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Block 3 Week 2 Dani > Sievert- Posterior Abdominal Wall > Flashcards

Sievert- Posterior Abdominal Wall Flashcards

1
Q

What are all the primary retroperitoneal structures?

A 
Urinary system
Adrenal glands
Sympathetic trunk and its branches to ganglia
Thoracic duct/cisterna chyli
Posterior abdominal wall
Aorta and IVC
Rectum
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2
Q

All the lymphatics from the gut drain ultimately to the (blank).

A

thoracic duct

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3
Q

The (blank) is where the thoracic duct has a dilation where all the lymphatics form the gut join together.

A

cisternae chyli

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4
Q

The rectum is both (blank) and (blank)

A

retroperitoneal

subperitoneal (distal 2/3rds)

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5
Q

2 layers of peritoneum with nerve fibers and blood vessels constitute a (Blank)

A

ligament

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6
Q

The (blank) makes up the anterior surface of the lesser sac

A

lesser omentum

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7
Q

Which kidney is lower?

A

right

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8
Q

The (blank) come off the aorta near the SMA and divide into anterior and posterior segmental branches as they reach the hilum.

A

renal arteries

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9
Q

These may have polar arteries on either pole due to developmental differences?

A

renal arteries

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10
Q

what does the blood supply to the ureter?

A

the renal, gonadal and vesicular arteries, illiac

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11
Q

What are the three sites of potential narrowing of the ureter?

A

transit from pelvis to ureter
pelvic brim
enrtance to the bladder

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12
Q

The ureter enters the bladder (blank

A

diagonlly

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13
Q

What is the innervation to the ureter?

A

T11-L2

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14
Q

What is the innervation to the kidney?

A

Parasympathetics S2-4 (pelvic) and Vagus

Sympathetics- thoracic splachnic nerves (lesser and least) and lumbar splachnics

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15
Q

Where do the sympathetics to the ureter synapse?

A

ganglia (aorticorenal,small ganglia on the renal artery and SMA)

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16
Q

Where do the parasympathetics synapse?

A

in renal sinu

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17
Q

The sensory fibers from the kidney return via the (blank) and (blank)

A

vagus and sympathetics

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18
Q

Sensory fibers from the ureters can travel similiar to he kidneys, but also return to DRGs; via (blank) spinal nerves, hence the changes that occur in pain as a (blank) moves along the ureter

A

T12-L2

renal calculus

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19
Q

(blank) Are only anatomically, not developmentally related to the kidney

A

suprarenal glands

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20
Q

(blank) is an endocrine gland

A

suprarenal glands

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21
Q

What is the blood supply to the adrenal gland?

A

Superior suprarenal off inferior phrenic
Middle suprarenal directly off the aorta
Inferior suprarenal off the renal

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22
Q

What is the venous drainage of the adrenal glands?

A

Venous drainage comes from signal vein. On the left you might have a branch that goes into renal vein. But both eventually go to IVC. Right typically just goes straight into IVC

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23
Q

What is the innervation to the adrenal glands?

A

Sympathetic fiber that enters adrenal medulla, enter as a preganglionic fiber 
Adrenal cortex has postganglionic fibers

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24
Q

(blank) fibers innervate secretory cells of the adrenal medulla

A

preganglionic sympathetic

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25
Q

The cells of the adrenal medulla will respond to stimulation of preganglionic by …….

A

secreting secreting epinephrine and norepinephrine for a systemic sympathetic response

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26
Q

What thoracic splachnic enters the adrenal medulla?

A

greater thoracic through celiac ganglion

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27
Q

(blank) arise from the superior hypogastric
plexus and supply the inferior plexus
with 90% of the sympathetics to the pelvis. The remaining 10% come from sacral splanchnics.

A

hypogastric nerves

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28
Q

hypogastric nerves arise from the (Blank) and supply the inferiorplexus with 90% of the sympathetics to the pelvis. THe remaining 10% comes from (blank)

A

hypogastric plexus

sacral splachnics

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29
Q

What innervates the infeiror plexus?

A

90% hypogastric nerves from superior hypogastic plexus

10% sacral splachnics

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30
Q

How can you differentiate between parasympathetics and sympathetics?

A

Sympathetics have to come from sympathetic chain

Parasympathetics come off the spinal cord (S2-4) and innervate the GI structures in the abdominal cavity.

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31
Q

The anterior and posterior vagal

Trunks course onto the anterior and posterior surfaces of the (blank) at its junction to the cardiac stomach.

A

esophagus

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32
Q

The anterior and posterior vagal
Trunks course onto the anterior and posterior surfaces of the esophagus at its junction to the cardiac stomach. From here they send fibers to the digestive organs as far as the (blank)

A

left colic flexure

33
Q

The anterior and posterior vagal
Trunks course onto the anterior and posterior surfaces of the esophagus at its junction to the cardiac stomach. From here they send fibers to the digestive organs as far as the left colic flexure. The rest of the gut tube gets parasympathetics fibers from (blank)

A

pelvic splachnics S2-4

34
Q

(blank) takes care of lesser curvature of stomach, some liver

A

Anterior vagal trunk

35
Q

(blank) takes care of greater curvature and intestinal track DJI and part of colon.

A

posterior vagal trunk

36
Q

The (blank) is formed by the combination of two lumbar trunks and one intestinal trunk at a small dilatation just inferior to the diaphragm known as the cisterna chyli

A

thoracic duct

37
Q

The left and right lumbar trunk meets up at the (blank)

A

cisterna chyli

38
Q

The cisterna chyli is the start of the (blank)

A

thoracic duct

39
Q

The thoracic duct is formed by the combination of (blank)

A

2 lumbar trunks and one intestinal trunk

40
Q

HOw do you get to the cistern chyli?

A

slit the right crus of the diaphragm

41
Q

What are the posterior wall muscles?

A

quadratus lumborum and psoas major

42
Q

Contraction of this can cause irritation of an inflamed appendix

A

psoas muscle

43
Q

What function in movement, not protection

A

posterior wall muscles

44
Q

(blank) attaches to illiac crest and stabilizes pelvis

A

quadratus lumborum

45
Q

What go over the quadratus lumborum and psoas muscle?

A

medial and lateral arcuate ligaments

46
Q

What are the nerves of the posterior wall?

A 
subcostal 
illiohypogastric
illioinguinal
lateral femoral cutaneous
genitofemoral
femoral 
obturator
47
Q

What level is the subcostal nerve at?

A

T12

48
Q

What level is the femoral nerve at?

A

L2-4

49
Q

What level is the obturator at?

A

L2-4

50
Q

What is on top of the psoas muscle>

A

genitofemoral nerve

51
Q

What nerve is the highest up right below diaphragm

A

subcostal nerve

52
Q

What nerve enters inguinal canal

A

illioinguinal nerve

53
Q

What nerve comes out right below illiac spine and into thigh?

A

lateral femoral

54
Q

What nerve is lateral to the psoas muscle?

A

the femoral

55
Q

What nerve is medial to the psoas muscle

A

the obturator

56
Q

What do the inferior phrenics supply?

A

adrenal gland and diaphragm

57
Q

What are the posterior wall veins to the IVC?

A 
inferior phrenic
hepatic
renal
right suprarenal
gonadal
common illiacs
lumbar veins-> ascending lumbar-> azygos system
58
Q

What are the abdominal aortic branches?

A 
inferior phrenics
celiac artery
middle suprarenal
renal
gonadel
IMA
lumbar arteries
common iliacs
median sacral artery
59
Q

What artery supplies the foregut?

A

celiac

60
Q

What artery supplies the midgut?

A

SMA

61
Q

What artery supplies the hindgut?

A

IMA

62
Q

What are all the parts of the diaphragm?

A 
central tendinous part (white inner)
peripheral muscular area
medial arcuate ligament
lateral arcuate ligament
crura
63
Q

(blank) is where the diaphragm abuts the psoas major muscle

A

medial arcuate ligament

64
Q

(blank) is where the diaphragm abuts the quadratus lumborum m.

A

lateral arcuate ligament

65
Q

(blank) extend inferiorly to attach to the vertebral bodies

A

crura

66
Q

HOw many cruras are there?

A

2

67
Q

What extend down onto lumbar vertebra?

A

crura

68
Q

Which is longer and wide, the left or right crua?

A

right crur

69
Q

What makes up the esophageal hiatus and sends its fascial lining down to the ligament of trites?

A

the right crura

70
Q

What structures penetrate the diaphragm?

A 
Inferior vena cava T8
Esophagus T10
Aorta T12
Thoracic splanchnic nerves
Sympathetic trunk 
Vagal trunks
71
Q

What level does the IVC penetrate the diaphragm?

A

T8

72
Q

What level does the esophagus penetrate the diaphragm?

A

T10

73
Q

What level does the aorta penetrate the diaphragm?

A

T12

74
Q

Note that the esophagus opening is usually formed entirely by fibers from the (blank)

A

right crura

75
Q

(blank) is an area developmentally where 2 things are closing off. Potential spot for weak area as a congential defect and can cause herniation; and result in hypoplastic lung. MOST common diaphragmatic hernia and results in poor lung development

A

lumbocostal trigone

76
Q

Why can hernias arise on the left(at lumbocostal trigone) much more often than the right side?

A

liver protects the right side

77
Q

What are the four embryonic structures the diaphragm comes from?

A
  1. Septum transversum
  2. Pleuroperitoneal membranes
  3. Dorsal mesentery of esophagus forms the crura
  4. Body wall from cervical somites
78
Q

A site of congenital diaphragmatic hernia is the left side in the area of the lumbocostal trigone. This is equivalent to a (blank) from failure to fuse of the pleuroperitoneal folds

A

Bochdalek hernia

79
Q

A site of congenital diaphragmatic hernia is the left side in the area of the lumbocostal trigone. This is equivalent to a Bochdalek hernia from failure to fuse of the (blank)

A

pleuroperitoneal folds

Block 3 Week 2 Dani (9 decks)

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