Lecture 16: Posterior Abdominal Wall, Kidneys, & Ureters Flashcards
What are the borders of the posterior abdominal wall?
Superior: Level of T12 vertebra, 12th rib, diaphragm
Inferior: Superior pelvic aperture
What is the pelvic aperture?
Also known as pelvic brim/inlet - it runs from pectineal and arcuate lines and posterior along the sacral promontory
What are the 4 muscles of the posterior abdominal wall?
- Quadratus Lumborum
- Psoas Major
- Iliacus
- Psoas minor
Action of quadratus lumborum (Bilateral and unilateral)
Bilateral: extends vertebral column
Unilateral: laterally flexes vertebral column
Action of psoas & iliacus
Hip flexors
The abdominal aorta enters the abdomen at the aortic hiatus. What level is this?
T12
The abdominal aorta is _____________
Retroperitoneal
At what level does the abdominal aorta bifurcate?
L4
The abdominal aorta bifurcates into…
L/R common iliac arteries
What are the branches of the abdominal aorta? (9 total in the list)
Celiac trunk
Superior Mesenteric
Inferior Mesenteric
L & R inferior phrenic
L & R middle suprarenal
L & R renal
L & R gonadal
4 pairs of lumbar arteries
Median (Middle) sacral
Define aneurysm
Localized dilation of a vessel
Where do abdominal aorta aneurysms typically occur?
Distal to renal arteries but ABOVE bifurcation
An abdominal aneurysm breaks down what layer of the aorta
Middle (Tunica Media)
T/F: You bleed out slowly with an aneurysm
F; you bleed out quickly.
Describe the stenting of an aortic aneurysm
Stent - blow balloon up - widen area for blood flow
IVC is the union of..
L/R common iliac veins
The IVC is to the ____ of the abdominal aorta
Right
What level does the IVC enter the thoracic cavity at the caval opening of diaphragm
T8
R. Suprarenal and gonadal veins drain into…
IVC
L. Suprarenal and gonadal veins drain into…
Renal V then to IVC
What are the pre-aortic lymph nodes?
Celiac
Superior mesenteric
Inferior mesenteric
Where do the pre-aortic lymph nodes receive lymph from?
Foregut
What lymph nodes are chains of nodes around either side of aorta?
Lumbar lymph nodes (lateral aortic, para-aortic)
What receives lymph from posterior abdominal wall structures and upper pelvic structures?
Lumbar lymph nodes
Pre-aortic and lumbar lymph nodes drain to…
Cisterna chyli
Where does the cisterna chyli begin?
Around level of L1-L2 vertebrae
The cisterna chyli drains…
superiorly as the thoracic duct
Milk fluid associated with lymph is called
Chyle
List the somatic nerves (lumbar plexus) of posterior abdominal wall
Subcostal
Iliohypogastric
Ilioinguinal
Genitofemoral
Lateral femoral cutaneous
Femoral
Obturator
What splanchnic nerves are not true splanchnic nerves?
Pelvic
What is the parasympathetic supply to the posterior abdominal wall
L/R Vagus nerves
At what level are the kidneys?
T12-L3 vertebrae
T/F the kidneys are stuck in place
F; they can move up 2-3 inches when breathing
Which kidney is slightly inferior? why?
R. Kidney - B/C of liver
Describe cortex and medulla of the kidney
Cortx: outer
Medulla: Inner
The medulla subdivides into..
Renal pyramids
What are the tips of renal pyramids?
Renal papillae
What are renal columns?
Extensions of cortex that separate pyramids
Renal papillae drain urine into…
Minor calyces
Minor calyces drain into 2-3
Major calyces
Major calyces drain into funnel-shaped
Renal pelvis
Renal pelvis drains into…
Ureter
From the kidney to outside, what is the order of CT coverings around the kidney
Renal capsule
Perinephric fat
Renal fascia
Paranephric fat
What is the blood supply to the kidney
Renal artery –> lobar (segmental) arteries
Describe lobar (segmental) arteries
End arteries - if they are occluded, blood supply is cut off to that portion of the kidney
The renal vein drains into the…
IVC
What is the innervation of the kidney
Renal plexus
What is the parasympathetic supply to the kidney?
Vagus (CN X) - No known effect
What is sympathetic supply to the kidney?
Lesser thoraic (T10-11), least thoracic splanchnic nerves (T12)
What is the function of the sympathetic nerves in the renal plexus?
Vasoconstricct renal vessels –> Less filtrate formation
What are the afferent component (sympathetic) to the kidney?
T10-L1 - aka where pain is referred to.
