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Anatomy Quiz 5 > Retroperitoneum > Flashcards

Retroperitoneum Flashcards

1
Q

What are the 5 muscles of the posterior abdominal wall?

A 
Diaphragm
Psoas major
Psoas minor
Quadratus lumborum
Iliacus
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2
Q

What muscle forms the superior most region of the posterior abdominal wall?

A

Diaphragm

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3
Q

Where does the psoas major originate?

A

Lumbar vertebrae

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4
Q

What muscles form the ilipsoas muscle?

A

Psoas major

Iliacus

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5
Q

Where does the iliopsoas muscle insert?

A

Lesser trochanter of the femur

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6
Q

Which muscle is a powerful flexor of the thigh?

A

Iliopsoas

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7
Q

Where does the quadratus lumborum lie?

A

Lateral to psoas major

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8
Q

Where does the quadratus lumborum originate?

A

12th rib

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9
Q

Where does the quadratus lumborum insert?

A

Iliac crest

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10
Q

The quadratus lumborum has an extra site of attachments before insertion. Where are they?

A

Transverse processes of lumbar vertebrae

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11
Q

What are the 2 functions of the quadratus lumborum?

A

Flex spine laterally

Stabilize 12th rib during valsalva

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12
Q

What nerves innervate the quadratus lumborum?

A

Branches of lumbar plexus

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13
Q

What nerves innervate the psoas major?

A

Branch of the lumbar plexus

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14
Q

Upon inspiration, the diaphragm flattens and squishes which 3 organs?

A

Liver
Spleen
Kidneys

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15
Q

What 3 structures are where the diaphragm originates?

A

Xyphoid process
Ribs
Lumbar vertebrae

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16
Q

What is a crura?

A

Part of the diaphragm that originates at the vertebrae

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17
Q

Which side of the diaphragm is higher?

A

Right- liver pushes it up

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18
Q

Where does the IVC pass through the diaphragm?

A

T8

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19
Q

Where does the esophagus pass through the diaphragm?

A

T10

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20
Q

Where does the aorta pass through the diaphragm?

A

T12

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21
Q

2 structures pass through the crura. They are?

A

Thoracic splanchnic nerves (all 3)

Azygos vein

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22
Q

Where does the sympathetic trunk lie in relation to the diaphragm?

A

Posterior

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23
Q

There are 3 arteries that supply the diaphragm. What are they and their origins?

A

Pericardiophrenic - internal thoracic artery
Musculophrenic - internal thoracic artery
Inferior phrenic - abdominal aorta

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24
Q

Which nerve(s) supply the motor innervation to the diaphragm?

A

Phrenic

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25
Q

Which nerve(s) supply the sensory information from the diaphragm?

A

Phrenic (central diaphragm)

T6-T12 intercostals (periphery)

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26
Q

True or False. The entire diaphragm is covered in a serosa.

A

False. Most of it is covered by a sensitive serosa of peritoneum except where bare area of liver joins

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27
Q

Below the abdominal musculature but above the peritoneum lies which layer?

A

Transversalis fascia

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28
Q

Between which 2 layers lies the extraperitoneal space?

A

Peritoneum and transversalis fascia

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29
Q

The anterior extraperitoneal space is referred to as?

A

Properitoneal space

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30
Q

The posterior extraperitoneal space is referred to as?

A

Retroperitoneal space

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31
Q

Name the layers of the posterior abdominal wall inward from the muscles.

A

Posterior abdominal wall muscles –> transversalis fascia –> retroperitoneal space –> peritoneum –> posterior body organs

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32
Q

Where do the vessels and nerves enter the kidney?

A

Renal hilum

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33
Q

What is the renal sinus and where is it located?

A

Fatty concavity of the medial hilum

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34
Q

The outer 1/3 of the kidney is?

A

Cortex

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35
Q

The renal medulla contains?

A

Renal pyramids

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36
Q

Cortical tissue between the renal pyramids is called?

A

Renal columns

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37
Q

The pointed ends of the renal pyramids are?

A

Renal papillae

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38
Q

Renal papillae empty urine into?

A

Minor calices

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39
Q

Merging of minor calices forms what?

A

Major calices

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40
Q

Where does the urine collect in the kidney before leaving into the ureters?

A

Renal pelvis

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41
Q

The kidneys receive blood from?

A

Renal arteries

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42
Q

Trace the path of the right and left renal arteries.

A

Right- passes posterior to IVC and connects to aorta (left of vertebrae)
Left- direct path to aorta (left of vertebrae)

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43
Q

Trace the path of the left and right renal veins.

A

Right- posterior to descending duodenum to IVC (right side of vertebrae)
Left- anterior to aorta and posterior to SMA (in angle) to IVC (right side of vertebrae)

44
Q

Where do the renal arteries branch from?

A

Abdominal aorta at L1 below the SMA

45
Q

What structure enters the hilum most anterior? Most posterior?

A

Anterior- Renal vein
Middle- Renal artery
Posterior- Renal pelvis

46
Q

Where do the kidneys lie in relation to the vertebral column?

A

T12 to L3

47
Q

What do the kidneys rest against superiorly? Inferiorly?

A

Superiorly- diaphragm

Inferiorly- quadratus lumborum

48
Q

Where does one percuss for kidney tenderness?

A

CVA- between 12th rib and vertebral column

49
Q

Which kidney is higher than the other?

A

Left kidney higher

Right is pushed down by liver

50
Q

Where do the adrenal glands lie on the kidneys?

A

Superior and medial

51
Q

Do the adrenal glands directly contact the kidney?

A

No, there’s a fibrous capsule between them

52
Q

What are the layers of fat and fascia surrounding the kidney from the outside inward?

A

Outside –> pararenal fat –> renal fascia –> perirenal fat –> renal capsule

53
Q

Where do the renal arteries branch?

A

Close to the hilum

54
Q

What do the renal arteries branch into?

A

4 anterior and 1 posterior branch

55
Q

If blockage of a renal artery occurs, how else does the kidney receive blood?

A

It doesn’t! Renal arteries are end arteries and don’t have any anastomosis

56
Q

The adrenal glands lie within which layer surrounding the kidneys?

A

Renal fascia

57
Q

The adrenal gland has two divisions. They are?

A

Cortex

Medulla

58
Q

The outermost layer of the adrenal gland is what? What does it secrete?

A

Cortex

Corticosteroids

59
Q

The innermost layer of the adrenal gland is? What does it secrete?

A

Medulla

Epinephrine and norepinephrine

60
Q

What three arteries supply the adrenal gland?

A

Superior suprarenal arteries
Middle suprarenal arteries
Inferior suprarenal arteries

61
Q

The superior suprarenal artery is a branch of what?

A

Inferior phrenic artery

62
Q

The middle suprarenal artery is a branch of?

A

Aorta

63
Q

The inferior suprarenal artery is a branch of what?

A

Renal arteries

64
Q

Where does the right adrenal gland blood drain?

A

Right suprarenal vein –> IVC

65
Q

Where does the left adrenal gland blood drain?

A

Left suprarenal vein –> Left renal vein

66
Q

As the ureter descends from kidneys to bladder, it passes:

A

Posterior to gonadal vessels

Anterior to bifurcation of common iliacs

67
Q

What 3 locations are where the ureters can become constricted?

A
  1. Ureteropelvic junction
  2. Pelvic brim (crossing common iliac vessels)
  3. Ureterovesical junction
68
Q

Where does the abdominal aorta enter the abdominal cavity?

A

T12

69
Q

At what level does the abdominal aorta bifurcate?

A

Umbilicus!

L4
T10 dermatome

70
Q

What does the abdominal aorta branch into?

A

2 common iliac arteries

71
Q

Where does the abdominal aorta run in relation to vertebrae and IVC?

A

Anterior to vertebrae

Left of IVC

72
Q

How many visceral and parietal branches come from the aorta?

A

6 visceral

3 parietal

73
Q

The branches of the aorta can be subdivided into 4 regions:

A

Ventral
Lateral
Dorsal
Terminal

74
Q

See the sheet for abdominal aorta branches

A

Memorize this!!

75
Q

IVC splits into common iliac veins where?

A

L5

76
Q

Trace the collateral venous circulation starting with the segmental lumbar veins. What does this bypass?

A

Segmental lumbar veins –> ascending lumbar veins –> azygos/hemiazygos –> SVC

This bypasses the IVC!

77
Q

Intraperitoneal viscera of the foregut lymph drains where?

A

Celiac nodes

78
Q

Intraperitoneal viscera from the midgut lymph drains where?

A

Superior mesenteric nodes

79
Q

Intraperitoneal viscera from hindgut lymph drains where?

A

Inferior mesenteric nodes

80
Q

Where do primarily retroperitoneal organs lymph drain?

A

Right and left lumbar nodes (along aorta and IVC)

81
Q

What are the three lymphatic trunks located in the abdominal cavity?

A

Right lumbar trunk
Left lumbar trunk
Intestinal trunk

82
Q

Where do the right, left and intestinal trunks drain?

A

Cisterna chyli

83
Q

What do the right and left lumbar trunks drain?

A

Legs, pelvis, urogenital system, abdominal wall, abdominal viscera

84
Q

What do the intestinal lymph trunks drain?

A

Celiac, superior and inferior nodes

85
Q

Primarily retroperitoneal organs are innervated by which sympathetic nerves?

A

Thoracic splanchnics

86
Q

Where do the thoracic splanchnics synapse?

A

Paravertebral/Pre-aortic ganglia

87
Q

What parasympathetics innervate the retroperitoneal organs?

A

Vagus nerve

88
Q

Somatic structures like the posterior muscles are innervated by what?

A

Branches of the lumbar plexus

89
Q

What three things make up the posterior abdominal wall?

A

Lumbar vertebrae
Skeletal muscles
Transversalis fascia

90
Q

What are the 3 types of visceral nerves that form plexuses in the abdomen?

A

Sympathetic visceral efferent
Parasympathetic visceral efferent
Visceral afferent

91
Q

What plexus do the visceral nerves form in the abdomen?

A

Aortic plexus

92
Q

Where do the sympathetic efferent nerves synapse?

A

Prevertebral ganglia

93
Q

What are the 2 types of sympathetic nerves that enter the aortic plexus?

A

Thoracic splanchnics

Lumbar splanchnics

94
Q

Where do the prevertebral ganglia for sympathetic synapse reside?

A

Within the aortic plexus

95
Q

Generally, thoracic splanchnics provide innervation to what regions of the abdomen?

A

Foregut

Midgut

96
Q

Generally, lumbar splanchnics provide sympathetic innervation to which abdominal region?

A

Hindgut

Pelvis

97
Q

What is the primary role of sympathetic efferents in the abdomen?

A

Constrict abdominal blood vessels to divert to structures that need it (during flight or fight)

98
Q

What are the 2 types of parasympathetic nerves that enter the aortic plexus?

A

Vagal trunks

Pelvic splanchnics

99
Q

Where do vagus nerves enter the abdomen?

A

With the esophagus at T10

100
Q

Where do the parasympathetics synapse in the abdomen?

A

Enteric ganglia in target organ

101
Q

True or False. The pelvic splanchnics synpase in the aortic plexus.

A

False. They synapse in the pelvic plexus, though it IS continuous with the aortic plexus.

102
Q

What is the main function of parasympathetics in the abdomen?

A

Promote digestion

103
Q

Visceral afferents carrying pain, nausea, cramps, etc. travel how?

A

Along with sympathetic AND parasympathetic fibers

104
Q

Visceral pain afferents travel how?

A

With sympathetic nerves

105
Q

Which afferent fibers travel with parasympathetic neurons?

A

Visceral reflex afferents

Anatomy Quiz 5 (3 decks)

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