Lecture 9: Posterior Abdominal Wall & Retroperitoneal Viscera

Question 1

What are the features of quadratus lumborum?

Answer 1

Rectangular, L5 and iliac crest to 12th rib - stabilises, sits behind vertebral column in paravertebral gutters

Question 2

What are the features of posts major?

Answer 2

Lumbar vertebrae, beneath inguinal ligament to lesser trochanter of femur, edge to edge with vertebrae

Question 3

What are the features of pesos minor?

Answer 3

Present in 2/3 of people, blend into psoas major

Question 4

What are the features of iliacus?

Answer 4

Trinagular, iliac fossa, lesser trochanter - iliopsoas tendon

Question 5

What are the 3 parts of thoracolumbar fascia - where do they attach?

Answer 5

Posterior - spinous process tip
Middle - transverse process tip
Anterior - front of transverse process

Question 6

Where do the layers of thoracolumbar fascia fuse and what is significant about this point?

Answer 6

12th rib - anterior abdominal wall muscles attach here (except for external oblique due to lat dorsi position)

Question 7

What does the thoracolumbar fascia surround?

Answer 7

Erector spinae and quadratus lumborum

Question 8

What is a psoas abscess?

Answer 8

Pus tracks down with psoas muscle and forms lump in pelvic region

Question 9

What muscle does the lumbar plexus happen within?

Answer 9

Psoas major

Question 10

Where are the ureters located?

Answer 10

Posterior ab wall

Question 11

How long are the ureters?

Answer 11

25cm

Question 12

What are the narrowing of the ureters?

Answer 12

• Exiting kidney at renal sinus where renal pelvis becomes ureter
• Tipping over pelvic brim
• Entering bladder

Question 13

Where do the kidneys sit?

Answer 13

Posterior ab wall on quadratus lumborum in paravertebral gutters

Question 14

What level do the kidneys sit at?

Answer 14

T12-L3 : right kidney lower due to liver

Question 15

Why do kidneys move with respiration?

Answer 15

Attached to diaphragm

Question 16

What are the dimensions of the kidney?

Answer 16

10cm long, 5cm wide, 2.5cm thick

Question 17

What are the features of the adrenal glands?

Answer 17

Right: party hat directly on top of kidney
Left: crescent on medial surface of kidney above hilum

Question 18

What is the kidney surrounded by?

Answer 18

Perinephric fat and renal fascia

Question 19

What is the arrangement of cells in the kidney?

Answer 19

Outer cortex and inner medulla sectioned into renal pyramids

Question 20

What direction does the hilum of the kidney face?

Answer 20

Anteromedially

Question 21

What is the order of structures in the kidney hilum?

Answer 21

Vein, artery, pelvis

Question 22

What does the renal artery branch from and what does it divide into?

Answer 22

Abdominal aorta, 5 segmental arteries for renal segments

Question 23

What happens to the arterial supply for the kidneys during development?

Answer 23

Develop lower in abdomen, take arterial supply from level that they are at - can retain accessory renal artery that enters hilum or kidney directly

Question 24

What is the relationship of the testicular veins to the renal veins?

Answer 24

Right testicular vein drains directly into IVC, left testicular vein drains into left renal vein

Question 25

What is the renal pelvis and how is it divided?

Answer 25

Dilated upper portion of ureter, divided into 2/3 major calyces which are each divided into 2/3 minor calyces - all going to a renal pyramid