2.3.1 Retroperitoneum and Kidneys Flashcards
Where does the lumbosacral trunk orginate? Lumbar plexus?
Lumbosacral trunk: (L4,5)
Lumbar plexus (L1-4)
What is a renal calculi? Lifetime likelihood in men and women
Kidney stone
Lifetime likelihood: men (19%), women (9%)
Red arrow and what is it vertebral column?(hint: might be joined with ilioinguinal nerve)
Iliohypogastric (L1)
Where are the kidneys located relative to the vertabrae?
T12-L3
Three anatomical locations where kidney stones can lodge
- Orgin from renal pelvis
- When crosses anteriorly over the iliac vessels
- Through bladder wall
How many arteries typically feed the adrenal gland?
3 (sup, mid, inf) suprarenal arteries
Where does the vein of each adrenal gland drain?
Right: drains into IVC
Left: drains into left renal vein
What is the major organ that touches the L kidney and not the R?
The pancreas
What is the vein of the adrenal gland?
Suprarenal vein
Does the adrenal gland receive parasympathetic innervation?
NO
What are the four renal structures?
Renal capsule, Renal hilum, Renal sinus, Renal pelvis
Red arrow?
Obdurator nerve (L2,3,4)
Runs DEEP, medial border psoas
What is the most common congenital diaphragmatic hernia and its location?
Bochdalek hernia; Back and to the left
What organ touches the R kidney that doesn’t touch the L kidney?
The Liver, duh
What is the standard kidney length?
Three vertabrae long
What does the genirofemoral nerve branch into?
Genital branch
Femoral branch: skin over femoral triangle
What this be?
Kidney with a benign cyst
What encloses the adrenal gland?
Gerota’s fascia
Red arrow?
Lumbosacral trunk (L4,5)
Location: Runs DEEP and MEDIAL to Psoas and Obdurator nerve, Joins S1 of sacral plexus
Red arrow?
Femoral nerve (L2,3,4)
Runs just lateral to psoas muscles
Where are horse-shoe kidneys typically found?
Around the lower lumbar vertebrae, since its ascent is prevented by the root of the inferior mesenteric artery
Typically horse-shoe kidneys are benign and undiagnosed
What are the three main posterior abdominal muscles and some of their characteristics?
Quadratus Lumborum, Psoas (insert on Lesser Trochanter), Iliacus
Where is referred pain from the diaphragm felt?
Shoulder region (C3-C5)
Red arrow?
Genitofemoral nerve (L1,2)
Runs on the anterior surface of psoas muscle
How frequent are congential diaphragmatic hernias?
1 in 2,500 newborns
The perirenal and pararenal spaces open inferiorly a pathway for what?
A pathway for pus to travel retroperitoneally to pelvis
Red arrow?
Subcostal nerve (T12)
Nerves you need to know
The bolded
Identify these two spaces around the kidney.
Blue arrow: perirenal space
Black arrow: pararenal space
Red arrow?
Lateral femoral cutaneous (of the thigh) (L2-3)
Identify these 3 nerves
Where does the adrenal gland sit relative to the vertabrae?
T12-L1
Describe the shapes of the adrenal glands?
Right: Pyramidal
Left: Crescent
What is lateral femoral cutaneous syndrome?
Mononeuropathy presenting variably as pain, numbness, tingling, burning or itching in anterolateral thigh. Multiple possible factors: compression (obesity, seltbelt trauma, tight belt/pants), endocrine/metabolic (alcoholism, diabetes), interventional outcome, ascites
How is the obdurator nerve distributed motorly?
Adductor muscles of thigh
What is the name for the fascia that surrounds the kidneys?
Renal (Gerota’s) fascia
Name the 3 openings in the diaphragm and their vertebral level.
IVC: T8
Esophagus: T10
Aorta: T12
Red arrow? (hint: iliohypogastic may be joined with this nerve)
Ilioinguinal (L1)
What cuts across the left renal vein?
The superior mesenteric artery (SMA)
What are the main innervators of the kidneys?
lesser splanchnic, least splanchnic, lumbar splanchnic (T10-L1)
If you cut the phrenic, how would the diaphragm be affected?
Paralysis of diaphragm
