Posterior Thoracic + Abdominal Walls Flashcards
adrenal glands
composed of adrenal cortex and adrenal medulla (chromaffin cells); superior to each kidney
kidneys
primarily retroperitoneal; right kidney is 12th ribs, left kidney is 11th and 12th ribs
renal pelvis
drains urine into ureter from major calyxes
renal pyramid
compose medulla; contain distal portion of collecting duct which opens at minor calyx, which form major calyxes
what is path of urine before ureter?
collecting duct, minor calyx, major calyx, renal pelvis, ureter
ureter
takes urine from kidney to bladder - goes over pelvic brim (where it crosses common iliac artery) and goes over two muscles (quadratus lumborum and psoas major)
what supplies each 1/3rd of the ureter?
upper 1/3: renal artery
middle 1/3: common iliac artery
lower 1/3: superior vesical artery
iliacus muscle
lateral femoral cutaneous nerve crosses this muscle to reach the ASIS (after emerging lateral to psoas major)
psoas major
kidneys lie against this muscle; nerves of posterior abdominal wall lie along it and against it; ureter crosses it also.
quadratus lumborum
muscle of posterior abdominal wall; kidneys lies against it; subcostal nerve runs medial to it
sympathetic trunk
runs down either side of spinal cord; in posterior mediastinum; T1 to L2/L3
subcostal nerve
below 12th rib; passes between psoas major and quadratus lumburom; innervates abdominal musculature and overlying skin of lateral and anterior abdominal wall; ventral rami of T12!
iliohypogastric nerve
emerges between psoas major and quadratus lumborum; innervates abdominal musculature and skin of inguinal and hypogastric regions of lateral and anterior abdominal wall
-T12/L1
ilioinguinal nerve
- medial/inferior to iliohypogastric nerve
- innervates abdominal musculature and skin of inguinal and hypogastric regions of lateral and anterior abdominal wall
- passes thru inguinal canal and superficial ring to innervate skin of medial thigh, labium majus, and anterior aspect of scrotum.
- L1
lateral femoral cutaneous nerve
- lateral to femoral nerve and to the psoas major
- crosses iliacus to reach ASIS
- descends posterior to inguinal ligament to innervate lateral thigh
- L1/L2
femoral nerve
- lateral to psoas major
- passes into anterior thigh posterior to inguinal ligament and lateral femoral artery
- from L2, 3, 4
genitofemoral nerve
- passes anterior (on top of) psoas major
- femoral branch passes posterior to inguinal ligament to innervate medial thigh
- genital branch enters inguinal canal thru deep ring to innervate cremasteric muscle
- L1, L2
obturator nerve
- passes medial to psoas major
- crosses pelvic brim and innervates medial thigh and skin
- L2, 3, 4
lumbosacral trunk
- goes to sacral plexus
- L4/L5
celiac ganglia
- destination of greater splanchnic nerves of T5-T9
- adjacent to celiac trunk
left vs. right renal artery
- arise from abdominal aorta at L2
- symmetric in length
- supply kidney
left renal vein
- longer than right renal vein
- goes from kidney to IVC, splitting into left suprarenal and left gonadal arteries
right renal vein
- shorter than left due to proximity to IVC
- goes from kidney to IVC
- does not branch: right suprarenal and right gonadal each drain separately into IVC
left and right suprarenal arteries and veins
-supply and drain blood from adrenal glands
common iliac arteries
- form from splitting of abdominal aorta at L4
- split into internal (midline) and external (lateral) iliac arteries
abdominal aorta spans what spinal cord segments?
T12 to L4
gonadal arteries
- form either testicular or ovarian artery
- arise between renal artery and IMA
- between L2 and L3
what is ductus venosus? what is its remnant?
- liver shunt from umbilical vein to IVC in pre-natal life
- remnant is ligamentum venosum
what are umbilical arteries? what are their remnants?
- umbilic arteries drain blood from fetus back to maternal blood supply
- remnant is medial umbilical ligaments
left and right crura of diaphragm
-tendons that extend from diaphragm to vertebral column
portal vs. caval
- portal is drainage into portal vein
- caval is drained into IVC, rather than portal vein
where do IVC, esophagus, and aorta enter the diaphragm?
I8-10E-A12 (IVC, T8; esophagus, T10; aorta, T12)
lateral arcuate ligaments
passes under diaphragm and arches over quadratus lumborum
medial arcuate ligaments
passes thru diaphragm and arches over psoas major
-MEDIAN acruate ligament forms the anterior aspect of the aortic hiatus
superior mediastinum
thymus, SVC, trachea (left and right main bronchi), esophagus, right and left brachiocephalic vein, aortic arch and its superior branches, thoracic duct, left recurrent laryngeal nerve, ligamentum arteriosum, phrenic nerve, vagus nerve
middle mediastinum
heart, ascending aorta, pulmonary trunk, pulmonary veins, phrenic nerve,
posterior mediastinum
- inferior to T4/5
- esophagus, vagus nerve, descending aorta, thoracic duct, sympathetic trunk, azygous + hemiazygous veins
braciocephalic trunk
right carotid and right subclavian
what is branching from SVC? what does that then branch into?
- SVC splits into left + right brachiocephalic vein
- each of those splits into left/right internal jugular vein (medial) and left/right subclavian vein
thoracic duct
- on left side of body
- drains left side of body and everything below abdomen (except left lower lobe of lung)
- drains into junction of left brachiocephalic vein (branchpoint of left internal jugular vein and left subclavian vein)
right lymphatic duct
- drains right upper chest including right lung, and left lower lobe of lung
- drains into junction of right brachiocephalic vein (branchpoint of right internal jugular vein and right subclavian vein)
aygous vein
- on right side of body
- passes over right main bronchus
- drains directly into SVC
what does vagus nerve pass over?
-left main bronchus
hemiazygous vein
- on left side of body
- crosses midline to drain into azygous vein at T8
where does posterior intercostal vein drain?
into azygous on right side and hemiazygous on left side
greater splanchnic nerves
-T5-T9
phrenic nerve
- C3, 4, 5 to diaphragm (motor fxn)
- innervate parietal pleura (which feel pain)
vagus nerve
cranial nerve 10, parasympathetic
left recurrent laryngeal nerve
- part of superior mediastinum
- branch of vagus nerve
- innervates larynx
- goes under aortic arch
right recurrent laryngeal nerve
- not part of superior mediastinum
- goes from right vagus nerve and hooks around right subclavian artery to innervate larynx
what is ductus arteriosus? what is its remnant?
- shunts blood from pulmonary trunk to aortic arch (goes below 3 branches of aortic arch)
- due to blood from SVC
- remnant is ligamentum arteriosum
what is foramen ovale? what is its remnant?
- shunts blood from right to left atrium due to pressure
- due to blood from IVC
- remnant: fossa ovalis
