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Anatomy 6512 > Diaphragm, Kidney & Posteror Abdominal Wall > Flashcards

Diaphragm, Kidney & Posteror Abdominal Wall Flashcards

1
Q

What is the origin of the phrenic nerve?

A

C3-C5

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2
Q

What paralysis can be caused by damage to the phrenic nerve/cervical cord?

A

Paralyzed hemidiaphragm cannot contract (descend)

  • remains high in thorax
  • recognizable on - radiographic chest films
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3
Q

What foramena and hiatuses are in the diaphragm?

A
  • Vena Cava foramen T8 (IVC)
  • Esophageal Hiatus T10
  • Aortic Hiatus T12
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4
Q

What are the Arcuate Ligaments or Lumbocostal arches?

A 
- 1 median arcuate lig.
arches over aorta
- 2 medial arcuate ligs.
arch over psoas mm.
- 2 lateral arcuate ligs.
arch over quadratus lumborum mm.
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5
Q

What are the Vessels of Diaphragm?

A

1) Pericardiacophrenic & superior phrenic aa
- supply superior surface (via int. thoracic a & thoracic aorta)
2) Inferior phrenic aa
- supply inferior surface (via abdominal aorta)
3) Musculophrenic aa
- supply periphery of diaphragm (via int. thoracic aa.)
4) Venous drainage is via accompanying vv to IVC

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6
Q

Where are the kidneys?

A

located lateral to vertebral column T12-L3

  • superior pole of L kidney at 11th rib
  • superior pole of R kidney at 12th rib
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7
Q

Kidneys are encapsulated by ___________

A

perirenal fat & renal fascia

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8
Q

During development, the kidneys ascend from ______

A

pelvis

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9
Q

What is the internal structure of the kidney?

A 
Fibrous capsule
Renal cortex = outer 1/3
Renal medulla = inner 2/3
	contains renal 
		pyramids
Renal papillae = receive 
	apex of pyramids
Minor calyces
Major calyces
Renal pelvis
Ureter
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10
Q

What is the vasculature of the kidneys?

A

1) Renal Arteries
- R longer
- R passes post to IVC
Each divides at hilum into segmental aa
end arteries

2) Renal veins to IVC
anterior to arteries
L is longer
L passes anterior to aorta

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11
Q

What is the pathway of kidney/urine drainage?

A 
Renal papillae = receive 
	tips of pyramids (urine)
to Minor Calyces
to Major Calyces
to Renal pelvis
to Ureter
to Urinary bladder
to Urethra
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12
Q

What is the path of the ureters?

A
  • Cross psoas major mm to enter bladder
  • Run obliquely posterior to gonadal vessels
  • Anterior to Ext. Iliac a.
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13
Q

Anomalies in the ureters

A
  • Bifid renal pelvis & ureters is fairly common

* Retrocaval ureters – occasional

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14
Q

What is the vasculature of the ureters?

A
  • Ureter Arteries – arise from 3-4 sources:
    1) renal a.
    2) testicular or ovarian a.
    3) abdominal aorta
    4) internal iliac a. (Pelvic cavity)

Veins of ureters drain into similarly named vv.

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15
Q

What is an Intravenous urogram (IVU)?

A

Patient is injected with iodinated contrast medium.

Media are excreted by glomerular filtration and by renal tubules.

Allows visualization of the ureters and bladder.

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16
Q

What are kidney stones (calculi)?

A
  • Form in kidney & progress to renal pelvis
    1) May spontaneously pass thru ureter into bladder
    2) Usually associated with considerable pain
    3) Larger stones my have to be surgically removed (~1cm)
    4) May be subjected to ultrasonic crushing
  • via lithotripsy
17
Q

How does Calculi Referred Pain work?

A

1) Waves of contraction force stone down thru ureter
2) Rhythmic pain occurs & is referred with descent of stone
3) Region of referred pain changes with level of obstruction
4) Gradually moves inferoanteriorly toward groin
- from side & back between ribs to pelvis to inguinal
- area of cutaneous innervation T11-12

18
Q

Adrenal (Suprarenal) Glands

A

R gland – roughly triangular
Lies superior to R kidney, posterior to IVC

L gland – more semilunar
Lies superomedial to L kidney near hilum

19
Q

What are Gross features: Adrenal (Suprarenal) Gland?

A

1) Fibrous capsule
2) Adrenal cortex = outer
produces adrenal steroids
3) Adrenal medulla = inner
portion that acts as sympathetic ganglion

20
Q

What is the vasculature of the Adrenal (Suprarenal) Glands?

A 
Richly vascularized due to
	endocrine function
Suprarenal aa – 3 sources
	Sup. suprarenal aa (6-8)
		Inferior phrenic a
	Middle suprarenal aa (1+)
		Abdominal aa
	Inf. suprarenal aa (1+)
		Renal aa
21
Q

What is the musculature of the posterior abdominal wall?

A

1) Transversus abdominus m.
2) Quadratus lumborum m.
3) Psoas major m
4) Iliacus m.
5) Psoas minor m.
6) Diaphragm

22
Q

What is the Arterial Supply of Posterior Wall?

A

1) Lumbar aa. - 4 pairs of aa, brs of Abdominal Aorta (sup to bifurcation)
* aorta bifurcates at L4 (level of umbilicus)

23
Q

What are the nerves of the posterior wall?

A

1) Ventral rami T12-L4
2) Lumbar plexus of nn.
located beneath fascia of posterior abd. mm.
3) ventral rami T12-L4
4) Lumbar plexus of nn.
note positions of the nerves relative to psoas major m.

  • Symp. trunks posterior as well
  • continuous with thoracic portions
24
Q

Where is the Subcostal n. and what does it supply?

A
  • ~1cm inferior to 12th rib
  • Supplies sensory to ant./lat. abd. wall
  • Supplies motor to abdominal mm.: EO, IO, TA, pyramidalis, RA, QL
25
Q

Where are the Iliohypogastric & Ilioinguinal Nn. and what do they supply?

A
  • Can arise from common trunk
  • descend ant. to QL
  • Iliohypogastric n. supplies skin of suprapubic region
  • Ilioinguinal n. runs thru inguinal call to supply it
  • Both also supply abd. mm.
26
Q

Where is the genitofemoral n. and what does it supply?

A
  • L1-L2
  • Pierces psoas major m.
  • descends along ant. surface
  • Splits to femoral br. & genital br.
  • Supplies skin inf. & med. to inguinal ligament
  • Supplies cremaster m. (of spermatic cord)
27
Q

Where is the Lateral Femoral Cutaneous N. and what does it supply?

A
  • L2-L3
  • Descends ant. to iliacus m.
  • Passes deep to inguinal ring
  • Inferior to ASIS
  • Supplies ant./lat. skin of thigh
28
Q

Where is the femoral n. and what does it supply?

A
  • L2-L4
  • Runs between iliacus & psoas major mm.
  • Passes deep to inguinal ligament
  • Inferior to ASIS
  • Supplies sensory & motor to anterior thigh
29
Q

Where is the Obturator N. and what does it supply?

A
  • L2-L4
  • Runs medial to psoas major mm.
  • Passes thru obturator foramen
  • Supplies sensory & motor to medial thigh
30
Q

Where is the lumbosacral trunk and what does it supply?

A
  • L4-5
  • Large n. trunk crosses over ala of sacrum
  • Descends into pelvis to help form sacral plexus
  • Provides general contributions to both plexuses

Anatomy 6512 (26 decks)

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