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GI > POSTERIOR ABDOMINAL WALLS & KIDNEYS (anat) > Flashcards

POSTERIOR ABDOMINAL WALLS & KIDNEYS (anat) Flashcards

1
Q

The kidneys are anterior to the 12th ribs with the left kidney slightly higher than the right. They are supplied and drained by what arteries and veins?

A

renal arteries and renal veins.

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2
Q

The kidney consists of an outer……..and inner………

A

cortex

medula

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3
Q

The medulla is comprised of renal pyramids. Each renal pyramid drains into a……………. These join to form a…………… These unite to form the renal pelvis, which is continuous with the ureter.

A

minor calyx

major calyx

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4
Q

Each kidney consists of………..segments. Each is supplied with blood from its own segmental artery, which are branches of the renal artery. Is there collateral circulation within the segmental arteries in the kideys?

A

5

NO collateral circulation between segments.

*Therefore, occlusion of a segmental artery results in necrosis of the affected tissue. It also means a kidney segment can be surgically removed without affecting surrounding segments though.

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5
Q

* Remember that there are accessory renal arteries (extra hilar).

A
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6
Q

Do the left and right renal VEINS have tributaries?

A

Right renal vein: no tributaries

Left renal vein: The left gonadal and suprarenal veins are tributaries.

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7
Q

What vein is involved in renal vein entrapment syndrome?

A

left renal vein! (It passes deep to the superior mesenteric artery, where it may be compressed)

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8
Q

A donor kidney may be transplanted to replace a nonfunctional kidney. The transplanted kidney usually is placed within the………………

A

iliac fossa

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9
Q

A kidney stone is also called a……………….

A

calculus

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10
Q

A kidney stone may become lodged within and obstruct the renal pelvis, ureter, bladder, or urethra. Urinary tract obstruction causes urine to back up with distention of the renal pelvis and calices (known as…………………..) and kidney failure

A

hydronephrosis

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11
Q

What arteries supply each portion of the ureter?

A
  1. Upper : branches of renal arteries
  2. Middle : branches from testicular/ovarian arteries, abdominal aorta and common iliac arteries .
  3. In the pelvic cavity: branches of internal iliac arteries .

* Arteries divide into ascending and descending branches which form a longitudinal anastomosis.

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12
Q

What veins supply each portion of the ureter?

A
  1. upper: renal v.
  2. Middle: gonadal v.
  3. In the pelvic cavity: branches of internal iliac veins.
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13
Q

What lymph nodes drain the kidneys?

A

paraaortic (lateral aortic or lumbar) nodes

* Green in pic

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14
Q

What lymph nodes drain the different portions of the ureters?

A

upper: paraaortic (lateral aortic) nodes
middle: common iliac nodes
inferior: external or internal nodes

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15
Q

Here is a slide with the nerve supply of the kidneys:

A
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16
Q

The suprarenal (adrenal) glands also consist of an outer cortex and an inner medulla. What is in the medulla and what is it responsible for?

A

Postganglionic sympathetic neuron cell bodies, which secrete catecholamines (adrenaline) for the fight-or-flight response.

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17
Q

What is the blood supply to the adrenal glands?

A
  1. Superior suprarenal a. (from inf. phrenic a.)
  2. Middle suprarenal a.(from abdominal aorta)
  3. Inferior suprarenal a. (from renal a.)
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18
Q

What veins drain the adrenal glands?

A
  1. Right suprarenal v. (which goes to inf. vena cava)
  2. Left suprarenal v. (which goes to left renal vein)
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19
Q

Nerve Supply to the suprarenal (adrenal) glands is primarily sympathetic. with fibers via greater, lesser, and least splanchnic nerves.

………………………fibers end in the adrenal medulla. *****VERY IMPORTANT********

Postganglionic fibers supplying blood vessels arise from ganglia around the aorta.

A

Preganglionic

20
Q

The abdominal aorta extends from the aortic hiatus of the diaphragm at vertebra…………, to its bifurcation into the common iliac arteries.

A

T12

21
Q

What are the visceral Branches of the Abdominal Aorta?

A

Unpaired arteries:

  • Celiac artery (L1): supply foregut
  • Superior mesenteric artery (L1): supply midgut
  • Inferior mesenteric artery (L3): supply hindgut

Paired arteries:

  • Middle suprarenal arteries
  • Renal arteries
  • Testicular or ovarian arteries
22
Q

When it comes to branches of the aorta, what are the posterior arteries and the terminal arteries?

A

Posterior arteries:

  • Inferior phrenic arteries
  • Lumbar arteries (4 pairs)
  • Median sacral artery

Terminal arteries:

•Common iliac arteries

23
Q

Repairing an abdominal aortic aneurism is usually complicated by the origin of the…………….. artery on the aneurysm.

A

inferior mesenteric

24
Q

What are the main tributaries that lead blood to the inferior vena cava?

A
  • Common iliacs
  • 5 Lumbar veins
  • Right testicular/ovarian vein
  • Renal veins
  • Rightsuprarenal vein
  • Inferior phrenic veins
  • Hepatic veins
25
Q

Where do each of the 5 lumbar veins empty?

A
  • 1 and 2 drain into azygos and hemi-azygos via the ascending lumbar vein
  • 5 drains into IVC via the iliolumbar vein
  • 3 and 4 drain directly into the IVC
26
Q

* Remember that the ascending lumbar veins connect iliac , iliolumbar and lumbar veins with the azygos and hemiazygos veins, and act as a collateral channel between upper and lower parts of the body if the inferior vena cava is blocked!

A
27
Q

What is the largest lymphatic vessel in the body?

A

thoracic duct

* It drains the lymph from all of the body below the diaphragm and the left half of the body above the diaphragm!

28
Q

The diaphragm is the chief muscle of inspiration. It consists of:

A
  • A central tendon
  • Peripheral muscle fibers
29
Q

What is an interesting fact about the height of the diaphragm?

A

It has a right dome that arches as high as the 5th rib and a left dome that arches to the 5th intercostal space.

30
Q

Where does the diaphragm attach?

A
  • Xiphoid process (sternal part)
  • Lower 6 costal cartilages and ribs (costal part)
  • Lumbar vertebrae, ant.longitudianal lig., IV discs. (lumbar part)
31
Q

The 5 lumbar attachments of the diaphragm are what?

A
  • Right crus from Lv1-3
  • Left crus from Lv1-2
  • Median arcuate ligament arching over the aorta
  • Medial arcuate ligament arching over the psoas major
  • Lateral arcuate ligament arching over the quadratus lumborum
32
Q

The diaphragm has apertures that allow structures to pass between the thorax and the abdomen! What are the major apertures?

A
  • caval opening
  • esophageal hiatus
  • aortic hiatus
33
Q

What passes through the caval opening of the diaphragm?

A

inferior vena cava (@ level T8) & the right phrenic nerve.

34
Q

What passes through the esophageal hiatus of the diaphragm?

A
  • esophagus (@ level T10)
  • Anterior & Posterior vagal trunks
  • esophageal branches of left gastric artery
35
Q

What passes through the aortic haitus of the diaphragm?

A
  • Aorta
  • Left Phrenic nerve
  • The greater and lesser splanchnic nerves
  • Hemiazygos vein
  • Sympathetic trunks and least splanchnic nerves
36
Q

What provides MOTOR innervation to the diaphragm?

A

Phrenic nerves (anterior rami C3-C5)

37
Q

The phrenic nerves and the lower 6 intercostal & subcostal nerves provides sensory innervation of the diaphragm?

What is the origin of the phrenic nerves?

What is the origin of the intercostal and subcostal nerves?

A
  • septum transversum
  • mesoderm from body wall
38
Q

2 different areas, based on sensory innervation, are sites for reffered pain from the diaphragm. What are these areas?

A
  • shoulder region (C3-C5 segments)
  • over costal margin of anterolateral abdominal wall (from peripheral regions of the diaphragm)
39
Q

If one phrenic nerve is injured, that hemidiaphragm is paralyzed on the ipsilateral side and will rise during inspiration. This is called what?

* Note that the condition may be asymptomatic!

A

paradoxical movement

40
Q

Describe the blood supply of the diaphragm.

A
41
Q

Muscles of the posterior abdominal wall include:

A

Iliopsoas (Psoas major and Iliacus)

Psoas minor

Quadratus lumborum

42
Q

Which posterior abdominal wall muscle is absent 40% of the time?

A

Psoas minor

43
Q

The quadratus lumborum muscle takes origin mainly from the iliac crest and inserts into the 12th rib and lumbar transverse processes.

What does it do?

what is it innervated by?

A
  • Stabilizes the 12th rib in position from below during inspiration
  • acting unilaterally, it helps to laterally flex the trunk to the ipsilateral side

innervated by: T12-L4

44
Q

The lumbar plexus of nerves is formed on the posterior abdominal wall by what?

A

the anterior rami of spinal nerves L1-4

* Also receives contributions from Subcostal n T12

45
Q

At its origin, the lumbar plexus is located anterior to the transverse processes of lumbar vertebrae embedded within the psoas MAJOR muscle. Relative to the psoas major, the various branches (located either anterior, medial or lateral) are what nerves?

A
  • Anterior: genitofemoral nerve
  • Medial: obturator nerve
  • Lateral: iliohypogastric , ilioinguinal , femoral and lateral cutaneous nerve of the thigh
46
Q

So, again, what are the branches of the lumbar plexus?

A

– Iliohypogastric& ilioinguinal nerves (L1)

– Genitofemoral nerve (L1-2)

– Lateral cutaneous nerve of the thigh (L2-3)

– Obturator nerve (L2 to L4)

– Femoral nerve (L2 to L4)

– Lumbosacral trunk (L4-5)

GI (9 decks)

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