7-A Posterior Abdominal Wall

Question 1

Where are the kidneys located?

Answer 1

between T11-L3 bilaterally posterior, right slightly lower than the left, overlapped posteriorly by the diaphragm and embedded in perirnal fat and enclose din renal fascia

Question 2

What parts of the urinary system are in the abdomen v. the pelvis?

Answer 2

abdomen (kidney and ureter) pelvis (urinary bladder and uretrha)

Question 3

Name the tip of the renal pyramid and the structures that follow its drainage path.

Answer 3

tip = papilla joined to the minor calyx, major calyx, renal pelvis and the uterter

Question 4

Vessels enter the kidney at what area?

Answer 4

The hilus

Question 5

The ______ ____ lines the abdominal cavity (type of fascia)

Answer 5

transveralis fascia

Question 6

Describe the layers (4) surrounding the kidney.

Answer 6

renal capsule, perirenal fat, renal fascia and parareanal fat (going deep to superficial)

Question 7

What is different about the left renal vein from the right?

Answer 7

left renal vein accepts blood from the adrenal gland and the gonads on the left

Question 8

The renal arteries are branches of the _____ near to the medial _______ _____ artery.

Answer 8

aorta, superior mesenteric a.

Question 9

What is nutcracker syndrome?

Answer 9

if the superior mesentery occuldes the left renal vein via entrapment, the blood can back up into the left gonadal artery and this artery can become congested and distended

Question 10

Describe the trigone of the bladder and the entrance points of the ureters

Answer 10

the ureters enter through the posterior wall of the bladder by way of an oblique path through the muscle (prevents urine backing up as bladder fills) the trigone is the smooth triangle on the posterior bladder that connects the urethers and the urethra

Question 11

What are the abdominal targets of the autonomic system?

Answer 11

body wall, viscera (slow digestion ie. )and adrenal medulla

Question 12

Sympathetics to body wall synapse where?

Answer 12

in the sympathetic chain ganglia

Question 13

Where do sympathetics to the viscera synapse?

Answer 13

to the abdominal and pelvic viscera, the sympathetics synapse in the pre vertebral ganglion (thoracic, lumbar or sacral splanchnic nerves are pre-synaptic; only cardiopulmonary splanchnics are post synaptic)

Question 14

What is the path of sympathetics traveling to the adrenal gland?

Answer 14

axons enter the sympathetic chain but do not synapse and then enter the greater thoracic splanchnic nerve which travels to the adrenal medulla and synapses on chromatin cells which stimulates secretion of epinephrine and norepinephrine

Question 15

There are white rami at which spinal levels vs. gray rami

Answer 15

white at T1-L2, gray rami at all levels

Question 16

Name 4 pre vertebral/ pre aortic ganglia

Answer 16

celiac ganglion, superior mesenteric ganglion, aorticorenal ganglion and inferior mesenteric ganglion

Question 17

What are pre vertebral ganglia

Answer 17

aggregations of postsynaptic sympathetic cell bodies

Question 18

Name the parasympathetic nerves in the abdominal cavity

Answer 18

vagus nerve and pelvic splanchnic nerves

Question 19

Name two plexuses that include the vagus

Answer 19

cardiopulmonary and the esophageal (include parasympathetic, sympathetic and viscerosensory)

Question 20

What types of fibers are in the pre-aortic plexus?

Answer 20

pre and post ganglionic sympathetic, preganglionic parasympathetic and viscerosensory

Question 21

After the celiac ganglia and plexus, what is the course of the vagus nerve?

Answer 21

along the lesser curvature of the stomach

Question 22

Adrenal cortex is derived from _______ while adrenal medulla is derived from ______

Answer 22

mesoderm v. neural crest cells

Question 23

Name 3 muscles of the posterior body wall

Answer 23

quadrates lumborum, the psoas major and psoas minor

Question 24

Is the border of the thorax static?

Answer 24

No, the boundary between the thorax and the abdomen move with each breath (flattening during inspiration)… the right dome is typically a bit higher than the left

Question 25

Name the 3 ligaments that make up the posterior border of the diaphragm

Answer 25

median arcuate ligament (over aorta), the medial arcuate ligament (over psoas muscles) and the lateral arcuate ligament over quadrates lumborum)

Question 26

What is the vertebrocostal trigone?

Answer 26

area above the left lateral arcuate ligament that less muscular because it is derived from the esophageal mesentery.

Question 27

Which crus wraps around the esophagus?

Answer 27

the right crura, the left just extends cranially from the vertebral column

Question 28

What enters the abdomen through the sternocostal hiatus?

Answer 28

the superior epigastric vessels

Question 29

What is the central part of the diaphragm called

Answer 29

the central tendon

Question 30

What passes through the vena caval foramen?

Answer 30

the inferior vena cava and the right phrenic nerve (T8)

Question 31

What runs through the esophageal hiatus?

Answer 31

esophagus, R/L vagal trunks and branch of L. gastric artery(T10)

Question 32

What passes through the aortic hiatus

Answer 32

the aorta, thoracic duct and the azygos vein (T12)

Question 33

Where do the sympathetic trunk and thoracic splanchnic nerves come through the diaphragm?

Answer 33

behind the medial arcuate ligament and the through the crura

Question 34

Name two types of diaphragmatic hernias.

Answer 34

congenital hernia (incomplete formation of the diaphragm) and a hiatal hernia (stomach exits through the hiatal hernia)

Question 35

Name the three arteries that supply the adrenal gland.

Answer 35

superior suprarenal artery (from inferior phrenic a.) middle suprarenal artery (branch of aorta) and inferior suprarenal artery (branch of the suprarenal artery

Question 36

Describe the venous flow from the adrenal gland

Answer 36

left drains to the renal vein and rich drains into the IVC

Question 37

Name 3 muscles that make up the bladder Hint, 2 of them are sphincters

Answer 37

detrusor muscle, involuntary and voluntary sphincter

Question 38

What nerve fibers inhibit unrination

Answer 38

lumbar and sacral sympathetic splanchnic nerves inhibit the contraction of the detrusor muscle and stimulate contraction of the involuntary sphincter

Question 39

What nerve fibers allow urination

Answer 39

pelvic splanchnic parasympathetic nerves stimulate the contraction of the detrusor muscle and inhibit contraction of involuntary sphincter

Question 40

Discuss the plexi that nerves travel to in order to reach the bladder

Answer 40

trivia via superior and inferior hypogastric plexus to vesicle plexus around bladder

Question 41

Which spinal nerves do the pelvic splancic come from

Answer 41

S2-4

Question 42

Name the aortic branches that course segmentally to the body wall

Answer 42

lumbar arteries

Question 43

Where do the ovarian and testicular arteries branch off of?

Answer 43

the aorta, fairly medially

Question 44

Where does the thoracic duct begin?

Answer 44

where the right an left lumbar and intestinal trunks converge to join the thoracic duct occurring between the aorta and the right crus of the diaphragm L1-2