2.3.1 Retroperitoneum and Kidneys

Question 1

Where does the lumbosacral trunk orginate? Lumbar plexus?

Answer 1

Lumbosacral trunk: (L4,5)

Lumbar plexus (L1-4)

Question 2

What is a renal calculi? Lifetime likelihood in men and women

Answer 2

Kidney stone

Lifetime likelihood: men (19%), women (9%)

Question 3

Red arrow and what is it vertebral column?(hint: might be joined with ilioinguinal nerve)

Answer 3

Iliohypogastric (L1)

Question 4

Where are the kidneys located relative to the vertabrae?

Answer 4

T12-L3

Question 5

Three anatomical locations where kidney stones can lodge

Answer 5

1. Orgin from renal pelvis
2. When crosses anteriorly over the iliac vessels
3. Through bladder wall

Question 6

How many arteries typically feed the adrenal gland?

Answer 6

3 (sup, mid, inf) suprarenal arteries

Question 7

Where does the vein of each adrenal gland drain?

Answer 7

Right: drains into IVC

Left: drains into left renal vein

Question 8

What is the major organ that touches the L kidney and not the R?

Answer 8

The pancreas

Question 9

What is the vein of the adrenal gland?

Answer 9

Suprarenal vein

Question 10

Does the adrenal gland receive parasympathetic innervation?

Answer 10

NO

Question 11

What are the four renal structures?

Answer 11

Renal capsule, Renal hilum, Renal sinus, Renal pelvis

Question 12

Red arrow?

Answer 12

Obdurator nerve (L2,3,4)

Runs DEEP, medial border psoas

Question 13

What is the most common congenital diaphragmatic hernia and its location?

Answer 13

Bochdalek hernia; Back and to the left

Question 14

What organ touches the R kidney that doesn’t touch the L kidney?

Answer 14

The Liver, duh

Question 15

What is the standard kidney length?

Answer 15

Three vertabrae long

Question 16

What does the genirofemoral nerve branch into?

Answer 16

Genital branch

Femoral branch: skin over femoral triangle

Question 17

What this be?

Answer 17

Kidney with a benign cyst

Question 18

What encloses the adrenal gland?

Answer 18

Gerota’s fascia

Question 19

Red arrow?

Answer 19

Lumbosacral trunk (L4,5)

Location: Runs DEEP and MEDIAL to Psoas and Obdurator nerve, Joins S1 of sacral plexus

Question 20

Red arrow?

Answer 20

Femoral nerve (L2,3,4)

Runs just lateral to psoas muscles

Question 21

Where are horse-shoe kidneys typically found?

Answer 21

Around the lower lumbar vertebrae, since its ascent is prevented by the root of the inferior mesenteric artery

Typically horse-shoe kidneys are benign and undiagnosed

Question 22

What are the three main posterior abdominal muscles and some of their characteristics?

Answer 22

Quadratus Lumborum, Psoas (insert on Lesser Trochanter), Iliacus

Question 23

Where is referred pain from the diaphragm felt?

Answer 23

Shoulder region (C3-C5)

Question 24

Red arrow?

Answer 24

Genitofemoral nerve (L1,2)

Runs on the anterior surface of psoas muscle

Question 25

How frequent are congential diaphragmatic hernias?

Answer 25

1 in 2,500 newborns

Question 27

The perirenal and pararenal spaces open inferiorly a pathway for what?

Answer 27

A pathway for pus to travel retroperitoneally to pelvis

Question 28

Red arrow?

Answer 28

Subcostal nerve (T12)

Question 29

Nerves you need to know

Answer 29

The bolded

Question 30

Identify these two spaces around the kidney.

Answer 30

Blue arrow: perirenal space Black arrow: pararenal space

Question 31

Red arrow?

Answer 31

Lateral femoral cutaneous (of the thigh) (L2-3)

Question 32

Identify these 3 nerves

Answer 32

Question 33

Where does the adrenal gland sit relative to the vertabrae?

Answer 33

T12-L1

Question 34

Describe the shapes of the adrenal glands?

Answer 34

Right: Pyramidal Left: Crescent

Question 35

What is **lateral femoral cutaneous syndrome**?

Answer 35

Mononeuropathy presenting variably as pain, numbness, tingling, burning or itching in anterolateral thigh. Multiple possible factors: compression (obesity, seltbelt trauma, tight belt/pants), endocrine/metabolic (alcoholism, diabetes), interventional outcome, ascites

Question 36

How is the obdurator nerve distributed motorly?

Answer 36

Adductor muscles of thigh

Question 37

What is the name for the fascia that surrounds the kidneys?

Answer 37

Renal (Gerota's) fascia

Question 38

Name the 3 openings in the diaphragm and their vertebral level.

Answer 38

IVC: T8 Esophagus: T10 Aorta: T12

Question 39

Red arrow? (hint: **iliohypogastic may be joined with this nerve**)

Answer 39

Ilioinguinal (L1)

Question 40

What cuts across the left renal vein?

Answer 40

The superior mesenteric artery (SMA)

Question 41

What are the main innervators of the kidneys?

Answer 41

**lesser splanchnic, least splanchnic**, lumbar splanchnic (T10-L1)

Question 42

If you cut the phrenic, how would the diaphragm be affected?

Answer 42

Paralysis of diaphragm