Lecture 1: Renal Patient Flashcards
Which vertebral levels are associated with the upper and lower pole of the kidneys?
- Upper pole at T12
- Lower pole at L3
Which 3 muscles of the posterior abdomen are in close relationship with the kidneys?
- Quadratus lumborum
- Psoas major
- Transversus abdominis
The autonomic innervation of the kidneys and upper half of ureter correlate with what vertebral levels?
T10-T11
What is the sympathetic, paraysympathetic, and collateral ganglia associated with the kidneys?
- Sympathetic = Lesser Splanchnic
- Parasympathetic = Vagus
- Ganglia = Superior Mesenteric
The autonomic innervation of the lower ureters, bladder, and pelvic organs are at what vertebral levels?
T12-L2
What is the sympathetic, parasympathetic, and collateral ganglia associated with the lower ureters, bladder, and pelvic organs?
- Sympathetic = Least/Lumbar Splanchnic
- Parasympathetic = Sacral (pelvic) Splanchnic (S2-S4)
- Ganglia = Inferior Mesenteric
Excessive distention of the ureter or spasm of its muscle due to a stone may cause referred pain from which spinal segments?
T11-L2
What is the location of the Anterior and Posterior Chapman’s points for the Kidney/Ureters?
- Anterior = 1’’ above and 1’’ lateral to umbilicus
- Posterior:
- Kidney = Intertransverse spaces btw T12 and L1
- Ureters = Intertransverse spaces btw L1 and L2
What is the location of the Posterior Chapman’s point for the Bladder/Urethra?
Superior edge of L2 TP
What is the pathway of lymph flow from the intrarenal plexi to the left subclavian V.?
Intrarenal plexi –> lateral aortic nodes –> thoracic duct: cisterna chyli to L. subclavian vein
Treatment of constipation in whom is very important so that bladder sx’s can improve?
A child
What are 2 contraindications to OMT in the renal patient?
- Pt is unable to tolerate OMT secondary to pain or positioning
- Delaying more definitive care
List 5 primary locations of SD which may cause a renal patient to be more susceptible to their disease?
- Rib
- Diaphragm
- Thoracic
- Lumbar
- Pelvic
Which Anterior Thoracic (AT) tenderpoints should you consider for treating a renal patient?
AT 9-12
Which posterior TP’s should you consider treating for a renal patient?
PT9-PL2
Local osteopathic fascial manipulation was found to decrease pain perception and what aspect of the kidney?
Improvement of kidney MOBILITY
Referred pain from the ureter may extend into the proximal anterior aspect of the thigh by projection to what nerve (L1, L2)
Genitofemoral nerve
After passing a stone, you recommend to a patient that he should drink plenty of water and avoid soft drinks/tea, which osteopathic model does this fall under?
Behavioral
Prescribing antibiotics as part of the tx regimen for pt with pyelonephritis is focusing on which osteopathic model (5-models)?
Metabolic Energetic
