Gross Anatomy Diaphragm, Posterolateral Abdominal Wall and Kidneys

Question 1

There are three foramina/apertures associated with or within the diaphragm. List each one, its approximate vertebral level, and contents

Answer 1

I 8 10 Eggs AT 12
Inferior vena cava - T8
Esophagus - T10
Azygos, aorta, and thoracic duct - T12

Question 2

List three characteristic features of the right crus of the diaphragm

Answer 2

larger and longer than the left crus

has two apertures for greater and lesser right splanchnic nerves (left has three - extra for hemiazygous)

Question 3

The boundaries of the posterolateral abdominal wall are ________________

Answer 3

superior: 10th-12th ribs
inferior: superior margin of the iliac crests
lateral: midaxillary line

Question 4

Which nerves are associated (directly or indirectly) with the following muscles: psoas major, psoas minor, and iliacus?

Answer 4

psoas major: femoral emerges from lateral border, so does lateral femoral cutaneous
psoas minor: ??????
iliacus: iliohypogastric and ilioinguinal along border of ilius bone

Question 5

The iliohypogastric nerve is sensory to ________________ and motor to ________________

Answer 5

sensory to the skin of the suprapubic and inguinal regions just superior to the labia majora/scrotal sac
motor to three abdominal wall muscles

Question 6

The genitofemoral nerve has two branches. List the functions of the branches and give their distribution

Answer 6

genital: motor to cremastor muscle
femoral: sensory to small area on anterior thigh

Question 7

Define renal sinus

Answer 7

the cavity deep to the hilus that contains vessels, nerves, fat, connective tissue, and renal pelvis (expanded ureter)

Question 8

define renal pelvis

Answer 8

formed by the fusion of 2-3 major calyces (funnel-like structure that fits over the tip of the pipilla and collects the urine that passes out of the collecting ducts) - upper proximal end of the ureter

Question 9

define renal lobe

Answer 9

medullary pyramid associated with cortical tissue - 8-11 lobes/kidney

Question 10

List three places that kidney stones are commonly found in the ureter

Answer 10

1. uretero-pelvic junction
2. as the ureter passes over the iliac vessels
3. at the junction with the urinary bladder

Question 11

List three characteristic features of the left kidney

Answer 11

1. slightly higher than the right kidney (because liver)
2. left renal artery slightly higher and is shorter
3. three layers of fat and fascia

Question 12

What structural differences exist between the right and left adrenal?

Answer 12

right: pyramidal in shape and slightly smaller than left
left: semilunar in shape

Question 13

What anastomotic connections exist within the kidney?

Answer 13

there is NO intercommunication - so occlusion of one of these vessels results in infarction of the area

Question 14

What is the significance of a psoas abscess?

Answer 14

may be mistaken for inguinal or femoral hernias

Question 15

What is the relationship of the left renal vein to the SMA? Aorta?

Answer 15

SMA: under
Aorta: over

Question 16

Where does the medial arcuate ligament come from? What goes under it?

Answer 16

diaphragm and psoas muscle

Question 17

Describe the course and functions of the ilioinguinal nerve

Answer 17

pierces the transversus abdominis and running forward towards teh anterior body wall, enters the inguinal canala and exits the superficial ring

• supplies motor to the three abdominal muscles
• supplies sensory to the skin of the pubic region, root of penis/clitoris, anterior walls of the scrotum or labia majora

Question 18

What is the clinical significance of the renal fascia on the inferior side of the kidney?

Answer 18

renal fascia does NOT create a closed compartment

kidney infections may spread down into pelvis, and pelvic infections may spread up to the kidneys