posterior abdominal wall Flashcards
what is the O and I of psoas minor?
ranges from T12-L1 vertebrae to the superior pubic ramus
what is the O and I of psoas major
ranges from T12-L5 vertebrae to lesser trochanter of iliopsoas
what is the O and I of iliacus?
Iliac fossa to lesser trochanter as iliopsoas
what muscles fuse together to form iliopsoas?
iliacus and psoas major
what is the O and I of quadratus lumborum?
Rib 12 and transverse process of the lumbar vertebrae to the iliac crest
what movement can be accomplished by quadratus lumborum?
Lateral flexion of the spine
the kidneys sit on top of which muscle
quadratus lumborum
what is the muscle that forms the lateral wall of the posterior abdominal wall?
transversus abdominis
what closes the superior border of the posterior abdominal wall?
diaphragm
which diaphragmatic extension is longer, right crus or left?
right crus
what hiatus is formed by the crossing of the right crus?
the esophageal hiatus
what level is the esophageal hiatus found?
T10
is the esophageal sphincter a functional or anatomical sphincter?
functional
what does the lateral arcuate ligament anchor to?
diaphragm at the superior border of quadratus lumbordum muscle
what does the medial arcuate ligament anchor to?
diaphragm at superior border of psoas major muscle
what does the median ligament join?
Connect the right and left crura
what forms the aortic hiatus? at what level?
the median arcuate ligament forms the aortic hiatus at T12
what nerve gives motor innervation to the abdominal wall and sensory to the skin of the anterolateral abdominal wall?
subcostal N
where does the subcostal N range from? where is it located?
from T12 and is located near the lateral arcuate ligament
what nerve gives motor innervation to the IO, TA and sensory to the skin of the lateral gluteal region and distal abdomen?
iliohypogastric N
where does the iliohypogastric N range from
T12-L1
where does the ilioinguinal range from? where does it travel?
from L1
Peaks out of quadratus lumborum, under psoas major
what type of innervation is provided by the ilioinguinal N?
Sensory to region of Pubis and scrotum/labia
where does the genitofemoral N range from?
L1-L2
What does the gentiofemoral N give innervation to?
Motor to cremaster muscle
Sensory to skin of the proximal thigh, scrotum/labia
how does the gentiofemoral N travel?
Pierces through psoas major and splits into 2 branches
what gives sensory innervation to the lateral thigh?
lateral femoral cutaneous N
where does the lateral femoral cutaneous N range from?
L2-L3
where does the femoral N range from?
L2-L4
what is innervated by the femoral N?
Motor to the anterior compartment of the thigh
Sensory to the anterior thigh and medial leg
where can the femoral N be located?
superficial to iliacus
where does obturator N range from?
L2-L4
What is innervated by obturator N?
Motor to medial compartment of the thigh
Sensory to skin of the medial thigh
at what level does the inferior phrenic A peak from the aorta?
T12
at what level does the Celiac trunk peak from the aorta?
T12
at what level does the SMA peak from the aorta?
L1
at what level does the Suprarenal A peak from the aorta?
L1
at what level does the renal A peak from the aorta?
L1-L2
at what level does the IMA peak from the aorta?
L3
how many pairs of lumbar aa do we have?
4 pairs
what type of organ are the kidneys
retroperitoneal
what is the function of the kidneys
Production of urine by filtering blood
where are the kidneys found in the body
- Located on either side of the spine
* T12-L3/L4 from a posterior view
what kidney lies lower?
the right kidney
how are kidneys shaped? why?
o Indented medially at hilum where structures such as renal A, V & ureter enter and exit the kidney
give the kidney a bean shape
what surrounds the kidney? in what order from outside to inside?
Renal capsule (fibrous) > perirenal fat > perirenal fascia (Gerota’s) > pararenal fat > parietal periotneum
what is contained in the medulla of the kidneys?
renal pyramids
what is produced by the renal pyramids?
majority of the urine
what is contained in the apex of the renal pyramids?
renal papilla
what is the function of the renal papilla?
Drains urine into minor calyx
what happens as the minor calyces merge?
formation or major calyx
what is formed by the aggregation of multiple major calyx
the renal pelvis
what does the renal pelvis narrow into?
the ureter
where do renal A. arise form?
aorta at L1/L2
which renal A is longer?
Right renal A is longer than the left renal A
where does the right renal A travel?
deep to IVC which is located to the right
what do the renal veins drain into?
into the IVC
which renal vein is longer?
the left renal vein is longer than the right
where does the left renal vein travel?
Passes anterior to abdominal aorta and inferior to SMA
what does the left renal vein drain into? what type of drainage is that?
drains into the left adrenal gland and left gonad
indirect drainage
in the hilum of the kidneys what sits anterior to the other vein or artery?
veins are anterior to artery
what is the ureter?
retroperitoneal tube
what is the function of the ureter?
Conveys urine from kidney to urinary bladder
how does the ureter travel in the posterior abdominal wall?
Descends through the abdomen anterior to psoas muscle
what does the ureter cross underneath? what does it enter?
crossed underneath of the gonadal vein and A.
will enter the pelvis between the common iliac bifurcation
what is horseshoe kidney?
o Congenital abnormality
Inferior pulls of the kidneys during fetal development causes them to get pulled together
what population is more prone to horseshoe kidney?
men
where will the horseshoe kidney be located?
sits much lower than regular kidneys due to presence of IMA which will prevent its ascent
how is the vasulature in donor kidneys re-anastamosed?
re-anastamosed to the iliac vessels, ureter is attached to the bladder
what happens to the degenerating kidney during kidney transplant?
it is not removed as this would lead to a much more invasive surgery
where are the adrenal glands located?
above the kidneys
what type of organ is the adrenal gland?
• Retroperitoneal endocrine organ
what is the adrenal gland surrounded by?
renal fascia
how are the adrenal glands structured?
capsule
cortex
medulla
what supplies arteriole blood to the adrenal glands
- superior suprarenal A
- middle suprarenal A
- inferior suprarenal A
where does then superior suprarenal A come from?
inferior phrenic A
where does then middle suprarenal A come from?
aorta
where does then inferior suprarenal A come from?
renal A
what does the left suprarenal vein drain into?
drains into the left renal veins and then into the IVC
indirect drainage
what does the right suprarenal vein drain into?
directly into the IVC
why is there sometimes indirect venous drainage?
due to the distance differences to be traveled between the left and right side relative to the IVC due to non symmetry of the body
what is produced by the adrenal gland?
adrenaline
aldosterone
cortisol (AAC)
what forms the IVC?
right and left common iliac V
what renal vein is longer left or right?
left due to further distance from the IVC
what renal artery is longer left or right?
right due to further distance from the aorta
where is the aorta and IVC located?
IVC is found on the right
aorta on the left
where does the IVC pass through the diaphragm?
through the caval hiatus at T8
what are the main tributaries that branch off of the IVC?
renal v right suprarenal v right gonadal v (testicular/ovarian) hepatic veins (right, left, intermediate) inferior phrenic veins lumbar veins
what veins have indirect drainage with the IVC? what do they drain into first?
inferior phrenic veins
left gonadal vein
both drain into the left renal vein first
what bring blood into the liver?
portal vein
what are the veins found in the liver? what is particular about them?
hepatic veins
they will divide the liver into what is known as clinical segments
what do the hepatic veins drain into?
into the IVC
What are the branches of the hepatic veins?
Intermediate vein
Left hepatic vein
Right hepatic vein
where is the urether found?
posterior to the abdomen
what is different between the female and male vasculature?
females will have 2 locations of water under the bridge compared to only one in males
what do the testicular vein and artery travel throuygh?
the deep inguinal ring
where does the ovarian vein and artery travel throygh?
travel into the pelvis to the ovaries
where does the gonadal A arise from? at which level?
aorta at L2
where does the gonadal A travel?
superior to IMA
where does the right gonadal vein drain into?
IVC
Where does the left gonadal vein drain into?
left renal vein and then into the IVC
What does water over the bridge refer to?
crossing of arteries and veins over the ureter
what is nutcracker syndrome a result of?
compression of the left renal vein
what can cause nutcracker syndrome?
dilation of SMA
What are some consequences of the nutcracker syndrome?
which leads to tortuous left renal and gonadal veins and varicoceles in the left tested
