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PHA 500 > 9. Posterior Ab Wall > Flashcards

9. Posterior Ab Wall Flashcards

1
Q

Retroperitoneal Space

A

Between parietal peritoneum and muscles of ab wall

Contains fat, blood vessels, organs

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2
Q

Kidneys

A

Primarily retroperitoneal

~T12-L3 vertebral levels

R slightly inferior than L

Surrounded by:
-paranephric (pararenal) fat
-renal fascia
perinephric (perirenal) fat

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3
Q

Renal Fascia

A

Helps prevent spread of infection/blood locally

Conduit for spread of fluids into pelvis

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4
Q

Kidneys: External Structures

A

Superior, inferior pole
Lateral, medial border

Renal hilum on medial border

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5
Q

Renal Hilum

A

A–>P
Renal vein
Renal artery
Renal pelvis

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6
Q

Kidneys: Internal Structures

A

Renal capsule
Renal cortex
Renal columns
Renal medulla

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7
Q

Pathway of Urine

A 
Renal papillae
Minor calices
Major calices
Renal pelvis 
Ureter
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8
Q

Pelvic Kidney

A

Anomalous kidney

Failure of kidney to ascend during development

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9
Q

Horseshoe Kidney

A

Anomalous kidney

Fused inferior poles

Ascent stopped by IMA

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10
Q

Ureters

A

Primarily retroperitoneal

Fibromuscular tubes extend from renal pelvis to bladder

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11
Q

Peristalsis

A

Transport of urine

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12
Q

Adrenal Glands

A

Primarily retroperitoneal

Superomedial to kidneys

Enclosed by renal fascia

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13
Q

Lymphatics of Kidneys/Adrenal Glands

A

Lumbar lymph nodes (along aorta) –> chyle cistern –> thoracic duct

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14
Q

Kidney Innervation: Parasympathetic

A

PreG CB: brain
PreG fibers: vagus nerves
PostG CB, fibers: wall of kidney

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15
Q

Kidney Innervation: Sympathetic

A 
Lateral horn of thoracolumbar spinal cord
Ventral root
Spinal nerve
Ventral ramus
White ramus communicans
Sympathetic trunk
Thoracic splanchnic nerves (esp least)
Renal (aorticorenal) ganglion
Kidney
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16
Q

Visceral Pain from Kidneys and Ureters

A

Follows sympathetic pathway - enters dorsal root

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17
Q

Referred Pain

A

Back, flank, genitals

Along L1 dermatome

18
Q

Adrenal Innervation: Sympathetic

A 
Lateral horn of thoracolumbar spinal cord
Ventral root
Spinal nerve
Ventral ramus
White ramus communicans
Sympathetic trunk
Thoracic splanchnic nerves (greater, lesser, least)
Secretory cells of adrenal medulla
19
Q

Adrenal Gland and the Sympathetic NS

A

Adrenal gland is an extension of the sympathetic NS

Release epinephrine and norepinephrine

20
Q

Abdominal Aorta

A

T12-L4

Bifurcation at L4 into common iliac arteries

L of midline

21
Q

Abdominal Aorta: Unpaired Branches

A

Celiac trunk
SMA
IMA

22
Q

Abdominal Aorta: Paired Branches (Supply)

A

Primarily retroperitoneal organs
Gonads
Body wall

23
Q

Abdominal Aorta: Paired Branches

A 
Inferior phrenic arteries
-superior suprarenal arteries
Middle suprarenal arteries
Renal arteries
Inferior suprarenal arteries
Gonadal arteries (ovarian/testicular)
Subcostal arteries
Lumbar arteries
24
Q

Inferior Phrenic Arteries

A

Supply inferior surface of diaphragm

and adrenal glands (via superior suprarenal arteries)

25
Q

Renal Arteries

A

R renal is longer and courses posterior to IVC

26
Q

Accessory Renal Arteries

A

Can happen

Failure of embryonic arteries to degenerate

27
Q

Abdominal Aortic Aneurysm

A

Can rupture

High mortality rates if not diagnosed (~90%)

Happens pretty close to bifurcation

Common

28
Q

Inferior Vena Cava

A

T8-L5

L5: union of common iliac veins

R of midline

Exits abdomen through caval opening

29
Q

IVC Tributaries

A

Parallel paired aortic branches

Except:
L gonadal vein
Hepatic veins (no arterial component)

30
Q

Left Gonadal Vein

A

Drains to L renal vein

Root of mesentery blocks path to IVC

31
Q

Posterior Ab Wall Muscles: Iliopsoas

A

Psoas major + Iliacus

Hip flexor

32
Q

Psoas Major

A

Origin: lumbar vertebrae
Fuses with iliacus
Insertion: Lesser trochanter of femur

33
Q

Iliacus

A

Origin: iliac fossa
Fuses with psoas major
Insertion: Lesser trochanter of femur

34
Q

Muscles of Posterior Ab Wall: Quadratus Lumborum

A

Origin: 12th rib and lumbar vertebrae
Insertion: Iliac crest

Lateral to psoas major

35
Q

Nerves (List)

A 
Subcostal (T12)
Iliohypogastric (L1)
Ilioinguinal (L1)
Genitofemoral (L1-L2)
Lateral cutaneous nerve of the thigh (L2-L3)
Femoral nerve (L2-L4)
Obturator nerve (L2-L4)

Greater, lesser, least splanchnic nerves

Sympathetic Trunks

36
Q

Nerves (Notes)

A

Ventral rami carry somatic motor, somatic sensory, sympathetic fibers

Everything but subcostal = lumbar plexus

37
Q

Subcostal Nerves

A

Ventral rami T12

T12 dermatome

Motor innervation to external and internal obliques, transversus abdominis

38
Q

Lumbar Plexus

A

Formed of ventral rami of lumbar spinal nerves (L1-L5)

39
Q

Diaphragm: Attachments

A

Xiphoid process
Costal margin
Ribs 11,12
Lumbar vertebrae (R/L crura)

40
Q

Diaphragm: Openings

A

Caval (IVC) opening: T8 (IVC)

Esophageal hiatus: T10 (esophagus, vagus nerves)

Aortic hiatus: T12 (aorta, bile duct, azygos vein)

PHA 500 (11 decks)

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