the body, and permit movement.
 PELVIC GIRDLE
The pelvic (hip) girdle transfers the weight of the upper body to
the legs.

It consists of a pair of coxal bones, each of which contains three

fused bones: the ilium, ischium, and pubis.

Together with the sacrum and coccyx, the pelvic girdle forms a
bowl‐shaped region, the pelvis, that protects internal
reproductive organs, the urinary bladder, and the lower part of
the digestive tract.
 The bony pelvis is the entire structure formed by the two hip bones,
the sacrum, and, attached inferiorly to the sacrum, the coccyx
The pelvic girdle is formed by a single hip bone. The hip bone
attaches the lower limb to the axial skeleton through its articulation
with the sacrum.
      
PELVIS
Fascia of Posterior Abdominal Wall
• A layer of fascia (sheet of connective tissue) lies between
the peritoneum and the muscles of the posterior abdominal wall. This
fascia is continuous with the transversalis fascia of the 
anterolateral abdominal wall.
• Whilst the fascia is one continuous sheet, it is anatomically correct to
name the fascia according to the structure it overlies.
1. Psoas Fascia
• The psoas fascia covers the psoas major muscle. It is attached to
the lumbar vertebrae medially, continuous with the thoracolumbar
fascia laterally and continuous with the iliac fascia inferiorly
2- Thoracolumbar fascia
• The thoracolumbar fascia consists of the three layers; posterior,
middle and anterior.
• Muscles are enclosed between these layers:
Quadratus lumborum – between the anterior and middle layers.
Deep back muscles – between the middle and posterior layers.
• The posterior layer extends between the 12th rib and the iliac
crest posteriorly. Laterally the fascia meets the internal oblique and
transversus abdominis muscles, but not the external oblique. As it
forms these attachments it covers the latissimus dorsi.
• The anterior layer attaches to the anterior aspect of the transverse
processes of the lumbar vertebrae, the 12th rib and the iliac crest.
Laterally the fascia is continuous with the aponeurotic origin of the
transversus abdominis muscle. Superiorly the fascia thickens to
become the lateral arcuate ligament, which joins the iliolumbar
ligaments 
 CLINICAL RELEVANCE
• The psoas sign is a medical sign that indicates
irritation to the iliopsoas group of muscles.
• The sign is elicited by flexion of the thigh at the
hip.
• The test is positive if the patient reports lower
abdominal pain.
• A right sided psoas sign is an indication
of appendicitis. As the iliopsoas contracts, it
comes into contact with the inflamed appendix,
producing pain.
CLINICAL RELEVANCE
• In lumbar tuberculosis an abscess in the psoas muscle of the
abdomen may be formed and the psoas fascia may determine the
path along which the abscess travels
• Abscess may drain inferiorly into the upper medial thigh and present
as a swelling in the region.
THANKYOU 