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

Abdomen: Kidney, Suprarenal Glands, Posterior Abdominal Wall Flashcards

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
Q

Each renal artery branch (5 segmental arteries) supplies

A
  • Independent renal segment
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26
Q

Kidney blood flow

A
  • Renal artery
  • Segmental arteries
  • Interlobar arteries
  • Arcuate arteries
  • Interlobular arteries
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27
Q

Renal veins

A
  • Left is longer than right
  • Left has additional tributaries
  • Left passes between aorta and SMA
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28
Q

Left renal veins additional tributaries

A
  • Left suprarenal
  • Left gonadal
  • Left inferior phrenic
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29
Q

Passage of left renal vein between aorta and SMA

A
  • Site of compression
  • Renal vein entrapment
  • “Nutcracker syndrome”
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30
Q

Suprarenal glands are between

A
  • Superior pole of kidney and diaphragm
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31
Q

Suprarenal glands are separated from kidney by

A
  • Septum of renal fascia
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32
Q

Right suprarenal gland

A
  • Pyramid-shaped
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33
Q

Left suprarenal gland

A
  • Crescent-shaped

- More medially oriented on kidney

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34
Q

Suprarenal gland consists of 2 parts

A
  • Cortex

- Medulla

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35
Q

Cortex of suprarenal gland

A
  • Androgens and corticosteroids
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36
Q

Medulla of suprarenal gland

A
  • Catecholamines (primarily epinephrine)

- Innervated by sympathetic presynaptic neurons

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37
Q

Arterial supply of suprarenal glands

A
  • Superior suprarenal (multiple branches from inferior phrenic)
  • Middle suprarenal (from AA)
  • Inferior suprarenal (from renal)
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38
Q

Venous drainage of suprarenal glands

A
  • Right suprarenal drains into the IVC

- Left suprarenal drains into the left renal vein

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39
Q

Innervation of suprarenal glands

A
  • Presynaptic sympathetics from T10-L1 directly innervate medulla
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40
Q

Posterior abdominal wall contains

A
  • 5 Lumbar vertebrae & IVD
  • Intervertebral disc
  • Ilium
  • Muscles
  • Lumbar plexus
  • Aorta & IVC
  • Aortic plexus
  • Lymph nodes
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41
Q

Muscles of the posterior abdominal wall

A
  • Psoas major and minor
  • Quadratus lumborum
  • Iliacus
  • Diaphragm
  • Transverse abdominis
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42
Q

Psoas Major superior attachment

A
  • TP of lumbar vertebrae

- Bodies & discs T12-L5

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43
Q

Psoas Major inferior attachment

A
  • Lesser trochanter of femur
  • Descends over pelvic brim
  • Posterior to inguinal ligament
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44
Q

Psoas Major innervation

A
  • Ventral rami L1-3
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45
Q

Psoas Minor superior attachment

A
  • T12,L1 bodies/IVD
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46
Q

Psoas Minor inferior attachment

A
  • Pectineal line

- iliopubic eminence

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47
Q

Iliacus superior attachment

A
  • iliac fossa
  • Ala of sacrum
  • Anterior sacroiliac ligaments
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48
Q

Iliacus inferior attachment

A
  • Psoas major tendon/lesser trochanter
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49
Q

Iliacus innervation

A
  • Femoral (L2-4)
50
Q

Iliopsoas muscle

A
  • Combination of iliacus and psoas major
51
Q

Iliopsoas muscle function

A
  • Trunk and thigh flexion

- Stabilize hip

52
Q

Quadratus Lumborum superior attachment

A
  • 12th rib

- TPs of Lumbar vertebrae

53
Q

Quadratus Lumborum inferior attachment

A
  • iliolumbar ligament

- iliac crest

54
Q

Quadratus Lumborum innervation

A
  • Ventral rami T12-L4
55
Q

Quadratus Lumborum function

A
  • Fixes 12th rib (inspiration)
  • Stabilizes trunk
  • Extends and lateral flex vertebral column
56
Q

Nerves of the posterior abdominal wall

A
  • Subcostal nerve (ventral rami T12)

- Abdominal sympathetic trunk

57
Q

Abdominal sympathetic trunk

A
  • 4 paravertebral ganglia

- Passes deep to medial arcuate ligament

58
Q

Lumbar plexus (L1-4)

A
  • Oriented around psoas major
59
Q

Branches of the lumbar plexus (L1-4)

A
  • 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
Q

Genitofemoral (L1,2) nerve

A
  • Genital and femoral branches
61
Q

Lateral femoral cutaneous (L2,3) nerve

A
  • Enters thigh deep to inguinal ligament
62
Q

Femoral (L2-4) nerve

A
  • Largest branch of lumbar plexus

- Enters thigh deep to inguinal ligament

63
Q

Obturator (L2-4) nerve

A
  • Supplies adductor thigh muscles
64
Q

Accessory obturator (L3,4) nerve

A
  • Not always present
65
Q

Lumbosacral trunk (L4,5)

A
  • Contributes to sacral plexus
66
Q

Direct branches of the abdominal aorta

A
  • Aortic hiatus (T12) to bifurcation into common iliac arteries (~L4)
  • Common iliacs arteries divide (~ L5/S1)
67
Q

Common iliacs arteries divide (~ L5/S1) into

A
  • Internal iliac: pelvis
  • External iliac: lower limb
  • Ureters pass anterior to the bifurcation of the CIA
  • Slightly left of midline
68
Q

Paired (parietal and visceral)

A
  • Inferior phrenic
  • Lumbar: 4 on each side
  • Middle suprarenal
  • Renal
  • Gonadal
69
Q

Unpaired (parietal and visceral)

A
  • Median sacral
  • Celiac trunk
  • Superior mesenteric
  • Inferior mesenteric
70
Q

Inferior vena cava

A
  • Formed by junction of common iliac veins (L5)
  • Ascends to the right of midline
  • Passes through diaphragm (T8)
  • Drains into right atrium
71
Q

Junction of common iliac veins (L5) is located

A
  • Posterior to right common iliac artery
72
Q

Portal vein does not drain directly into the inferior vena cava

A
  • Portal vein > liver > hepatic veins > IVC
73
Q

Differences left vs right tributaries of IVC

A
  • Left gonadal > left renal
  • Left suprarenal > left renal
  • Left inferior phrenic > left renal
74
Q

The right gonadal, suprarenal, inferior phrenic drain into the

A
  • Inferior vena cava
75
Q

Major tributaries of the inferior vena cava

A
  • L/R hepatic
  • L/R renal
  • L/R common iliac
  • L/R internal/external iliac
  • L/R femoral
  • R suprarenal
  • R gonadal
76
Q

Lumbar lymph nodes (lateral aortic) receive drainage from

A
  • Gonads
  • Kidneys
  • Suprarenal glands
  • Posterior abdominal wall
77
Q

Pre-aortic lymph nodes (celiac, superior and inferior mesenteric) receive drainage from

A
  • GI tract
78
Q

Cisterna chyli and anterior aspect of L1,2 bodies receive drainage from

A
  • Lumbar lymph nodes (lateral aortic)

- Pre-aortic lymph nodes (celiac, superior and inferior mesenteric)

79
Q

Cisterna chyli and anterior aspect of L1,2 bodies drain TO

A
  • Left venous angle
80
Q

Pre-aortic nodes (celiac, superior and inferior mesenteric) drain THROUGH

A
  • Intestinal lymphatic trunks
81
Q

Lumbar lymph nodes (lateral thoracic) drain THROUGH

A
  • Lumbar lymphatic trunks
82
Q

Cisterna chyli and anterior aspect of L1,2 bodies drain THROUGH

A
  • Thoracic duct
83
Q

Autonomic plexues

A
  • Celiac plexus
  • Superior mesenteric plexus
  • Inferior mesenteric plexus
84
Q

Celiac plexus

A
  • Surrounds celiac trunk

- Celiac ganglion

85
Q

Superior mesenteric plexus

A
  • Surround origin of SMA

- Superior mesenteric ganglion

86
Q

Inferior mesenteric plexus

A
  • Surrounds IMA

- Inferior mesenteric ganglion

87
Q

Autonomic plexuses contain

A
  • Presynaptic and postsynaptic sympathetic nerve fibers

- Presynaptic parasympathetic nerve fibers

88
Q

Diaphragm

A
  • Double-domed musculotendinous structure
  • Separates thoracic and abdominal cavities
  • Function in the abdominal cavity
89
Q

Components of the diaphragm

A
  • Central tendon

- Muscular periphery

90
Q

Diaphragm separates

A
  • Thoracic and abdominal cavities
91
Q

Diaphragm function in the abdominal cavity

A
  • Increase intraabdominal pressure (Valsalva maneuver)
92
Q

Diaphragm sphincter function

A
  • Helps prevent esophageal reflux

- Right crus of the diaphragm forms esophageal hiatus

93
Q

Parts of the diaphragm

A
  • Sternal
  • Costal
  • Lumbar
94
Q

Sternal part of diaphragm attaches to

A
  • Xiphoid process
95
Q

Costal part of diaphragm attaches to

A
  • Inner surface of costal cartilage ribs 7-10

- Ribs 11 & 12

96
Q

Lumbar part of diaphragm attaches to

A
  • Medial and lateral arcuate ligaments

- L1-L3 vertebral bodies, IVD

97
Q

Left crus of diaphragm attaches to

A
  • L1,L2
98
Q

Right crus of diaphragm attaches to

A
  • L1-3
99
Q

MediaN arcuate ligament of diaphragm attaches to

A
  • Connects crura
100
Q

MediaL arcuate ligament (medial lumbocostal arch) of diaphragm attaches to

A
  • L1 (L2) vertebral body to L1 TP
101
Q

Lateral arcuate ligament (lateral lumbocostal arch) of diaphragm attaches to

A
  • L1 TP to tip of 12th rib
102
Q

Diaphragmatic apertures

A
  • Caval opening
  • Esophageal hiatus
  • Aortic hiatus
  • Smaller openings
103
Q

Caval opening is located

A
  • T8 level, right of midline
104
Q

Caval opening contains

A
  • IVC (adherent to diaphragm)
  • Right phrenic nerve
  • Lymph vessels
105
Q

Esophageal hiatus is located

A
  • T10 level

- Formed by right crus of diaphragm

106
Q

Esophageal hiatus contains

A
  • Esophagus
  • Anterior and posterior vagal trunks
  • Esophageal branches of left gastric a. & v.
107
Q

Aortic hiatus is located

A
  • T12

- Formed by crura and median arcuate ligament

108
Q

Aortic hiatus contains

A
  • Aorta (passes posterior to diaphragm, not adherent)
  • Thoracic duct
  • Azygos and hemiazygos veins
109
Q

Smaller openings transmit

A
  • Greater and lesser splanchnic nerves
110
Q

Smaller opening structures

A
  • Sympathetic trunk
  • Least splanchnic nerve
  • Pass posterior to medial arcuate ligament
111
Q

Sternocostal foramen transmit

A
  • Superior epigastric vessels

- Lymph

112
Q

Arterial bloody supply of diaphragm

A
  • Pericardiophrenic
  • Musculophrenic
  • Inferior phrenic arteries
  • Intercostal arteries
113
Q

Motor nerve supply of diaphragm

A
  • Left & right phrenic nerves (C3-5)
114
Q

Central sensory supply of diaphragm

A
  • Phrenic
115
Q

Periphery nerve supply of diaphragm

A
  • Lower intercostal nerves

- Subcostal nerves

116
Q

Types of diaphragmatic hernias

A
  • Congenital
  • Acquired
  • Hiatal
117
Q

Congenital diaphragmatic hernia

A
  • Embryological defect in diaphragm development

- Can cause pulmonary hypoplasia (high mortality rate)

118
Q

Two types of congenital diaphragmatic hernias

A
  • Bochdalek: posterolateral (left-sided is most common)

- Morgagni: anterior

119
Q

Bochdalek congenital hernia

A
  • Posterolateral

- Left-sided is most common

120
Q

Morgagni congenital hernia

A
  • Anterior
121
Q

Acquired hernia

A
  • Trauma (blunt or penetrating)

- More common on the left

122
Q

Hiatal hernia

A
  • Hernia through esophageal hiatus

Gross Anatomy (50 decks)

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