Posterior Abdominal Wall and Retroperitoneum

Question 1

Name the structures the psoas major muscle relates with

Answer 1

Kidneys, ureters, Cecum, Appendix, Pancreas, Sigmoid Colon, Lumbar lymph nodes, Nerves of posterior abdominal wall

Question 2

Which renal vein is longer?

Answer 2

The left (it has to cross the aorta)

Question 3

Does the left renal vein cross the aorta anterior to it, or posterior to it

Answer 3

Cross anterior to aorta (usually)

Question 4

Which kidney is more commonly donated and why?

Answer 4

Left, it gives a longer vein

Question 5

Which renal artery is longer?

Answer 5

The right

Question 6

Where does the SMA arise in relation to the renal arteries and veins and then where does it run relative to these vessels?

Answer 6

Arises superior to them, cross over them anteriorly

Question 7

Where does the ureter cross the iliac arteries, and does it cross anterior or posterior

Answer 7

Crosses external iliac just below common iliac bifurcation (into internal/external). The ureter crosses anterior to the artery/vein

Question 8

Varicocele

Answer 8

Abnormal enlargement of a vein that drains the scrotum

Question 9

What veins become dilated, resulting in a varicocele?

Answer 9

Veins of the pampiniform plexus

Question 10

On which side are varicoceles more common and why?

Answer 10

Left, because right testicular vein enters IVC at an acute angle, which is more favorable to flow than the 90 degree angle the left testicular vein enters the left renal vein at

Question 11

What is indicative of a positive psoas test and briefly explain how the test works

Answer 11

Pain is indicative of positive test. Test involves providing backwards pressure while patient flexes hip, this presses the psoas muscle against structures related to it, indicating if one of them is the source of the problem

Question 12

Four conditions which may be suggested by a positive psoas test

Answer 12

Sacroiliac disease, IV disc disease, Adenocarcinoma of the pancreas, Appendicitis

Question 13

What is the only nerve of the posterior abdominal wall that pierces the psoas muscle?

Answer 13

The genitofemoral (L1,L2)

Question 14

At what level does the abdominal aorta bifurcate?

Answer 14

L4/L5

Question 15

What transverse plane approximates the level of the aorta bifurcation?

Answer 15

The transumbilical plane (L3/L4), which is just slightly above the aortic bifurcation (L4/L5)

Question 16

Where is the most common site of abdominal aortic aneurysm?

Answer 16

Below renal arteries and veins and above aortic bifurcation

Question 17

If the IMA is compromised, where might the distal bowel get collateral flow from?

Answer 17

The SMA and/or inferior iliac system

Question 18

Name the tributaries of the IVC

Answer 18

Common iliacs, Renal veins, Hepatic veins, Lumbar veins, Ascending lumbar veins, Inferior phrenic veins, Right suprarenal, Right gonadal

Question 19

Arteries supplying the diaphragm

Answer 19

Pericardiophrenic, musculophrenic, superior phrenic, inferior phrenic

Question 20

Veins supplying the diaphragm

Answer 20

Pericardiophrenic, musculophrenic, inferior phrenic

Question 21

Which kidney is usually more superior?

Answer 21

Left is usually superior to right

Question 22

Two recesses around the liver

Answer 22

Hepatorenal recess, subphrenic recess

Question 23

Three ureteric constriction

Answer 23

Junction with renal pelvis, brim of pelvic inlet, bladder wall