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GIR Test 1 > B5-011 Posterior Abdominal Wall and Nerves > Flashcards

B5-011 Posterior Abdominal Wall and Nerves Flashcards

1
Q

the foregut and midgut are innervated by parasympathetics from the

A

vagus nerve

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2
Q

the hindgut is innervated by parasympathetics from the

A

pelvic spanchic nerves

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3
Q

the foregut is sympathetically inervated via

A

thoracic splanchic nerves T5-T9

(greater splanchnic)

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4
Q

the midgut is sympathetically innervated via

A

thoracic splanchic nerves T8-T12

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5
Q

the hindgut is sympathetically innervated by

A

lumbar splanchic nerves L1-L2

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6
Q

pain from the foregut refers to

A

epigastrium

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7
Q

pain from the midgut refers to

A

umbilical region

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8
Q

pain from the hindgut refers to

A

hypogastrium

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9
Q

foregut derivatives

5

A
  • esophagus
  • stomach
  • liver and pancreas
  • billiary apparatus
  • proximal duodenum
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10
Q

midgut derivatives

4

A
  • small intestine
  • cecum and vermiform appendix
  • ascending colon
  • right half of transverse colon
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11
Q

hindgut derivatives

5

A
  • left half of transverse colon
  • descending colon
  • sigmoid colon
  • rectum
  • superior anal canal
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12
Q

sympathetic or parasympathetic function?

contrict blood vessels of skin and GI tract

A

sympathetic

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13
Q

sympathetic or parasympathetic function?

decreases peristalsis of gut, constricts spinchters

A

sympathetic

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14
Q

sympathetic or parasympathetic function?

stimulates suprarenal glands to release adrenaline

A

sympathetic

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15
Q

sympathetic or parasympathetic function?

stimulates peristalsis

A

parasympathetic

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16
Q

sympathetic or parasympathetic function?

inhibits sphincters, stimulates contraction of bladder and rectum

A

parasympathetic

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17
Q

nerve

T5-T9

A

greater splanchnic

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18
Q

nerve

T10-T11

A

lesser splanchnic

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19
Q

nerve

L1-L2

A

lumbar splanchnic

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20
Q

parasympathetic nerves of the abdomen

2

A

vagus
pelvic splanchnic

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21
Q

nerve

S2-S4

A

pelvic splanchnic

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22
Q

nerve

T12

A

least splanchic

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23
Q
  • located near celiac trunk
  • many fibers of the greater splanchic synapse here
A

celiac ganglia

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24
Q
  • located near superior mesenteric artery
  • fibers from greater and lesser splanchnic synapse here
A

superior mesenteric ganglion

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25
Q
  • located along renal arteries
  • fibers from the greater splanchnic, least, and lumbar synapse here
A

aorticorenal ganglia

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26
Q
  • located near inferior mesenteric artery
  • fibers from the least and lumbar splanchnics will synapse here
A

inferior mesenteric ganglia

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27
Q

only fibers that actually synapse in the prevertebral ganglia

A

sympathetic

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28
Q

gives rise to renal, testicular/ovarian, and ureteric plexuses

A

intermesenteric plexus

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29
Q

gives rise to hypogastric nerves, which form the inferior hypogastric plexus

A

superior hypogastric

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30
Q

situated on the sides of the rectum, cervix of uterus, and bladder

A

inferior hypogastric plexus

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31
Q

provide sympathetic innervation to rectum

A

lumbar splanchic L1-L2

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32
Q

provide parasympathetic innervation to rectum

A

pelvic splanchnic

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33
Q

somatic nerve that innervates the rectum below the pectinate line

A

pudendal nerve

cause pain from external hemmorhoids

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34
Q

for the rectum, pain travels with […] nerves

para or sympathetic

A

parasympathetic

pelvic splanchnic

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35
Q

generally, pain travels with

sympathetic or parasympathetic

A

sympathetics

except below pelvic line

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36
Q

below the pelvic line, pain travels with

para or sympathetics

A

parasympathetics

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37
Q

where is the pelvic pain line?

A
  • inferior limit of peritoneum
  • GI tract: middle of sigmoid colon
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38
Q

visceral reflexes that maintain homestasis travel with the

para or sympathetic

A

parasympathetics

vagus/pelvic splanchnic

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39
Q

visceral afferents with input for pain travel with

sympathetic or para

A

sympathetics

above pelvic pain line

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40
Q

visceral afferents with input for pain travel with the […] distal to the middle of the sigmoid colon

sympathetic or para

A

parasympathetic

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41
Q

back/flank pain
fever
inguinal mass
limp
anorexia
weight loss

A

psoas abscess

associated with Tb

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42
Q

positive poas sign

A

lower abdominal pain ellicited by extending limb

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43
Q

the lumbar part of the diaphragm attaches to the medial and lateral […] ligament

A

arcuate

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44
Q

which crus of the diaphragm?

  • larger and longer
  • attaches to L3-L4

in 80% of people, wraps to esophageal hiatus

A

right

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45
Q

which crus of the diaphragm?

  • attaches to L2-L3
  • shorter
A

left

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46
Q

what diaphragmatic hiatus?

  • located at T8
  • IVC and rt. phrenic n. pass through
A

caval hiatus

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47
Q

what diaphragmatic hiatus?

  • located at T10
  • esophagus and vagal trunks pass through
A

esophageal hiatus

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48
Q

what diaphragmatic hiatus?

  • located at T12
  • aorta, thoracic duct, and sometimes azygous pass through
A

aortic hiatus

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49
Q

vascular structure

T12-L4

A

aorta

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50
Q

vascular structure

T12

A

celiac

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51
Q

vessel

L1

A

superior mesenteric a.

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52
Q

vessel

L1/L2

A

renals

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53
Q

vessel

L2

A

gonadal

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54
Q

vessel

L3

A

inferior mesenteric artery

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55
Q

vessel

bifurcation

A

L4

biFOURcation

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56
Q

the body of the pancreas and splenic v. are located at what vertebral level?

A

L1/L2

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57
Q

the left renal v. is located at what vertebral level?

A

L2

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58
Q

the horizontal part of the duodenum is located at what vertebral level?

A

L3

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59
Q

innervated by preganglionic sympathetics from T6-L2

A

adrenal glands

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60
Q

which kidney is in contact with the liver, duodenum, and ascending colon?

A

right

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61
Q

which kidney is in contact with the stomach, spleen, pancrease, jejunum, and descending colon?

A

left

62
Q

renal papilla empty into the

A

minor calyx

63
Q

2-3 minor calices come together to form a

A

major calyx

64
Q

major calyx dump into the

A

renal pelvis

65
Q

posterior to the ductus deferens in males or uterine artery in females

A

ureter

66
Q

3 constriction points of ureter

A
  • ureteropelvic junction
  • crossing illiac artery/pelvic brim
  • ureter enters bladders

places where kidney stones can become lodged

67
Q

subcostal nerve is located at

A

T12

68
Q

iliohypogastric and ilioinguinal nerves are found at what vertebral level?

if its a common nerve it’s called anterior ramus

A

L1

iliohypogastric is always superior

69
Q

exits L2-L3 deep to inguinal ligament and ASIS

A

lateral cutaneous nerve of the thigh

70
Q

provides sensory to skin over mons pubis and hypogastric region

A

iliohypogastric

71
Q

supplies sensory over inguinal ligament, medial thigh, and anterior labia or scrotum

A

ilioninguinal nerve

72
Q

nerve that follows the psoas major muscle posteriorly

A

femoral

73
Q
  • innervates anterior muscles of thigh
  • helps with hip flexion, knee extension
  • sensory to anterior thigh and medial surface of leg
A

femoral nerve

74
Q

nerve that follows psoas major anteriorly

A

genitofemoral

75
Q
  • innervates cremaster muscles
  • sensory to skin of upper thigh
  • innervates anterior scrotum
A

genitofemoral

76
Q

nerve lies medial to psoas major

A

obturator nerve

77
Q
  • innervates adductor compartment of thigh
  • helps with adduction
  • sensory to medial aspect of thigh
A

obturator nerve

78
Q

muscles of the muscular floor

4

A
  • psoas major/minor
  • illiacus
  • quadratus lumborum
  • diaphragm
79
Q

tendonous arch of the crura of diaphragm

A

median arcuate ligament

80
Q
  • fascial thickening of the psoas fascia
  • lateral to median arcuate ligament
A

medial arcuate ligament

81
Q

thickening of fascia lining the quadratus lumborum

A

lateral arcuate ligament

82
Q

colicky pain without jaundice

A

gallstones blocking cystic duct

83
Q

what structures are endangered during a cholecystectomy?

A

portal triad
liver
common hepatic duct
proper hepatic artery
right and left hepatic arteries

84
Q

what artery is ligated during a cholecystectomy?

A

cystic artery

85
Q

what landmarks are used to identify the cystic artery?

A

cystohepatic triangle (of Calot)

bile duct, common hepatic duct, surface of liver

86
Q

what two organs are most likely to be affected by cholecysto-enteric fistulas?

A

duodenum: cause small bowel obstruction
transverse colon

gas can enter the gallbladder

87
Q

what causes the intial pain with kidney stones?

A

stone stuck in pelvico-ureter junction

88
Q

3 constriction sites for kidney stones

A
  • pelvico-ureter junction
  • external iliac artery / pelvic brim
  • bladder wall
89
Q

why is pain from kidney stones intermittent?

A

when it gets stuck at constriction points, it causes stretching which causes pain

90
Q

does the pain travel with the sympathetics or parasympathetics in the ureter?

A

sympathetics

91
Q

what nerve fibers pick up pain in the ureter?

A

lesser and least splanchnic

92
Q

when does pain start to travel with the parasympathetics?

A

below the pelvic line

middle of sigmoid colon and below

93
Q

what ligaments/vessels would be cut in a splenectomy?

A

splenic artery/vein close to spleen
gastrosplenic ligament

94
Q

what ligament contains the short gastrics?

A

gastrosplenic

95
Q

what structures should be avoided during splenectomy?

A

short gastrics
cutting splenic artery close to pancreas
tail of pancreas
left gastro-omental artery

96
Q

what ligament contains the splenic artery?

A

splenorenal

97
Q

what ligament contains the tail of the pancreas?

A

splenorenal

98
Q

what vessels supply the fundus of the stomach?

A

short gastrics

99
Q

what ligaments contain the gastro omentals?

A

gastrocolic

100
Q

starts in the gastrosplenic ligament and continues in the gastrocolic ligament

A

left gastro-omental

101
Q

what artery is contained in the splenorenal ligament?

A

splenic a.

102
Q

bloody vomit associated with portal hypertension can be an indication of

A

rupture of esophageal varices

103
Q

what causes caput medusae

A

paraumbilical veins anastomosing with epigastrics

104
Q

results from anastamosis of superior and middle rectal vein

A

hemorrhoids

105
Q

which nerve is responsible for sensation over the root of the penis and anterior scrotum or the mons pubis and labium majora?

A

ilioinguinal

106
Q

which nerve is responsible for sensation over the lateral thigh “pocket area”?

A

lateral femoral cutaneous

107
Q

which nerve will provide motor to the anterior compartment of the thigh?

A

femoral nerve

108
Q

3 anatomic constrictions along the ureter

A
  • renal pelvis/ureter
  • ureter/pelvic brim
  • ureter/urinary bladder

points where kidney stones get stuck

109
Q

receive lymphatic drainage from the descending colon, sigmoid colon, and superior aspect of the rectum

A

inferior mesenteric nodes

110
Q

cancer cells from adenocarcinomia within the superior aspect of the rectum may metastasize to the inferior mesenteric nodes after reaching the […] nodes

A

pararectal

111
Q

receive lymph from the gluteal region, inferior rectum, and pelvic viscera

A

internal iliac nodes

112
Q

receive lymphatic drainage from the pelvic organs in direct contact with peritoneum

A

external iliac lymph nodes

113
Q

receive lymphatic drainage from posterior abdominal wall, gonads, testies, kidney, ureters, uterus, and uterine tubes

A

lumbar nodes

114
Q

receive lymphatic drainage from midgut

A

superior mesenteric nodes

115
Q

emerges from medial border of psoas at the pelvic brim

A

obturator nerve

116
Q

most inferior nerve emerging from lateral border of psoas major

A

femoral nerve

117
Q

lumbar plexus is formed within the […] muscle

A

psoas major

118
Q

emerges on anterior surface of psoas major and passes downward on the face of the muscle

A

genitofemoral

119
Q

emerge from lateral border of psoas major

4

A

iliohypogastric
ilioinguinal
lateral cutaneous
femoral

120
Q

if the IVC is obstructed, how can bloodflow bypass it?

A

ascending lumbar veins to azygous and hemiazygous

caval-caval anastomosis

121
Q

[…] nerves are wrapped around the esophagus and onto the stomach

must be given close attention during repairs of esophageal hiatus

A

vagus

122
Q

the inferior hypogastric (pelvic) plexus contains preganglionic parasympathetic fibers from the […] nerves

A

pelvic splanchnic

123
Q

the lumbar and sacral splanchnic nerves and the sacral sympathetic chain ganglia contrain preganglionic […] fibers

A

sympathetic

124
Q

pain from the stomach with travel with what nerve?

A

greater splanchnic

125
Q

pain from the distal small intestin, cecum, ascending colon, transverse colon, and kidneys would be carried by what nerve?

A

lesser splanchnic

126
Q

pain from the descending colon and kidneys would be carried by what nerve?

A

least splanchnic

127
Q

parasympathetic nerve fibers found in the inferior hypogastric plexus come from which nerve?

A

pelvic splanchnic

128
Q

pain from the distal sigmoid colon would travel with what nerve?

A

pelvic splanchnic

129
Q

what two structures pass through the caval hiatus at T8?

A

IVC and right phrenic

130
Q

what structures pass through the esophageal hiatus at T10?

A

esophagus, anterior and posterior vagal trunks

131
Q

what structures pass through the aortic hiatus at T12?

A

aortic, thoracic duct, sometimes azygous

132
Q

the left phrenic and sympathetic chain travel through which diaphragmatic hiatus?

A

none, directly pierce diaphragm

sorry it was tricky

133
Q

celiac trunk is located at

A

T12

134
Q

SMA is located at

A

L1

135
Q

renal arteries are located at

A

L1/L2

136
Q

gonadal arteries are located at

A

L2

137
Q

the IMA is located at

A

L3

138
Q

the bifurcation of the aorta is located at

A

L4

139
Q

what two veins drain into the left renal vein?

A

left adrenal
left phrenic

140
Q

the right adrenal vein drains into

A

into the IVC

141
Q

what two veins join to form the portal vein?

A

superior mesenteric and splenic

142
Q

the inferior mesenteric vein will usually drain into the […] but sometimes […]

A

splenic vein
sometimes contributes to formation of portal vein

143
Q

the subcostal nerve and anterior ramus of L1 are located posterior to the

A

kidney

144
Q

located posterior to psoas major and enters the thigh deep to the inguinal ligament

A

femoral nerve

145
Q

located anterior to psoas major

A

genitofemoral

146
Q

located medial to psoas major

A

obturator n.

147
Q

located on the lateral side of the vertebrae

A

sympathetic chain

148
Q

structures anterior to right kidney

3

A

liver
duodenum
ascending colon

149
Q

structures anterior to left kidney

5

A

stomach
spleen
pancreas
jejunum
descending colon

150
Q

located posterior to kidneys

3

A

posterior abdominal wall
subcostal nerve
anterior ramus of L1 and its branches

GIR Test 1 (16 decks)

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