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Block 4 Anatomy > Posterior Abdominal Wall, Kidney > Flashcards

Posterior Abdominal Wall, Kidney Flashcards

1
Q

The diaphragm consists of radially arrayed fibers which arise from bony elements of the thoracic outlet and insert into the _____ tendon

A

Central Tendon

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2
Q

The diaphragm is divided into three parts based on where the muscle arises from. The sternal portion arises from ?

A

Xiphoid Process

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3
Q

The costal portion of the diaphragm arises from ?

A

Lower ribs

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4
Q

The vertebral portion of the diaphragm arises from the _______ vertebrae of the spinal column via the _______ crura which blends with the anterior longitudinal ligament of the vertebral column

A

Lumbar Vertebrae

Musculotendinous Crura

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5
Q

What structures passes posterior to the median ligament of the diaphragm?

A

Aorta

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6
Q

What structures passes posterior to the MEDIAL ligament of the diaphragm?

A

Psoas Major

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7
Q

What structures passes posterior to the Lateral ligament of the diaphragm?

A

Quadratuc Lumborum

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8
Q

The diaphragm receives its motor innervation primarily form the _____ nerve?

A

Phrenic Nerve (C3-C5)

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9
Q

How is sensory information from the diaphragm carried back to the spinal cord?

A

By the phrenic nerve with some contributions from intercostal nerves around the periphery

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10
Q

What supplies blood to the superior surface of the diaphragm?

A

Musculophrenic,
pericardicophrenic and
superior phrenic arteries

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11
Q

What supplies blood to the inferior surface of the diaphragm?

A

Inferior Phrenic Artery

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12
Q

The kidneys are RETROperitoneal and are located in the ________ ________

A

Paravertebral Gutters

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13
Q

At what vertebral level do the Kidneys lie?

A

T 12
L 1
L 2
L 3

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14
Q

Which kidney is slightly higher than the other?

A

The left is slightly higher than the right

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15
Q

The kidneys and suprarenal glands are embedded in a thick fatty layer consisting of pararenal and perirenal fat separated by a membranous layer of what?

A

Renal Fascia

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16
Q

Medially the kidneys are in contact with what muscle and gland?

A

Psoas Major Muscle and Suprarenal Glands

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17
Q

What muscle are the kidneys in contact with posteriorly

A

Quadratus Lumborum

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18
Q

What 3 major structures should be found at the hilum of the Kidney?

A

Renal Artery
Renal Vein
Ureters

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19
Q

The hollow fat-filled space that surrounds the structures at the hilum of the kidney is called?

A

Renal Sinus

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20
Q

Upon entering the IVC, the renal vein is ventral or dorsal to the renal artery?

A

Ventral

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21
Q

The left renal vein is longer, passes between the Superior Mesenteric Artery and Aorta, and typically receives which two veins before entering the IVC?

A

Left gonal vein and left suprarenal vein

**Notes:
These two veins on the right side drain directly into the IVC Pg. 217 of Theima

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22
Q

The Renal Arteries arise from the abdominal aorta at what spinal level?

A

2nd Lumbar vertebrae

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23
Q

The right renal artery is longer than the left… Why?

A

Because it has to pass posterior to the IVC

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24
Q

What is the relationship of the ureter to the vessels at the hilum of the kidney?

A

The ureter is posterior to the renal vessels at the hilum

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25
Q

The ureter courses ______peritoneal on top of which muscle until it crosses what landmark?

A

RETROperitoneal on top of the Posas Major muscle until it reaches the bifurcation of the common iliac artery to enter the pelvis at the pelvic brim

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26
Q

What vessels cross anteriorly to the ureter on the posterior body wall of the abdomen?

A

Gonadal Artery and Vein

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27
Q

The suprarenal glands are embedded in _______ fat within the ______ fascia

A

Perirenal fat within the renal fascia

28
Q

what 3 arteries supply the suprarenal gland? (notbolded terms)

A

Superior Suprarenal Artery (From Inferior Phrenic)
Middle Suprarenal Artery (from Aorta)
Inferior Suprarenal Artery ( from renal Artery)

29
Q

What is the veinous drainage of the suprarenal gland? (Bolded terms)

A

Right side: a single Suprarenal vein to the IVC

Left side: a single Suprarenal vein into the left renal vein to the IVC

30
Q

The inferior vena cava passes through which hiatus at what level

A

Caval Hiatus at the 8th thoracic vertebrae

31
Q

The Diaphragm attaches to the vertebral bodies via what ligaments

A

Right and Left Crura

– dissector also says Musculotendinous ligament

32
Q

What are the lumbar attachments levels of the right and left Crus

A

Right: L1, L2, L3

Left: L1 and L2

33
Q

The right crus forms what hiatus at what vertebral level?

A

Esophageal hiatus at 10th TV

34
Q

What nervous system structure goes through the esophageal hiatus?

A

Thoracic Splancnic Nerves and Vagal trunks

35
Q

Between the right and left Crura, they arch to form which Hiatus?

A

Aortic hiartus at the 12th Thoracic vertebrae

36
Q

The posterior abdominal wall is primarily made up of what bones and muscles?

A

The 5 lumbar verbetbrae

Psoas Major and Quadratus Lumborum

37
Q

Where can the psoas Minor muscle be found?

A

A long flat tendon on the anterior surface of the psoas major muscle

38
Q

What structures does the quadratus lumborum run laterally between?

A

12th rib and iliac crest

39
Q

Together the psoas major and the quadratus lumborum, innervated by the lumbar plexus, form what structure that contains the kidneys

A

paravertebral gutters

40
Q

The abdominal aorta descends on the anterior surface of the lumbar vertebrae until it divides into two common iliac arteries at what vertebral level?

A

4th lumbar vertebrae

41
Q

What are the 3 pairs of paired VISCERAL arteries from the Aorta?

A

Renal artery
Middle Suprarenal artery
Gonadal arteries

42
Q

The gondal arteries descend obliquely and laterally deep to the peritoneum and enter the pelvic cavity by passing _______ to the external iliac artery

A

Ventral

43
Q

What are the paired parietal branches of the Aorta?

A

Inferior Phrenic artery
&
four pairs of lumbar arteries on each side

44
Q

What is the path of the lumbar arteries between the posterior abdominal wall muscles ?

A

They arise from L1-L4 and pass deep to the psoas major muscle and ventral to the Quadratus Lumborum muscle onto the posterior body wall

45
Q

what is the median sacral artery?

A

a single midline branch from the bifircation of the aorta

46
Q

How and where is the Inferior Vena Cava formed?

A

the IVC is formed at the 5 lumbar vertebrae by the junction of the two common iliac veins that drain the perineum, pelvic and lower limb

47
Q

List the main tributaries of the IVC

A

Lumbar veins
right gonadal vein
right and left renal veins
right suprarenal vein

48
Q

The Cisterna Chyli lies ______ to the aorta, on the body of the ______ lumbar vertebra and receives lymphatic flow from lumbar and intestinal channels

A

Posterior

1st lumbar vertebrae

49
Q

The lumbar plexus arises from L1-L4 and provides cutaneous branches where?

A
  1. Anterior and Lat. Walls of lower trunk
  2. Anter. surface of scrotum and Labia majora
  3. Anter. and Medial surface of thigh
  4. Medial surface of leg
50
Q

The lumbar plexus arises from L1-L4 and provides motor fibers where?

A

Muscles of lower abdominal wall
&
Muscles in anterior & medial compartment of thigh

51
Q

What nerve is the ventral ramus of the T12 Spinal nerve?

A

Subcostal nerve

52
Q

Which to 2 nerves am I describing:
Begin retroperitoneal on the posterior-lateral abdominal wall the two nerves fuse, come around the body wall anteriorly. One ends at the suprapubic region and the second enters the inguinal canal and exits the superficial inguinal ring where it becomes the anterior scrotal and labial nerve

A

Iliohypogastic & Ilioninguinal

53
Q

The genitofemoral nerve courses ______ to the psoas major muscles and travels partly through the inguinal canal and exits the ________ ______ to then motor innervate the ______ muscle

A

Ventral

Superficial Ring

Cremaster Muscle

54
Q

What are the motor and sensory nerves of the lower limb from the lumbar plexus?

A

Obturator nerve (most Medial)
Femoral nerve
Lateral Femoral cutaneous nerve

** Pg 425 of Theima

55
Q

The sympathetic trunks enters the abdomen deep to the ______ _________ arches being deep to the IVC on the _______ and deep to the aorta the _______.

A

Medial lumbocostal arches

Deep to IVC on right
Deep to aorta on left

56
Q

What is the path and distribution of the anterior vagal trunk in the abdomen?

A

The anterior vagal trunk follows the lesser curvature of the Stomach, with a branch to the liver and gallbladder

57
Q

What is the path and distribution of the posterior vagal trunk in the abdomen?

A

The posterior vagal trunk passes posterior to the cardia of the stomach and provides some branches to the stomach, but most fibers distribute to the foregut and midgut

58
Q

The lumbar portion of the diaphragm attaches specifically to what 3 bony structures?

A

the bodies of 1st lumbar vertebrae,
to the transverse process of L1, and
to the tip of the 12th rib.
(from our lecture slides and Theima pg 52)

59
Q

The ________ plane passes through the hilum of each kidney, even though the right
kidney is more inferior than the left kidney.

A

transpyloric

60
Q

The kidneys, adrenal glands, and the
gonads are supplied by paired arterial branches off the aorta. The venous return of
these three organs is direct to the ____?

A

IVC

61
Q

True or false: The renal fascia encloses BOTH the kidneys and suprarenal glands.

A

True

62
Q

True or false: the renal fascia is a complete closed sac around the kidneys and suprerenal glands.

A

False! It is open below to allow for respiratory excursions that push the kidneys downward

63
Q

The pyramids of the Kidney clearly appear striated because of the ordered array of parallel structures in them. What are those structures?

A

Loops of Henle, vasa rectae, collecting ducts

64
Q

Both the renal pelvis and the columns of

the medulla are amorphous in appearance because of the structures they contain. What are those structures?

A

They contain the glomeruli and proximal

and distal convoluted tubules.

65
Q

Deep to the psoas major are what two motor nerves to the thigh?

A

the femoral nerve and the obturator nerve

66
Q

What is the nerve trunk that communicates between the lumbar and sacral plexuses?

A

the lumbosacral trunk

Block 4 Anatomy (4 decks)

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