Exam 2: Lecture 7 and 8 Flashcards
What are the ligaments of the diaphragm?
right crus, medial, lateral and middle arcuate ligament,
What is the difference between the median and middle arcuate ligament?
Median arcuate ligament - single arch created by the diaphgram passing behind
medial arcuate ligament - where psoas major passes under
What is the origin of the psoas minor?
Lateral surface of T12- L1 and intervertebral disc
What is the origin of the quadratus lumborum?
Transverse process of L5, iliolumbar ligament, iliac crest
What is the innervation of the psoas minor?
ventral rami L1
What is the innervation of the iliacus?
femoral nerve
What does the SMA supply?
midgut
What does the IMA supply?
hindgut
What does the internal iliac artery supply?
supplies pelvis and perineum
What does the external iliac artery supply?
passes under inguinal ligament to supply leg
How is the femoral artery formed?
the celiac artery branches to internal iliac (supplies pelvis and perineum) and external iliac (passes under inguinal ligament to supply leg) and becomes femoral artery once it passes the inguinal ligament
Why does the left supra renal vein drain into the renal vein instead of the IVC?
To avoid crossing over the aorta due to the high pressure of the aorta (Nut cracker)
What is the path or innervation of the posterior abdomen?
Pre-ganglion travels via ventral ramus and enter the sympathetic trunk to white ramus communicans, but don’t synapse - travel via splanchnic nerve near unpaired aortic branches (CT, SMA, IMA, Renals) where we synapse and post-ganglionic nerve travels via our plexuses to our target digestive organ
What does the iliohypogastric nerve and ilio-inguinal nerve innervate?
Anterior abdominal muscles (transverse abdominus and internal oblique muscles
What does the femoral nerve innervate?
innervates iliacus and the anterior thigh
What does the lateral cutaneous nerve of the thigh innervate?
goes through psoas muscles and cut over top the iliacus and underneath the inguinal to innervated skin of the lateral aspect of the thigh
What is the motor innervation of the gentifemoral branch?
male cremaster muscle, women: labia majora
What is the motor innervation of the obturator?
Obturator externus, pectineus, medial thigh muscles
What is the motor innervation of the femoral branch?
iliacus, pectineus, anterior thigh muscles
What is the actions of the quadratus lumborum?
lateral flexion of trunk
What is the insertion of the iliacus and psoas major?
Lesser trochanter of the femur
What is the insertion of quadratus lumborum?
Transverse process L1-L4 and rib 12
What are the Muscles of the posterior abdomen
Help with body posture
Diaphragm, Psoas major/minor, Quadratus lumborum and Iliacus
What is the origin of the psoas major?
Lateral surface of T12- L5, transverse processes of lumbar vertebrae, intervertebral disc T12- L5
What are the bones of the posterior abdomen?
floating ribs, Lumbar vertebrae, Sacrum, and Pelvic bones - Iliac fossa and Iliac crests
What is the origin of the iliacus?
Iliac fossa, anterior sacro- iliac and iliolumbar ligaments, upper lateral surface of sacrum
What does the perinephric fat surround?
surrounds kidneys and adrenal glands
What surrounded the perinephric fat?
Renal fascia (extraperitoneal fascia)
What does the peranephric fat surround?
posterior and posterolateral to kidneys and adrenal glands outside of renal fascia
What are parts of the kidney’s?
Renal cortex
Renal columns- Extensions of cortex
Renal medulla, Renal pyramid, Renal papilla, Renal sinus, Minor calyx, Major calyx, Renal pelvis
Hilum of kidney - Entry/ exit point
What nerve innervated the kidneys?
renal plexus
What is the renal papilla?
where the collecting ducts lies and converge at the tip of the pyramid called the renal papilla
Where does the loop of Henle lay?
renal medulla
What are the vasculature drainage of the renals?
Left Renal vein (longer) right renal vein- Passes under SMA to drain into IVC
What are the arteriole supplies of the e of the renals?
Left and right Renal arteries branch off of the abdominal aorta near the SMA - Left arises slightly higher
How is the renal pelvis formed?
Formed by the major and minor calyx converging
What is the Lymphatic drainage of kidneys?
Lateral aortic (lumbar) nodes
At what point does filtrate become urine?
Once drained out of the renal papilla
What is the arteriole supply to the adrenal glands?
Superior suprarenal artery - Branch off of inferior phrenic artery
Middle suprarenal artery - Off of abdominal aorta
Inferior suprarenal artery - Branch off of renal artery.
Where are the 3 constriction points of the ureters?
- Uretopelvic junction - where pelvis becomes ureter
- Pelvic brim - where ureters cross common iliac artery and pelvis begins
- Where ureters enter bladder (posterior/inferior)
What is the trigone of the bladder?
Smooth triangular area between ureter openings and urethra known as the trigone
What is the role of the ureter?
Retroperitoneal muscular tubes that transport urine from kidneys to bladder
What is the innervation of the ureters?
Innervation: renal, aortic, superior hypogastric and inferior hypogastric plexuses
What is the venous drainage (vasculature) of the ureters?
Upper end: Renal arteries
Middle: aorta, testicular/ ovarian artery Or branches off the common iliac artery
Pelvis: internal iliac artery
What is the passage way of the urethra?
Begins at the base of the bladder and extends out of the perineum and Passes through internal and external urethral sphincters
*4cm in women and 20cm in men
What type of muscle makes up the internal uretha?
smooth
What type of muscle makes up the external uretha?
skeletal
What are the 4 parts of the male urethra and their passage points?
Pre-prostatic - short
Prostatic - passes through prostate
Membranous (short) - goes through external spinchter
Spongy (longest portion) - goes through corpus spongiosum
What is the attachment and action of the psoas major?
flexes the hip; attached on the body of lumbar, T12 and transverse process
What are the branches of the abdominal aorta?
celiac, phrenic, SMA, suprarenal, renal, gonadal, IMA, lumbar, middle sacral, and common iliac artery
What are the 3 major places where the portal circulation forms anastomoses with the systemic circulation?
Esophagus - Azygos system
Inferior Rectum/ Anus - Middle and inferior rectal veins
Paraumbilical area - Veins on ant abdominal wall
What venous structures are drained into the portal vein?
structures supplied by the celiac, SMA, and IMA drain into the portal vein
What does the portal vein divide into in the liver?
Portal vein divides into sinusoids in the liver that drain into hepatic veins into the IVC
Where do the lyphatics of the posterior abdomen converge and drain into?
thoracic duct
What innervates the abdominal viscera?
Abdominal viscera is innervated by splanchnic nerves (nerves that connect the sympathetic trunk to plexuses/ganglia near the aorta)
What is the major terminal nerve branches of the lateral lumbar plexus?
Iliohypogastric n and Ilio- inguinal nerve –> innervates Anterior abdominal muscles, Femoral nerve –> innervated Iliacus and the anterior thigh
Lateral cutaneous nerve of the thigh
What is the major terminal nerve branches of the medial lumbar plexus?
Obturator nerve innervatesMedial thigh
What is the major terminal nerve branches of the anterior lumbar plexus?
Genitofemoral nerve
