Posterior Abdominal Wall Flashcards
The kidneys are primarily…
retroperitoneal
What are the 3 layers that surround the kidneys, from superficial to deep?
paranephric fat
renal fascia
perinephric fat
What does the renal fascia do?
It helps to prevent the spread of infection locally but acts a channel for the spread of infection into the pelvis
Where are the kidneys located?
at the T12-L3 vertebral levels, right kidney lies slightly more inferior than left kidney
Where is the renal hilum located? What does it contain?
located on the medial border of the kidney
contains: renal vein, renal artery, renal pelvis (anterior to posterior)
What is the renal capsule?
the very thin outer layer of the kidney
What is deep to the renal capsule?
The renal cortex
What is included in the renal medulla?
renal pyramids and renal columns
Trace the pathway of urine
renal papillae (apex of renal pyramid) >
minor calyx >
major calyx >
renal pelvis >
ureter
What are the 2 types of anomalous kidneys?
pelvic kidney- failure to ascend during development
horseshoe kidney- right and left kidneys unite at inferior poles, ascent stopped by IMA
Describe the ureters
primarily retroperitoneal
fibromuscular tubes extending from renal pelvis to bladder
transport urine via peristaltic contractions
Describe the adrenal (suprarenal) glands
primarily retroperitoneal
located on the superomedial aspect of the kidney
enclosed by renal fascia
located in right or left UQ
Where does lymph drain from the kidneys and adrenal glands?
to the lumbar lymph nodes >
chyle cistern >
thoracic duct
Trace the pathway of parasympathetic innervation of the kidneys
Preganglionic cell bodies in the brain >
preganglionic cell fibers: vagus nerve >
postganglionic cell bodies and fibers: wall of the kidney
Trace the pathway of sympathetic innervation of the kidneys
preganglionic cell bodies: lateral horn of the thoracolumbar spinal cord >
Postganglionic cell fibers:
- ventral root >
- spinal nerve>
- ventral ramus >
- white ramus communicans >
- sympathetic trunk >
- thoracic splanchnic nerves >
synapse at renal ganglion >
follow arterial branches to target organ
visceral pain from kidneys/ureter
follow sympathetic pathway back to spinal cord but enters the dorsal root, refers to back, flank, groin and genitals
Trace the pathway for sympathetic innervation to the adrenals
lateral horn >
ventral root>
spinal cord>
ventral rami >
white ramus communicans >
sympathetic trunk >
thoracic splanchnic nerves >
secretory cells of renal medulla
Where is the abdominal aorta
T12 (aortic hiatus)
L4 (bifurcation into common iliac arteries
What are the unpaired branches of the abdominal aorta which supply to abdominal organs?
celiac trunk
SMA
IMA
What are the paired branches of the abdominal aorta which supply primarily retroperitoneal organs, gonads and body wall?
inferior phrenic arteries, middle suprarenal arteries, renal arteries (gives off inferior suprarenal arteries) , gonadal arteries, subcostal arteries, lumbar arteries
abdominal aortic aneurysm
can rupture, high mortality rate (90%) if not diagnosed
Where is the IVC located in the abdomen
T8 (caval opening) - L5 bifurcation into common iliac veins
located to the right of midline
Tributaries of the IVC parallel the paired branches of the aorta except…
the left gonadal vein drains to the left renal vein
the hepatic veins have no arterial complement
What are the muscles of the posterior abdominal wall?
iliopsoas (psoas major and iliacus)
quadratus lumborum
