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Anatomy > Posterior Abdomen > Flashcards

Posterior Abdomen Flashcards

1
Q

Retroperitoneal structures include…

A
  • kidneys and adrenal glands
  • aorta and IVC
  • lymphatic channels and nerves
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2
Q

What ribs are in posterior abdominal wall?

A

ribs 11 and 12

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3
Q

what other bones are in posterior abdominal wall?

A
  • Lumbar vertebrae
  • sacrum
  • pelvic bones
    • iliac fossa
    • iliac crest(s)
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4
Q

Muscles in the posterior abdominal wall

A
  • Diaphragm
  • Psoas major
  • Psoas minor
  • Quadratus lumborum
  • Iliacus
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5
Q

what do Psoas Major (minor) and iliacus (iliopsoas) do and what are there innervation’s?

A

Powerful flexors of the hips

Innervation:
Ventral Rami L1-L3 (PM)
Femoral Nerve (Iliopsoas)

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6
Q

what do Quadratus lumborum do and what are their innervations?

A

Depress and stabilize rib 12, some lateral bending of trunk

Innervation:
Ventral Rami T12-L4

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7
Q

What creates the posterior wall

Superiorly, Laterally, Medially?

A

Superiorly: diaphragm
Laterally: Quadratus lumborum
Medially: Psoas major

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8
Q

What structures pass through the diaphragm?

A
  • Aortic Hiatus
  • Caval opening
  • Esophageal Hiatus
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9
Q

Aortic Hiatus passing through the diaphragm

A
  • Aorta
  • Thoracic Duct
  • At T12
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10
Q

Caval Opening passing through the diaphragm

A
  • IVC
  • Right phrenic nerve
  • Left passes through muscle
  • T8
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11
Q

Esophageal hiatus passing through the diaphragm

A
  • Esophagus
  • Ant and post vagal trunks
  • esophageal branches of left gastric artery and vein, lympathic vessels
  • T10
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12
Q

What are Crus

A

connective tissue tendon connecting muscle to bony frame work

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13
Q

What passes thru a sleeve of the right crus?

A

Esophagus

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14
Q

differences between MEDIAN Arcuate Ligament VS MEDIAL Arculate ligaments

A

Median: singular arch, between L and R Crus, holds diaphragm open
Medial: bilaterally to right or left of R and L Crus and allows Psoas Major to pass

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15
Q

Lateral arcuate ligament

A

larger batwing structures- rib attachments

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16
Q

Name the Viscera organs of the urinary system

A
  • Kidneys (2)
  • Ureters (2)
  • Bladder
  • Urethra
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17
Q

Function of Kidneys

A

filter blood and make urine

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18
Q

Function of Ureters

A

Conduit for urine from kidneys to bladder

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19
Q

Function of bladder

A

storage of urine prior to elimination

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20
Q

Function of Urethra

A

Passageway or urine from bladder to the outside.

-Very variable in length and width of tube in women and men

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21
Q

Describe the kidneys

A

-retroperitoneal
-lateral to vertebral column
-extend from vertebra T12-L3
-Right kidney somewhat lower than left becuase of liver
-Left kidney is longer and more slender
-Left is in contact with ribs 11 and 12
-Right only comes in contact with rib 12
-

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22
Q

A part of the kidney (not all) sits on this muscle

A

Quadratus lumborum

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23
Q

What is the kidney in contact with laterally and superiorly?

A

Laterally: In contact with transversus abdominus
Superiorly: What kidneys are mostly sitting on its the diaphragm (the diaphragm is also the back wall of the kidneys)

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24
Q

Perlnephric Fat

A

Surrounds kidneys and adrenal glands and vessels ON TOP OF the kidneys capsule

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25
Q

Renal Fascia

A

Surrounds PERInephric Fat and is (extraperitoneal fascia)

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26
Q

Peranephric Fat

A

Most outer layer that surrounds kidneys and adrenal gland. It is outside adrenal fascia and is retroparatineal too.
-Posterior and posterolateral to kidneys and adrenal glands, outside of renal fascia

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27
Q

Renal Cortex

A

OUTER REGION OF KIDNEY

  • Parts of the cortex extend in medulla (called renal columns)
  • good part of medulla/glomerulus sits in cortex
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28
Q

Renal Medulla

A

INNER REGION
Renal medulla is where magic happens and where henle loops down too

Renal pyramid (where loop of henle is)- stripy and converge at…
Renal papulla
-once we drain our filtrate our collecting duct thru the renal papilla- its now called urine
-urine travels via minor calyx
-minor calyx converge to major calyx
-major calyx goes to renal pelvis (hilum of kidney)
-funnel shape tube is exiting at renal pelvis as the ureter and urine travels down that way
Urine travels thru Minor Calyx and then Major Calyx and then to Renal Pelvis (at hilum of kidney)

29
Q

Hilum of Kidney

A

Entry/Exit point

-How urine travels down into ureter in the hilum of the kidney

30
Q

Innervation of the kidney

A

Renal Plexus

31
Q

Lymphatic Drainage of the Kidney

A

Kidneys drained by lateral aortic (lumbar nodes)

32
Q

Left and Right Renal arteries branch off of the…

A

Abdominal Aorta near the SMA

33
Q

Which is longer? R or L renal artery? Why?

A

L renal vein is LONGER than the RIGHT because it has to cross under SMA/over aorta to get to IVC

34
Q

Nutcracker Syndrome

A

-superior emsentary artery travess over top of revnal vein(nutcracker syndrome) an aneurysm in aorta or messentary artery would hinder blood flow from kidney and cause damage to nephron

35
Q

What is in danger of being squished in Nutcracker Syndrome?

A

L Renal vein is in danger of being compressed if you have any issues in abdominal aorta or SMA

36
Q

Adrenal/Suprarenal Glands

A
  • Sits on top of the kidneys
  • Consists of an outer cortex and inner medulla
  • makes hormones like EPI and cortisol and aldosterone
37
Q

Blood Supply to Adrenal/Suprarenal Glands

A
  • Superior Suprarenal Artery
  • Middle Suprarenal Artery
  • Inferior Suprarenal Artery
38
Q

Superior Suprarenal Artery

Branch off…

A

Inferior Phrenic

-Inferior phrenics are paired arteries coming off of abdominal aorta- just proximal to celiac trunk

39
Q

Middle Suprarenal Artery branch off…

A

Off of Abdominal Aorta

40
Q

Inferior Suprarenal Artery branch off…

A

Branch off of renal artery

41
Q

Why is there a big blood supply to the adrenal glands?

A

Because EPI/alot of hormones travel to these glands so a lot of blood supply is needed- think about how fast EPI enters blood and acts right away

42
Q

Describe the Ureters

A

Muscular tubes that transport urine from kidneys to bladder

  • Retroperitoneal
  • Collapsable lumen
  • Mostly in pelvis but can rise when full
43
Q

Ureter can constrict at 3 points. Where are they?

A
  • Uretopelvic junction
  • Pelvic brim-where ureters cross common iliac artery
  • Where ureters enter bladder
44
Q

-Uretopelvic junction

A
  1. First constriction is where is where the uropelvis becomes the ureter bc it is very narrow and at top where ureter Beginsis the very first constriction– called the UREOPELVIC JUNCTION
45
Q

-Pelvic brim-where ureters cross common iliac artery

A

Where is passes over top of common iliac- can see aorta as it gets to pelvis, divides to supply the legs and pelvis and perineum and to get into bladder, the ureters must cross over common iliacs (high pressure in blood vessels)- when u have things crossing, the thing w the strongest pressure WINS, common iliacs would win- PELVIC INLET- where pelvis begins

46
Q

-Where ureters enter bladder

A

Third constriction is where Ureters enter the bladder (posterior and inferior)

47
Q

Describe passing of kidney stones

A

kidney stones (start in kidney) so they have to pass thru ureter (painful since its not supposed to accomidate them(rocks just pee) and stretch) problem is when kidneys BLOCK ureters, larger ones stay in kidney so smaller ones are worst bc they have to pass thru whole system

48
Q

Vasculature of the Ureters

A

Upper End: Renal Arteries
Middle:Aorta testicular/ovarian artery OR branches off the common iliac artery
Pelvis: Internal iliac Artery

49
Q

Innervation of Ureters

A

Renal, Aortic Superior hypogastric and inferior hypogastric plexuses

50
Q

Bladder location

A

Location: entirely in pelvis when empty but extends into abdomen when full

51
Q

Bladder Structure

A

Base of the bladder is shaped like an inverted triangle

52
Q

Trigone

A

in bladder- Smooth triangular area between ureter openings and urethra

-Where UTI prone since the infection would originate in the urethra then travel up to ureters (untreated UTI can make their way up ureters and infect kidneys)

53
Q

Do Ureters go thru top of bladder?

A

NO- instead, behind it and come up a little bit (important for functino)- since when u are done peeing u can make sure urine doesn’t go backwards. When were releasing urine from bladder the opening of ureters are being closed so urine wont go back

54
Q

Where does the Urethra begin and extend to?

A

Begins at the base of the bladder and extends out of the perineum

55
Q

What does the urethra pass through

A

Passes through internal and external urethral sphincters

56
Q

Male VS Female Urethra

A

Male: 20 cm long, 4 parts: Pre-prostatic, prostatic, membranous, spongy

Female: Urethra only about 4 cm long

57
Q

Venous Return

A

Everything drains to IVC:

  • Common iliac vein
  • Lumbar Veins (3rd & 4th)
  • Right testicular or ovarian vein
  • Left drains into left renal vein
  • Renal veins
  • Right suprarenal veins
  • Inferior phrenic veins
  • Hepatic Veins
58
Q

Lymphatic Drainage

A

Lympathic drainage converges on lymph nodes and vessels associated with major posterior wall blood vessels which eventually drains in the thoracic duct

  • Pre-aortic nodes
  • Right and Left lateral aortic/lumbar nodes
59
Q

What fibers will be in Plexuses?

A
  1. sympathetic: mostly preganglion fibers (same in abdomen and thorax–so most of visceral afferents (sensory) is goig to travel with sympathetic fibers. SO our sympa efferets is going to travel with visceral EFFERETN
    • ppain travels w sympathetic fibers
      2. Preganglionic PARA sympathetic fibers from pelvic splanics or vagus
60
Q

All plexus can carry…

A

both para or sympathetic fibers

61
Q

Ganglia is where…

A

where sympa fibers synapse, not seen for parasympa since theyre on the walls of the target organs

62
Q

What is Parasympathetic and Sympathetic controlled by?

A

Parasympa: controlled via vagus or pelvic splanchnics

Syma: controlled via greater, lesser, thoracic (lumbar and in some cases sacral) splanchnics

63
Q

Somatic control is mainly accomplished by…

A

Lumbar Plexuses (spinal nerves interweaving among one another)

64
Q

Major terminal nerve branches

A

Anterior: Genitofemoral Nerve
Medial: Obturator Nerve
Lateral: Iliohypogastric Nerve and Ilioinhuinal Nerve, Femoral Nerve, lateral cutaneous nerve of the thigh

65
Q

Obturator Nerve branch from

A

Medial Thigh

66
Q

Iliohypogastric Nerve and Ilioinguinal Nerve branch from

A

Anterior abdominal muscles

67
Q

Femoral Nerve branch from

A

Iliacus and the anterior thigh

68
Q

Referred Pain

A

Referred pain: sensory information coming back to a spinal region, and its coming from 2 different places, your brain cant interpret where it came from

- in heart, the same innervation is located in arm so that pain in arm is felt when u get heart attack
- in arm, pain sensation is very not localized

Important in the abdomen because it is very localized- not speicfic. P397 of book* thoaracic splanchnics

69
Q

What is the pain pathway for the forgut, midgut, and flanks

A

-Pain in greater splanchnic pathway for foregut (upper thorax)
Pain in lesser splanchnic pathway for midgut (umbilical region)–(appendix)
Least splaninick pathway is for flanks (kidneys and ureter)

Anatomy (11 decks)

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