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GI I > Posterior abdomen wall > Flashcards

Posterior abdomen wall Flashcards

1
Q

what is the function of the kidney

A

filter blood, produce urine and secrete renin

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2
Q

what layers are the kidneys between

A

between parietal peritoneum and musculature of posterior abdominal wall and diaphragm

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3
Q

which direction is the inferior pole of the kidney oriented

A

more lateral and hilum anteromedially

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4
Q

What is posterior to the kidneys

A

diaphragm, psoas major, quadratus lumborum, transversum abdominis, subcostal n, iliohypogastric, ilioinguinal n

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5
Q

what structures are anterior to the right kidney

A

liver, duodenum, ascending colon

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6
Q

what structures are anterior to the left kidney

A

stomach, spleen, pancreas, jejunum, descending colon

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7
Q

describe the renal fascia

A

each kidney is surrounded with fat and fascia

anterior and posterior layers that blend medially with adventitia or renal vessels

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8
Q

describe the renal fat

A

pararenal fat is found external to renal fascia

perirenal fat is found between kidney and the renal fascia

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9
Q

Describe structures in the renal sinus

A

open sapce in kidney with renal calyces, renal pelvis, vessels, nerves and lymph

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10
Q

Describe the cortex of the kidney and what is in it

A

glomeruli, proximal and distal convoluted tubules with medullary rays as well

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11
Q

Describe the medulla of the kidney

A

collecting tubules with renal pyramids

cortical columns

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12
Q

what is the apex of the renal pyramid called

A

renal papillae

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13
Q

how many minor calyces are in a major

A

2-3

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14
Q

What is the function of the suprarenal glands

A

endocrine

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15
Q

what hormones does the suprarenal gland secrete

A

cortisol, aldosterone, androgens, epi and norepi

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16
Q

What separates kidney and suprarenal gland

A

thin septum

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17
Q

what are the shapes of the suprarenal glands

A

right is pyramidal shaped

left is crescent shaped

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18
Q

What is the function of the cortex of suprarenal glands

A

produce the steroids like glucocorticoids and mineralocorticoids

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19
Q

What is the function of the medulla of the suprarenal glands

A

postganglionic sympatheticneurons, epinephrine,noreepi

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20
Q

Describe the aa that supply suprarenal glands

A

superior suprarenal a, middle and inferior

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21
Q

where do the suprarenal aa get their supply from

A

superior is from inferior phrenic a
midd is from aorta, LV1
inferior is from rectal a

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22
Q

Describe venous drainage of suprarenal glands

A

right suprarenal vein drains to IVC

left suprarenal vein joins left renal vein then enters IVC

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23
Q

Where do the lymph nodes around suprarenal glands drain

A

lumbar lymph nodes

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24
Q

What is the function of diaphragm

A

respiration

decreases intrathoracic pressure and increases intraabdominal pressure

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25
Q

Describe the superior and inferoir surfaces of diaphragm

A

superior is convex

inferior is concave

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26
Q

the right and left domes of the diaphragm reach what rib level in expiration

A

5th rib

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27
Q

Describe the components of the central tendon

A

3 leaves- right left and central

attached to pericardium via pericardiocophrenic ligament

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28
Q

what are the muscular portions of diaphragm

A

sternal– smallest, attached to xiphoid
costal– largest inserts into internal ribs 7-12
lumbar portion– attaches to LV1-LV3 on R crus
attaches to LV1-LV2 on L crus

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29
Q

What are the 3 arcuate ligaments of diaphragm

A

median arcuate
medial arcuate
lateral arcuate

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30
Q

what forms the esophageal hiatus

A

the Right crus folding in on itself

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31
Q

where is the median arcuate ligament

A

tendinous arch between left and right crura

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32
Q

what structure forms aortic hiatus

A

the median arcuate ligament

33
Q

Where is the medial arcuate ligament

A

tendinous arch from transverse process of LV1 to the transverse process

34
Q

What muscle does the medial arcuate lig span over

A

psoas major

35
Q

Where is the lateral arcuate lig

A

atch from transverse process LV1 to 12th rib

36
Q

what muscle does the lateral arcuate lig span over

A

quadratus lumborum

37
Q

Where is the lumbocostal triangle

A

muscular weakness between costal and lumbar portions of diaphragm
herniation area

38
Q

What is the membrane of the lumocostal triangle derived from embryologically

A

pleuroperitoneal membrane

39
Q

What are the 3 main hiatuses in diaphragm and where are they

A

caval hiatus through central tendon at TV8 with IVC and right phrenic n
esophageal hiatus at TV10 with esophagus, ant/post vagal trunks and branches of left gastric a
Aortic hiatus TV12 between left and right crura to transmit aorta and thoracic duct

40
Q

What is the motor innervation of diaphragm

A

C3C4C5

41
Q

Where does sensory inn come from for diaphragm

A

phrenic and inferior 6 intercostal nn

42
Q

What occurs with phrenic nerve sectioning

A

paralysis of 1/2 diaphragm

permanent elevation of diaphragm and paradoxical movement during respiration

43
Q

Where will there be referred pain from diapragm

A

shoulder from phrenic and thoracic wall from intercostal nn

44
Q

What aa supply diaphragm and where do they come from

A

superior phrenic from thoracic aorta
inferior phrenic from abdominal aorta
pericardiacophrenic and musculophrenic fron internal thoracic aa

45
Q

Describe venous drainage of diaphragm

A

superior phrenic vein to IVC
pericardiacophrenic cc and musculophrenic vv to internal thoracic vein
inferior phrenic v on the right goes to IVC
on the left merges with supra renal v to drain to renal v

46
Q

describe lymph drainage of diahragm

A

superior phrenic nodes –>mediastinal lymph nodes

inferior diaphragmatic nodes–>superior diaphragmatic and or lumbar nodes

47
Q

Where is the origin and insertion of psoas major

A

bodies and transverse processes of TV12-LV5 intervertebral disks
inserts on lesser trochanter

48
Q

what is the action and inn of psoas major

A

action if flexion of thigh and flexion vertebral column

innervation ventral rami L1-L3

49
Q

What are the origins and insertion of psoas minor

A

bodies TV12-LV1 intervertebral disks

inserts iliopectineal eminence

50
Q

what is the action and inn of psoas minor

A

action- flexion vertebral column

innervation: ventral rami of L1

51
Q

origin and insertion of iliacus

A

origin- iliac fossa

insertion- lesser trochanter

52
Q

action inn of iliacus

A

action flexion of thigh

inn femoral n

53
Q

origin and insertion quadratus lumborum

A

iliac crest, iliolumbar ligament

inserts on 12th rib transverse processes of lumbar vertebrae

54
Q

what is action and inn quadratus lumborum

A

action extends/side bends vertebral column and assists in pulling lower rubs down for inspiration
inn by ventral rami T12-L4

55
Q

What is the psoas sign or iliopsoas test

A

pain on extension of thigh against resistance–> abdominal infection

56
Q

What organs can be invovled in infection on r side

A

kidneys ureters, cecum appendix ascending colon and sacroiliac joint

57
Q

what organs can be involved in infection on the L side

A

kidneys, ureters, descnding colon, sigmoid colon, pancreas, sacroiliac joint

58
Q

What are the nn on the posterior wall

A

sympathetic chain, subcostal n and lumbar plexus

59
Q

What does the subcostal n inn

A

cutaneous and motor inn to anterior body wall

60
Q

What ventral rami make up lumbar spinal nn

A

L1-L5

61
Q

what sensory and motor inn does the lumbar plexus supply

A

sensory to anterolateral abdominal wall, inguinal region, anterior scrotum/labia major, gluteal region, perineum and lower limb
motor to anterolateral wall and posterior wall and lower limb

62
Q

What are the branches off lumbar plexus and their level originations

A 
iliohypogastric L1
ilioinguinal L1
Femoral n L2-L4
lateral cutaneous n of thigh L2-L3
genitofemoral n L1,L2
obturator L2-L4
lumbosacral trunk L4-L5
accessory obturator L3-L4
63
Q

describe path of iliohypogastric

A

forms posteiror medial arcuate log, arches over quadratus lumborum and pierces transversum abdominis runs between IAO and EAO then ends as suprapubic cutaneous branches

64
Q

describe the path of ilioinguinal n

A

parallels iliohypogastric then near ASIS pierces IAO and runs between it and EAO
ENTERs inguinal canal and provides anterior scrotal/anterior labial branches

65
Q

what 5 nn exit lateral to psoas major

A

subcostal n,iliohypogastric, ilioinguinal, lateral femoral cutaneous n femoral n

66
Q

Where does femoral n course

A

lateral to psoas major, runs across iliac us and then deep to inguinal log

67
Q

What nn pass medial to psoas

A

obturator internus
accessory obturator
lumbosacral trunk–>cont with sacral plexus

68
Q

Where does genitofemoral n course and its branches

A

pierce psoas major,
genital branch enters inguinal canal to inn cremaster
femoral branch under inguinal lig to cutaneous inn of anterior thigh

69
Q

Where does the obturator n exit pelvis

A

obturator canal to enter medial thigh

70
Q

Where does the abdominal aorta course

A

continuation of thoracic aorta at TV12 courses midline anterior to LV1-LV4 then divides into R and L common iliac aa at LV4

71
Q

what lays anterior to abdominal aorta

A

autonomic n plexuses
pancreas
left renal vein
duodenum

72
Q

what lays posterior to abdominal aorta

A

left lumbar veins

cistern chyli and thoracic duct

73
Q

What are all the unpaired branches off aorta

A

celiac, SMA IMA, median sacral LV4

74
Q

what are the paired aa and levels

A 
inferior phrenic aa TV12
Lumbar aa LV1-LV4
middle suprarenals LV1
renal aa LV1LV2
gonadal aa LV2
common iliac aa LV4
75
Q

Where does IVC course

A

forms anterior to LV5 at union of left and right common iliac vv
ascends post body wall to right of aorta passes through diphragm at TV8

76
Q

What can cause abdominal aortas

A

abnormal collagen diseases usually

and atherosclerosis

77
Q

what lay anterior to IVC

A

liver, bile duct, portal vein, duodenum, pancreas, right gonadal a, right common iliac a

78
Q

What lay posterior to IVC

A

right psoas major

right inferior phrenic a, right middle suprarenal a, right renal am right lumbar aa

79
Q

What vv drain into IVC

A 
common iliacs
lumbar vv
R gonadal v
renal vv
right suprarenal
collareral branches from asceding lumbar
inferior phrenic v
hepatic vv

GI I (14 decks)

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