Ureter/Muscles of the Posterior Abdominal Wall Flashcards
What is the muscular tube that connects the kidney to the urinary bladder?
Ureter
Is the ureter intra- or retroperitoneal?
Retroperitoneal
The ureter descends over what muscle?
Psoas major muscle
The ureter is crossed by which vessels?
Gonadal vessels
The ureter crosses what structure?
The common iliac artery at its bifurcation
Where do the upper and lower parts of the ureter lie, respectively?
Upper - Abdomen, Lower - Pelvis
Where are the three constriction locations where kidney stones can become lodged?
Ureteropelvic junction, pelvic brim, and where the ureter enters the wall of the bladder
Branches of what five arteries make up the blood supply to the ureter?
Renal artery, gonadal artery, aorta, common iliac artery, superior vesical artery
Which branches of the ureter’s blood supply are responsible for the abdominal portion of the ureter?
Renal artery, gonadal artery, aorta, and common iliac artery
Which branch of ureter blood supply is responsible for the pelvic portion of the ureter?
Superior vesical artery
What is the innervation of the ureter?
Renal plexus and hypogastric plexus
The suprarenal glands go by what name in general mammals?
Adrenal glands
What part of the suprarenal gland secretes catecholamines?
Medulla
What are the catecholamines secreted by the medulla of the suprarenal gland?
Epinephrine and norepinephrine
The medulla of the suprarenal gland is also known as what?
Modified sympathetic ganglion
What part of the suprarenal gland secretes corticosteroids?
Cortex
Can we live without suprarenal glands?
No
Is the suprarenal gland intra- or retroperitoneal?
Retroperitoneal
The suprarenal gland lies on what aspect of the kidney?
Superomedial
What surrounds the suprarenal gland?
A capsule and renal fascia
What is Addison’s Disease?
Adrenal hypo function that affects mainly corticosteroid output
What is the shape of the right suprarenal gland?
Pyramidal
What is the shape of the left suprarenal gland?
Semilunar
What is the connection between the suprarenal gland and overall autonomic nerve supply?
Relative to size, it has the largest autonomic nerve supply of any organ
What is the arterial blood supply to the suprarenal gland?
Superior, middle, and inferior suprarenal arteries
From where does the superior suprarenal artery arise?
Inferior phrenic artery
From where does the middle suprarenal artery arise?
Aorta
From where does the inferior suprarenal artery arise?
Renal artery
What is the venous blood supply to the suprarenal gland?
Suprarenal vein
To where does the right suprarenal vein drain?
Directly into the inferior vena cava
To where does the left suprarenal vein drain?
Into the left renal vein
What is the innervation of the suprarenal gland?
Primarily sympathetic from the celiac plexus and thoracic splanchnic nerves
Pain from the kidney or suprarenal gland is often referred to what area?
Paralumbar region or flank
What is the phrase coined about the pathway of pain from a kidney stone?
“The loin to the groin” (lumbar region to inguinal region)
The ureter receives innervation from what cord levels?
T11-L2
If kidney pain is accompanied by a high fever, what does that usually mean?
Kidney infection
Kidney infections are more common in what gender?
Females
Why are kidney infections more prevalent among females?
Due to their shorter urethras
What five things make up the abdominal aspect of the diaphragm?
Right crus, left crus, median arcuate ligament, medial arcuate ligament, lateral arcuate ligament
A weakness in what area of the abdominal diaphragm may cause hiatal hernia?
Right crus
What part of the abdominal diaphragm originates from the upper three lumbar vertebrae?
Right crus
The right crus splits to surround what structure?
Esophagus
What part of the abdominal diaphragm originates from the upper two lumbar vertebrae?
Left crus
Which crus of the abdominal diaphragm is shorter and smaller?
Left
What part of the abdominal diaphragm is a thickening of fascia which connects the body of the 1st lumbar vertebra to the transverse process of the 1st lumbar vertebra?
Medial arcuate ligament
What part of the abdominal diaphragm is a thickening of fascia which connects the right crus to the left crus?
Median arcuate ligament
The median arcuate ligament forms the border of what structure?
Aortic hiatus
The medial arcuate ligament passes over what structures?
Psoas major muscle and sympathetic trunk
What part of the abdominal diaphragm is a thickening of fascia which connects the transverse process of the 1st lumbar vertebra to the 12th rib?
Lateral arcuate ligament
The lateral arcuate ligament passes over what muscle?
Quadratus lumborum
What is the origin of the psoas major?
Transverse processes and bodies of T12-L5 and corresponding intervertebral discs
What is the insertion of the psoas major?
Lesser trochanter
What is the innervation of psoas major?
Lumbar nerves 1-3
What is the function of psoas major?
Flexes thigh, flexes trunk
What is the origin of psoas minor?
Bodies and intervertebral discs of T12-L1
What is the insertion of psoas minor?
Pecten pubis, iliopubic eminence
What is the innervation of psoas minor?
1st lumbar nerve
What is the function of psoas minor?
Flexes trunk
The psoas minor muscle is found in what percentage of the population?
60%
Why doesn’t the psoas minor have any effect on flexing the thigh?
It doesn’t cross the joint
What is the origin of the iliacus muscle?
Iliac fossa, iliac crest, ala of sacrum
What is the insertion of the iliacus muscle?
Lesser trochanter via tendon of psoas major
What is the innervation of the iliacus muscle?
Branches of femoral nerve (L2, L3)
What is the function of the iliacus muscle?
Flexes thigh, tilts pelvis forward
How is the psoas sign performed?
Thigh is flexed against resistance (positive if pain present)
What does positive right psoas pain suggest?
Acute appendicitis
What is the origin of quadratus lumborum?
Iliolumbar ligament, iliac crest
What is the insertion of quadratus lumborum?
12th rib, transverse processes of L1-4
What is the innervation of quadratus lumborum?
Subcostal nerve, lumbar nerves 1-4
What is the function of quadratus lumborum?
Depresses 12th rib, flexes trunk laterally
The lumbar plexus is formed by what anterior primary rami?
L1, L2, L3, and part of L4
What are the branches of the lumbar plexus?
Iliohypogastric nerve, ilioinguinal nerve, genitofemoral nerve, lateral cutaneous nerve of thigh, femoral nerve, obturator nerve
What branch of the lumbar plexus is sensory to the skin covering the pubis and gluteal region?
Iliohypogastric nerve (L1)
What is the iliohypogastric nerve cord level?
L1
Which branch of the lumbar plexus supplies sensory innervation to the skin of the scrotum (or labia majora) and the thigh?
Ilioinguinal nerve
The ilioinguinal nerve emerges from what structure?
Superficial inguinal ring
What is the ilioinguinal cord level?
L1
What are the two branches of the genitofemoral nerve?
Genital branch and femoral branch
What branch of the genitofemoral nerve supplies the cremaster muscle?
Genital branch
What branch of the genitofemoral nerve supplies the skin over the femoral triangle?
Femoral branch
What are the cord levels for the genitofemoral nerve?
L1, L2
What branch of the lumbar plexus supplies the skin of the anterior and lateral aspects of the thigh?
Lateral cutaneous nerve of thigh
What are the cord levels for the lateral cutaneous nerve of the thigh?
L2, L3
What branch of the lumbar plexus supplies the muscles and skin of the thigh?
Femoral nerve
What are the cord levels for the femoral nerve?
L2, L3, L4
What branch of the lumbar plexus supplies the muscles and skin of the medial surface of the thigh?
Obturator nerve
What are the cord levels for the obturator nerve?
L2, L3, L4
The sacral plexus is formed by the anterior primary rami of what cord levels?
L4-S4
What is the very first nerve located on the posterior abdominal wall?
Subcostal nerve
What are the largest paired arteries that come off of the abdominal aorta?
Renal arteries
What branches of the abdominal aorta are homologous to the intercostals in the thorax?
Lumbar arteries
How many pairs of lumbar arteries coming off of the abdominal aorta are there?
4
What are the branches of the abdominal aorta?
Celiac trunk, superior and inferior mesenteric arteries, inferior phrenic artery, middle suprarenal artery, renal artery, gonadal (testicular or ovarian) artery, lumbar arteries, median sacral artery
Where does the abdominal aorta bifurcate into the right and left common iliac arteries?
Anterior to the fourth lumbar vertebra
What does each common iliac artery bifurcate into?
Internal and external iliac arteries