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ANAT 214 > Posterior Abdominal Wall and Kidneys > Flashcards

Posterior Abdominal Wall and Kidneys Flashcards

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1
Q

Where is the posterior abd wall

A

Posterior to gastrointestinal tract, spleen and pancreas
Extension of posterior mediastinum

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2
Q

What is in the retroperitoneal space

A

Posterior abd wall

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3
Q

What is retroperitoneal space bounded by

A

Posterior =Bones, muscles
Anterior = peritoneum

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4
Q

What passes through retroperitoneal space

A

Structures between thorax to pelvis, head to abd region, transit region, big vessels
Aorta, nerve plexuses, ivc , sympathetic trunk, lymphatic, lumbar plexus, kidney and suprarenal glands (urinary system)

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5
Q

WHAT ARE BONY BOUNDARIES OF POST ABD WALL

A

Lumbar vertebrae
Pelvis
Thorax

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6
Q

Describe lumbar vertebrae - bones post abd wall

A

5
Lordosis
Inward curvature

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7
Q

Describe pelvis - Gen - bones post abd wall

A

Superior aspect of pelvic bone, crest, ilia, pubic symphysis, psis, asis

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8
Q

Describe ilia - pelvis - bones post abd wall

A

Attached laterally to sacrum (sacroiliac joint)
Upper part of each ilium expand outward wing like area = iliac fossa- forms bone

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9
Q

Describe important landmark of pelvis - bones post abd wall

A

Anterior superior iliac spine = anterior extremity of iliac bone

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10
Q

Describe pubic symphysis - pelvis- bones post abd wall

A

Between the 2 pubic tubercles

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11
Q

Describe thorax - bones post abd wall

A

Costal margin, ribs 11-12, xiphoid process

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12
Q

Describe relationship of ribs of thorax that bound post abd wall and kidneys

A

Rib 11 is posterior to superior part of left kidney
Rib 12 is posterior to superior part of BOTH kidneys

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13
Q

Describe muscles of post abd wall - medially

A

Psoas major and minor
Fills space between vertebral bodies and transverse processes of t12 to L5
For hip flexion + iliacus muscle, proximal insertion on femur

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14
Q

What muscle passes under MEDIAL accurate ligament of diaphragm

A

Psoas

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15
Q

Describe bursa pain

A

Psoas major, going out = bursa, can be inflamed = pain when work out a lot

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16
Q

Describe muscles of post abd wall - laterally

A

Quadratus lumborum
Square muscle, lumbar, seals back, laterally. = abd muscle, but at back = open so filled with this muscle
Fills space between rib 12 and iliac crest
Overlapped by Psoas medially

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16
Q

What passes under lateral accurate ligament of diaphragm

A

Quadratus lumborum

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17
Q

Describe muscles of post abd wall - inferiorly

A

Iliacus
Fills iliac fossa on each side - anterior aspects
Joins Psoas before insertion on proximal femur
More support for Psoas, and stronger powerful hip flexion, also for caecum and sigmoid = cushions gut

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17
Q

Describe muscles of post abd wall - superiorly

A

Diaphragm - must jump over the muscles to properly seal abd region
Anchored to lumbar vertebrae by musculotendinous crura =
Right crus = l1-l3 - lower due to liver
Left crus = l1-l2

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18
Q

Describe Crura of post and wall generally

A

From tending us arch to allow passage between cavities

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19
Q

Describe median arcuate ligament

A

Under = Aorta - t12 (passes between the 2 crura, needs to be protected, follows spine closely), thoracic duct (drains Lower ribs and abd), lymphatic confluent (drains all uppe body)
MIDLINE - between 2 crura

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20
Q

Describe medial arcuate ligament

A

L for more lateral than median
Psos under, sympathetic trunk - continues down and follows spine
From transverse process l1 to crus

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21
Q

Describe lateral arcuate ligament

A

From transverse process l1 to rib 12 laterally
Quadratics lumborum under

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22
Q

What passes trough crura

A

Greater, lesser and least splanchnic nerves= though muscle fibre, presyn symp to gut, can be impinged - sciatic, through priformis muscle
Azygous/hemiazygous = azygous - muscles, help go up against gravity, hemi - ascending lumbar, passes through diaphragm

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23
Name 3 principe hiatuses in diaphragm
T8 = caval aperture, IVC T10 = esophageal aperture, eso, vagal trunk T12= aortic aperture, aorta, thoracic duct
24
What is the superior lumbar triangle
Region of weakness
25
What are borders of superior lumbar triangle
Medially = quadratus lumborum muscle Laterally = internal oblique abd muscle Superiorly = rib 12 Floor of triangle = transversalis fascia NO STRONG MUSCLES
26
Describe superior lumbar triangle clinical correlate
In regard to inf pole of kidneys - location for lumbar hernia Protrusion of abd content bc wall cannot resist increased abd pressure Just fascia - only thing between quadrants and transverus abdominus is transversalis fascia
27
Describe post abd wall - costovertebral angle
Vulnerable Zone of superior lumbar triangle overlying the kidney
28
Describe kidney punch test
Costovertebral angle tenderness - cvat, Murphys punch signs = medical test If percussion of the area elicits pain,test is positive and would suggest infection around kidney = if triggers pain Mechanically induce stimulation Wresting - done sometimes
29
What conditions can be found by kidney punch
Perinephric Abscess Pyelonephritis Renal stone
30
Describe importance of abdominal muscle tone
Contraction of abd wall muscles - especially trans versus abdominus = important to maintain core, popcan core If push on it = expands, do not want diaphragm to be tense but TIGHT - if too tense = will increase pressure in muscle layer on compartments Also pelvic floor muscles need to be tonic to resist pressure - icreases when breathes and with organ functions - like peristalsis
31
Name all intraperitoneal organs
Stomach, * Duodenum (1st part) Liver, * Spleen, * Pancreas (only tail) * Jejunum * Ileum, * Cecum, * Appendix, * Transverse colon, * Sigmoid colon,
32
Name all retroperitoneal organs
S = suprarenal glands * A = Aorta and IVC * D = Duodenum (all but the 1st part) * P = Pancreas (all but the tail) * U = Ureter and bladder * C = Colon (ascending and descending) * K = Kidneys * E = Esophagus * R = Rectum (Lower 2/3) = attached to, but not in It
33
Describe spaces of peritoneal cavity
Folding of parietal to visceral peritoneum creates recesses/spaces Serous fluid -lube, everything slides
34
Name spaces of peritoneal cavity
Paracolic gutter Hepatorenal recess Subphrenic recess Lesser sac
35
Describe paracolic gutter
Space between colon and abd wall - connect inf portion abd region to upper portion
36
Describe hepatorenal recess
Morrisons pouch Between posterior aspect of liver and anterior aspect kidneys
37
DESCRIBE subphrenic recess
Between diaphragm and liver
38
Describe lesser sac - spaces of peritoneal cavity
Behind lesser omentum, opening behind hepatoduodenal ligament Bad since celiac trunk, and, plexuses, pancreas
39
Describe clinical relevance of spaces of peritoneal cavity
Bile pus or blood from abd vsicera can collect in sites remote from organ of origin Ex = spine position, infected fluid from right iliac fossa (appendicitis), can enter hepatorenal/subphrenic recesses = ex = fluid moves to paracolic (behind liver), gutter can reach liver region and get to hepatorenal recess and then subphrenic recess = infect kidneys liver… Peritonitis DYNAMIC, moves
40
Describe kidney
Bean shaped organ - 11 cm length
41
What is function of kidney
Filter blood Regulate blood pressure, ionic and hydric balance Eliminate metabolic waste —> produce urine About 1.2litres/min in adult
42
Where is general location of kidney
Retroperitoneal Anterior to quadratus lumborum Anterior to psoas Under diaphragm
43
Describe left kidney
Anterior to rib 11 and 12 Vertebral level of t12 to l2 - slightly higher Posterior to spleen, tail of pancreas and left colic Flexure More protected by ribs
44
Describe right kidney
Anterior to rib 12 Vertebral level of l1-l3 - lower since liver takes up space Posterior to liver descending portion of duodenum, right colic Flexure
45
Nam renal fascia arrangement from superficial to deep
Cushions, more padding, layers of abd wall Posterior abdominal wall muscles Transversalis fascia Pararenal fat Renal fascia Perirenal fat Fibrous renal capsule
46
Describe pararenal (paranephric) fat
Accumulation of fat posterior and lateral to kidney extra layer fat, only on posterior side
47
Describe renal fascia
Gerota’s Like sock for kdiney - pouch Membranous fat condensation, surrounds each kdiney and suprarenal gland Enclosing perirenal fat
48
Describe perirenal (perinephric) fat
Contained in renal fascia Extraperitoneal fat Outside renal capsule, surrounding kidneys
49
Describe fibrous renal capsule
Completely invest kidneys
50
Describe kidneys external structure
10-15 cm long Lateral edge =smooth and convex Medial border = hilum pierced by renal vein, artery and renal pelvis/ureter Renal sinus = expansion of hilum within kidney, filled of perirenal fat
51
Describe internal structure kidneys
Cortex and medulla Contains 2 mil nephrons, renal functional units
52
Describe renal cortex
Outer region Deep to fibrous capsule Extend into medullary region as renal Columns
53
Describe renal medulla
Inner region Arranged into renal pyramids, base face outwards Apex fitting in miso calyx - renal papilla
54
Describe blood filtration pathway
Blood filtered through pyramids (nephrons) —> urine secreted at papilla —> into 11 minor calyx —> 3 major calyx —> eventually into renal pelvis and to ureter
55
Describe hillum of kidney
Vessels enter organ - midline medial Front = vein, mid = artery, behind = ureter
56
Describe renal sinus
Open space where urinary system and vessels enter kdiney, not sealed
57
Describe renal pyramids
Where urine produced and converge to papilla
58
Describe arterial supply kidneys
Renal arteries from abd aorta - paired visceral Right renal = longer, since passes under ivc (left renal artery shorter)
59
Describe venous drainage kidneys
Renal veins from ivc, anterior to arteries Left renal vein is longer, passes under SMA (Right renal vein shorter) * left gonadal vein, left adrenal vein drain into left renal vein
60
Describe innervation of kidneys - gen
Renal plexus from celiac Plexus Found along renal ateries
61
Desire in certain of kidneys - specific psns and sns
Sns = triggers vasoconstriction, reducing renal blood flow Psns = not well understood
62
Describe clinical relevance - nutcracker syndrome
Left renal vein entrapment Sydney me - due to dilation of sma If collapse or high pressure sma = can block left renal vein In Amab = cause varicoceles, = enlargement of testicular veins in scrotum - varices,
63
What is female Equivalent of nutcracker syndrome
Conjecture pelvic syndrome During messes = pain, tenderness and discomfort due to lack of Venous drainage
64
Describe ureter
Muscular tube transport urine from kdiney to bladder Delicate, carries urine
65
Where is general location of ureter
Retroperitoneal Oriented vertically, anterior to psoas muscle Enters pelvis by crossing common iliac artery Water under the bridge - under organs
66
Describe the 3 points of constriction of ureter
Where stones can get lodged- when try to get out - ureteropelvic junction - junction renal pelvis/ureter Crosses iliac vessels - strong arteries, where most get lodged Entry to bladder
67
What is urine pathway
Renal papilla —> minor calyx —> Major calyx —> Renal pelvis —> Ureter —> Bladder
68
Where is general location of suprarenal glands
Retroperitoneal Associated with superior pole of each kidney - top of kdiney Contained in renal fascia and perirenal fat
69
Describe anatomy of suprarenal Glands generally
Outer cortex and inner medulla
70
Describe suprarenal gland cortex
Influence blood pressure and volume Controlling sodium and water retention by kidneys
71
Describe suprarenal gland medulla
Primarily composed of nervous tissues = Stimulated by preganglionic symapthetic fibres from celiac plexus Functions like sympathetic ganglia - secrete catecholamines (epinephrine, norepinephrine)
72
Describe suprarenal glands arterial supply
Vital gland so 3 regions give it blood Suprarenal arteries Superior = from inferior phrenic from abd aorta Middle = directly from abd aorta Inferior = from renal artery
73
Describe suprarenal glands venous drainage
Usually 1 suprarenal vein Right = ivc Left = drains into renal vein first

ANAT 214 (34 decks)

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