Posterior Abdominal Region

Question 1

Kidney position

Answer 1

T12 to L3, right slightly lower than left

Question 2

Renal artery origin level

Answer 2

Between L1 to L2 beneath superior mesenteric artery branch from abdominal aorta

Question 3

Ureter pathway

Answer 3

Descend retroperitoneally on medial aspect of psoas major muscle.
At pelvic brim crosses the end of common iliac artery/beginning of external iliac artery and enters the pelvic cavity

Question 4

Ureter points of constriction

Answer 4

Ureteropelvic junction
Pelvic brim where it crosses common iliac vessels
Entrance to bladder

Question 5

Arterial supply to suprarenal gland

Answer 5

superior suprarenal arteries - from inferior phrenic arteries
Middle suprarenal artery - abdominal aorta
Inferior suprarenal artery - renal arteries

Question 6

Abdominal aorta pathway

Answer 6

originate from T12 to L4 when it bifurcates

Question 7

Visceral branches of abdo aorta

Answer 7

Coeliac trunk (anterior)
SMA (anterior)
IMA (anterior)
Paired - suprarenal (lateral), renal (lateral), gonadal (anterior)

Question 8

Posterior branches of abdo aorta

Answer 8

Inferior phrenic arteries (lateral)
Lumbar arteries (posterior)
Median sacral artery (posterior)

Question 9

Anterior surface of IVC crossed by

Answer 9

Right common iliac artery
Right gonadal artery
Inferior and superior part of duodenum
Head of pancreas
Bile duct
portal vein
Liver

Question 10

Tributaries to IVC

Answer 10

Common iliac veins
Lumbar veins
Right gonadal vein
Renal veins
Right suprarenal vein
Inferior phrenic veins
Hepatic veins
No tributaries from abdo part of GI tract, spleen, pancreas or gallbladder as these drain into portal venous system

Question 11

Para-aortic nodes

Answer 11

Body wall, kidneys, suprarenal glands and testes/ovaries.

Drain structures on either side of aora.

Question 12

Pre-aortic nodes

Answer 12

Arranged according to 3 branches of abdominal aorta, divided into coeliac, superior mesenteric and inferior mesenteric nodes
Drains midline structure eg liver, bowel pancreas

Question 13

Cisterna chyli

Answer 13

Posterior to right side of abdominal aorta and anterior to bodies of L1 and L2, marks beginning of thoracic duct

Question 14

Lumbar plexus

Answer 14

Anterior rami of L1 to L3 and most of anterior ramus of L4. Also receives contribution from T12 (subcostal) nerve.

Question 15

Branches of lumbar plexus

Answer 15

Iliohypogastric L1
Ilioinguinal L1
Genitofemoral L1, L2
Lateral cutaneous nerve of thigh L2, L3
Obturator L2-L4
Femoral L2-L4

Question 16

Relative to psoas major, lumbar plexus branches are

Answer 16

anterior - genitofemoral
Medial - obturator
Lateral - iliohypogastric, ilioinguinal, femoral nerves, lateral cutaneous nerve of thigh