Diaphragm, Kidneys, and Post. Abd. Wall Flashcards
____ innervate the diaphragm
right and left phrenic nerves
phrenic n. comes from ____ and is found on the anterior surface of the ____; it descends between ____ to enter the thoracic cavity; passes into abdominal cavity with ____
cervical nerves (C3, 4, and 5); scalene m. ; subclavian artery and vein; IVC
supplies right and left hemidiaphragms; sole motor innervation to the diaphragm
phrenic nerves
supplies lateral borders of diaphragm and some sensory
intercostal nerves
phrenic nerve is ___ sensory
30%
irritation to both the superior and inferior surfaces of the CENTRAL part of the diaphragm is carried by sensory fibers in the ____
phrenic n.
irritation to the superior and inferior surfaces of the PERIPHERAL portions of the diaphragm is carried by the _____
intercostal nerves
phrenic n. originates from ____ spinal segments, which explains paralysis from ____ (paralysis of diaphragmatic respiration)
C3-5; cervical cord injuries
C3-5 spinal segments from somites from mesoderm
paralyzed hemidiaphragm cannot _____
contract (descend)
IVC passes through the diaphragm at vertebral level ___ via the ____
T8; vena cava foramen
esophagus passes through diaphragm at vert. level ___ via _____
T10; esophageal hiatus
aorta passes through diaphragm at vert. level ___ via ____
T12; aortic hiatus
arcuate ligaments or lumbocostal arches
1 median arcuate ligament
2 medial arcuate ligaments
2 lateral arcuate ligaments
median arcuate ligament arches over ____
aorta
2 medial arcuate ligaments arch over ____
psoas muscles
2 lateral arcuate ligaments arch over ____
quadratus lumborum muscles
vessels of the diaphragm
- pericardiacophrenic & superior phrenic aa.
- inferior phrenic aa.
- musculophrenic aa.
pericardiacophrenic and superior phrenic aa. supply the ____ via ____ and _____
superior surface of the diaphragm; internal thoracic a; thoracic aorta
inferior phrenic a. supplies the ____ via the _____
inferior surface of diaphragm; abdominal aorta
musculophrenia aa. supply the _____ via _____
periphery of the diaphragm; internal thoracic arteries
the kidneys are located lateral to the vertebral column at level ____
T12-L3
Superior pole of left kidney is at ____ and superior pole of right kidney is at ____
11th; 12th rib
kidneys are encapsulated by ____ and ____
perirenal fat; renal fascia
the kidneys ascend from the ____ during development
pelvis
ectopic pelvic kidney remains ____; horseshoe kidney below _____ and transplanted kidneys are placed in the _____
anterior to sacrum; IMA; lower abdomen
perirenal (or perinephric) fat is located _____ and pararenal (or paranephric) fat is located ____
inside the renal fascia; outside the renal fascia
anterior most structures at hilums of the kidneys
renal veins
renal arteries are between the ___ and ____
renal pelvis; renal vein
____ is the most posterior structure at the hilum
renal pelvis
____ is shorter because the IVC is positioned on the ____
right renal vein shorter than the left renal vein bc IVC is positioned on the right
____ is shorter because the abdominal aorta is positioned on the ____
left renal a. shorter than right bc aorta positioned on left
left renal vein crosses ___ to abdominal aorta, but ____ is anterior to the left renal vein
anterior; SMA
outer most layer of the kidney is a ____
fibrous capsule
outer 1/3 of the kidney
renal cortex
inner 2/3 of the kidney
renal medulla
renal medulla contains ____ and ____ between them
renal pyramids; renal columns
receive apex of renal pyramids
renal papillae
adjacent to renal papilla is the ____
minor calyx
major calyces combine at _____
renal pelvis
right renal artery passes posterior to the ____
IVC
each renal artery divides into ____ at the hilum
segmental aa.
vascular supply to the kidneys does not anastomose, so they are called _____
end arteries
drainage of kidney/urine
renal papillae receive urine at tips/apex of pyramids > minor calcyes > major calyces > renal pelvis > ureter > urinary bladder > urethra
ureter arteries arise from 3-4 sources:
- renal a.
- testicular or ovarian aa.
- abdominal aorta or common iliac a.
- internal iliac a. (pelvic cavity)
allows visualization of ureters and urinary bladder
intravenous urogram (IVU)
in an IVU, pt is injected with ____; media are excreted by ____ and by _____
iodinated contrast medium; glomerular filtration; renal tubules
kidney stones or ____ form in the ____ and progress to ____
calculi; kidney; renal pelvis
kidney stones may spontaneously pass thru ____ to ____; may be subjected to ____ via _____
ureter; bladder; ultrasonic crushing; lithotripsy
calculi cause _____ as waves of contraction force stone through ureter; ____ pain occurs and is referred with descent of stone
referred pain; rhythmic
gradually moves _____ toward the groin; from ____ to _____ to ____
inferoanteriorly; from the side and back between ribs; to the pelvis to inguinal
area of cutaneous innervation from calculi referred pain
T11-12
the right adrenal or suprarenal gland is roughly ____; lies superior to right kidney and posterior to ____
triangular; IVC
left adrenal (suprarenal) gland is more ____; lies _____ to the left kidney near the hilum
semilunar; superomedial
adren (suprarenal) gland have their own _____
fibrous capsule
outer portion of adrenal gland that produces adrenal steroids
adrenal cortex
inner portion of adrenal gland that acts as sympathetic ganglion (modified neuronal cells), medullary, or chromaffin cells
adrenal medulla
adrenal glands are richly vascularized due to ____
endocrine function
3 sources of suprarenal arteries
- superior suprarenal arteries (6-8) - come from inferior phrenic aa.
- middle suprarenal arteries (1+) - come from abdominal aorta
- inferior suprarenal arteries (1+) - come from renal aa.
posterior abdominal wall musculature
transversus abdominis m. quadratus lumborum m. psoas major m. psoas minor m. diaphragm
4 pairs of arteries that are branches of the abdominal aorta, superior to bifurcation
lumbar aa.
the aorta bifurcates at about vertebral level ___ which is about the level of the ____
L4; umbilicus
nerves of the posterior wall
ventral rami T12-L4; lumbar plexus of nn, located beneath fascia of posterior abdominal wall
about 1 cm inferior to 12th rib; supplies sensory to anterior/lateral abdominal wall
subcostal nerve (T12)
subcostal nerve (T12) supplies motor to abdominal mm. :
external oblique, internal oblique, transversus abdominis, pyramidalis, rectus abdominis, quadratus lumborum
can arise from common trunk; descend anterior to quadratus lumborum; both supply abdominal muscles
iliohypogastric and ilioinguinal nerves (L1)
____ supplies skin of suprapubic region
iliohypogastric n.
____ runs through inguinal canal to supply it
ilioinguinal n.
pierces psoas major m. and descends along anterior surface
genitofemoral n. (L1-L2)
genitofemoral n. splits to ____ and ____
femoral branch; genital branch
genitofemoral n. supplies skin ____ and supplies ____ (of the spermatic cord)
inferior and medial to inguinal ligament; cremaster m.
descends anterior to iliacus m.; passes deep to the inguinal ring, inferior to ASIS
lateral femoral cutaneous n. (L2-L3)
lateral femoral cutaneous n. supplies _____
anterior/lateral skin of the thigh
runs between iliacus and psoas major mm. ; passes deep to inguinal ligament, inferior to ASIS
femoral n. (L2-L4)
femoral n. supplies _____
sensory and motor to anterior thigh
runs medial to psoas major mm.
obturator n. (L2-L4)
obturator n. passes through ____ and supplies _____
obturator foramen; sensory and motor to medial thigh
large n. trunk that crosses over ala of sacrum; descends into pelvis to help form sacral plexus; provides general contributions to both plexuses
lumbosacral trunk (L4-L5)
