Sievert: posterior abdominal wall

Question 1

Structures that are retroperitoneal

Answer 1

urinary system
adrenal glands
sympathetic trunk and its branches to ganglia
thoracic duct/cisterna chyli
posterior abdominal wall
aorta and IVC
rectum

Question 2

peritoneal ligaments

Answer 2

lesser omentum
epiploic foramen
lesser sac
gastrosplenic ligament
splenorenal ligament

Question 3

Two ligaments that make up the lesser sac

Answer 3

hepatogastric

hepatoduodenal

Question 4

Which kidney is lower?

Answer 4

right kidney

Question 5

What ribs does the left kidney cover? What about the right kidney?

Answer 5

11 and 12

part of 12

Question 6

Which layer of fat is between the peritoneum and the renal fascia? Which layer lies between the kidney and the renal fascia?

Answer 6

pararenal; perirenal

Question 7

Near what mesenteric branch of the aorta do the renal arteries come off?

Answer 7

near the superior mesenteric branch

Question 8

3 areas of narrowing of the ureter

Answer 8

1. where the ureter leaves the kidney
2. where the ureter passes over the pelvic brim
3. where the ureter enters the bladder

Question 9

Where does parasympathetic innervation to the kidneys come from? Where do these neurons synapse?

Answer 9

Levels S2-4 (pelvic splanchnics) and the vagus

on ganglia in the renal sinus

Question 10

Where does sympathetic innervation to the kidneys come from? Where do they synapse?

Answer 10

lesser and least thoracic splanchnics and lumbar splanchnics

on ganglia on superior mesenteric artery or renal artery

Question 11

How do sensory fibers from the kidneys return to the spinal cord?

Answer 11

Via the vagus and the sympathetics

Question 12

Where do sensory fibers from the ureters return to?

Answer 12

T11-T12 spinal nerves

Question 13

Are the suprarenal glands developmentally related to the kidney?

Answer 13

No

Question 14

What kind of gland is the suprarenal gland?

Answer 14

endocrine

Question 15

What is the blood supply to the suprarenal glands?

Answer 15

superior suprarenal off inferior phrenic
middle suprarenal directly off the aorta
inferior suprarenal off the renal

Question 16

Discuss the innervation to the adrenal gland. Is the neuron to the adrenal gland postganglionic or preganglionic? Are the neurons to the cortex post or preganglionic?

Answer 16

preganglionic; postganglionic

Question 17

Where do hypogastric nerves arise from?

Answer 17

the superior hypogastric plexus

Question 18

Where do 90% of the sympathetics to the pelvis come from?

Answer 18

hypogastic nerves

Question 19

Where do the remaining 10% of sympathetics to the pelvis come from?

Answer 19

sacral splanchnics

Question 20

Where do the vagal trunks terminate?

Answer 20

left colic flexure

Question 21

After the left colic flexure, where does the remainder of the gut tube get its parasympathetic fibers from?

Answer 21

pelvic splanchnics S2-4

Question 22

Formed by the combination of two lumbar trunks and one intestinal trunk as a small dilation just inferior to the diaphragm known as the cisterna chyli

Answer 22

thoracic duct

Question 23

What is the small dilation just inferior to the diaphragm known as?

Answer 23

cisterna chyli

Question 24

What are two muscles of the posterior wall musculature?

Answer 24

quadratus lumborum

psoas major

Question 25

List the abdominal aortic branches from superior to inferior

Answer 25

``` Inferior phrenics celiac artery middle suprarenal SMA renal gonadal IMA lumbar arteries common iliacs median sacral artery ```

Question 26

The lumbar veins connect the IVC to the (blank) which ultimately connects to the azygos system

Answer 26

ascending lumbar vein

Question 27

What is the ligament where the diaphragm abuts the quadratus lumborum?

Answer 27

Lateral arcuate ligament

Question 28

What is the ligament where the diaphragm abuts the psoas major?

Answer 28

Medial arcuate ligament

Question 29

This extends inferiorly to attach to the vertebral bodies

Answer 29

crura.

Question 30

Which crura is tighter, longer, and makes up the esophageal hiatus

Answer 30

right crura

Question 31

Two areas of the diaphragm

Answer 31

central tendinous area | peripheral muscular area

Question 32

A site of congenital diaphragmatic hernia.

Answer 32

lumbocostal trigone

Question 33

Four embryonic structures forming the diaphragm

Answer 33

1. septum transversum 2. pleuroperitoneal membranes 3. dorsal mesentery of esophagus forms the crura 4. body wall from cervical somites

Question 34

Endoscopic examination of colon and distal end of small bowel with a fiberoptic camera

Answer 34

colonoscopy

Question 35

A twisting of the intestine causing bowel obstruction

Answer 35

volvulus

Question 36

Diverticuli most commonly occur in which region of the colon?

Answer 36

sigmoid colon

Question 37

The yolk stalk connects the the small bowel to the yolk sac. Usually, the duct fully obliterates around the 9th week of gestation. If not, what forms?

Answer 37

Meckel's diverticulum

Question 38

The enfolding of one segment of the intestine within another; part of the intestine invaginates in another section of the intestine

Answer 38

intussusception

Question 39

At what level does the IVC penetrate the diaphragm?

Answer 39

T8

Question 40

At what level does the esophagus penetrate the diaphragm?

Answer 40

T10

Question 41

At what level does the aorta penetrate the diaphragm?

Answer 41

T12

Question 42

3 other structures that pass through the diaphragm?

Answer 42

``` thoracic splanchnic nerves (through) sympathetic trunk (behind the diaphragm) vagal trunks (through the esophageal hiatus) ```

Question 43

What does the septum transversum form?

Answer 43

The central tendinous area

Question 44

What do the pleuroperitoneal membranes form?

Answer 44

The peripheral muscle area

Question 45

What does the dorsal mesentary of the esophagus form?

Answer 45

crura and esophageal hiatus

Question 46

What forms up the lateral portions of the diaphragmatic muscles?

Answer 46

cervical somites

Question 47

Where do 90% of sympathetics to the pelvis come from? Where does the other 10% come from?

Answer 47

hypogastric nerves; sacral splanchnics

Question 48

What nerve lies medial to the psoas muscle?

Answer 48

obturator

Question 49

What nerve lies lateral to the psoas muscle?

Answer 49

femoral

Question 50

What nerve runs on top of the psoas muscle?

Answer 50

genitofemoral

Question 51

What nerve lies under rib 12?

Answer 51

subcostal

Question 52

List the layers of the kidney from internal to external

Answer 52

kidney, perirenal fat, renal fascia, pararenal fat, transversalis fascia

Question 53

The ureter receives branches from these three arteries

Answer 53

renal gonadal vesicular