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Gross Anatomy > Abdomen: Kidney, Suprarenal Glands, Posterior Abdominal Wall > Flashcards

Abdomen: Kidney, Suprarenal Glands, Posterior Abdominal Wall Flashcards

(122 cards)

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1
Q

Kidneys

A
  • Produce urine
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2
Q

Ureters

A
  • Convey urine to bladder
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3
Q

Suprarenal glands

A
  • Endocrine system
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4
Q

Kidneys, ureters, and suprarenal glands are all

A
  • Retroperitoneal
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5
Q

Left kidney position/relationship

A
  • T11-L3

- Hilum at transpyloric plane (L1)

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6
Q

Right kidney position/relationship

A
  • T11-L3
  • About 5-6cm lower than the left (b/c of liver)
  • Fingers width from iliac crest
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7
Q

Renal fascia and surrounding connective tissue function

A
  • Helps maintain kidney position
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8
Q

Renal fascia and surrounding connective tissue contains

A
  • Kidney capsule
  • Perinephric fat (perirenal fat capsule)
  • Renal fascia
  • Paranephric fat
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9
Q

Perinephric fat (perirenal fat capsule)

A
  • Surrounds kidney and suprarenal gland

- Extends into renal sinus

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10
Q

Renal fascia encloses

A
  • Perirenal fat
  • Kidneys
  • Suprarenal gland
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11
Q

Kidney location

A
  • Position changes with respiration and posture

- Lateral to vertebral column

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12
Q

Superior to kidneys

A
  • Suprarenal glands
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13
Q

Posterior to kidneys

A
  • Diaphragm and ribs 11 & 12 (superior aspect)

- Separates from pleura

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14
Q

Anterior to right kidney

A
  • Right colic flexure
  • Liver
  • 2nd part of duodenum
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15
Q

Anterior to left kidney

A
  • Tail of the pancreas
  • Left colic flexure
  • Stomach
  • Spleen
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16
Q

Borders/margins of kidneys

A
  • Lateral: convex

- Medial: concave; hilum

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17
Q

Poles of kidneys

A
  • Superior: suprarenal gland located here

- Inferior:

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18
Q

Renal sinus

A
  • Space within the kidney

- Filled with vessels, nerves, fat, renal pelvis and calices

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19
Q

Renal hilum

A
  • Entrance/exit of the renal sinus
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20
Q

Renal hilum contains

A
  • Renal sinus
  • Renal vein (anterior)
  • Renal artery (middle)
  • Ureter (posterior)
  • Nerve plexus
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21
Q

Urine flow

A
  • Collecting duct in renal pyramid excreted at renal papilla
  • Minor calyx
  • Major calyx
  • Renal pelvis (basin)
  • Ureter
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22
Q

Sites of constriction and urteric calculi obstruction

A
  • Ureteropelvic jxn
  • Crossing of external iliac vessels & pelvic brim
  • Bladder wall
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23
Q

Ureter

A
  • Connect renal pelvis to bladder
  • Descend on the psoas muscle
  • Crosses common (or external) iliac arteries
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24
Q

Renal Arteries

A
  • Arise from AA at the level of L1/2
  • Right is longer than left
  • Branch into 5 segmental arteries
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25
Each renal artery branch (5 segmental arteries) supplies
- Independent renal segment
26
Kidney blood flow
- Renal artery - Segmental arteries - Interlobar arteries - Arcuate arteries - Interlobular arteries
27
Renal veins
- Left is longer than right - Left has additional tributaries - Left passes between aorta and SMA
28
Left renal veins additional tributaries
- Left suprarenal - Left gonadal - Left inferior phrenic
29
Passage of left renal vein between aorta and SMA
- Site of compression - Renal vein entrapment - “Nutcracker syndrome”
30
Suprarenal glands are between
- Superior pole of kidney and diaphragm
31
Suprarenal glands are separated from kidney by
- Septum of renal fascia
32
Right suprarenal gland
- Pyramid-shaped
33
Left suprarenal gland
- Crescent-shaped | - More medially oriented on kidney
34
Suprarenal gland consists of 2 parts
- Cortex | - Medulla
35
Cortex of suprarenal gland
- Androgens and corticosteroids
36
Medulla of suprarenal gland
- Catecholamines (primarily epinephrine) | - Innervated by sympathetic presynaptic neurons
37
Arterial supply of suprarenal glands
- Superior suprarenal (multiple branches from inferior phrenic) - Middle suprarenal (from AA) - Inferior suprarenal (from renal)
38
Venous drainage of suprarenal glands
- Right suprarenal drains into the IVC | - Left suprarenal drains into the left renal vein
39
Innervation of suprarenal glands
- Presynaptic sympathetics from T10-L1 directly innervate medulla
40
Posterior abdominal wall contains
- 5 Lumbar vertebrae & IVD - Intervertebral disc - Ilium - Muscles - Lumbar plexus - Aorta & IVC - Aortic plexus - Lymph nodes
41
Muscles of the posterior abdominal wall
- Psoas major and minor - Quadratus lumborum - Iliacus - Diaphragm - Transverse abdominis
42
Psoas Major superior attachment
- TP of lumbar vertebrae | - Bodies & discs T12-L5
43
Psoas Major inferior attachment
- Lesser trochanter of femur - Descends over pelvic brim - Posterior to inguinal ligament
44
Psoas Major innervation
- Ventral rami L1-3
45
Psoas Minor superior attachment
- T12,L1 bodies/IVD
46
Psoas Minor inferior attachment
- Pectineal line | - iliopubic eminence
47
Iliacus superior attachment
- iliac fossa - Ala of sacrum - Anterior sacroiliac ligaments
48
Iliacus inferior attachment
- Psoas major tendon/lesser trochanter
49
Iliacus innervation
- Femoral (L2-4)
50
Iliopsoas muscle
- Combination of iliacus and psoas major
51
Iliopsoas muscle function
- Trunk and thigh flexion | - Stabilize hip
52
Quadratus Lumborum superior attachment
- 12th rib | - TPs of Lumbar vertebrae
53
Quadratus Lumborum inferior attachment
- iliolumbar ligament | - iliac crest
54
Quadratus Lumborum innervation
- Ventral rami T12-L4
55
Quadratus Lumborum function
- Fixes 12th rib (inspiration) - Stabilizes trunk - Extends and lateral flex vertebral column
56
Nerves of the posterior abdominal wall
- Subcostal nerve (ventral rami T12) | - Abdominal sympathetic trunk
57
Abdominal sympathetic trunk
- 4 paravertebral ganglia | - Passes deep to medial arcuate ligament
58
Lumbar plexus (L1-4)
- Oriented around psoas major
59
Branches of the lumbar plexus (L1-4)
- Ilioinguinal (L1) - Iliohypogastric (L1) - Genitofemoral (L1,2) - Lateral femoral cutaneous (L2,3) - Femoral (L2-4) - Obturator (L2-4) - Accessory obturator (L3,4) - Lumbosacral trunk (L4,5)
60
Genitofemoral (L1,2) nerve
- Genital and femoral branches
61
Lateral femoral cutaneous (L2,3) nerve
- Enters thigh deep to inguinal ligament
62
Femoral (L2-4) nerve
- Largest branch of lumbar plexus | - Enters thigh deep to inguinal ligament
63
Obturator (L2-4) nerve
- Supplies adductor thigh muscles
64
Accessory obturator (L3,4) nerve
- Not always present
65
Lumbosacral trunk (L4,5)
- Contributes to sacral plexus
66
Direct branches of the abdominal aorta
- Aortic hiatus (T12) to bifurcation into common iliac arteries (~L4) - Common iliacs arteries divide (~ L5/S1)
67
Common iliacs arteries divide (~ L5/S1) into
- Internal iliac: pelvis - External iliac: lower limb - Ureters pass anterior to the bifurcation of the CIA - Slightly left of midline
68
Paired (parietal and visceral)
- Inferior phrenic - Lumbar: 4 on each side - Middle suprarenal - Renal - Gonadal
69
Unpaired (parietal and visceral)
- Median sacral - Celiac trunk - Superior mesenteric - Inferior mesenteric
70
Inferior vena cava
- Formed by junction of common iliac veins (L5) - Ascends to the right of midline - Passes through diaphragm (T8) - Drains into right atrium
71
Junction of common iliac veins (L5) is located
- Posterior to right common iliac artery
72
Portal vein does not drain directly into the inferior vena cava
- Portal vein > liver > hepatic veins > IVC
73
Differences left vs right tributaries of IVC
- Left gonadal > left renal - Left suprarenal > left renal - Left inferior phrenic > left renal
74
The right gonadal, suprarenal, inferior phrenic drain into the
- Inferior vena cava
75
Major tributaries of the inferior vena cava
- L/R hepatic - L/R renal - L/R common iliac - L/R internal/external iliac - L/R femoral - R suprarenal - R gonadal
76
Lumbar lymph nodes (lateral aortic) receive drainage from
- Gonads - Kidneys - Suprarenal glands - Posterior abdominal wall
77
Pre-aortic lymph nodes (celiac, superior and inferior mesenteric) receive drainage from
- GI tract
78
Cisterna chyli and anterior aspect of L1,2 bodies receive drainage from
- Lumbar lymph nodes (lateral aortic) | - Pre-aortic lymph nodes (celiac, superior and inferior mesenteric)
79
Cisterna chyli and anterior aspect of L1,2 bodies drain TO
- Left venous angle
80
Pre-aortic nodes (celiac, superior and inferior mesenteric) drain THROUGH
- Intestinal lymphatic trunks
81
Lumbar lymph nodes (lateral thoracic) drain THROUGH
- Lumbar lymphatic trunks
82
Cisterna chyli and anterior aspect of L1,2 bodies drain THROUGH
- Thoracic duct
83
Autonomic plexues
- Celiac plexus - Superior mesenteric plexus - Inferior mesenteric plexus
84
Celiac plexus
- Surrounds celiac trunk | - Celiac ganglion
85
Superior mesenteric plexus
- Surround origin of SMA | - Superior mesenteric ganglion
86
Inferior mesenteric plexus
- Surrounds IMA | - Inferior mesenteric ganglion
87
Autonomic plexuses contain
- Presynaptic and postsynaptic sympathetic nerve fibers | - Presynaptic parasympathetic nerve fibers
88
Diaphragm
- Double-domed musculotendinous structure - Separates thoracic and abdominal cavities - Function in the abdominal cavity
89
Components of the diaphragm
- Central tendon | - Muscular periphery
90
Diaphragm separates
- Thoracic and abdominal cavities
91
Diaphragm function in the abdominal cavity
- Increase intraabdominal pressure (Valsalva maneuver)
92
Diaphragm sphincter function
- Helps prevent esophageal reflux | - Right crus of the diaphragm forms esophageal hiatus
93
Parts of the diaphragm
- Sternal - Costal - Lumbar
94
Sternal part of diaphragm attaches to
- Xiphoid process
95
Costal part of diaphragm attaches to
- Inner surface of costal cartilage ribs 7-10 | - Ribs 11 & 12
96
Lumbar part of diaphragm attaches to
- Medial and lateral arcuate ligaments | - L1-L3 vertebral bodies, IVD
97
Left crus of diaphragm attaches to
- L1,L2
98
Right crus of diaphragm attaches to
- L1-3
99
MediaN arcuate ligament of diaphragm attaches to
- Connects crura
100
MediaL arcuate ligament (medial lumbocostal arch) of diaphragm attaches to
- L1 (L2) vertebral body to L1 TP
101
Lateral arcuate ligament (lateral lumbocostal arch) of diaphragm attaches to
- L1 TP to tip of 12th rib
102
Diaphragmatic apertures
- Caval opening - Esophageal hiatus - Aortic hiatus - Smaller openings
103
Caval opening is located
- T8 level, right of midline
104
Caval opening contains
- IVC (adherent to diaphragm) - Right phrenic nerve - Lymph vessels
105
Esophageal hiatus is located
- T10 level | - Formed by right crus of diaphragm
106
Esophageal hiatus contains
- Esophagus - Anterior and posterior vagal trunks - Esophageal branches of left gastric a. & v.
107
Aortic hiatus is located
- T12 | - Formed by crura and median arcuate ligament
108
Aortic hiatus contains
- Aorta (passes posterior to diaphragm, not adherent) - Thoracic duct - Azygos and hemiazygos veins
109
Smaller openings transmit
- Greater and lesser splanchnic nerves
110
Smaller opening structures
- Sympathetic trunk - Least splanchnic nerve - Pass posterior to medial arcuate ligament
111
Sternocostal foramen transmit
- Superior epigastric vessels | - Lymph
112
Arterial bloody supply of diaphragm
- Pericardiophrenic - Musculophrenic - Inferior phrenic arteries - Intercostal arteries
113
Motor nerve supply of diaphragm
- Left & right phrenic nerves (C3-5)
114
Central sensory supply of diaphragm
- Phrenic
115
Periphery nerve supply of diaphragm
- Lower intercostal nerves | - Subcostal nerves
116
Types of diaphragmatic hernias
- Congenital - Acquired - Hiatal
117
Congenital diaphragmatic hernia
- Embryological defect in diaphragm development | - Can cause pulmonary hypoplasia (high mortality rate)
118
Two types of congenital diaphragmatic hernias
- Bochdalek: posterolateral (left-sided is most common) | - Morgagni: anterior
119
Bochdalek congenital hernia
- Posterolateral | - Left-sided is most common
120
Morgagni congenital hernia
- Anterior
121
Acquired hernia
- Trauma (blunt or penetrating) | - More common on the left
122
Hiatal hernia
- Hernia through esophageal hiatus

Gross Anatomy (50 decks)

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