Abdomen 9B Flashcards
Thoracic Diaphragm contains? (6)
Musculotendinous structure that forms “roof: of abdominal cavity Caval foramen esophageal hiatus aortic hiatus central tendon muscular portions of diaphragm
Three openings allow IVC, esophagus and aorta to pass through
- caval foramen a. most anterior opening, IVC passes through 2. esophageal hiatus a. located “between” caval foramen and aortic hiatus, esophagus passes through 3. aortic hiatus a. most posterior opening, aorta passes through
Central Tendon contains?
caval foramen (IVC passes through)
3 muscular portions of diaphragm
sternal part costal part lumbar part
Sternal Part of Diaphragm
two small sections of muscle that attach to xiphoid process
Costal part of Diaphragm
arises from inferior six costal cartilage and ribs
Lumbar Part of Diaphragm
arise from lateral & medial arcuate ligaments, also arises from upper lumbar vertebrae to form right and left crura a. lateral arcuate ligament - arches over quadratus lumborum b. medial arcuate ligament – arches over psoas c. right crus – forms esophageal hiatus, contributes to aortic hiatus d. left crus - contributes to aortic hiatus
4 Muscles of the Posterior Wall of the Abdomen
- Psoas major 2. Iliacus 3. Quadratus lumborum 4. Transverse abdominis
Nerves that are visible along the posterior abdominal wall (7)
- subcostal nerve 2. lumbar plexus (L1 – L4) a. iliohypogastric nerve b. ilioinguinal nerve c. lateral femoral cutaneous nerve d. femoral nerve e. obturator nerve f. genitofemoral nerve
Suprarenal Glands (3)
A. Located superior aspect of each kidney B. Surrounded by fatty tissue C. “Separated” from the kidney via renal fascia
Internal Features of Suprarenal Gland (2)
- suprarenal cortex a. secretes cortisol, aldosterone and androgens 2. suprarenal medulla a. neural tissue similar to cells of sympathetic nervous system b. secrete catecholamines (epinephrine and norepinephrine)
4 General Features of the Kidney
A. Located retroperitoneal B. Each kidney approximately 4” x 2” and 1” thick C. Each kidney is “in contact” with the diaphragm and posterior wall muscles (psoas, quadratus lumborum, transverse abdominis) D. Suprarenal glands located on superior portion of each kidney
Right Kidney (3)
a. upper pole located anterior to 12th rib b. located “posterior” to ascending colon and liver c. right kidney is approximately one finger width above iliac crest
Left Kidney (2)
a. upper pole located anterior to 11th and 12th rib b. located “posterior” to stomach, spleen, pancreas, jejunum and descending colon
how do Kidney’s “move” with respiration?
- kidneys descend (approximately 1+ inches) with inspiration 2. can palpate right easier than left when patient takes a breath in
Renal Capsule and surrounding fatty layers
- each kidney is surrounded by layer of fibrous capsule (renal capsule or true capsule) 2. the next layer is fat known as perirenal fat which is further surrounded by a layer of thin fibrous tissue known as renal fascia (false capsule) 3. a layer of fat known as pararenal fat surrounds the renal fascia a. collagen fibers pass through this layer to help “anchor” the kidney
Renal Hilum
indention on medial side of kidney 1. entrance for renal pelvis, renal artery and vein
2 Layers of the internal kidney
- cortex a. contains 1-2 million nephrons (functional “filtering” unit of the kidney) 2. medulla a. contains 5 – 10 renal pyramids…apex of pyramid is known as renal papilla
Blood supply to kidney for filtration
- renal artery 2. segmental arteries 3. interlobar arteries 4. arcuate arteries 5. radiate arteries (interlobular) 6. afferent arteries 7. glomerular capillaries…blood is filtered here in Bowman’s capsule 8. efferent arteries…blood secrete waste products into tubule for excretion here 9. vasa recta…helps to remove excessive concentration of sodium, chloride and other solutes 10. venous return eventually drains into IVC
Collecting duct pathway of the kidney
- nephrons drain into collecting tubules 2. collecting tubules drain into renal papilla 3. renal papilla drain into each minor calyces 4. 5 - 10 minor calyces drain into major calyces 5. 2 or 3 major calyces drain into renal pelvis 6. renal pelvis drains into ureter which drains into bladder a. renal pelvis is a funnel shaped “duct” that is continuous with the ureter
Nephron consists of? (4)
- Renal corpuscle 2. Proximal convoluted tubule 3. Henle’s loop 4. Distal convoluted tubule
Renal corpuscle
a. juxtomedullary renal corpuscle located near junction of cortex and medulla b. cortical renal corpuscle located in cortex c. renal corpuscle is 1st site for “filtering” blood
Proximal convoluted tubule
a. Passive reabsorption occurs here b. substances that have been filtered into the tubule can pass back into the blood c. 65% of H20 and sodium that were filtered into Bowman’s capsule are reabsorbed from proximal convoluted tubule d. the reabsorption occurs passively as a result of osmotic gradients in the interstitial fluid of the medulla
Function and 2 types of Henle’s Loop
a. Function is to maintain a gradient of osmotic pressure in the interstitial fluid of the medulla Ascending and Descending limb of Henle’s Loop
Descending limb of Henle’s Loop is …
• permeable to H20 and NOT to sodium (and other solutes) • this H20 is reabsorbed from the tubule • fluid in tubule becomes more and more concentrated as it descends
Ascending limb of Henle’s Loop is …
• permeable to sodium (and other solutes) and NOT to H20 • thus sodium is reabsorbed from the tubule • fluid in tubule becomes less and less concentrated as it ascends
In the early (first 2/3) distal convoluted tubule…
(i) sodium is reabsorbed (ii) H20 is NOT permeable in this section thus NOT reabsorbed (iii) Because the sodium is leaving the urine…the urine becomes very diluted as it passes through the tubule
In the late (distal 1/3) distal convoluted tubule
(i) H20 is reabsorbed……ONLY if ADH (antidiuretic hormone) is present…why? 1. ADH will make this section of the distal convoluted tubule permeable to H20 2. ADH also does this in the collecting duct (ii) Now the urine starts to become concentrated again
2 Major functions of distal convoluted tubule
–secretion of waste products for excretion in the urine may occur in the distal convoluted tubule –reabsorption of sodium and H20 occurs here
Collecting Tubule
- multiple nephrons will empty into the collecting tubule 2. collecting tubule will descend to the renal papilla and drain into minor calyces 3. If ADH is present H20 will be reabsorbed out of collecting tubule as urine descends a. Thus the urine continues to become more and more concentrated
Ureters
A. Smooth muscular tube…25 – 30 cm long B. Descend anterior along psoas and anterior to internal iliac arteries
Three regions of constriction…potential for kidney stone to be lodged (Ureter)
- junction of renal pelvis and ureter (ureteropelvic junction) 2. as ureter passes over pelvic brim 3. as the ureter enters the bladder
