Exam 1 Anatomy Flashcards
Five F’s of Abdominal Protrusions
1) Fluid
2) Food/Fat
3) Fetus
4) Feces
5) Flatus
Superior Border of Anterior Abdominal Wall
1) Xiphoid Process (medial)
2) Costal Cartilages (Ribs 7-10)
Inferior Border of Anterior Abdominal Wall
1) Iliac Crest
2) Inguinal Ligament
3) Pubic Bone (medial)
Linea Alba
Medial vertical line in between “abs”
Linea Semilunares
Lateral vertical lines to the sides of the “abs”
McBurney’s Point
Site of maximum tenderness in Acute Appendicitis. 1/3 of way up between Right ASIS and Umbilicus
Dermatome for Enlarged Appendix Pain
T10
Layers of Anterior Abdominal Wall (Superficial to Deep)
1) Skin
2) Superficial Fascia (Camper’s and Scarpa’s)
3) Deep Fascia
4) Transversalis Fascia
5) Extraperitoneal Fat
6) Parietal Peritoneum
Camper’s Fascia
Fatty layer containing superficial gastric vessels.
- Continues as Superficial Fascia of Thigh.
- Fat extends into female labia majora
- Dartos muscle in male scrotum
Scarpa’s Fascia
Deeper dense membranous layer of superficial fascia.
- Fused with Fascia Lata (Deep Fascia of Thigh)
- Continues in Perineum and Scrotum as Colle’s Fascia
Colle’s Fascia
Continuation of Scarpa’s Fascia in Perineum and Scrotum. Membranous layer of superficial perineal fascia.
Muscles Covered by Deep Fascia of Abdominal Wall
1) External Oblique
2) Internal Oblique
3) Transversus Abdominis
Space to Access Retroperitoneal Structures without Entering Peritoneal Cavity
Transversalis Fascia and Extaperitoneal fat
Flat Muscles of the Anterolateral Abdominal Wall (Superficial to Deep)
1) External Oblique
2) Internal Oblique
3) Transversus Abdominis
Origin: External Oblique
Ribs 5-12
Insertion: External Oblique
1) Linea Alba
2) Pubic Tubercle
3) Anterior 1/2 of Iliac Crest
Innervation: External Oblique
1) Thoraco-Abdominal Nerves
2) Subcostal Nerves
Origin: Internal Oblique
1) Thoracolumbar Fascia
2) Iliac Crest
3) Inguinal Ligament
Insertion: Internal Oblique
1) Ribs 10-12
2) Linea Alba
3) Pubis
Conjoint Tendon
Common tendon of insertion of Internal Oblique and Transversus Abdominis on Pubis
Innervation: Internal Oblique
1) Thoraco-Abdominal Nerves
2) Subcostal Nerves
3) Iliohypogastric Nerves
4) Ilioinguinal Nerves
Origin: Transversus Abdominis
1) Ribs 7-12
2) Thoracolumbar Fascia
3) Iliac Crest
4) Inguinal Ligament
Insertion: Transversus Abdominis
1) Linea Alba
2) Pubic Crest
Innervation: Transversus Abdominis
1) Thoraco-Abdominal Nerves
2) Subcostal Nerves
3) Iliohypogastric Nerves
4) Ilioinguinal Nerves
Origin: Rectus Abdominis
Pubic Symphysis/Crest
Insertion: Rectus Abdominis
1) Ribs 5-7
2) Xiphoid Process
Origin: Pyramidalis
Anterior Pubis
Insertion: Pyramidalis
Linea Alba
Innervation: Pyramidalis
Subcostal Nerves / L1
Functions of Anterolateral Abdominal Muscles
1) Flex Trunk
2) Rotate Trunk (Flat Muscles only)
3) Compress and Support Viscera
4) Tense Linea Alba (Pyramidalis)
Forms Rectus Sheath
Aponeuroses of three anterolateral muscles surrounding each Rectus Abdominis muscle
Contents of Rectus Sheath
1) Rectus Abdominis m.
2) Pyramidalis m.
3) Superior and Inferior Epigastric Vessels
4) Terminal ends of T7-T12 Nerves
Arcuate Line
Arch of fibers marking change in fascia contributing to Anterior/Posterior layers of Rectus Sheath. It’s a point middway between umbilicus and pubis
Above the Arcuate Line
Rectus Abdominis completely enclosed by aponeuroses of abdominal wall muscles
Below the Arcuate Line
Aponeuroses pass anterior to Rectus Abdominis. No posterior wall, direct contact with Transversalis Fascia
Spigelian Hernia
Occurs along Linea Semilunares at or below Arcuate Line
Ventral Rami: Thoracoabdominal Nerves
T7-T11
Ventral Rami: Subcostal Nerves
T12
Ventral Rami: Iliohypogastric Nerve
L1
Ventral Rami: Ilioinguinal Nerve
L1
Four Major Arteries Supplying Anterior Abdominal Wall
1) Internal Thoracic
2) Aorta
3) External Iliac
4) Femoral
Branches of Internal Thoracic Artery Supplying Ant. Abdominal Wall
1) Superior Epigastric Artery
2) Musculophrenic Artery
Branches of Aorta Supplying Ant. Abdominal Wall
1) Posterior Intercostal Arteries
2) Subcostal Arteries
Branches of External Iliac Artery Supplying Ant. Abdominal Wall
1) Inferior Epigastric Artery
2) Deep Circumflex Iliac Artery
Branches of Femoral Artery Supplying Ant. Abdominal Wall
1) Superficial Epigastric Artery
2) Superficial Circumflex Iliac Artery
Source of Blood to Lower Body in Case of Aortic Coarctation
Superior and Inferior Epigastric Arteries Anastomosis
Two Major Veins for Anterior Abdominal Wall Drainage
1) Axillary Vein (from Lateral Thoracic Vein)
2) Femoral Vein (from Superficial Epigastric Vein)
Caput Medusae
Paraumbilical and Superficial Epigastric Veins become enlarged and dilated/varicose when portal vein obstructed
Causes of Caput Medusae
1) Cirrhosis
2) Chronic Hepatitis
3) Portal Hypertension
Umbilical Fold
Coverings of peritoneum on lower internal surface of abdominal wall.
Total of Five: 1x median, 2x medial, 2x lateral
Median Umbilical Fold
Found anterior to bladder.
Contains: Obliterated Urachus / Allontoic Ducts
Medial Umbilical Folds
Runs from Internal Iliac Artery to Umbilicus
Contains: Obliterated Umbilical Arteries
Lateral Umbilical Folds
Cover the Inferior Epigastric Vessels.
Peritoneal Fossa
Depressions lateral to umbilical folds. Potential site for hernia.
Umbilical Hernia
Herniation of Intestinal Loops through the Umbilical Ring. through area of weakness of umbilical scar
Congenital Umbilical Hernia
Omphalocele (Failure of part of midgut to return to abdominal cavity during fetal development)
Acquired Infantile Umbilical Hernia
Small hernia occurring in infants/children. Defect in Linea Alba; protrusion during crying, straining or coughing.
Resolves without treatment by 3-5 years.
Acquired Adult Umbilical Hernias
Common in females, obese, pregnant, or ascites – along with weakened abdominal wall. Called Paraumbilical Hernia when sac does not protrude through Umbilical Scar but instead through Linea Alba.
Epigastric Hernia
Occurs through Linea Alba above umbilicus in the epigastric region
Beginning of Inguinal Canal
Deep/Internal Ring in Transversalis Fascia. Site where Spermatic Cord protrudes through abdominal wall
Origin of Internal Spermatic Fascia
Formed from Transversalis Fascia
End of Inguinal Canal
Superficial/External Ring in External Oblique m. aponeurosis.
Origin of External Spermatic Fascia
Continuation of External Oblique m. aponeurosis over spermatic cord
Inferior Floor of Inguinal Canal
Inguinal Ligament
Structure Forming Inguinal Ligament
External Oblique Aponeurosis
Lacunar Ligament
Extension of the Inguinal Ligament reinforcing the medial third.
Pectineal Ligament
Thickening of the Periosteum continuous with Lacunar Ligament at the Pectineal Line
Structures Inside Inguinal Canal
1) Ilionguinal Nerve
2) Genital Branch of Genitofemoral Nerve
3) (males) Spermatic Cord / associated
4) (female) Round Ligament of Uterus
Cremasteric Reflex
Stroking medial aspect of thigh produces reflex contraction of Cremaster muscle and ipsilateral elevation of testis/scrotum
Sensory: Ilioinguinal Nerve (L1)
Motor: Genital Branch of Genitofemoral Nerve (L1-L2)
Gubernaculum
Condensed band of mesenchyme extending from lower pole of developing gonad through Inguinal canal to Labioscrotal Swelling.
Males: Fibrous cord connecting testes to scrotum
Females: Round Ligament of the Uterus
Processus Vaginalis
Evagination of Parietal Peritoneum formed before testes descend.
Remnant of degenerated Processus Vaginalis
Tunica Vaginalis – part retained as covering on Testes/Epididymis
Cryptorchidism
Incomplete testicle descent
Testis Layers (Superficial to Deep)
1) Parietal Layer of Tunica Vaginalis
2) Cavity of Tunica Vaginalis
3) Visceral Layer of Tunica Vaginalis
4) Tunica Albuginea
Tunica Albuginea
White fibrous capsule surrounding testis
Layers of the Spermatic Cord (Superficial to Deep)
1) External Spermatic Fascia
2) Cremasteric Fascia
3) Internal Spermatic Fascia
Indirect Inguinal Hernia
Congenital and most common. Caused by incomplete obliteration of Processus Vaginalis. Herniation through Deep Ring in Lateral Inguinal Fossa, transversing entire canal.
LATERAL to Inferior Epigastric Artery
Direct Inguinal Hernia
Acquired. Caused by weakness of Posterior Wall of Inguinal Canal. Herniation through Peritoneum and Transversalis Fascia in Hesselbach’s Triangle.
MEDIAL to Inferior Epigastric Artery
Corona Mortis
Anatomical variant with a connection between Obturator and Inferior Epigastric Vessels. At danger of being cut during (esp. femoral) hernia surgery
Hydrocele
Collection of fluid in testes or spermatic cord. Results from persistent (unclosed) Processus Vaginalis and also inflammation of the testis
Variocele
Dilation and tortuous coursing of Pampiniform Plexus of Testicular Veins. Results from defective valves in vein but can also indicate left kidney or renal vein problems. Usually in left side.
Rugae
Ridges/folds on inner surface of stomach
Pylorid Sphincter
Leads from stomach into small intestine
Four Parts of the Duodenum (in order)
1) Superior
2) Descending
3) Horizontal
4) Ascending
Entry Point of Major Duodenal Papilla
Descending part of Duodenum
Hepatopancreatic Ampulla of Vater
Entry point of Common Bile Duct and Main Pancreatic Duct into Descending pt. of Duodenum. Contains Major Duodenal Papilla
Hepatopancreatic Sphincter of Oddi
Smooth muscle around Hepatopancreatic Ampulla
Minor Duodenal Papilla
Entrance of Accessory Pancreatic Duct into Duodenum (2nd pt)
Junction between Foregut and Midgut
Major Duodenal Papilla
Endoscopic Retrograde Cholangiopancreatography (ERCP)
Endoscope passed down esophagus through stomach to major duodenal papilla. Catheter inserted into papilla to gain access to biliary system
Suspensory Muscle (Ligament of Treitz)
Attached to fourth part of Duodenum (Ascending) from Right Crus of Diaphragm
Duodenum Curves Around This Structure
Head of the Pancreas
Meckel’s Diverticulum
Persistence of Vitelline Duct (connection to Yolk Sac) as outpouching of Ileum. Asymptomatic usually but can contain stomach/pancreatic tissue or be site of infection.
Retro or Intraperitoneal: Ascending Colon
Retro
Retro or Intraperitoneal: Transverse Colon
Intra
Retro or Intraperitoneal: Descending Colon
Retro
Retro or Intraperitoneal: Sigmoid Colon
Intra
Retro or Intraperitoneal: Rectum
Retro
Hepatic (Right Colic) Flexure
Transition of Ascending and Transverse Colon from Retroperitoneal Space to Intraperitoneal Space
Splenic (Left Colic) Flexure
Transition of Transverse Colon and Descending Colon from Intraperitoneal to Retroperitoneal Space
Teniae Coli
Muscular coat around Large Intestine arranged into 3 longitudinal bands
Plicae Semilunares
Infoldings of intestinal wall between Haustra
Appendices Epiploicae
Peritoneum-covered pouches of fat on Large Intestine. Attached in rows along the Teniae Coli
Abdominal Region of Spleen
Left Hypochondrial (Intraperitoneal)
Surfaces of the Spleen
1) Gastric
2) Renal
3) Colic
Exposed to Traumatic Injuries at Ribs 7-10
Spleen
Splenorenal Ligament
Connects spleen to left kidney; contains tail of Pancreas
Abdominal Region(s) of Pancreas
Epigastric and Left Hypochondrial Regions. Retroperitoneal except small part of its tail in Splenorenal Ligament
Only part of the Pancreas posterior to Super Mesenteric Vessels
Uncinate Process
Abdominal Region(s) of Liver
Right Hypochondrial and Epigastric Regions. Intraperitoneal.
Liver Lobes
1) Right
2) Caudate
3) Quadrate
4) Left
Porta Hepatis contents
1) Portal Vein
2) Hepatic Arteries
3) Hepatic Ducts
4) Lymph
5) Nerves
Origin of Round Ligament (of Liver)
Former Umbilical Vein
Ligamentum Venosum
Obliterated Ductus Venosus (fetal connection between umbilical vein and IVC).
Its groove separates off the left lobe
Hepatoduodenal Ligament
Contains “Portal Triad”
1) Bile Duct
2) Hepatic Artery
3) Portal Vein
Obstructive Jaundice
Caused by blockage of bile ducts from gall stones or tumor/compression of pancreas
Volvulus
Abnormal twisting of the intestines.
Embryonic Origin from Mesoderm
Spleen
Embryonic Origin from Foregut Tube
1) Esophagus
2) Stomach
3) Upper Duodenum
Embryonic Origin from Foregut Outrgrowths
1) Liver
2) Gall Bladder
3) Pancreas
Embryonic Origin from Midgut Tube
1) Lower Duodenum
2) Jejunum
3) Ileum
4) Cecum
5) Appendix
6) Ascending Colon
7) Prox. 2/3 Transverse Colon
Embryonic Origin from Midgut Outgrowths
Lower part of Pancreas
Supplies Blood to Foregut
Celiac Trunk
Supplies Blood to Midgut
Superior Mesenteric Artery
Supplies Blood to Hindgut
Inferior Mesenteric Artery
Embryonic Origin from Hindgut Tube
1) Distal 1/3 of Transverse Colon
2) Descending Colon
3) Sigmoid Colon
4) Superior pt. of Rectum
Epiploic Foramen
Opening at edge of Lesser Omentum where Lesser and Greater Sacs communicate
Secondarily Retroperitoneal
Structure originally developed inside Peritoneum but fused to the body wall later
Mesentery
Double layer of peritoneum that suspends viscera from body wall. Nerves and blood vessels travel in it in the abdomen.
Ventral Mesentery
Attaches organs to Anterior Abdominal Wall. Develops in association with the liver.
Named Parts:
1) Lesser Omentum
2) Falciform Ligament
3) Coronary Ligament
4) Left/Right Triangular Ligaments
Lesser Omentum
Connects Lesser Curvature (Stomach) to the Liver.
Comprised of Two Ligaments:
1) Hepatogastric Ligament
2) Hepatoduodenal Ligament
Falciform Ligament
Part of Lesser Omentum. Connects Liver to Anterior Abdominal Wall
Dorsal Mesentery
Attaches organs to Posterior Abdominal Wall
Named Parts:
1) Greater Omentum
2) “The Mesentery”
Greater Omentum
Hangs down off Greater Curvature (Stomach). Connects to Transverse Colon.
Comprised of Three Ligaments:
1) Gastrophrenic Ligament
2) Gastrosplenic Ligament
3) Gastrocolic Ligament
“The Mesentery”
Describes mesentery of Jejunum and Ileum. Attaches small intestine to a root of less than six inches, oblique from upper left to lower right.
Peritoneal Gutters
Channels created within peritoneal cavity where parts of GI tract fuse to Posterior Abdominal Wall. Provide pathway for spread of bacteria-infected and ascitic fluid in cavity
Peritoneal Recesses / Pouches
Fossa formed by Peritoneal Folds. Determine extent and direction of spread of pathological fluids that enter cavity.
Hepatorenal Recess (of Morison)
Found between right kidney and diaphragm, part of the Greater Sac. Lowest part of the abdominopelvic cavity when patient laying down.
Infections can spread from here to Lesser Sac through Epiploic Foramen. Lymphatics on inferior surface of Diaphragm can absorb/spread disease to systemic circulation.
Peritoneal Adhesions
Fibrous bands of scar tissue that form between abdominal organs and walls, joining them abnormally.
Branches from Celiac Trunk
1) Left Gastric Artery
2) Splenic Artery
3) Common Hepatic Artery
Branches from Left Gastric Artery
Esophageal Branches
Branches from Splenic Artery
1) Left Gastroepiploic Artery (close to spleen)
2) Short Gastric Arteries (to Fundus)
Branches from Common Hepatic Artery
1) Proper Hepatic Artery
2) Gastroduodenal Artery
Terminal Branches from Gastroduodenal Artery
Not necessarily direct
1) Supraduodenal Artery
2) Superior Pancreaticoduodenal Artery
3) Right Gastroepiploic Artery
Terminal Branches from Proper Hepatic Artery
Not necessarily direct
1) Right Gastric Artery
2) Right/Left Hpeatic Artery
3) Cystic Artery
Anastomosis Vessels between Celiac Trunk and Superior Mesenteric Artery
Superior and Inferior Pancreaticoduodenal Arteries
Branches from Superior Mesenteric Artery
1) Inferior Pancreaticoduodenal Artery
2) Intestinal Branches
3) Middle Colic Artery
4) Right Colic Artery
5) Ileocolic Artery
Form Arcades and Casa Recta in Mesentery
Intestinal Branches of Superior Mesenteric Artery
Marginal Artery of Drummond
Mid-hindgut transitional anastomosis, along entire margin of colon. Between Superior and Inferior Mesenteric Arteries.
Pre-Aortic Nodes
1) Celiac
2) Superior Mesenteric
3) Inferior Mesenteric
Converge as Intestinal Trunk
Para-Aortic Nodes
Lateral to Aorta and drain parts of posterior abdomen.
Converge as Lumbar Trunks
Cisterna Chyli
Confluence of Pre-Aortic (Intestinal) and Para-Aortic (Lumbar) Trunks that mark beginning of Thoracic Duct
Developmental Predecessor of Liver at Four Weeks
Hepatic Diverticulum (Foregut)
Ventral Bud of Pancreas
From: Hepatic Diverticulum
Forms: Head and Uncinate Process
Duct: Main Pancreatic Duct
Dorsal Bud of Pancreas
From: Dorsal Surface of Duodenum
Forms: Body and Tail
Duct: Accessory Pancreatic Duct
Gallbladder Developmental Origin
Hepatic Diverticulum
Origin of Common Bile Duct
Common stalk of the liver and gall bladder
Annular Pancreas
Rare, congenital abnormality characterized by ring of Pancreatic tissue encircling the descending portion of Duodenum. Caused by incomplete rotation of Ventral Pancreatic bud. Can constrict/obstruct duodenum.
Developmental Fate of Dorsal Mesentery Extending from Spleen and Fusing to Posterior Abdominal Wall
Becomes:
1) Splenorenal Ligament
2) Gastrosplenic Ligament
Gastroschisis
Ventral body wall defect that results in herination of intestinal loops to Amniotic Cavity. Failure of body wall to close.
Cloaca
Expanded terminal part of Hindgut endoderm. Proximal to the Cloacal Membrane.
Proctodeum
Anal pit, composed of Ectoderm. Pushes inward to form distal opening of gut tube
Urogenital Septum
Divides cloaca into:
1) Urogenital Sinus
2) Anorectal Canal
Pectinate Line
The anal canal is formed from endoderm (hindgut) and ectoderm (body wall). Junction between two regions is the Pectinate Line.
Imperforate Anus
Fistula between rectum and vagina
Origin: Quadratus Lumborum
1) Iliolumbar Ligament
2) Posterior Iliac Crest
Insertion: Quadratus Lumborum
1) Lower border of 12th rib
2) Transverse Processes of L1-L4
Action: Quadratus Lumborum
1) Extends and laterally flexes trunk
2) Fixes 12th rib during inspiration
Innervation: Quadratus Lumborum
T12, L1-L4
Origin: Psoas Major
1) Transverse Processes of Lumbar Vertebrae
2) Sides, IV discs, and bodies of T12-L5
Insertion: Psoas Major
Lesser Trochanter of Femur (Iliopsoas Tendon)
Action: Psoas Major
Flexes thigh and trunk
Innervation: Psoas Major
L2-L4 (via Lumbar Plexus)
Origin: Psoas Minor
T12 and L1 sides, IV discs, and bodies
Insertion: Psoas Minor
Iliopubic Eminence
Action: Psoas Minor
Weak flexor of trunk
Innervation: Psoas Minor
L1
Origin: Iliacus
Iliac Fossa
Insertion: Iliacus
Lesser Trochanter of Femur (Iliopsoas Tendon)
Action: Iliacus
Flexes thigh and trunk
Innervation: Iliacus
Femoral Nerve (L2-L4)
Iliopsoas Test
Tests for Appendicitis
Origin: Diaphragm
1) Xiphoid Process
2) Lower 6 Ribs
3) Upper Lumbar Vertebra
Right and Left Crura
Musculotendinous bands that originate from anterior surfaces of the Upper Three (Right Crus) and Upper Two (Left) lumbar vertebrae
Gives rise to Suspensory Muscle of the Duodenum
Right Crus
Median Arcuate Ligament
Tendinous band that unites right and left crura, anterior to aorta
Insertion: Diaphragm
Central Tendon. Aponeurosis of the muscle, derived form the Septum Transversum
Openings in the Diaphragm
1) Inferior Vena Cava Foramen (T8)
2) Esophageal Hiatus (T10)
3) Aortic Hiatus (T12)
Inferior Vena Cava Foramen
Contained inside the Central Tendon (Diaphragm) at T8.
Contents:
1) Right Phrenic Nerve
Esophageal Hiatus
Opening at T10, encircled by the Right Crus.
Contents:
1) Esophagus
2) Esophageal Branches of Left Gastric Vessels
3) Vagal Trunks
Aortic Hiatus
Opening at T12, posterior of Diaphragm.
Contents:
1) Aorta (Celiac Trunk originates right below)
2) Thoracic Duct
3) Azygous Vein
Medial Arcuate Ligament
Superior thickening of Psoas fascia that overlies Psoas Major muscle
Lateral Arcuate Ligament
Superior thickening of Quadratus Lumborum fascia overlying the muscle
Fat/Fascia Surrounding Kidneys (Superficial to Deep)
1) Paranephric Fat
2) Renal Fascia
3) Perinephric Fat
4) Renal Capsule
Contents of Kidney Hila
1) Renal Artery/ Vein
2) Renal Pelvis
3) Autonomic Nerves
4) Lymph
Anterior to Posterior: VAP
Sites Kidney Stones Can Lodge
1) Junction of Renal Pelvis and Ureter
2) Pelvic Inlet
3) Entrance to Bladder
Unpaired Visceral Branches from Abdominal Aorta
1) Celiac Trunk (T12)
2) Superior Mesenteric a. (L1)
3) Inferior Mesenteric a. (L3)
Paired Visceral Branches from Abdominal Aorta
1) Middle Suprarenal a. (L1)
2) Renal a. (L1)
3) Gonadal a. (L2)
Paired Parietal Branches from Abdominal Aorta
1) Inferior Phrenic a. (T12)
2) Subcostal a. (T12)
3) Lumbar Arteries (L1-L4)
Abdominal Aorta Bifurcation
Gives off R/L Common Iliac Arteries at L4
Lumbar Plexus Nerves (L1-L4)
1) Iliohypogastric Nerve (L1)
2) Ilioinguinal Nerve (L1)
3) Genitofemoral Nerve (L1, L2)
4) Lateral Femoral Cutaneous (L2, L3)
5) Femoral Nerve (L2-L4)
6) Obturator Nerve (L2-L4)
Iliohypogastric Nerve
L1.
- Sensory: Skin of Upper Inguinal and Suprapubic Regions
- Motor: Internal Oblique and Transversus Abdominis Muscles
Ilioinguinal Nerve
L1
Passes through Inguinal Canal.
- Sensory: Skin of Lower Inguinal Region, Groin, and Medial Thigh
- Motor: Internal Oblique and Transversus Abdominis muscles.
Genitofemoral Nerve
L1, L2
- Genital Branch: Cremaster m.
- Femoral Branch: Skin of Anterior/Medial Thigh
Lateral Femoral Cutaneous Nerve
L2, L3
Skin of lateral and Anterior Thigh
Femoral Nerve
L2-L4
Anterior Thigh Muscles
Obturator Nerve
L2-L4
Medial Thigh Muscles
Ganglia in Abdomen for Sympathetic Trunk Presynaptic Fibers
1) Celiac Ganglion
2) Aoritocrenal Ganglion
3) Superior Mesneteric Ganglion
4) Inferior Mesenteric Ganglion
Splanchnic Nerves
Leave trunk in Thorax and descend through Diaphragh. Contain motor (preganglionic sympathetic) and sensory (visceral afferent) fibers to/from Abdomino-Pelvic viscera. Enter Celiac ganglion or plexuses on Aorta
Superior to Inferior:
1) Greater Splanchnic Nerve
2) Lesser Splanchnic Nerve
3) Least Splanchnic Nerve
Pelvic Kidney
Kidneys fail to ascend and remain at brim of pelvis; may be asymptomatic
Horseshoe Kidney
Fusion of lower poles of the two kidneys. May impinge on ureters, blocking passage of urine.
Unilateral Double Kidney
Double kidney with separate ureters/vessels on one side. Ureters enter bladder at abnormal angle, blocking urine.
Rosette Kidney
Fusion of kidneys at their hila; usually remains in Pelvis
Bifid Ureter
Ureters may join in lower third of their course. Either open through common orifice or independently into bladder. Increased potential for infection or calculus formation.
