Post. Abdominal Viscera And Wall Flashcards

1
Q

Kidneys location

A

. 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

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2
Q

Perirenal fat

A

. Btw kidney and renal fascia

. Surrounds and helps protect kidney

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3
Q

Pararenal fat

A

. Outside renal fascia

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4
Q

Hilus of kidney

A

. Where vessels enter/leave

. Has sinus that is space surrounding these vessels

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5
Q

Kidney parenchyma

A

. Cortex
. Medulla w/ renal pyramids (14 each, base towards cortex, apex/papilla into minor calyx) and renal column (cortical tissue extending into medulla)

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6
Q

Kidney duct system

A

. 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

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7
Q

Kidney blood supply

A

. 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

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8
Q

Kidney innervation

A

. Renal (aorticorenal) plexus
. Parasympathetic from vagus nerve
. Postganglionic sympathetic fibers from aorticorenal ganglion
. Visceral sensory fibers for pain travel along-side sympathetic motor

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9
Q

Ureter

A

. 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

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10
Q

Ureter blood supply

A

. Renal a.
. Gonadal a.
. Abdominal aorta

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11
Q

Renal and ureteric calculi

A

. 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)

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12
Q

Suprarenal (adrenal) glands structure and innervation

A

. 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

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13
Q

Adrenal gland blood supply

A

. L suprarenal v. Drains into R suprarenal vein that goes to IVC

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14
Q

Thoraco-abdominal diaphragm

A

. 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

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15
Q

Diaphragm Origins

A

. 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

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16
Q

Diaphragm innervation

A

. Phrenic n. (All motor and sensory except to periphery)

. T6-11 intercostal/subcostal nn. (Periphery, mostly sensory but some motor)

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17
Q

Diaphragm superior surface blood supply

A

. 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

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18
Q

Inf. Surface diaphragm blood supply

A

. Inf. Phrenic aa.

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19
Q

Structures piercing diaphragm

A

. 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

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20
Q

Lower esophageal sphincter

A

. Prevents regurgitation by constricting when diaphragm contracts
. Physiological, not anatomical, sphincter

21
Q

Psoas major OIA

A

. O: transverse processes of L1-5, sides of bodies T12-L5 and discs
. I: lesser trochanter via iliopsoas tendon
. A: bi/unilaterally flexes thigh, bilaterally flexes trunk if thigh stabilized, unilaterally lat. flexes vertebral column toward same side

22
Q

Psoas major N

A

N: vertebral rami of L2-4 (post. Divisions)

23
Q

Iliacus OIAN

A

. O: iliac crest and sup. 2/3 of iliac fossa, ala of sacrum, ant. Sacroiliac ligaments
. I: lesser trochanter of femur via iliopsoas tendon
. A: flexes thigh and stabilizes hip joint
. N: ventral rami of L2-4 nerves (post. Divisions)

24
Q

Iliopsoas muscle

A

. Iliacus w/ psoas major

25
Q

Psoas minor OIAN

A
O: T12-L1 bodies and disc
I: iliopubic eminence
A: weak trunk flexor
N: ventral ramus of L1
. Absent in 40% people, when present it lies ant. To psoas major
26
Q

Quadratus lumborum OIAN

A

O: iliolumbar ligament, internal lip of iliac crest
I: inf. Border 12th rib, transverse processes L1-4
A: one side contracted lat. flexes vertebral column to same side, fixes 12th rib during inspiration
N: subcostal n. And L1-4 (ant. Division)

27
Q

Thoracolumbar fascia

A

. Thick, covers origin of erector spinae muscle in lumbar region
. Ant. Layer: ant. Surface of quadratus lumborum
. Middle layer: attached to transverse processes of lumbar vertebrae
. Post layer: attached to spinous processes
. Middle and post. Layers join lat. at aponeurosis of transversus abdominis muscle

28
Q

Transversalis fascia

A

. Deep surface of transversus abdominis and quadratus lumborum muscles
. Part of larger fascial layer that lines deep surface of entire abdominal cavity (endoabdominal fascia)

29
Q

Abdominal aorta course

A

. Enters through aortic hiatus
. Terminates at L4 by splitting into R/L common iliac aa.
. Common iliac aa. Split into external and internal iliac aa.

30
Q

Abdominal aorta visceral branches

A

. Paired: suprarenal, renal, testicular/ovarian

. Unpaired: celiac a., sup. And inf. Mesenteric aa.

31
Q

Abdominal aorta parietal branches

A

Paired: inf. Phrenic aa (to inf. Diaphragm)., lumbar aa
Unpaired: median sacral aa.

32
Q

Lumbar arteries

A

. Post. Abdominal wall
. 4 arteries paired in segmental fashion
. Arise from post. Side of aorta
. Run post. To quadratus lumborum muscle

33
Q

Median sacral artery

A

. Arises from inf. Surface of aorta as it bifurcated
. Runs along ant. Surface of sacrum
. Final pair of lumba aa. May arise from it

34
Q

T/F IVC receives blood from GI tract

A

F, that is drained by portal v.

35
Q

IVC tributaries

A

. Paired visceral vv. (Renal vv both drain to IVC., R testicular goes to IVC, L testicular goes to L renal v., R suprarenal v. To IVC, L suprarenal v. Goes to L renal v.)
. Paired parietal vv.: inf. Phrenic vv. To IVC, lumbar vv., hepatic vv. (3 branches drain liver)

36
Q

Ascending lumbar vv.

A

. Connects lumbar, IVC, and lumbar vv. On each side

. Joins azygos system of veins sup.

37
Q

Iliac lymph trunks

A

. Drain into lumbar lymph trunks alongside aorta

38
Q

lumbar lymph nodes

A

Lay alongside aorta

39
Q

Intestinal lymph trunk

A

. Drains most of abdominal digestive tract

40
Q

Cisterna chyli

A

. Dilated inf. End of thoracic duct

. Gets lumbar lymph trunks and intestinal trunk

41
Q

Lumbar plexus

A

. Ventral rami L1-4

. Roots of plexus

42
Q

Branches of lumbar plexus

A

. Muscular branches to quadratus lumborum and psoas major muscles
. Iliohypogastric and ilioinguinal nn
. Genitofemoral n.
. Lat. femoral cutaneous n. (Lat. cutaneous n. Of thigh)
. Femoral n.
. Obturator n.

43
Q

Iliohypogastric and ilioinguinal n.

A

. L1

. To muscles of lower abdominal wall, skin of upper high, and ant. Side of scrotum/labium majus

44
Q

Genitofemoral n.

A

. L1-2
. Runs down ant. Surface of psoas muscle to reach cremaster, skin of upper thigh, and ant. Side of scrotum
. Involved in cremaster reflex

45
Q

Lat. femoral cutaneous n.

A

. Post. Divisions of L2-3

. Sensory skin to thigh and buttock

46
Q

Femoral nerve

A
. Post. Divisions of L2-4
. In groove btw iliacus and psoas major
. Enters thigh lat. to femoral a. 
. Supplies skin of ant. And med. thigh
. Motor to muscles in ant. Compartment of thigh and iliacus
47
Q

Obturator n.

A

. Ant. Division L2-4
. Emerges med. to psoas major muscle and crosses pelvic brim
. Exits via obturator foramen
. Motor to muscles of med. compartment of the thigh
. Sensory to skin of med. thigh

48
Q

Lumbosacral trunk

A

. part of L4 and all of L5

. Descends into pelvis where it contributes to sacral plexus