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Anatomy > Posterior Abdominal Organs, Posterior Abdominal Wall and Diaphragm > Flashcards

Posterior Abdominal Organs, Posterior Abdominal Wall and Diaphragm Flashcards

1
Q

The posterior abdominal viscera are located in the (1) between the (2) and the (3) and (4) of the posterior abdominal wall

A
  1. retroperitoneal space
  2. posterior parietal peritoneum
  3. muscles
  4. bones
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2
Q

The retroperitoneal space contains what?

A
  • kidneys
  • ureters
  • suprarenal glands
  • aorta
  • IVC
  • abdominal portions of sympathetic trunks
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3
Q

What lies retroperitoneally on the posterior abdominal wall, one on each side of the vertebral column?

A

kidneys

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4
Q

What is the function of the kidneys?

A

remove excess water, salts, and wastes of protein metabolism from blood white returning nutrients and chemicals to the blood

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5
Q

What conveys the waste products from the blood into the urine, which drains through the ureters to the urinary bladder?

A

kidneys

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6
Q

What run inferiorly from the kidneys, passing over the pelvic brim at the bifurcation of the common iliac arteries?

A

ureters

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7
Q

What runs along the lateral wall of the pelvis and enter the urinary bladder?

A

ureters

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8
Q

What type of epithelium are the ureters and bladder made of and what does it allow for?

A
  • transitional epithelium
  • allows for stretching
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9
Q

The superomedial aspect of each kidney normally contacts a (1), which is separated from the kidney by a weak fascial septum

A

suprarenal gland

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10
Q

The suprarenal glands function as part of the (1)

A

endocrine system

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11
Q

What are the kidneys well protected by?

A
  • their position within the abdomen
  • cushioning layers of fat
    ** an outer pararenal layer
    ** inner perirenal layer
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12
Q

What are the outer pararenal layer and inner perirenal layer of fat surrounding the kidneys separated by?

A

renal fascia

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13
Q

What are the kidney coverings from superficial to deep?

A
  • paranephric fat
  • renal fascia
  • perinephric fat
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14
Q

What is the fat external to the renal fascia, is the most obvious on the posterior surface of kidneys, and surrounds the entire area?

A

paranephric fat

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15
Q

What encloses the kidneys, suprarenal glands, and perinephric fat EXCEPT inferiorly?

A

renal fascia

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16
Q

What is the renal fascia continuous with?

A

the diaphragmatic fascia

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17
Q

What is found within renal fascia, extends into the renal sinus, is a fibrous capsule, and surrounds the kidney?

A

perinephric fat

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18
Q

Inferior to the kidney, there is no (1)

A
  1. renal fascia
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19
Q

The posterior surface of the kidney is related to the (1) muscle

A

quadratus lumborum

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20
Q

What structures are located anterior to the right kidney?

A
  • liver
  • duodenum
  • ascending colon
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21
Q

What is the left kidney related to?

A
  • stomach
  • spleen
  • pancreas
  • jejunum
  • descending colon
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22
Q

What descends diagonally across the posterior surfaces of the kidneys?

A
  • subcostal nerve and vessels
  • iliohypogastric nerves
  • ilioinguinal nerves
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23
Q

Where is the diaphragm found in relation to the kidneys?

A

superiorly

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24
Q

What is found on the anterior surface of the right kidney?

A
  • liver
  • duodenum
  • ascending colon
  • hepatorenal recess
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25
Q

What is found on the anterior surface of the left kidney?

A
  • stomach
  • spleen
  • pancreas
  • jejunum
  • descending colon
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26
Q

At the concave medial margin of each kidney is a vertical cleft, the (1)

A
  1. renal hilum
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27
Q

The renal hilum is the entrance to the space within the kidney, the (1), which is occupied by fat in which the renal pelvis, calices, vessels, and nerves are embedded

A
  1. renal sinus
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28
Q

What is found in the renal hilum, anterior to posterior?

A
  • renal vein
  • renal artery
  • renal pelvis
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29
Q

What provides some, but not much protection to the kidneys (less protection on the right side since the liver pushes the right liver down)?

A

ribs 11 and 12 (floating ribs)

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30
Q

What are the different parts of the kidneys?

A
  • renal cortex
  • renal medulla
    ** renal column
    ** renal pyramid
  • papilla
  • minor calyx
  • major calyx
  • renal pelvis
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31
Q

What does the renal pelvis drain into?

A

ureters

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32
Q

What parts of the kidney are important in the adrenal gland?

A

renal cortex and medulla

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33
Q

What contains lots of nephrons and glomeruli?

A

renal column

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34
Q

What is a major reason for anemia?

A

chronic kidney disease

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35
Q

The renal arteries arise at the level of the IV disc between which vertebrae?

A

L1 and L2

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36
Q

What does the right renal artery pass posterior to?

A

the IVC

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37
Q

Which renal artery is longer?

A

the right

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38
Q

Typically, each renal artery divides close to the hilum into (1) that are end arteries that do not anastomose?

A
  1. 5 segmental arteries
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39
Q

What do the renal veins lie anterior to?

A

renal arteries

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40
Q

What does the left renal vein pass anterior to?

A

aorta

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41
Q

Which renal vein is longer?

A

left renal vein

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42
Q

Each renal vein drains into what?

A

the IVC

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43
Q

What are the names of the 5 segmental aa branching off the renal arteries?

A
  • superior
  • anterosuperior
  • anteroinferior
  • inferior
  • posterior
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44
Q

25% of the population have what?

A

accessory (extrahilar) aa

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45
Q

What is the left renal vein found between?

A

SMA and aorta

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46
Q

What are tributaries of the left renal vein?

A
  • inferior phrenic v
  • suprarenal v
  • gonadal v
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47
Q

What does the left gonadal v drain into?

A

left renal vein

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48
Q

What does the right gonadal v drain into?

A

the IVC

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49
Q

What are muscular ducts with narrow lumina that carry urine from the kidneys to the urinary bladder?

A

ureters

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50
Q

What is the superior end of the ureter, or renal pelvic, formed through?

A

merging of two or three major calices (each of which was formed by the merging of 2 or 3 minor calices)

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51
Q

Each minor calyx is indented by the apex of the (1) - the (2)

A
  1. renal pyramid
  2. renal papilla
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52
Q

The ureters run inferomedially anterior to the psoas major and tips of the transverse processes of the lumbar vertebrae and cross the (1) just beyond the bifurcation of the (2)

A
  1. external iliac artery
  2. common iliac artery
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53
Q

The ureters are normally constricted to a variable degree in what three places?

A
  1. the junction of ureters and renal pelvis (renal uteropelvic junction)
  2. where ureters cross the brim of the pelvic inlet (“pelvic inlet” brim)
  3. during their passage through the wall of the urinary bladder
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54
Q

What are the constricted areas of the ureters potential sites of?

A

obstruction by ureteric (kidney) stones

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55
Q

Parts of the ureter that are more narrow, what will be more likely?

A

more constriction

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56
Q

What is the arterial supply of the ureters?

A
  • renal artery
  • gonadal arteries
  • abdominal aorta (common iliac a)
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57
Q

What is the venous drainage of the ureters?

A
  • renal veins
  • gonadal vv
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58
Q

What are located between the superomedial aspects of the kidneys and diaphragmatic crura?

A

adrenal glands

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59
Q

What separates the adrenal glands from the kidneys?

A

fibrous tissue

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60
Q

What attaches the adrenal glands to the crura of the diaphragm?

A

renal fascia

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61
Q

What is the shape of the right adrenal gland?

A

pyramid-shaped

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62
Q

What is the shape of the left adrenal gland?

A

crescent-shaped

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63
Q

What does the right adrenal gland lie anterior to?

A

the diaphragm

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64
Q

What does the right adrenal gland make contact with?

A
  • IVC (anteromedially)
  • liver (anterolaterally)
65
Q

What is the left adrenal gland related to?

A
  • spleen
  • stomach
  • pancreas
  • left crus of the diaphragm
66
Q

What are the two parts of each adrenal gland?

A
  • suprarenal cortex
  • suprarenal medulla
67
Q

What part of the adrenal gland secretes corticosteroids and androgens?

A

suprarenal cortex

68
Q

What part of the adrenal gland secretes epinephrine and norepinephrine?

A

suprarenal medulla

69
Q

What is the sympathetic response mediated by?

A

adrenal medulla

70
Q

What are the arteries that supply the adrenal gland?

A
  • superior suprarenal a (inferior phrenic a ~ 6-8)
  • middle suprarenal a (abdominal aorta 1≥ SMA)
  • inferior suprarenal a (renal a 1≥)
71
Q

What is the venous drainage of the right adrenal gland?

72
Q

What is the venous drainage of the left adrenal gland?

A

left renal vein (joined by inferior phrenic v)

73
Q

What type of fibers synapse directly in the suprarenal gland?

A

pre-synaptic sympathetic fibers

74
Q

What is the sympathetic innervation of the kidneys?

A

aorticorenal ganglion
- lesser splanchnic (T10-T11)
- least splanchnic (T12)

75
Q

What is the innervation of the ureters?

A

plexuses
- renal
- abdominal aorta
- superior hypogastric

76
Q

What supplies pain to the ureters?

A

GVA fibers (T11-L2)

77
Q

What is the parasympathetic innervation of the kidneys and ureters?

A

vagus nerve
ureters also receive parasympathetic innervation from the pelvic splanchnics

78
Q

What is the innervation of the adrenal glands?

A

abdominopelvic splanchnic
- lesser (T10-T11): aorticorenal
- least (T12): renal plexus

79
Q

Are there parasympathetic fibers running to the adrenal medulla?

A

No, only sympathetic

80
Q

What is the abdominal wall composed of from deep/posterior to superficial/anterior?

A
  1. 5 lumbar vertebrae associated with IV discs
  2. posterior abdominal wall muscles
  3. lumbar plexus, composed of the anterior rami of lumbar spinal nerves
  4. fascia (including thoracolumbar fascia)
  5. diaphragm (contributing to superior part of the posterior wall)
  6. fat, nerves, vessels, and lymph nodes
81
Q

What are the posterior abdominal wall muscles?

A
  • psoas
  • quadratus lumborum
  • iliacus
82
Q

The posterior abdominal wall is covered with a (1) layer of endo-abdominal fascia, which lies between the parietal peritoneum and the muscles

A

continuous

83
Q

What is the fascia lining the posterior abdominal wall continuous with?

A

the transversalis fascia that lines the transversus abdominis muscle

84
Q

What is thickened superiorly to form the medial arcuate ligament and fuses laterally with the quadratus lumborum and thoracolumbar fascia?

A

the psoas fascia

85
Q

Inferior to the iliac crest, the (1) is continuous with the part of the iliac fascia covering the iliacus muscle

A
  1. psoas fascia
86
Q

What is the anterior layer of the thoracolumbar fascia?

A

quadratus lumborum fascia

87
Q

What covers the quadratus lumborum muscle?

A

quadratus lumborum fascia (anterior layer of thoracolumbar fascia)

88
Q

What does the anterior layer of the thoracolumbar fascia attach to?

A
  • anterior surface of transverse processes of lumbar vertebrae
  • iliac crest
  • the 12th rib
89
Q

What is the anterior layer of the thoracolumbar fascia continuous laterally with?

A

the aponeurotic origin of the transversus abdominis muscle

90
Q

What is thickened superiorly to form the lateral arcuate ligaments and is adherent inferiorly to the iliolumbar ligaments?

A

the anterior layer of the thoracolumbar fascia

91
Q

What are the main pared muscles in the posterior abdominal wall?

A
  • psoas major
  • iliacus
  • quadratus lumborum
92
Q

What lies along the lateral sides of the inferior part of the psoas major?

93
Q

What lies adjacent to the transverse processes of the lumbar vertebrae and lateral to the superior parts of the psoas major?

A

quadratus lumborum

94
Q

What do the iliacus and psoas form?

95
Q

What has a long flat tendon passing down the anterior surface of the psoas major muscle?

A

psoas minor muscle

96
Q

What is absent entirely in some individuals and may be present on only one side of the body in others?

A

psoas minor muscle

97
Q

What originates on the lateral surface of T12 and L1?

A

psoas minor muscle

98
Q

What inserts onto the iliopubic eminence and arcuate line of the ilium?

A

psaos minor

99
Q

What is the action of the psoas minor muscle?

A

tilts pelvis posteriorly

100
Q

What innervates the psoas minor?

101
Q

What originates on transverse processes of L1-L5, bodies of T12-L5 and IV discs below bodies of T12-L4

A

psoas major

102
Q

What inserts on the lesser trochanter of the femur

A

psoas major

103
Q

What innervates the psoas major?

104
Q

What are the actions of the psoas major?

A

flexion
- thigh with iliacus
- vertebral column and lateral bending
- trunk with iliacus sitting

105
Q

What muscle in only present in about 60% of the population?

A

psoas minor

106
Q

What originates on the iliac fossa within the abdomen?

107
Q

What inserts on the lowermost surface of the lesser trochanter of the femur?

108
Q

What is the action of the iliacus?

A
  • flexes thigh at the hip
  • helps maintain erect position
  • hip joint stabilizer
109
Q

What innervates the iliacus?

A

femoral nerve (L2-L4)

110
Q

What muscles are the chief thigh flexors?

A

iliopsoas muscles (iliacus + psoas)

111
Q

What originates on the 12th rib and tips of lumbar transverse processes?

A

quadratus lumborum

112
Q

What inserts onto the lip of the iliac crest?

A

quadratus lumborum

113
Q

What are the actions of the quadratus lumborum?

A
  • extends and laterally flexes vertebral column
  • fixes 12th rib during inspiration
114
Q

What innervates the quadratus lumborum?

A

T12 and lumbar plexus (L1-L4)

115
Q

What is a dome-shaped, musculotendinous partition separating the thoracic and abdominal cavities?

116
Q

What is the chief muscle of inspiration?

A

the diaphragm

117
Q

What forms the convex floor of the thoracic cavity and the concave roof of the abdominal cavity?

118
Q

What part of the diaphragm is the only part that moves during inspiration?

A

only its central parts

119
Q

What does the periphery of the diaphragm (fixed origin of the muscle) attach to?

A

the inferior margin of the thoracic cage and superior lumbar vertebrae

120
Q

Which dome of the diaphragm is higher due to the liver?

121
Q

What is the muscular part of the diaphragm that is situated with fibers that converse radially on the trifoliate central aponeurotic part?

A

central tendon

122
Q

What has no bony attachments and is incompletely divided into 3 leaves?

A

central tendon of the diaphragm

123
Q

What is the superior aspect of the central tendon fused with?

A

the inferior surface of the fibrous pericardium

124
Q

The central tendon of the diaphragm is closer to what?

A

anterior part of the thorax

125
Q

What are the domes of the diaphragm formed by?

A
  • the liver (right) with some contribution from the right kidney and adrenal gland
  • fundus of the stomach and spleen (left) with some contribution from the left kidney and adrenal gland
126
Q

What is the aponeurotic portion of the diaphragm?

A

where central tendon fuses with fibrous pericardium

127
Q

What are the three parts of the diaphragm?

A
  • sternal part
  • costal part
  • lumbar part
128
Q

What does the sternal part of the diaphragm attach to?

A

posterior aspect of xiphoid process

129
Q

What do the costal parts of the diaphragm attach to?

A

internal surfaces of the inferior six costal cartilages and adjoining ribs

130
Q

What does the lumbar part of the diaphragm arise from?

A
  • medial and lateral arcuate ligaments (aponeurotic arches)
  • three superior lumbar vertebrae (L1-L3)
131
Q

What part of the diaphragm forms the domes?

A

costal part

132
Q

What part of the diaphragm forms the right and left muscular crura that ascend to the central tendon?

A

lumbar part

133
Q

What are musculotendinous bundles that arise from the anterior surfaces of the bodies of the superior three lumbar vertebrae, anterior longitudinal ligament, and IV discs?

A

crura of the diaphragm

134
Q

What crura is the larger and longer crus that arises from the first 3 or 4 lumbar vertebrae?

A

right crus

135
Q

What crura arises from the first 2 or 3 lumbar vertebrae?

136
Q

What are the right and left crura united by?

A

the median arcuate ligament

137
Q

What crura passes over the anterior surface of the aorta?

A

median arcuate ligament

138
Q

What attaches on each side of the diaphragm; they are thickenings of the fascia covering the psoas and quadratus lumborum muscles?

A

medial and lateral arcuate ligaments

139
Q

What permits structures to pass between the thorax and the abdomen?

A

diaphragmatic apertures

140
Q

What are the names for the 3 large apertures going into the diaphragm for the IVC, esophagus, and aorta?

A
  • caval opening
  • esophageal hiatus
  • aortic hiatus
141
Q

What level is the caval opening?

142
Q

What level is the esophageal hiatus?

143
Q

What level is the aortic hiatus?

144
Q

What passes through the caval opening?

A
  • IVC
  • terminal branches of right phrenic n and lymph
145
Q

What diaphragmatic aperture widens at inspiration?

A

caval opening

146
Q

What passes through the esophageal hiatus?

A
  • esophagus
  • vagal trunks
  • left gastric vessels and lymphatics
147
Q

What passes through the aortic hiatus?

A
  • aorta
  • thoracic duct
  • azygos vein
148
Q

What nerve could be injured at T10?

A

vagus nerve

149
Q

What innervates the diaphram, what fibers does it provide, and what do those fibers do?

A
  • phrenic nerve
    ** GSE: motor innervation
    ** GSA: pain and proprioception
150
Q

What blood vessels supply the superior surface of the diaphragm?

A

internal thoracic a
- pericardicophrenic vessels
- musculophrenic vessels
thoracic aorta
- superior phrenic artery

151
Q

What blood vessels supply the inferior surface of the diaphragm?

A

right inferior phrenic vessels
- aorta (celiac a) and IVC
left inferior phrenic vessels
- IVC and L adrenal v

152
Q

What are the unpaired abdominal arteries and their associated levels?

A
  • celiac a (T12)
  • SMA (L1)
  • IMA (L3)
153
Q

What are the paired visceral abdominal arteries and their associated levels?

A
  • suprarenal (L1)
  • renal a (L1)
  • gonadal a (L2)
154
Q

What are the paired parietal abdominal arteries and their associated levels?

A
  • subcostal (L2)
  • inferior phrenic (T12)
  • lumbar (L1-L4)
  • median sacral
155
Q

What is the main vein of the posterior abdominal wall?

A

IVC (L3-L5)-T8

156
Q

What collects poorly oxygenated blood from the lower limbs (non-portal blood)?

157
Q

All tributaries of the IVC drain directly into it except what?

A
  • left gonadal vein
  • left suprarenal vein
158
Q

What do the left gonadal and left suprarenal vein drain into?

A

left renal vein and then into the IVC

Anatomy (25 decks)

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