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GI ANAT > POSTERIOR ABDOMINAL WALL > Flashcards

POSTERIOR ABDOMINAL WALL Flashcards

1
Q

What is the posterior abdominal wall composed of?

A

5 lumbar vertebrae (L1 - L5) and their associated IV Disks

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2
Q

What are the 3 main muscles in the posterior abdominal wall?

A

ILIACUS
PSOAS MAJOR
QUADRATES LUMBORUM

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3
Q

What are the special features of the LUMBAR VERTEBREA?

What do the lower couple ribs do?

A

BIG BODY
LONG/SLENDER TRANSVERCE PROCESSES
short/thick spinous process (hatched-shaped)

NO DEMIFACETS OR TRANSVERSE COSTAL FACTS

LOWER COUPLE RIBS PROVIDE PROTECTION TO THE KIDNEYS

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4
Q

What is the strongest hip flexure in the body?

What forms this structure (2 other muscles)

A

ILIOPSOAS

Illiacus muscle
PSOAS MAJOR

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5
Q

What is the function of the PSOAS MAJOR?

What innervates the PSOAS MAJOR?

A

ACTS INFERIORLY W/ ILIACUS to flex thigh
ACTS INFERIORLY W/ ILIACUS TO FLEX TRUNK (when sitting)
Acts superiorly to flex vertebral column laterally

VENTRAL RAMI OF L1-L4

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6
Q

What innervates the ILIACUS MUSCLE?

What is the ILLIACUS MUSCLE FUNCTION?

A

FEMORAL NERVE L2-L4

FLEXES THIGH
STABALIZES HIP JOINT
(ACTS W/ the inferior portion of the PSOAS MAJOR)

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7
Q

What innervates the QUADRATUS LUMBORUM?

What is the function of QUADRATUS LUMBORUM?

A

Ventral rami of T12-L4

EXTENDS VERTEBRAL COLUMN
LATERALLY FLEXES VERTEBRAL COLUMN
fixes 12th rib during inspiration

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8
Q

What 4 types of vessels does the ABDOMINAL AORTA give off? (these are 4 categories of vessels)

A

UNPAIRED VISCERAL BRANCHES
PAIRED VISCERAL BRANCHES

UNPAIRED PARIETAL BRANCHES
PAIRED PARIETAL BRANCHES

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9
Q

What branches off of the unpaired visceral branches?

A

Celiac trunk (T12)
SUPERIOR MESENTERIC Artery (L1)
INFERIOR MESENTERIC Artery (L3)

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10
Q

What branches off of the paired visceral branches?

A

MIDDLE SUPRARENAL Artery (L1)
RENAL Artery (L1)
GONADAL Artery (L2)

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11
Q

What branches off of the unpaired parietal branch ?

A

Median Sacral Artery (L4)

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12
Q

What are the branches off of the paired parietal branch?

A

INFERIOR PHRENIC Artery (T12)
LUMBAR ARTERIES (4 pairs)

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13
Q

What does the abdominal aorta bifurcate into?

What level does the abdominal aorta bifurcate at?

A

LEFT COMMON ILIAC Artery
RIGHT COMMON ILIAC ARTERY

L4

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14
Q

The localized enlargement of the aorta inferior to the level of the renal arteries is called? (BELOW L1)

(Normally this is fine.. unless it has ruptured.. 90% mortality rate)

A

Abdominal Aortic Aneurysm (AAA)

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15
Q

What size diameter of the abdominal aorta is surgery recommended?

A

5 cm

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16
Q

If the abdominal aorta diameter/width is 5cm or bigger, what procedure is it called?

Explain the procedure?

A

ENDOVASCULAR ANEURYSM REPAIR

You place an expandable stent graft SO THAT BLOOD CAN BE SHUNTED TOWARDS the left and right common iliac.

DON’T ACTUALLY OPERATE ON THE AORTA ITSELF

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17
Q

What forms the IVC?
What vertebral level does it form at?

A

LEFT AND RIGHT COMMON ILIAC VEINS
L5

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18
Q

What sends blood to the IVC (VEINS)?

A

LEFT AND RIGHT COMMON ILIAC VEINS
3 HEPATIC VEINS (LEFT, RIGHT, MIDDLE)
LEFT AND RIGHT INFERIOR PHRENIC VEINS
LEFT AND RIGHT RENAL VEINS
3rd and 4th LUMBAR VEINS
RIGHT GONADAL VEIN
RIGHT SUPRARENAL VEIN

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19
Q

Where does the Left suprarenal vein and Left gonadal vein dump blood to?

A

Left Renal Vein –> IVC

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20
Q

What spinal nerves form the lumbar plexus?

A

Ventral rami of L1-L4 Spinal Nerves

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21
Q

What are 6 major branches of the lumbar plexus?

(REMEMBER.. first nerve you will see will be SUBCOSTAL NERVE) for orientation purposes

A

ILLIOHYPOGASTRIC NERVE (L1)
ILLIOINGUINAL NERVE (L1)
LATERAL FEMORAL CUTANOUES NERVE (L2-L3) - sits on top of iliacus muscle
FEMORAL NERVE (L2-L4)
GENITOFEMORAL NERVE (L1-L2) - sits on top of the psoas major muscle)
OBTURATOR NERVE (L2 - L4) - medial side of psoas muscle

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22
Q

What sits on top of the kidneys?

A

SUPRARENAL GLAND (ADRENAL GLAND)

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23
Q

Are the kidneys retro or intraperitoneal?

A

RETROPERITONEAL

24
Q

Where is urine produced?
What structure does the urine go through to get to the bladder?

A

Produced in the kidneys and goes to the bladder via the URETERS.

25
Q

What level does the left kidney lie?
What level does the right kidney lie?

A

LEFT KIDNEY –> T12-L3
RIGHT KIDNEY –> L1-L4

26
Q

Describe the urinary pathway?

A

Urine released into the RENAL PAPILLA –> MINOR CALYX –> MAJOR CALYX –> RENAL PELVIS –> URETUR

27
Q

What supplies blood to the kidneys?

A

RENAL ARTERIES

28
Q

What syndrome is associated when the SMA compresses the LEFT RENAL VEIN?

A

NUTCRACKER SYNDROME

29
Q

What does the renal arteries divide into? (Hint: 5 of them)

These are “end” arteries because they do not form an anastomosis.

A

5 SEGMENTAL ARTERIES

SUPERIOR (APICAL) ARTERY
ANTEROSUPERIOR ARTERY
ANTERINFERIOR ARTERY
INFERIOR ARTERY
POSTERIOR ARTERY

30
Q

What are the KIDNEY FASCIAL LAYERS?
(outermost –> innermost)

A

PARANEPHRIC FAT –> RENAL FASCIA –> PERINEPHRIC FAT

31
Q

Is the ureter retro or intraperitoneal?

A

RETROPERITONEAL

32
Q

What supplies the ureter with blood?

A

RENAL ARTERIES
GONADAL ARTERIES
SUPERIOR VESICAL ARTERIES

33
Q

What are the 3 URETER CONSTRICTIONS?

A

URETEROPELVIC JUNCTION (where it starts)
As the ureter cross the pelvic brim and/or
crosses the external iliac (lower)
As ureter traverses the bladder wall (lower)

34
Q

What are the 2 structures of the suprarenal gland (adrenal gland)?

A

SUPRARENAL CORTEX (ADRENAL CORTEX)

SUPRARENAL MEDULA (ADRENAL MEDULLA)

35
Q

What does the ADRENAL CORTEX (SUPRARENAL CORTEX) SECRETE?

A

Corticosteroids and Androgens

36
Q

What does the ADRENAL MEDULA (SUPRARENAL MEDULA) secrete?

A

Contain chromaffin cells which secrete catecholamines (mostly epi 80%)

37
Q

What is CUSHING SYNDROME?
What are some of the symptoms?

A

TOO MUCH CORTISOL (HYPOcortosolism)

MOON FACE (ROUND FACE)
BUFFALO HUMP
Purple striae (REDDISH too)
High blood pressure
Rapid weight gain (PHAT BODY and SKINNY legs)

38
Q

What is ADDISON SYNDROME (PRIMARY ADRENAL INSUFFICIENCY)?
What are some of the symptoms?

What is the treatment?

A

DESTRUCTION of suprarenal cortex (adrenal cortex) –> LOW CORTISOL (HYPOcortisolism)

chronic diarrhea
mouth lesions
dizziness when standing up
salt cravings
Hyperpigmentation of skin

Corticosteroid shots
hydrocortisone

39
Q

What is CONN SYNDROME?
What are they symptoms?

What is the treatment?

A

Small tumor that produce HELLA aldosterone. Usually it has to do with a pituitary adenoma that produces ACTH causing adrenal cortex (zone glomerulosa) to produce lot of aldosterone.

hypernatremia and hypokalemia –> HIGH BP (hypertension)

LAPROSCOPIC ADRENALECTOMY (remove adrenal gland + tumor)

40
Q

Carcinomas of the CHROMAFFIN CELLS WITHIN THE SUPRERENAL MEDULLA (ADRENAL MEDULLA) are called?

A

PHAEOCHROMOCYTOMA

41
Q

What are Phaeochromocytomas?

What can phaeochromocytomas cause/

A

Tumor of the chromaffin cells within the adrenal medula –> cause episodic release of catecholamines

Can cause hyperglycemia and hypertension

42
Q

What is the treatment of phaechromocytomas?

A

ADRENERGIC ALPHA-BLOCKADES (give before surgery)

43
Q

What supplies blood to the SUPRARENAL GLAND (ADRENAL GLAND)?

A

SUPERIOR SUPRARENAL artery (comes of inferior phrenic artery)
MIDDLE SUPRARENAL artery (comes of aorta)
INFERIOR SUPRARENAL artery (comes of renal artery)

44
Q

Where does lymph from the SUPRARENAL glands (Adrenal glands), kidney, ureter drain into?

A

LUMBAR LYMPH NODES

45
Q

What 2 cavities the diaphragm separate?

A

THORACIC CAVITY and ABDOMINAL CAVITY

46
Q

What is the main function of the diaphragm?

A

CHIEF MUSCLE OF INSPIRATION

47
Q

What nerves innervates the diaphragm?

A

PHRENIC NERVES

48
Q

What are the 3 parts of the diaphragm?
Central tendon is in the middle.

A

STERNAL PART
COSTAL PART
LUMBAR PART

49
Q

What are the musculotendinous bundles that arise in the diaphragm?
Where verterbral levels can they reach down to?

A

Right and Left crus (crura)

Right crus can run down to L3.
Left crus can run down to L2

50
Q

What are the fibrous ligaments (5) that help anchor the diaphragm to the posterior abdominal wall?

A

Median arcuate ligament (made up mostly of right crus)
2 Medial arcuate ligaments (made up of mostly psoas muscle fascia)
2 Lateral arcuate ligaments (made up of mostly quadratus lumborum fascia)

51
Q

What is the only part of the diaphragm that moves?

During inspiration, what happens to the diaphragm?

A

Central Tendon

Inspiration –> diaphragm DESCENDS
Expiration –> diaphragm ASCENDS

52
Q

What are the 3 DIAPHRAGMATIC APERTURES?

A

CAVAL OPENING (IVC passes through) (T8 - at the central tendon specifically)

ESOPHAGEAL HIATUS (esophagus passes through at T10) (right crus form this)

AORTIC HIATUS (T12) (Aorta doesn’t technically pierce the diaphragm)

53
Q

What nerves innervates the diaphragm? (takes care of somato-motor innervation)

A

PHRENIC NERVE (ventral rami of C3-C5)

54
Q

What takes care of somatosensory innervation of the diaphragm?

A

PHRENIC and INTERCOSTAL NERVES

55
Q

What arteries supply blood to the SUPERIOR PORTION of the diaphragm?

A

SUPERIOR PHRENIC ARTERY
PERICARDIOCOPHRENIC ARTERY
MUSCULOPHRENIC ARTERY

56
Q

What supplies blood to the INFERIOR PORTION of the diaphragm?
This is the primary blood supply to the diaphragm.

A

INFERIOR PHRENIC ARTERIES

GI ANAT (7 decks)

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