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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
Describe the superior and inferoir surfaces of diaphragm
superior is convex | inferior is concave
26
the right and left domes of the diaphragm reach what rib level in expiration
5th rib
27
Describe the components of the central tendon
3 leaves- right left and central | attached to pericardium via pericardiocophrenic ligament
28
what are the muscular portions of diaphragm
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
29
What are the 3 arcuate ligaments of diaphragm
median arcuate medial arcuate lateral arcuate
30
what forms the esophageal hiatus
the Right crus folding in on itself
31
where is the median arcuate ligament
tendinous arch between left and right crura
32
what structure forms aortic hiatus
the median arcuate ligament
33
Where is the medial arcuate ligament
tendinous arch from transverse process of LV1 to the transverse process
34
What muscle does the medial arcuate lig span over
psoas major
35
Where is the lateral arcuate lig
atch from transverse process LV1 to 12th rib
36
what muscle does the lateral arcuate lig span over
quadratus lumborum
37
Where is the lumbocostal triangle
muscular weakness between costal and lumbar portions of diaphragm herniation area
38
What is the membrane of the lumocostal triangle derived from embryologically
pleuroperitoneal membrane
39
What are the 3 main hiatuses in diaphragm and where are they
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
What is the motor innervation of diaphragm
C3C4C5
41
Where does sensory inn come from for diaphragm
phrenic and inferior 6 intercostal nn
42
What occurs with phrenic nerve sectioning
paralysis of 1/2 diaphragm | permanent elevation of diaphragm and paradoxical movement during respiration
43
Where will there be referred pain from diapragm
shoulder from phrenic and thoracic wall from intercostal nn
44
What aa supply diaphragm and where do they come from
superior phrenic from thoracic aorta inferior phrenic from abdominal aorta pericardiacophrenic and musculophrenic fron internal thoracic aa
45
Describe venous drainage of diaphragm
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
describe lymph drainage of diahragm
superior phrenic nodes -->mediastinal lymph nodes | inferior diaphragmatic nodes-->superior diaphragmatic and or lumbar nodes
47
Where is the origin and insertion of psoas major
bodies and transverse processes of TV12-LV5 intervertebral disks inserts on lesser trochanter
48
what is the action and inn of psoas major
action if flexion of thigh and flexion vertebral column | innervation ventral rami L1-L3
49
What are the origins and insertion of psoas minor
bodies TV12-LV1 intervertebral disks | inserts iliopectineal eminence
50
what is the action and inn of psoas minor
action- flexion vertebral column | innervation: ventral rami of L1
51
origin and insertion of iliacus
origin- iliac fossa | insertion- lesser trochanter
52
action inn of iliacus
action flexion of thigh | inn femoral n
53
origin and insertion quadratus lumborum
iliac crest, iliolumbar ligament | inserts on 12th rib transverse processes of lumbar vertebrae
54
what is action and inn quadratus lumborum
action extends/side bends vertebral column and assists in pulling lower rubs down for inspiration inn by ventral rami T12-L4
55
What is the psoas sign or iliopsoas test
pain on extension of thigh against resistance--> abdominal infection
56
What organs can be invovled in infection on r side
kidneys ureters, cecum appendix ascending colon and sacroiliac joint
57
what organs can be involved in infection on the L side
kidneys, ureters, descnding colon, sigmoid colon, pancreas, sacroiliac joint
58
What are the nn on the posterior wall
sympathetic chain, subcostal n and lumbar plexus
59
What does the subcostal n inn
cutaneous and motor inn to anterior body wall
60
What ventral rami make up lumbar spinal nn
L1-L5
61
what sensory and motor inn does the lumbar plexus supply
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
What are the branches off lumbar plexus and their level originations
``` 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
describe path of iliohypogastric
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
describe the path of ilioinguinal n
parallels iliohypogastric then near ASIS pierces IAO and runs between it and EAO ENTERs inguinal canal and provides anterior scrotal/anterior labial branches
65
what 5 nn exit lateral to psoas major
subcostal n,iliohypogastric, ilioinguinal, lateral femoral cutaneous n femoral n
66
Where does femoral n course
lateral to psoas major, runs across iliac us and then deep to inguinal log
67
What nn pass medial to psoas
obturator internus accessory obturator lumbosacral trunk-->cont with sacral plexus
68
Where does genitofemoral n course and its branches
pierce psoas major, genital branch enters inguinal canal to inn cremaster femoral branch under inguinal lig to cutaneous inn of anterior thigh
69
Where does the obturator n exit pelvis
obturator canal to enter medial thigh
70
Where does the abdominal aorta course
continuation of thoracic aorta at TV12 courses midline anterior to LV1-LV4 then divides into R and L common iliac aa at LV4
71
what lays anterior to abdominal aorta
autonomic n plexuses pancreas left renal vein duodenum
72
what lays posterior to abdominal aorta
left lumbar veins | cistern chyli and thoracic duct
73
What are all the unpaired branches off aorta
celiac, SMA IMA, median sacral LV4
74
what are the paired aa and levels
``` inferior phrenic aa TV12 Lumbar aa LV1-LV4 middle suprarenals LV1 renal aa LV1LV2 gonadal aa LV2 common iliac aa LV4 ```
75
Where does IVC course
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
What can cause abdominal aortas
abnormal collagen diseases usually | and atherosclerosis
77
what lay anterior to IVC
liver, bile duct, portal vein, duodenum, pancreas, right gonadal a, right common iliac a
78
What lay posterior to IVC
right psoas major | right inferior phrenic a, right middle suprarenal a, right renal am right lumbar aa
79
What vv drain into IVC
``` 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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