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SHB Exam 2 > Abdomen III > Flashcards

Abdomen III Flashcards

1
Q

What are the layers of the posterior abdominal wall, starting w/the deepest?

A
  1. Bony layer
  2. Muscles
  3. Fascia
  4. Visceral layer
  5. Partial peritoneal layer
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2
Q

What bones form the bony layer of the post abd wall?

A
  • Iliac bone (iliac fossa + crest)
  • Lumbar vertebrae
  • Last 2 ribs
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3
Q

What mm. form the m. layer of the post abd wall?

A

Psoas major, psoas minor (may be absent), iliacus & quadratus lumborum mm.

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4
Q

What organs lie retroperitoneally at the post abd wall’s visceral layer?

A
  • Suprarenal glands
  • Abd aorta + IVC
  • Ureters
  • Kidneys
    (basically kidney stuff + aorta)
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5
Q

What n. plexus is formed in the area of the post abd wall?

A

Lumbar plexus

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6
Q

What fascia are at the post abd wall?

A
  • Psoas fascia
  • Iliac fascia
  • thoracolumbar fascia
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7
Q

Iliacus m: OIIA?

A

O: Sup 2/3 iliac fossa, ala of sacrum, ant sacro-iliac ligaments
I: Lesser trochanter of femur and shaft inf to it, and to psoas major tendon

I: Femoral n.
A: Flexes hip and stablizes hip joint; acts w/psoas major m.

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8
Q

Psoas major m: OIIA?

A

O: Transverse process of lumbar vertebrae, sides of bodies of T12-L5 + intervening discs
I: Lesser trochanter of femur

I: Ventral rami of first 4 lumbar nn.
A: Acting superiorly w/iliacus, flexes hip; acting inferiorly, flexes vertebral column laterally; used to balance trunk in sitting position; acting inferiorly w/iliacus, flexes trunk

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9
Q

Psoas minor m: OIIA?

A

O: Vertebral margins of T12-L1 + their intervertebral discs
I: Pectineal line, iliopectineal eminence

I: Ventral rami of 1st lumbar n.
A: Flexes pelvis on vertebral column

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10
Q

Quadratus lumborum m: OIIA?

A

O: Medial half of inf border of 12th rib, tips of lumbar transverse processes
I: Iliolumbar ligament, internal lip of iliac crest

I: Ventral rami of T12 and first 4 lumbar nerves
A: Extends and laterally flexes vertebral column, fixes 12th rib during inspiration

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11
Q

Diaphragm: OIIA?

A

O: Xiphoid process (sternal part), lower 6 costal cartilages (costal part), L1-L3 vertebrae (lumbar part)
I: *Central tendon (converges at midline)

I: Phrenic n.
A: Chief m. of resp, draws central tendon down and forwards

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12
Q

What are the elevated right and left regions of the diaphragm called?
Which is higher?

A

Right and left copula

- right is higher

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13
Q

What is the insertion of the diaphgram?

A

Central tendon (converging aponeuroses)

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14
Q

The right crus of the diaphragm runs up to partially form the _________ and runs down to form the _________.

A
  • esophageal hiatus

- suspensory ligament of duodenum

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15
Q

Where does the left crus of the diaphragm arise from?

A

Bodies of upper 2 L-vertebrae.

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16
Q

Where does the right crus of the diaphragm arise from?

A

Upper 3 lumbar vertebrae

larger, stronger, longer than left

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17
Q

The median arcuate ligament forms the __________ by uniting crossing crura

A

Aortic hiatus

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18
Q

The medial arcuate ligaments run across the upper portion of what?

A

Psoas major m.

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19
Q

The lateral arcuate ligaments run across the upper portion of what?

A

Quadratus lumborum m.

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20
Q

What else comes thru the esophageal hiatus w/the esophagus?

A

2 vagus nn.

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21
Q

What travels through the aortic hiatus?

A

ATA
Aorta
Thoracic duct
Azygos v.

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22
Q

What vertebral nn. makeup the lumbar plexus?

Where is it formed?

A

T12/L1/L2/L3/L4/(L5), ventral rami

- Inside psoas major m.

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23
Q

What supplies the subcostal n?

A

T12

24
Q

What supplies the iliohypogastric n?

A

L1

25
Q

What supplies the ilioinguinal n?

*What does this nerve run though?

A

L1

*Superficial inguinal ring

26
Q

What supplies the femoral n?

A

L2, L3, L4

27
Q

What supplies the obturator n?

A

L2, L3, L4

28
Q

What’s common b/w the subcostal, iliohypogastric, ilioinguinal, and lateral femoral cutaneous nn. initial locations?

A

All run in front of quadratus lumborum m.

29
Q

*Which n. accompanies the spermatic cord/round ligament of uterus, continues thru inguinal canal, and emerges thru the superficial inguinal ring?

A

Ilioinguinal n.

30
Q

*What’s the physical location of the genitofemoral n?

A

Emerges in the front of psoas m. by piercing it and descends on its anterior surface

31
Q

What does the genitofemoral n. divide into? *What do each of them do?

A
  • Genital branch (supplies cremaster m.)

- Femoral branch (supplies skin of femoral triangle)

32
Q

*Where can you find the lateral femoral cutaneous n.?

A

On top of Iliacus m.

33
Q

*What’s the location of the femoral n?

A

Descends in-b/w psoas major and iliacus

34
Q

What’s the location of the obturator n?

A

Descends along medial border of psoas m.

35
Q

What vertebrae does the kidney span from?

A

T12-L3 in erect position

36
Q

Posteriorly, what ribs do the right and left kidney each reach?

A

Right: 12th
Left: 11th

37
Q

What comes into the hilum of the renal pelvis, anterior to posterior?

A

VAP:
renal Vein
renal Artery
Pelvis of ureter

38
Q

Explain the drainage from the renal pyramid.

A
  • Renal pyramid
  • > renal papilla
  • > minor calyx
  • > major calyx
  • > renal pelvis
  • > ureter
39
Q

What do the renal aa. arise from?

At what level?

A
  • Abdominal aorta

- L2

40
Q

What’s unique about the left renal a?

A

Longer than the right and passes posterior to the IVC

41
Q

Describe what happens along the path of the renal a.

A
  • Gives the inferior suprarenal a.

- Enters the hilum of the kidney and divides into 5 segmental aa. (end aa.)

42
Q

What do right and left renal vv. dump into?

A

IVC

43
Q

What is unique about the left renal v?

A

Longer than the right and passes anterior to the abdominal aorta (below origin of the SMA)

44
Q

What vv. does the left renal v. receive?

A
  1. Left suprarenal v.
  2. Left gonadal (testicular or ovarian) v.
  3. May give rise to inferior hemiazygos v.
45
Q

What are the 3 sites of constriction of the ureter?

A
  1. Ureto-pelvic junction (where it joins renal pelvis)
  2. Pelvic inlet (where it crosses pelvic brim)
  3. Uretovesicular junction (at wall of urinary bladder–narrowest point)
46
Q

What aa. supply the suprarenal gland (and what do they come off of?)

A
  • Superior suprarenal a. (from inferior phrenic a., which comes off aorta)
  • Middle suprarenal a. (from abdominal aorta)
  • Inferior suprarenal a. (from renal a.)
47
Q

Where does the suprarenal v. drain on the right and on the left?

A
  • Right: IVC

- Left: left renal v.

48
Q

At what vertebral level does the abd aorta bifurcate?

Into what aa. does it bifurcate?

A
  • L4

- Right and left common iliac aa.

49
Q

What are the single and paired branches of the abdominal aorta, sup to inf?

A

T12: celiac a. (single visceral); subcostal (paired parietal), inferior phrenic (paired parietal)
L1: SMA (single); suprarenal (paired visceral), renal (paired visceral)
L2: Gonadal a. (paired visceral)
L3: IMA (single visceral)
L1-L4: lumbar a. (paired parietal)

50
Q

Where does median sacral a. arise?

A

From aorta, just above bifurcation (supplies rectum + anal canal)

51
Q

What is the right gonadal vein a tributary too? What about the left?

A

Right: IVC
Left: renal v.

52
Q

At what vertebral level does the IVC form? What 2 veins come together to form it?

A
  • L5

- Common iliac vv. (right and left)

53
Q

What vv. drain into the IVC in the abd? (just review it)

A
  • Right gonadal (drains into left renal on left, usually)
  • Right suprarenal (drains into left renal on left, usually)
  • Hepatic vv.
  • Right and left renal vv.
  • 3rd and 4th lumbar vv.
  • Inferior phrenic vv.
  • May receive azygos v.
54
Q

What is a cisterna chyli? Where is it? What is it formed by?

A
  • A dilated lymphatic sac (at the bottom end of the thoracic duct)
  • Lies just to the right and posterior to the aorta.
  • Formed by the intestinal and lumbar lymph trunks.

(narrows superiorly to give the thoracic duct)

55
Q

Where does the thoacic duct drain into, specifically?

A

Junction b/w left subclavian and IJV (“jugular subclavian junction”)

SHB Exam 2 (17 decks)

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