Post. Abdominal Viscera And Wall Flashcards
Kidneys location
. T12 to L3 w/ right one lower than the left
. Inf. Pole may be palpable (esp. right one)
. Sup. Pole under cover of ribs
. W/in retroperitoneal fat
. Renal fascia encloses kidney and some fat
. Has fibrous capsule
Perirenal fat
. Btw kidney and renal fascia
. Surrounds and helps protect kidney
Pararenal fat
. Outside renal fascia
Hilus of kidney
. Where vessels enter/leave
. Has sinus that is space surrounding these vessels
Kidney parenchyma
. Cortex
. Medulla w/ renal pyramids (14 each, base towards cortex, apex/papilla into minor calyx) and renal column (cortical tissue extending into medulla)
Kidney duct system
. Dozen large collecting ducts of each pyramid empty at papilla into minor calyx
. 1+ papilla share minor calyx
. 2+ minor calyces unite to form major calyx
. 2-3 major calyces unit to form renal pelvis that drains to ureter
Kidney blood supply
. From renal a. That divides at hilus into 5 segmental branches
. Each is end artery
. Accessory renal aa. Also end arteries
. Venous drainage to IVC via renal vein
Kidney innervation
. Renal (aorticorenal) plexus
. Parasympathetic from vagus nerve
. Postganglionic sympathetic fibers from aorticorenal ganglion
. Visceral sensory fibers for pain travel along-side sympathetic motor
Ureter
. Muscular drainage tube from renal pelvis to post. Side of urinary bladder
. Bloackage causes severe pain when ureter contracts
. Descends vertically on psoas muscle then crosses at beginning of external iliac a. To enter pelvis
Ureter blood supply
. Renal a.
. Gonadal a.
. Abdominal aorta
Renal and ureteric calculi
. Calculi (pebbles) in calices of kidney, ureters, or urinary bladder
. Renal calculus pass from kidney into penal pelvis and ureter causing tube distension
. Severe rhythmic pain as it is gradually forced down ureter by waves on contractions
. Visceral afferents conveying pain to T11-L2 innervation areas (lumbar, hypogastric region, external genitalia, and testis)
Suprarenal (adrenal) glands structure and innervation
. Flat endocrine gland against diaphragm on sup. Pole of each kidney
. Cortex: outer part secreting steroids (essential for life)
. Medulla: inner that secretes catecholamines (not essential for life), secretory cells are modified sympathetic postganglionic neurons synapse gets w/ preganglionic fibers from T10-L2
. Blood supply: several suprarenal aa. To reach periphery of gland, venous from single suprarenal vein
Adrenal gland blood supply
. L suprarenal v. Drains into R suprarenal vein that goes to IVC
Thoraco-abdominal diaphragm
. Thin, voluntary muscle partition btw thoracic and abdominal cavities
. Dome-like, R side higher then L from liver
. Central tendon: C-shaped w/ convexity ant., aponeurosis for muscle fiber insertion
Diaphragm Origins
. Sternal from xiphoid process
. Costal from lower 6 costal cartilages and lower 2 bony ribs
. Vertebral: right crus (1st 3 lumbar bodies and discs, larger than L, surrounds esophageal hiatus) and left crus (1st 2 lumbar bodies/discs), arcuate ligaments
Diaphragm innervation
. Phrenic n. (All motor and sensory except to periphery)
. T6-11 intercostal/subcostal nn. (Periphery, mostly sensory but some motor)
Diaphragm superior surface blood supply
. Sup. Phrenic aa. Branches from aorta to post. Position
. Pericardiacophrenic and musculophrenic aa. From internal thoracic aa. To ant. And central position
. Lower 6 post. Intercostal and subcostal aa. From thoracic aorta to lat. positions
Inf. Surface diaphragm blood supply
. Inf. Phrenic aa.
Structures piercing diaphragm
. IVC via vena canal foramen in central tendon at T8
. Esophagus via esophageal hiatus at T10 w/ ant. And post. Vagal trunks
. Aorta via aortic hiatus under median arcuate ligament at T12
. Thoracic splanchnic nn. (Greater, lesser, least) pierce crura