Posterior Wall

Question 1

what prevents a perinephric abscess from spreading to the other kidney?

Answer 1

renal fascia, unless the kidney is injured/infected

Question 2

if nephroptosis occurs, do the adrenal glands move also?

Answer 2

no, adrenal glands have a separate fascial compartment & are attached to diaphragm

Question 3

what is an ectopic kidney?

Answer 3

congenital misplaced kidney

Question 4

how can you determine nephroptosis from ectopic kidney?

Answer 4

nephroptosis will have a ureter that’s loose and coiled

Question 5

why are transplanted kidneys placed in iliac fossa?

Answer 5

lack of inferior support in lumbar region, greater access to blood vessels, convenient access to bladder

Question 6

how is chronic renal failure treated?

Answer 6

renal transplant

Question 7

polycystic disease of the kidneys is an important cause of?

Answer 7

renal failure

Question 8

extension of which muscle can increase pain caused by inflammation of in the pararenal area?

Answer 8

psoas

Question 9

accessory renal vessels occur because?

Answer 9

failure of embryonic vessels to degenerate when the kidney ascends during development

Question 10

where can the renal vein become entrapped?

Answer 10

between the superior mesenteric artery and abdominal aorta

Question 11

renal vein entrapment syndrome can cause?

Answer 11

-hematuria/proteinuria -abdominal pain/vomiting (compression of duodenum) -left testicular pain in men (varicocele)

Question 12

incomplete division of the ureteric bud results in?

Answer 12

bifid ureter

Question 13

complete division of the ureteric bud results in?

Answer 13

supernumerary kidney

Question 14

what is a retrocaval ureter?

Answer 14

ureter that passes posterior to IVC & comes back to attach at bladder

Question 15

how does a horseshoe kidney occur?

Answer 15

fusion of the inferior poles of the kidneys

Question 16

what vertebral level is a horseshoe kidney?

Answer 16

L1-L3 because inferior mesenteric artery prevents normal relocation of kidney

Question 17

failure of a kidney to ascend during development causes?

Answer 17

ectopic pelvic kidney

Question 18

what is a renal calculus?

Answer 18

kidney stone

Question 19

where can a renal calculus become lodged?

Answer 19

calices of kidneys, ureters, or bladder

Question 20

disturbal of the phrenic nerve causes?

Answer 20

hiccups

Question 21

unless a person has an accessory phrenic nerve, sectioning of the phrenic nerve causes?

Answer 21

complete paralysis & eventual atrophy of the corresponding side of muscular part of diaphragm

Question 22

how can paralysis of a hemidiaphragm be recognized?

Answer 22

radiograph: permanent elevation and paradoxical movement

Question 23

pain from irritation of the diaphragmatic pleura or peritoneum is referred to?

Answer 23

C3-5 dermatome in shoulder region

Question 24

pain from irritation of peripheral regions of diaphragm is localized to?

Answer 24

skin over costal margins of anterolater abdominal wall

Question 25

rupture of diaphragm & viscera hernia can be caused from?

Answer 25

• trauma from motor vehicle accident
• sudden increase in intrathoracic or intra-abdominal pressure

Question 26

where is a herniation likely to occur from rupture of diaphragm?

Answer 26

through lumbocostal triangle

Question 27

what condition is comorbid with congenital diaphragmatic hernia?

Answer 27

pulmonary hypoplasia (usually left sided due to liver on right blocking hernia)

Question 28

what are causes of a psoas abscess?

Answer 28

TB and other infections that spread from blood to vertebrae, and then to psoas fascia

Question 29

what will produce a postive right psoas sign?

Answer 29

acutely inflamed appendix

Question 30

posterior abdominal wall pain can be caused by?

Answer 30

adenocarcinoma of the pancreas (advanced stages)

Question 31

what is a partial lumbar sympathectomy?

Answer 31

• surgical removal of lumbar sympathetic ganglia by division of rami communicantes
• treats arterial disease

Question 32

what is an abdominal aortic aneurysm?

Answer 32

• localized enlargement of aorta
• congenital or acquired weakness of arterial wall

Question 33

rupture of abdominal aorta can cause?

Answer 33

• severe back/abdomen pain
• 90% mortality from heavy blood loss

Question 34

what are the three collateral venous routes that can return blood to the heart if the IVC is obstructed?

Answer 34

• superior/inferior epigastric
• thoracoepigastric
• epidural venous plexus (communicates with lumbar veins)

Question 35

where would a persistent left IVC be located?

Answer 35

• inferior to renal vein on left side
• connects renal, IVC, & left common iliac veins