Theme 3 anatomy

Question 1

Retroperitoneal organs: Definition and Examples [5]

Answer 1

Mesentery/peritoneum over anterior surface only

Aorta
IVC
Kidney
Suprarenal glands

Question 2

Secondary retroperitoneal organs [3]

Answer 2

pancreas
duodenum
asc + desc colon

Question 3

Kidney location & poles [4]

Answer 3

Sup pol - T12
Inf pol - L3
Rightly slightly lower

Posterior and wall

Question 4

Kidney relations [3]

Answer 4

Diaphragm, superior

Psoas major, medial

Quadratus lumborum, posterior and lateral

Question 5

Right kidney [4]

Answer 5

right suprarenal gland
liver
right colic flexure
duodenum

Question 6

Left kidney [6]

Answer 6

left suprarenal gland
 stomach
spleen
pancreas
 left colic flexure
jejunum

Question 7

Parenchima

Answer 7

Renal pyramid and cortex

Question 8

Renal pyramid & cortex

Answer 8

Parenchima

Question 9

Hilum of kidneys - VAN

Answer 9

Aorta -> renal artery
Renal vein -> IVC

Vein anterior to artery

Lymph -> lateral aortic nodes

Question 10

Suprarenal glands

Answer 10

Over kidney
Separate from fascial compartment
Pyramidal and semilunar

Suprarenal arteries and veins Abdominopelvic n

Question 11

Functional suprarenal [3]

Answer 11

Cortex: Corticosteroids and sex hormones

Medulla: adrenaline

Question 12

Bladder and urethra

Answer 12

Located in true pelvis

Bladder = inverted pyramid with urethra at apex

Question 13

Kidney protection [3]

Answer 13

perirenal fat, ribs, vertebral column

Question 14

Renal transplant

• Incision
• Insertion
• Anastomosis

Answer 14

renal artery to external iliac artery
renal vein to external iliac vein

Incision done just over inguinal ligament (parallel)
Iliac fossa

Question 15

Kidney Malformation [5]

Answer 15

Bilateral/Unilateral renal agenesis

Supernumerary kidneys

Renal fusion

Ectopic kidney

Simple/polycystic kidney

Question 16

Diaphragm

• Anchors
• Hiatus
• Innervation
• VAN

Answer 16

Crura 
Central tendon 
T8 
T10 
T12 

Sup/inf phrenic
Intercostal (T5-11) and Subcostal (T12)
Phrenic

Question 17

Quad Lumb

• Innervation
• VAN

Answer 17

Posterior to kidneys
Rib 12 - iliac crest
Trans abd = lat attachment
Abd stability and lateral flexion

Lumbar x2

Question 18

Iliac + Psoas

• Innervation
• VAN

Answer 18

Iliacus: iliac blade

Psoas: Lumbar vertebrae

Lesser trochanter femur
Hip flexors

L2-4
T12-L4

Question 19

Somatic

Answer 19

Voluntary control and sensation

• ant/post abdominal walls and joints
• L1-4

Question 20

Autonomic

Answer 20

Segmented structure

• BV and sweat glands
• Symp chain (paravertebral)

Viscera

• Splanchnic
• Celiac, sup and inf mesenteric (prevertebral)

Question 21

Prevertebral ganglia

Answer 21

nerves originate in spinal cord and project to these ganglia bypassing the symp chain and from these to the viscera => splanchnic nerves

Question 22

Somatic abdominal pain arises from [4]

Answer 22

skin
fascia
muscle
parietal peritoneum

Precisely localised and severe

Question 23

Visceral abdominal pain arises from [3]

Answer 23

abdominal organs
mesenteries
visceral peritoneum

Dull pain

Question 24

Visceral abdominal pain causes [3]

Answer 24

stretching viscus or mesentery

impaired blood supply to viscus

chemical damage to viscus

Question 25

Referred pain

Answer 25

Describes pain at a location other than site of origin stimulus but supplied by same or adjacent segments of the spinal cord both somatic and visceral structures may produce referred pain Examples: visceral pain from stomach T5-9 visceral pain from appendix T10 visceral pain from gall bladder T7-9; but with parietal peritoneum involvement C3,4

Question 26

Kidney function [3]

Answer 26

``` Regulation of blood ionic composition (e.g. Na) pH (excrete H+) volume (water) pressure (renin) osmolarity ``` Production of hormones (e.g. calcitriol) Excretion of wastes and foreign substances

Question 27

Renal colic [4]

Answer 27

Peristaltic waves of ureter in attempting to pass a stone Agonising pain – skin over area supplied Severe pain spreads to CNS (nausea) Enter spinal cord at level T11-L2