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SF3_3 (Kereen) > Posterior Abdominal Wall > Flashcards

Posterior Abdominal Wall Flashcards

1
Q

The posterior abdominal wall consist of?

A

fascia, muscles and their vessels and spinal nerves

The overlying skin is continuoys with that of the back

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2
Q

The psoas majors contains which plexus?

A

Lumbar plexus

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3
Q

What are the problems caused by the psoas?

A

lower back pain, sacroiliac pain, sciatica, disc problems, spindylolysis, scoliosis, hip degeneration, knee pain, menstruation pain, infertility, and digestive problems

Biomechanical problems = pelvic tilt, leg length discrepancies, kyphosis, and lumbar lordosis

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4
Q

Blood supply and innervation to the diaphragm?

A

blood supply: infereior phrenic arteries

innervation: phrenic nerves (C3-C5) - sensory and motor

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5
Q

What is the origin of the diaphragm?

A

Sternal = xiphoid process

Costal = at the lower six ribs

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6
Q

Describe the diaphragm

A

dome shaped swptum that seperates the thoracic cavity from the abdominal cavity.

Convex upper surface forms floor of thoracic cavity

concave under surface forms roof of abdominal cavity.

Peripheral parts consist of muscularis fibers that take origin from the circumference of the inferior thoracic aperture and converge to be inserted into a central tendon.

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7
Q

How many lumbosacral arches are contained in the diaphragm?

A

2 (on either side)

Medial

Lateral

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8
Q

The muscles of the diaphragm arise from?

A

Somite level 3-5

(this also correspinds tot he levels of segmental nerves providing inntervation of the diaphragm)

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9
Q

How are the muscular fibers of the diaphragm grouped?

A

They are grouped acording to their origin (sternal, costal, and lumbar)

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10
Q

Sphincter like arrangement of the righ crus of the diaphragm acts like?

A

acts as a lower esophagel sphincter

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11
Q

Lateral arcuate ligament is located where?

A

runs from L1 transverse process to rib 12

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12
Q

Medial arcuate ligament is located where?

A

runs from L! transverse process to L1 vertebral body (crus of diaphragm)

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13
Q

What is the purpose of the median arcuate ligament?

A

unites left and right crura of diaphragm insertion : central tendon

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14
Q

The left and right crura end at which vertebral level?

A

Right crus = LIII

Left crus = LII

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15
Q

The passing of the inferior vena cava through the diaphragm occurs at which vertebral level?

A

T8, through the central tendon

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16
Q

The esophageal hiatus is at which vertebral level?

A

T10

usually in the muscles of the right crus

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17
Q

The aortic hiatus is located at which vertebral level?

A

T12

posterior to the diaphragm (median arcuate liagment)

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18
Q

The adrenal glands are covered by?

A

Renal fascia

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19
Q

What is produced in the cortex and the medulla of the adrenal glands?

A

Cortex - mineral corticocoids, glucocorticoids, sex hormones

Medulla - epinephrine and norepinephrine

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20
Q

Although variations of the blood supply to the adrenal glands are common, there are usually three arteries that supply each adrenal gland. What are they?

A

Right and left Superior Suprarenal arteries (branch of right and left inferior phrenic arteries)

Rght and left middle suprarenal arteries (branch from abdominal aorta)

Right and left inferior suprarenal arteries (branch of renal artery)

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21
Q

Which two organs have the greatest blood supply per gram of tissue?

A

Adrenal glands and thyroid gland

Up to 60 arterioles may enter each adrenal gland

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22
Q

Venous drainaige of the adrenal glands is achieved via the?

A

suprarenal veins

(these anastamose with the infrior phrenic veins)

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23
Q

What are the layers surrounding the kidneys?

A

Periphrenic fat

renal fascia/transverse fascia

periphrenic fat

Anterior abdominal wall muscles/quadratus lumborum muscles/psoas major muscle

another layer of fat

Peritoneum

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24
Q

What are the constrictions in the ureters?

A
  1. first constriction = ureteropelvic junction
  2. Second constriction = pelvic inlet
  3. Third constriction = entrance to bladder
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25
Q

Blood supply to the ureters

A

branches of renal artery, testicular/ovarian arteries, abdominal aorta, common iliac, internal iliac

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26
Q

Somatic nervous system

A

Lumbar plexus

Includes:

Iliohypogastic nerve

Ilioingunal nerve

Genitofemoral nerve

Lateral femoral cutaneou nerve

Femoral nerve

Obtrurator nerve

Lumbosacral trunk

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27
Q

Branches of the sympathetic trunk (R&L)

A

Lumbar splanchnic nerve.

Celiac plexus

Superior mesenteric plexus

renal plexus

inferior mesenteric plexus

aortic plexus

Hypogastric plexus

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28
Q

Lumbar Plexus

A

T12, L1-5

Subcostal (T12)

Iliohypogastic (L1 main nerve)

Ilioinguinal (L1 collateral branch)

Genitofemoral (L1, 2)

Lateral femoral cutaneous (L2, L3)

Femoral (posterior division L2, 3, 4)

Obturator (anterior division L2, 3.4)

Lumbosacral trunk (L4,5)

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29
Q

Circulation of the posterior abdominal wall comes from which three main arteries?

A

Abdominal aorta

Inferior vena cava

Portal vein

30
Q

Branches of the abdominal aorta

A

Unpaired branches

Celiac trunk

superior mesenteric artery

inferior mesenteric artery

median sacral artery

paired branches

inferior phrenic arteries

suprarenal arteries

Gonadal arteries

Common iliac arteries

renal arteries

lumbar arteries

31
Q

Branches of the inferior vena cava?

A

Hepatic veins

renal veins

lumbar veins

common iliac veins

32
Q

The azygous vein connects to which two systems?

A

To the systems of superior vena cava and inferior vena cava

33
Q

This vein provides an alternate path for blood to the right atrium when either of the vena cavae is blocked

A

Azygous vein

34
Q

What is cystic fibrosis?

A

An inherited condition that affects the cells that produce mucous, sweat, and digestive juices. These secreted fluids are normally thin and slippery but in cystic fibrosis they become thick and sticky, which causes them to plug tubes, ducts and passageways especially in the lungs and pancreas

35
Q

What is the funciton of the kidneys?

A

Maintain blood purity by removing nitrogen compounds (urea, uric acid, creatinine), excessive ions to maintain electrolyte balance (K+, H+), and remove toxins

36
Q

The kidneys are intraperitoneal or retroperitoneal?

A

REtroperitoneal

37
Q

Which kidney sits lower in the posterior abdominal wall?

A

Right

38
Q

At which level of the vertebra would you find the hilum of the kidney?

A

L1

This is the transpyloric plane

39
Q

The kidneys are located between which two vertebral levels?

A

T12 and L3

40
Q

The posterior surface of the kidney relates to which muscle?

A

Quadratus lumborum muscle

41
Q

What are the three layers that surround the kidney?

A

Renal capsule

Adipose capsule

renal fascia (anterior and posterior)

42
Q

There are three nerves that cross the kidney, what are they?

A

Subcostal n.

Iliohypogastic n.

Ilioinguinal n.

43
Q

Paralysis of the lower abdominal wall and hernia may be caused by?

A

Damage to the subcostal, ilioinguinal, and iliohypogastric nerves during kidney transplant.

44
Q

The upper pole of the kidneys rest upon what?

A

The diaphragm and they move with each breath

45
Q

Which muscles surround the kidney?

A

Psoas major (medial, posterior)

Quadratus lumborum (lateral, posterior)

Anterolateral abdominal wall muscles

46
Q

Which structures provide support and protection of the kidney?

A

Perineal fat

Renal fascia

47
Q

The renal fascia is the condensation of what?

A

Condensation of sub-serous connective tissue

48
Q

Blood supply of the kidney

A

Renal artery branches into

segmental arterires -> lobar artery -> interlobar artery -> arcuate artery

49
Q

Nerves to the ureters aris from which plexus?

A

Renal plexus

Consist of sympathetic and parasympathetic fibers.

50
Q

The renal plexus is supplied by which nerves?

A

Thorasic splanchnic n.. mostly least splanchnic n.

51
Q

What is the direction the urethers run?

A

posteriorinferiorly on the lateral wall of the pelvis, external to the parietal peritoneum, and anterior to the internal iliac aa., then they curve anteromedially to enter the posterior superior angle of the bladder

52
Q

Where are the potential sites for calculi distress in the ureters?

A

Where the constrictors are located (in the beginning, where it crosses the pelvic brin, and where it enters the bladder)

53
Q

What affects does a stone have on the ureter?

A

Smooth muscle of the ureter feels intense peristaltic contraction which produces ureteric pain

Urine is backed up and causes dilation of the renal pelvis and calyces.

54
Q

Congenital Pelviureteric Obstruction causes what to teh kidney?

A

Hyronephrosis

(pressure atrophy of the kidney)

This is marked by dilation of the renal pelvis

Patient may present with abdominal pain

55
Q

The kidney is usually placed in the which fossa?

A

Iliac fossa

56
Q

Renal Transplant

A

A transplant kidney is not usually placed in the same location (iliac fossa) of the original kidney therefor a alternate blood supply is used for reconnection.

Renal a, previously branching from the abdominal aorta in the donor, is often coonected to the external iliac artery in the recipient

Renal vein, previously draining to the IVC in the donor, is often connected to the external iliac vein in the recipient.

57
Q

The muscle that makes up the bladder is know as the?

A

Detrusor muscle

58
Q

In females where is the bladder located?

A

anterior and inferior to the uterus

An enormous uterus limits the expansion of the bladder = urinary frequency and urgency i.e pregnancy

59
Q

On there way tot he bladder, as the ureter pass in proximity to the lateral fornices of the _____, they cross _______ to the uterine arteries

A

vagina

inferior

60
Q

During surgical procedures on the uterus and ovaries what is a great risk?

A

The ureters

Must be identified before ligating or cutting any tissue in the region of the pelvis

61
Q

The internal urethral spinchter is made of _________ _________ muscle and is _________.

A

Circular Smooth muscle

Involuntary

62
Q

Where is the internal urethral sphincter located?

A

located at the bladder’s inferior end and the urethra’s proximal end at the junction of the urethra with the urinary bladder

63
Q

Where is the external urethral sphincter located?

A

at the bladder’s distal inferior end in females and inferior to the prostate (at the level of the membranous urethra) in males is a secondary sphincter to control flow of urine through the urethra.

64
Q

The external urethral sphincter is made of ______ muscle and is _____.

A

Skeletal muscles

Voluntary

65
Q

In males the urethra passes through what?

A

The prostate gland

66
Q

Prostate cancer will grow into the ?

A

bladder, ectum, and peritoneum

Tumors may occlude the urethra

67
Q

What is BPH?

A

Benign Prostate hypertrophy

Enlargement of inner part of prostate gland, most median lobe, by action of testosterone

68
Q

What are the side effects of BPH?

A

swelling of the uvula compresses the internal urethral orifice causing intermitent retention of urin

69
Q

BPH occurs mainly in?

A

aged men

they have urinary frequency but cant expell urine

70
Q

WHy are females more prone to UTI?

A

Because the urethra is located in close proximity to the Vagina

and

the urethra is short

SF3_3 (Kereen) (14 decks)

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