Retroperitoneum Flashcards
Posterior Abdominal Wall
(contents)
- Lumbar Vertebral Column
- Skeletal Muscle (Psoas Major and Psoas Minor, Iliacus, Quadratus Lumborum, Diaphragm)
- Overlying Transversalis Fascia
Psoas Major
Origin: Lumbar Vertebrae
Combines with: Iliacus Muscle (Iliopsoas)
Insertion: Lesser trochanter of the femur
Action: most powerful flexor of the thigh at the hip joint
Quadratus Lumborum
- lateral to the psoas major
Origin: 12th Rib
Insertion: Iliac Crest
Attachments: Lumbar Vertebrae
Action: Flexes spine laterally
**stabalized 12th rib and therefore diaphragm during respiratory exersion (i.e. valsalva maneuver)
Nerve Supply: Lumbar Plexus
Iliacus
Origin: Ilium
Insertion: Lesser trochanter of the femur
**combines with psoas major to form iliopsoas
Diaphragm
- thin dome-shaped musculo-tendinous partition separating the thoracic and abdominal contents
Action: flattens during inspiration pushing down abdominal contents
Origins: Xiphoid process, ribs, and lumbar vertebrae
** higher on right side because of the liver
Crura
- parts of the diaphragm that arise from the vertebrae
Major Openings of the Diaphragm
T8 - IVC (Foramen of the Vena Cava)
T10 - Esophagus (Esophageal Hiatus)
T12 - Aorta (Aortic Hiatus)
Structures that pass through Diaphragm
(Other)
Pass through Crura:
- Greater, Lesser, and Least Splanchnic Nerves
- Azygous veins
Pass posterior to diaphragm:
- Sympathetic trunks
Pass through the diaphragm:
- Phrenic Nerves
Blood Supply to the Diaphragm
Two branches of the internal thoracic artery:
- Percardiophrenic Artery
- Musculophrenic Artery
Directly from the aorta:
- Inferior Phrenic Arteries
Abdominal Surface of the Diaphragm
- except for bare area covered by highly sensitive serosal layer of the peritoneum
Diaphragm Innervation
Phrenic Nerve - motor (efferent) and sensory (afferent) innervation (C3, C4, C5)
Intercostal Nerves - sensory (afferent) innervation to the periphery of the diaphragm (T6-T12)
Properitoneal Space
- ANTERIOR extraperitoneal space between the transversalis fascia and the peritoneum
Retroperitoneal Space
- POSTERIOR extraperitoneal space between the transversalis fascia and the peritoneum
Viscera of the Retroperitoneal Space
Kidneys (primary)
Adrenal Glands (primary)
Ureters (primary)
Duodenum (Distal) (secondary)
Pancreas (secondary)
Ascending/Descending Colons (secondary)
(arteries, veins, nerves, and lymphatics)
Kidneys (Function)
- filter 200 liters fluid/day
- urinary output 600-1500 cc/day
- regulate total water volume of body and osmolality
- regulate concentration of extracellular ions
- help regulat longer term acid-base balance
- help eliminate drugs/toxins
**therefore complex anatomy
Renal Hilum
- vertical cleft on the medial margin of the kidney where vessels, nerves, and lympatics enter/leave
Renal Sinus
- fat-filled cavity at the medial border of the renal hilum
Renal Cortex
- forms out 1/3 of renal substance
Renal Medulla
- composed of renal pyramids
Renal Columns
- cortical substance that extends between the renal pyramids into the medulla
Renal Pyramids
- project from the renal sinuses towards the surface of the kidneys
Renal Papillae
- blunted, perforated apices (area cribosa( of the pyramids projecting into the minor calyces of the renal pelvis where they discharge urine
Minor calyces
- each receives a renal papillae
Major Calyces
- 2 or 3 minor calyces coalesce to form the major calyx