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IKK - Anatomy Exam 2 > Post Abd/Kidney/Diaphragm > Flashcards

Post Abd/Kidney/Diaphragm Flashcards

1
Q

INSPIRATION:

what happens to lung size? diaphragm size? is muscle contracting or relaxing?

A

INSPIRATION
lungs increasing
diaphragm decreasing
because diaphragm contracting

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2
Q

EXPIRATION:

what happens to lung size? diaphragm size? is muscle contracting or relaxing?

A

EXPIRATION:
lungs decrease
diaphragm increases
muscle relaxing

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3
Q

What 3 nerves innervate the diaphragm?

A

Right phrenic nerve
Left phrenic nerve
Intercostal nerve

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4
Q

What do each of the 3 nerves that innervate the diaphragm innervate specifically?

A

Right phrenic = right hemidiaphragm
Left phrenic = left hemidiaphragm
Intercostal n = lateral borders of diaphragm

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5
Q

Where does phrenic nerve original (which vertebral level)

A

C3/4/5 KEEP ME BREATHING AND ALIVE

ventral rami of cervical plexus of nerves

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6
Q

How does the phrenic nerve run relative to the scalene muscle?

A

Phrenic nerve runs right over anterior surface of scalene muscle

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7
Q

How does the phrenic nerve run relative to the subclavian artery/vein?

A

Phrenic nerve runs BETWEEN subclavian artery and vein while moving towards thorax

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8
Q

What will detect irritation to superior/inferior surfaces of central diaphragm?

A

sensory fibers from phrenic nerve

*eventually anastomose with intercostal n

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9
Q

What will detect irritation to the superior/inferior surfaces of lateral diaphragm?

A

sensory fibers of intercostal n

*eventually anastomose with phrenic n

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10
Q

Paralysis of the cervical region results in paralysis of ______

A

diaphragmatic respiration

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11
Q

T/F Paralyzed hemidiaphragm remains low in thorax on an x-ray

A

FALSE

Paralyzed hemidiaphragm remains high in thorax because cannot contract (=descend)

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12
Q

What 3 structures pierce through the diaphragm?

A

IVC, Esophagus, Aorta

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13
Q

What are the 3 diaphragm aperatures? What are their vertebral levels? What pierces through them?

A
  1. Vena Cava Foramen
    - T8, IVC
  2. Esophageal hiatus
    - T10, esophagus
  3. Aortic Hiatus
    - T12, aorta
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14
Q

What is the location of all diaphragm aperatures relative to vertebral column?

A

All aperatures are adjacent to the bodies of the vertebral column meaning they are close to the midline

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15
Q

What does arcuate mean?

A

Arch

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16
Q

Arcuate ligaments aka ______

A

lumbocostal arches

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17
Q

What are the 3 arcuate ligaments of the diaphragm?

A

aka lumbocostal arches

  1. median arcuate ligament
  2. medial arcuate ligaments
  3. lateral arcuate ligaments
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18
Q

What is the location of the 3 arcuate ligaments relative to the abdominal wall and diaphragm?

A

all on inferior edge of diaphragm

all against posterior abdominal wall

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19
Q

What does the median arcuate ligament arch over?

A

the aorta

it is the superior opening of the aortic hiatus

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20
Q

What do the medial arcuate ligaments arch over?

A

psoas major (the first muscle lateral to the vertebral column)

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21
Q

What do the lateral arcuate ligaments arch over?

A

arch over quadratus loborum m

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22
Q

What are the 4 vessels of the diaphragm?

A
  1. Pericardiophrenic
  2. Superior phrenic
  3. Inferior phrenic
  4. Musculophrenic
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23
Q

Pericardiophrenic and superior phrenic:

- what are they branches of? what do they supply?

A

Branches of internal thoracic and thoracic aorta

supply superior surface

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24
Q

Inferior phrenic

- what is it a branch of? what does it supply?

A

branch of abdominal aorta

supplies inferior surface

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25
Q

Musculophrenic aa

- what is it a branch of? what does it supply?

A

branch of internal thoracic

supplies periphery of diaphragm

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26
Q

Where is the kidney located relative to the vertebral column?

A

Lateral to column at levels T12-L3

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27
Q

Where are the superior poles of the right and left kidney?

A

right kidney = 12th rib

left kidney = 11th rib

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28
Q

Where do kidneys develop? How do they get to their permanent position?

A

develop in pelvic region and ascend to abdominal cavity

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29
Q

What is an ectopic pelvic?

A

kidney remains anterior to sacrum

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30
Q

What is a horseshoe kidney?

A

two kidneys appear fused at midline and cannot ascend because they are caught on the IMA

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31
Q

Where are transplanted kidneys placed?

A

In lower abdomen because it’s easier to vascularize there

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32
Q

Suprarenal gland aka ____

A

adrenal gland

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33
Q

Where are the suprarenal glands located?

A

superior pole of kidney

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34
Q

Is the hilum of the kidney concave or convex? how does vasculature get in?

A

hilum is concave and is split open so it is open for vessels to penetrate

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35
Q

Kidney is covered with ___ fascia on which surfaces? why?

A

renal fascia

covered anterior and posterior because kidney is retroperitoneal

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36
Q

What is the difference between paranephric fat and perinephric fat?

A

paranephric fat = outside renal fascia

perinephric fat = inside of renal fascia and extends into hilum to fill the hilum space

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37
Q

Layers of inner kidney from superficial to deep?

A

Dense, fibrous capsule = outer layer
Renal cortex = outer 1/3
Renal medulla = inner 1/3

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38
Q

What is within the renal medulla?

A

Renal pyramids and renal columns

39
Q

What are renal papillae?

A

receive apex of pyramids and serves as collecting tip where excretory fluids begin to collect

40
Q

What is the relationship between minor and major calyces?

A

Minor calyces come together to form a major calyce

41
Q

From renal pyramids to ureter, trace the pathway of excretory fluid

A

renal pyramid -> renal papillae -> minor calyce -> major calyce -> renal pelvic -> ureter

42
Q

Veins are ____(anterior/posterior)____ to arteries in kidney vasculature?

A

VEINS ARE ANTERIOR TP ARTERIES IN KIDNEY VASCULATURE

43
Q

Between two kidneys is IVC and abdominal aorta. Which sits closer to which kidney?

A

IVC is near right kidney

Abdominal aorta is near left kidney

44
Q

Which is longer: right or left renal artery?

A

right renal artery is longer than left renal artery

45
Q

Which is longer: right or left renal vein?

A

left renal vein is longer than right renal vein

46
Q

What is the path of the right renal artery?

A

passes posteriorly to IVC to reach right kidney

47
Q

What is the path of the left renal vein?

A

passes anteriorly to abdominal aorta

48
Q

What are the 3-4 vascular sources for the ureter?

A
  1. renal artery
  2. testicular/ovarian artery
  3. abdominal aorta/common iliac a
  4. internal iliac a (pelvic cavity)
49
Q

Where does the ureter exit the kidney?

A

at the ureteropelvic junction of the hilum

50
Q

Is the ureter retroperitoneal or intraperitoneal?

A

retroperitoneal

think: kidney is retroperitoneal too

51
Q

What is the ureter’s pathway relative to the common iliac vein?

A

ureter crosses over the common iliac vein close to the pelvic brim

52
Q

What is an intravenous urogram?

A

patient injected with iodonated contrast medium

media is excreted by glomerular filtration by renal tubules and allows visualization of the ureters and bladder

53
Q

Why are kidney stones called calculi?

A

they are a buildup of calcium

54
Q

What size kidney stone needs surgical removal?

A

ones larger than 1cm

55
Q

What is lithotripsy?

A

ultrasonic crushing of a kidney stone to break it up

56
Q

What is the shape of the right and left adrenal glands?

A

right adrenal gland = triangular shape

left adrenal gland = semilunar in shape

57
Q

What is the position of right/left adrenal gland relative to the kidneys?

A

right adrenal gland: posterior to IVC and superior to right kidney

left adrenal gland: superomedial to left kidney near hilum

58
Q

Three portions of the adrenal gland from superficial to deep?

A

Dense fibrous capsule = outermost
Adrenal cortex = outer layer
Adrenal medulla = inner layer

59
Q

What does the adrenal cortex produce?

A

adrenal steroids

60
Q

What is significant about the adrenal medulla?

A

acts as sympathetic ganglion

has chromaffin (modified medullary neuronal cells)

61
Q

What are chromaffin?

A

Modified medullary neuronal cells found in the adrenal medulla

62
Q

Why are the adrenal glands so vascularized?

A

because they’re part of the endocrine system which relies on vascular supply for their product distribution

63
Q

3 main vessels that supply the adrenal glands? how many per each?

A
  1. superior suprarenal arteries 6-8
  2. middle suprarenal arteries 1+
  3. inferior suprarenal arteries 1+
64
Q

Where do the 3 main adrenal gland vessels branch from?

A
  1. superior suprarenal arteries branch from inferior phrenic artery
  2. middle suprarenal arteries branch from abdominal aorta
  3. inferior suprarenal arteries branch from renal artery
65
Q

What are the 6 musculs of the posterior abdominal wall?

A
  1. Transversus abdominus
  2. Quadratus Lumborum
  3. Psaos Major
  4. Iliacus m
  5. Psaos minor
  6. Diaphragm
66
Q

What is the arterial supply for the posterior abdominal wall musculature?

A 
lumbar arteries (4 pairs)
- branches of abdominal aorta superior to bifurcation
67
Q

What innervates the posterior abdominal wall musculature?

A

ventral rami T12-L4

LUMBAR plexus = somatic = sensory and motor

68
Q

Are lumbar plexus sensory or motor?

A

lumbar plexus is somatic therefore sensory AND motor

69
Q 
What nerve originates at the following locations:
T12: \_\_\_\_\_
L1: \_\_\_\_\_
L1-L2: \_\_\_\_\_
L2-L3: \_\_\_\_\_
L2-L4: \_\_\_\_\_
L2-L4: \_\_\_\_\_
L4-L5: \_\_\_\_\_
A 
T12: subcostal nerve
L1: iliohypogastric and ilioinguinal n
L1-L2: genitofemoral nerve
L2-L3: Lateral femoral cutaneous n
L2-L4: femoral n
L2-L4: obturator n
L4-L5: lumbosacral trunk
70
Q

Subcostal nerve location? What vertebral level?

A

~1cm inferior to 12th rib

@T12

71
Q

What does the subcostal nerve supply for sensory? what about motor?

A

sensory: anterior and lateral abdominal wall
motor: EO, IO, TA, pyramidalis, RA, QL

72
Q

What vertebral level do ilioinguinal and iliohypogastric n come from?

A

L1

can arise from common trunk - often do

73
Q

Ilioinguinal and hypogastric n physical relationship with QL?

A

the nerves descend anterior to QL

74
Q

What does the iliohypogastric nerve supply?

A

the suprarubic region

75
Q

What does the ilioinguinal nerve supply?

A

runs through the inguinal canal to supply it

runs along roof of canal and exits superficial ring

76
Q

What vertebral level does the genitofemoral nerve come from?

A

L1-L2

77
Q

What does the genitofemoral nerve split into?

A 
femoral branch (lateral)
genital branch (mesial)
78
Q

What muscle is the genitofemoral nerve associated with?

A

Psoas major

it pierces this muscle and runs along anterior surface of psaos major

79
Q

What does the genitofemoral nerve supply?

A

supplies skin inferior and medial to inguinal ligament

also supplies cremaster muscle of spermatic cord

80
Q

What vertebral level does the lateral femoral cutaneous nerve come from?

A

L2-L3

81
Q

What muscle/structures are associated with the lateral femoral cutaneous nerve?

A

nerve descends anterior to iliacus m., passes deep to inguinal ring and exits inferior to ASIS

82
Q

What does the lateral femoral cutaneous nerve supply?

A

supplies anterior/lateral skin of thigh

83
Q

What vertebral level does the femoral nerve come from?

A

L2-L4

84
Q

What two muscles does the femoral nerve run between?

A

iliacus and spoas major mm

85
Q

What is the path femoral nerve takes to get to the thigh?

A

passes deep to inguinal ligament and inferior to ASIS

86
Q

What does the femoral nerve supply?

A

supplies sensory and motor to anterior thigh

87
Q

What vertebral level does the obturator nerve come from?

A

L2-L4

88
Q

What course does the obturator nerve take to get to the thigh?

A

runs medial to psoas major mm

passes through obturator foramen

89
Q

What does the obturator nerve supply?

A

supplies sensory and motor medial thigh

90
Q

What is the difference between femoral n and obturator n? What are similarities?

A

both supply sensory and motor to thigh

femoral supplies anterior thigh
obturator supplies medial thigh

91
Q

What vertebral level does the lumbosacral trunk come from?

A

L4-L5

92
Q

What is the course of the lumbosacral trunk?

A

crosses over sacrum and descends into pelvis to help form sacral plexus

93
Q

What does the lumbosacral trunk do?

A

provides general contributions to both plexus

joins with sacral trunk to form psiatic nerve

IKK - Anatomy Exam 2 (13 decks)

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