Diaphragm Kidney And Posterior Wall

Question 1

Phrenic nerve

Answer 1

C3, 4, and 5 keep me breathing and alive

Innervates the diaphragm

Predominately motor
Many sensory that anastomose with peripheral diaphragm

Paralyzed hemidiaphramatic will cause one side to be left in the thoracic cavity

Question 2

Diaphragm apertures

Answer 2

I hate ten eggs at noon
IVC at T8
Esophagus at T 10
Aorta at T12

All close to midline

Question 3

Arcuate ligaments

Answer 3

1 median over the aorta
2 medial arch over Psoas major
2 lateral arch over quadratic lumburum

Question 4

Vessels to diaphragm

Answer 4

Pericardiacophrenic and superior phrenic
-off thoracic aorta

Inferior phrenic
- off abdominal aorta

Musculophrenic a
- off interior thoracic

Question 5

Kidneys

Answer 5

L at 11 th rib
R at 12 th rib
Encapsulated by peri renal fat and renal fascia
Ascend from pelvis in development
- ectopic pelvic
-horseshoe
-transplanted kidneys in lower abdomen

Question 6

Kidney adipose layers

Answer 6

Retroperitoneal 
Outside to inside:
-paranephric fat
-renal fascia
-perinephric fat: fills the hilum space

Question 7

Kidney vascular urge differences

Answer 7

Renal arteries:
R longer passes posterior to IVC

Renal veins:
L longer passes anterior to aorta

Question 8

Ureter arteries

Answer 8

Renal a
Testicular a
Abdominal aorta or common iliac
Internal iliac a (pelvic cavity)

Question 9

Intravenous urogram

Answer 9

Injected with iodinated contrast medium
Seen in the ureter and renal tubules
Shows blockages

Calculi or renal stones are cause of many blockages

Question 10

Adrenal glands

Answer 10

R glands- roughly triangular and lies posterior to IVC

L glands- more semilunar and superior medial to hilum
Pushed down by stomach

Cortex- 3 zones that make steroids
Medulla- sympathetic ganglion, chromatic cells or medullary cells

Question 11

Adrenal vasculature

Answer 11

Superior suprarenal= inferior phrenic a
-6-8
Middle suprarenal = abdominal aorta
Inferior suprarenal= renal a

Question 12

Posterior abdominal wall muscles

Answer 12

Transversus abdominis

Quadratus lumborum

Psoas minor

Psoas major

Question 13

Posterior wall vasculature

Answer 13

Lumbar arterial branches
4 pairs
At L4 at level of umbilicus

Question 14

Nerves of posterior wall

Answer 14

Subcostal n
Iliohypogastric n
Ilioinguinal n
Lateral cutaneous n

Question 15

Subcostal n

Answer 15

Inferior to 12 th rib
Sensory to anterolateral abdominal wall
Motor to EO IO TA Pyramidalis RA QL

T12

Question 16

Iliohypogastric and ilioinguinal n

Answer 16

L1
Common trunk
Descend anterior to QL

IH supplies skin supra pubic region
II supples inguinal canal to supply it

Both supply abdominal muscles

Question 17

Genitofemoral n

Answer 17

L1-2
Pierces Psoas major
Splits to femoral and genital

Supplies skin of inguinal ligament
Supplies cremaster muscle of spermatic cord

Question 18

Lateral femoral cutaneous

Answer 18

L2-3
Descends anterior to iliacus m
Inferior to ASIS

Michael Jordan nerve
Supplies anterior lateral skin of thigh

Question 19

Femoral n

Answer 19

L2-4
Runs between iliacus and Psoas major
Passes deep to inguinal ligament
Inferior to ASIS
Supplies sensory and motor to anterior thigh

Question 20

Obturator

Answer 20

L2-4
Runs medial to Psoas major
Passes through ubturator foramen
Supplies medial thigh