Kidneys and Posterior Abdominal Wall

Question 1

What organs lie on the posterior abdominal wall?

Answer 1

Kidneys
Pancreas
Duodenum
Suprarenal gland
Blood vessels (aorta and IVC)

Question 2

Name the four major muscles of the posterior abdominal wall.

Answer 2

Diaphragm
Quadratus Lamborum
Psoas Major
Iliacus

Question 3

What is the function of the diaphragm and where does it attach to?

Answer 3

Function: allows breathing to occur. Separates the thoracic cavity from the abdominal cavity.
Attaches to the 12th rib.

Question 4

Where is the quadratus lamborum and what is its function?

Answer 4

Superficial to the psoas major
Originates from the iliac crest and iliolumbar ligament.
Function: Stabilises the 12th rib during inspiration. Causes flexion and extension of the vertebral collumn.

Question 5

Where is the psoas major and what is its function?

Answer 5

Immediately lateral to lumbar vertebrae.
Originates from the transverse process and vertebral bodies of T12-L5. - Runs deep to the inguinal ligament.
Attaches to the lesser trochanter of the femur.
Function: flexion of the thigh at the hip and lateral flexion of the vertebral collumn.

Question 6

Where is the iliacus and what is its function?

Answer 6

Inferior on the posterior wall. Combines with the psoas major to form the iliopsoas which is the major flexor of the thigh.
Originates from surface iliac fossa.

Question 7

What are the 3 nerves related to the psaos major and where are their spinal origins?

Answer 7

Iliohypogastric nerve - L1
Ilioinguinal nerve - L1
Genitofemoral nerve - L1 + L2

Question 8

Name the 3 main unpaired branches of the abdominal aorta.

Answer 8

Coeliac trunk (T12)
Superior mesenteric artery (L1)
Inferior mesenteric artery(L3)

Question 9

Name the 6 paired arteries that branch off of the abdominal aorta.

Answer 9

Inferior phrenic (T12)
(Middle) Suprarenal (L1)
Renal (L1-L2)
Lumbar (4 pairs) (L1-L4)
Gonadal (L2)
Common iliac (aorta bificates into common iliac) (L4)

Question 10

Name the 7 tributaries of the inferior vena cava and their vertebral level.

Answer 10

Hepatic veins (left and right) - T8
Right inferior phrenic vein - T8
Right suprarenal vein - L1
Renal veins (left and right) - L1
Right gonadal vein - L2
Lumbar veins - L1-L5
Common iliac veins - L5 (merge to form the IVC)

Question 11

Where do the left suprarenal vein, left inferior phrenic and left gonadal vein drain into?

Answer 11

Into the left renal vein - as the inferior vena cava is not laterally symettrical.

Question 12

What 4 structures make up the urinary system?

Answer 12

Kidneys - purify blood and excrete waste.
Ureters - drain urine from kidneys to bladder.
Urinary bladder - stores urine
Urethra - drains urine from bladder to outside body.

Question 13

Where are the kidneys located in the body?

Answer 13

Sit in the loins - grooves either side of the vertebral collumn.
Located around the transpyloric plane.
Right kidney sits slightly lower than the left due to the liver.
Between 11th and 12th rib.

Question 14

What is perirenal and pararenal fat?

Answer 14

Perirenal - fat inside the renal fascia

Pararenal - fat outside the renal fascia.

Question 15

Where does the duodenum lie in relation to the kidneys?

Answer 15

Duodenum crossed infront of the hilum of the right kidney. - Both are reteroperitoneal.

Question 16

Where do the suprarenal glands lie in relation to the kidneys?

Answer 16

Just superior to each kidney.
Right is triangular shaped.
Left is crescent-shaped.

Question 17

What part of the large intestines cross infront of the kidneys?

Answer 17

The transverse mesocolon.

Question 18

What is the hilum of the kidney?

Answer 18

Where the renal artery enters the kidney and the renal vein and ureter leave the kidney.

Question 19

Name the three main internal structures of the kidney.

Answer 19

Cortex
Medulla
Pelvis

Question 20

What are the calyx’s of the kidney?

Answer 20

Chambers of the kidney through which urine passes through.

Question 21

Outline the arterial supply of the suprarenal glands.

Answer 21

ALL and paired
Superior suprarenal arteries - branch off of the inferior phrenic artery.
Middle suprarenal arteries - branch off the abdominal aorta.
Inferior suprarenal arteries - branch off of the renal arteries.

Question 22

Outline the venous drainage of the suprarenal glands.

Answer 22

Only ONE vein for each gland.
Left: suprarenal vein drains into the left renal vein and back into the IVC.
Right: suprarenal vein drains directly into the IVC.

Question 23

What are the 3 areas of the ureter where kidney stones may get stuck?

Answer 23

Pelvo-uteric junction = narrowest part of the ureter
Where the ureter crosses the external iliac artery - potential for compression.
Uretero-vesico junction = where ureter enters bladder.

Question 24

What is the blood supply to the ureters?

Answer 24

Renal, gonadal (direct branches from the aorta)

Question 25

Name the 3 functional zones of the suprarenal glands and their functions.

Answer 25

Zona glomerulosa - controls salt and water balance.
Zona fasciculata - regulates body carbohydrates
Zona reticularis - secretes precursors of steroid sex hormones.