The Kidney and the Posterior Abdominal Wall Flashcards
Name the retroperitoneal structures.
- duodenum
- pancreas
- kidneys
- ascending and descending colon
- rectum
What is the name of the triangle of connective tissue found at the base of the back?
The thoracolumbar fascia
What are the names of the connective tissues where the diaphragm arches over the posterior abdominal wall muscles and vessels?
The median, medial and lateral arcuate ligaments
What is the most lateral posterior abdominal wall muscle?
What are it’s origins and attachments?
Quadratics lumborum
It attaches to the:
- The lumbar vertebra transverse processes medially
- 12th rib
- posterior iliac crest
What is the more medial posterior abdominal wall muscle?
What are it’s origins and attachments?
Psoas major
It is attached to:
- Iliacus muscle on the iliac fossa to form iliopsoas which attaches to the lesser trochanter of the femur
- Transverse processes of the lumbar vertebrae
What is the nerve supply to both psoas major and quadratics lumborum?
From the lumbar plexus (L1, 2 and 3)
Where is the lumbar plexus found?
Inside psoas major
Which level spinal nerves form the lumbar plexus?
T12 - L5
At what level does the thoracic aorta enter the abdominal cavity and through which structure?
It travels under the median arcuate ligament created by the diaphragm at the level of T12
At what level does the vena cava enter the abdominal cavity?
T8
At what level does the oesophagus enter the abdominal cavity?
T10
At what level does the abdominal aorta bifurcate?
What does it bifurcate into?
L4
Right and left common iliac arteries
What are the X3 lateral branches of the abdominal aorta, what level does each arise and what does each supply?
1) suprarenal = L1 = suprarenal gland
2) renal = L1/2 = kidneys
3) gonadal = L2 = gonads
How many paired branches does the abdominal aorta give off to supply the body wall?
X4
At what level do the right and left common iliac veins converge to for, the IVC?
L5
What is the name for the opening in the diaphragm through which the vena cava enters the thoracic cavity?
At what level does this occur?
The caval opening
T8
What are the tributaries of the IVC?
NOT the arterial supply of the GI tract, these are drained via the hepatic portal system.
The lumbar and renal veins are the same as the arteries.
The gonadal and suprarenal veins drain into the left renal vein, and therefore the IVC via this
Between what X2 levels do the aorta and IVC move from anterior/posterior and vice verse?
Which is anterior higher up?
The IVC is more anterior around the level of the kidneys.
They swap before the level of bifurcation so that the aorta is more anterior.
Is the renal vein or renal artery more anterior?
Renal vein
Which aortic vessel travels over the top of the renal vein?
The superior mesenteric artery
What level are the middle of the kidneys?
L1
Which kidney is higher and which is lower?
Why is this?
Right = lower Left = higher
Due to liver
What ribs are at the level of each kidney?
Right = 12th
Left = 11th
Which of the suprarenal glands is triangular in shape and which is crescent?
Right = triangular
Left = crescent
What are layers surrounding the kidney?
Kidney Renal capsule Perirenal fat Renal fascia Pararenal fat
What is the name of the cortex of kidney that extends between the triangular sections of medulla?
Renal columns
What are the triangular sections of kidney medulla called?
Renal pyramids
What are the initial structures of drainage that extend off each renal pyramid?
Minor calcycles
What is the main section of kidney that links the major calyces with the ureters?
The renal pelvis in the renal hilum
What is the arterial supply to the suprarenal glands?
Where do each of these arteries arise from?
There is x3 arteries:
1) superior suprarenal
= from the inferior phrenic which comes off the aorta
2) middle suprarenal
= direct from the aorta
3) inferior suprarenal
= from the renal artery
How many functional lobes does the kidney have?
X5
Where does the suprarenal vein drain on the right hand side?
Direct to the IVC
Where does the suprarenal vein drain on the left hand side?
Down to the left renal vein then to the IVC
Which structure do the ureters cross over on the way to the bladder?
The external iliac arteries
