Retroperitoneal Structures and Posterior Abdominal Wall

Question 1

Contents of Retroperitoneal Space

Answer 1

Part of the duodenum, most of the pancreas, ascending and descending colon, kidneys, suprarenal glands, major vessels, some muscles

Question 2

Secondarily retroperitoneal organs

Answer 2

duodenum, pancreas, portions of colon

Question 3

Layers of retroperitoneal Fascia

Answer 3

parietal peritoneum (anteriorly), transversalis fascia (laterally), thoracolumbar fascia (posteirorly), renal fascia to surround suprarenal glands, kidneys, ureters, major vessels, and fat.

Question 4

Perinephric fat

Answer 4

Bury the suprarenal/adrenal glands

Question 5

Relationship of kidneys to ribs

Answer 5

Left kidney–> 11th and 12th ribs

Right kidney–> 12th rib only, more inferior

Question 6

function of renal medulla

Answer 6

Concentration of urine

Question 7

Flow from renal papilla to ureter

Answer 7

renal papilla–> minor calyces–> major calyces–> renal pelvis–> ureter

Question 8

Course of ureters

Answer 8

Course along transverse processes of lumbar vertebrae, cross the external iliac arteries, enter the posterolateral wall of the bladder

Question 9

Blood supply of suprarenal glands

Answer 9

Superior suprarenal artery from inferior phrenic artery, middle suprarenal artery from aorta, and inferior suprarenal artery from renal artery

Question 10

Branches of renal artery

Answer 10

inferior suprarenal artery, gonadal artery, arteries to ureter

Question 11

Nutcracker syndrome

Answer 11

Congenital compression of left renal vein between the SMA and aorta. Can cause renal hypertension, swelling/pain in gonads,

Question 12

Posterior abdominal wall muscles

Answer 12

Quadratus lumborum, psoas major, iliac, psoas minor

Question 13

Innervation of quadratus lumborum

Answer 13

Ventral rami of T12, L1-L4

Question 14

Innervation of psoas major

Answer 14

Lumbar plexus branches L2-L4

Question 15

Positive psoas sign

Answer 15

Pain on contraction of psoas major can support diagnosis of inflamed appendix

Question 16

Innervation of iliacus muscle

Answer 16

Femoral nerve L2-L4

Question 17

Innervation of psoas minor muscle

Answer 17

lumbar peux branches L2-L4

Question 18

Action of psoas minor

Answer 18

Weak flexor of trunk

Question 19

Action of iliacus muscle

Answer 19

flexion, lateral rotation of the hip

Question 20

Action of psoas major muscle

Answer 20

flexion, lateral rotation at the hip, lateral bending, flexion of trunk

Question 21

Action of quadratus lumborum

Answer 21

Lateral bending of trunk

Question 22

Origin of quadratus lumborum

Answer 22

Iliac crest

Question 23

Origin of iliacus muscle

Answer 23

iliac fossa

Question 24

Insertion of iliacus

Answer 24

lesser trochanter of femur

Question 25

Insertion of psoas major

Answer 25

lesser trochanter of femur

Question 26

Insertion of diaphragm

Answer 26

Central tendon

Question 27

Lateral arcuate ligament

Answer 27

Passage of quadratus lumborum, subcostal neurovascular bundle

Question 28

Medial arcuate ligament

Answer 28

Passage of psoas major, sympathetic trunk

Question 29

Median arcuate ligament

Answer 29

forms aortic hiatus

Question 30

Caval foramen

Answer 30

passageway for IVC at T8

Question 31

Esophageal hiatus

Answer 31

esophagus, vagal trunks at T10

Question 32

Aortic hiatus

Answer 32

aorta, thoracic duct at level of T12

Question 33

Venous drainage of left gonadal vein

Answer 33

goes to left renal vein then to IVC

Question 34

Venous drainage of ascending lumbar vein

Answer 34

goes to azygos/hemiazygos vein

Question 35

Renal Fascia

Answer 35

surrounds kidney, suprarenal glands, ureters, major vessels, and fat

Question 36

Medulla of adrenal glands

Answer 36

Target for preganglionic sympathetic fibers. It’s like a ganglion that secretes hormones.

Question 37

Right adrenal gland

Answer 37

pyramid shaped, positioned between kidney and IVC, also in contact with bare area of liver.

Question 38

Left adrenal gland

Answer 38

crescent shaped, sits right behind the body of the stomach, tucked behind the spleen, splenic artery, pancreas and stomach.

Question 39

Venous drainage of kidney

Answer 39

Not a digestive organ so it does NOT go to the liver. It goes to IVC.

Question 40

Function of kidney

Answer 40

excretion of waste, excess solutes, resorption of nutrients, critical role in maintaining blood volume and pressure.

Question 41

What passes through the hilum of the kidney

Answer 41

renal artery, renal vein, ureter, nerves, and lymphatics

Question 42

Blood supply to kidneys

Answer 42

Renal artery from aorta branches to segmental arteries (usually 5), then further subdivided into interlobar arteries.

Question 43

Right renal artery relationship to IVC

Answer 43

Passes posterior to IVC

Question 44

Inferior phrenic arteries

Answer 44

Branch off of abdominal aorta and supply diaphragm from inferior surface as well as adrenal glands

Question 45

Middle suprarenal arteries

Answer 45

come right off of aorta?

Question 46

Inferior suprarenal arteries

Answer 46

come off of renal artery

Question 47

Location of the left renal vein

Answer 47

crosses over aorta, beneath superior mesenteric artery

Question 48

right suprarenal veins

Answer 48

drain directly to IVC

Question 49

left suprarenal veins

Answer 49

drain to renal vein then to IVC