L22-Posterior Abdominal Wall Flashcards
What is the fascia of the posterior abdominal wall called?
The thoracolumbar fascia (different layers surround the quadratus lumborum and erector spinae)
What is the iliopsoas test for?
Testing for the psoas abscess (flexion of the thigh)
What does the psoas abscess travel on?
The fascia of the psoas major
What are the three anterior midline branches?
Celiac trunk, superior mesenteric artery, inferior mesenteric artery
What are the three lateral paired branches off of the abdominal aorta?
- Middle suprarenal arteries
- Renal arteries
- Gonadal (ovarian/testicular) arteries
What are the three posterolateral branches of the abdominal aorta?
-Subcostal arteries -Inferior phrenic arteries -Lumbar arteries ( 4 branches from L1-L4)
What does the abdominal aorta split into? What do these divisions bifurcate to?
Abdominal aorta splits into common iliac arteries.
Common iliac arteries split into the internal and external iliac arteries
What artery runs directly inferior to the end of the abdominal aorta?
The median sacral artery
Where can you palpate an abdominal aorta? Where can a rupture be felt?
Can palpate left of the midline (use ultrasound to confirm) -90% fatal if unrecognized -can repair with graft -rupture felt as back pain as it is posterior
What are the three exceptions of veins that don’t parallel the arteries (and names) off of the inferior vena cava?
- The portions of the portal system
- the left gonadal vein
- the left suprarenal vein
What four veins drain into the hepatic portal vein?
- Right and Left Gastric veins
- splenic vein
- superior mesenteric vein
- inferior mesenteric vein (indirectly)
Where do the left gonadal and left suprarenal veins drain into?
Into the left renal vein (the veins on right drain directly into IVC)
What is the pathway for lymphatics in the posterior abdominal region?
Lumbar lymphatic trunks –> chyle cistern –> thoracic duct
What two nerves travel through the inguinal canal?
Ilioinguinal nerve and genitofemoral nerve
What are the three categories of nerves off of the sympathetic trunk you can find in the posterior abdominal wall?
Abdominopelvic splanchnic nerves: 1) greater splanchnic 2) lesser splanchnic 3) least splanchnic
What are the two types of fat found around the kidneys? What is their function? What divides the associated fat?
- Pararenal (retroperitoneal) fat
- Perirenal (perinephric) fat
- The renal fascia separates the two
- Prevent the contralateral spread of infection
What is the outer edge of the internal portion of the kidneys called?
The cortex
What two structures can you find in the medulla of the kidney?
- Renal pyramids
- Renal papillae
What is nutcracker syndrome?
A compression of the left renal vein between SMA and Aorta
- Results in hematuria and swelling of left scrotum (only left because the left testicular vein drains back into the renal vein and when it is compressed the blood backs up)
What is the structure of the kidney where all the calices drain called?
The renal pelvis
The renal pelvis drains into what?
The ureter
What are the three natural constrictions of the ureters?
- exiting the renal pelvis
- crossing the pelvic brim
- entering the urinary bladder
*** can be places where kidney stones get stuck
What vessels supply the ureters?
- Ureteric branches (from renal a.)
- inferior vesicle a. (from internal iliac)
What glands sit on top of the kidneys?
Left and right suprarenal (Adrenal) glands
What is the inside of the suprarenal gland called? How about the outside portion?
- Medulla (inside)
- Cortex (outside)
How many blood vessels feed the adrenal glands?
MANY!
- superior suprarenal (many)
- middle suprarenal
- inferior suprarenal
Veins: single suprarenal on each side (right drains to IVC, left drains to left renal)
