Diaphragm, Kidneys, & Posterior Abdominal wall

Question 1

at what spinal level is the caval opening in the diaphragm ? what goes through there

Answer 1

T8 - IVC

Question 2

at what spinal level is the abdominal hiatus and what goes through there

Answer 2

T10 - esophagus

Question 3

at what spinal level is the aortic hiatus and what goes through there ?

Answer 3

T12 - abdominal aorta

Question 4

where does the phrenic nerve supply and where does it originate

Answer 4

supplies motor and some sensory to diaphragm

-originates at C3-C5

Question 5

what is the difference b/w paralysis of diaphragmatic respiration and paralysis hemidiaphragm

Answer 5

paralysis hemidiaphragm only half of the diaphragm is affected
-will not contract during inspiration thus remains high (diaphragm goes down when contracting/inspiration)

Question 6

what does the median arcuate ligament arch over ?

Answer 6

arches over the abdominal aorta

Question 7

what do the 2 medial arcuate ligaments arch over ?

Answer 7

psoas minor m. and psoas major m.

Question 8

what do the 2 lateral arcuate ligaments arch over ?

Answer 8

quadratus and lumborum mm

Question 9

what vasculature supplies the superior surface of the diaphragm ?

Answer 9

pericardiacophrenic and superior phrenic aa.

-via internal thoracic and thoracic aorta

Question 10

what vasculature supplies the inferior surface of the diaphragm

Answer 10

inferior phrenic a.

-via abdominal aorta

Question 11

what vasculature supplies the periphery of the diaphragm ?

Answer 11

musculophrenic a.

-via internal thoracic a.

Question 12

what is the difference in location of the superior pole’s of the Right and left kidneys

Answer 12

R superior pole at 12th rib

L superior pole at 11th rib (more superior)

Question 13

where do the kidneys ascend from during development

Answer 13

ascend from the pelvis

Question 14

where are the kidneys located in reference to the peritoneum

Answer 14

retroperitoneal

Question 15

which renal artery is longer ? why

Answer 15

Right renal artery b/c it passes posterior to IVC

Question 16

which renal vein is longer ? why ?

Answer 16

Left renal vein b/c it passes anterior to abdominal aorta

Question 17

what is the outer 1/3 of the kidney called, inner 2/3 ?

Answer 17

outer 1/3 is renal cortex

inner 2/3 is renal medulla

Question 18

explain the drainage of urine in the kidney starting from the renal pyramid

Answer 18

pyramids to renal papillae to minor calyces to major calyces

—-> renal pelvis —-> ureter —–> bladder —-> urethra

Question 19

the ureters cross what muscle as they descend to the urinary bladder

Answer 19

cross psoas major m. running obliquley posterior to gonadal arteries

Question 20

the ureters recieve arterial blodd from 4 sources, what are they starting most superior?

Answer 20

• renal a.
• gonadal aa.
• abdominal aorta
• internal iliac a.

Question 21

what is a intravenous urogram and what is it used for

Answer 21

test which allows to visualize the ureters and urinary bladder for location of stones

Question 22

kidney stones are also called _____ and produced where ?

Answer 22

calculi, formed in the kidney

Question 23

explain calculi referred pain

Answer 23

referred pain changes as stone descends down ureter

Question 24

where are the adrenal glands and what is the difference b/w the right and left glands

Answer 24

they are on top of kidney (suprarenal)

• Right is triangular
• Left is semilunar shape

Question 25

what is the difference in function of the adrenal cortex vs. the adrenal medulla

Answer 25

``` adrenal cortex (outer part) - produces hormones/steroids adrenal medulla (inner) - acts as a sympathetic ganglion ```

Question 26

what are the 3 sources of suprarenal arteries that supply the adrenal gland

Answer 26

superior suprarenal - branch of inferior phrenic a. middle suprarenal - branch of abdominal aorta inferior suprarenal - branch of renal a.

Question 27

why is the adrenal gland so well vascularized

Answer 27

because of its endocrine function

Question 28

at what level does the abdominal aorta bifurcate

Answer 28

L4

Question 29

what arteries supply the posterior abdominal wall

Answer 29

4 pairs of lumbar arteries

Question 30

there are 6 muscles that make up the posterior abdominal wall, can you name them ?

Answer 30

- transversus abdominus - quadratus lumborum - psoas major - psoas mior - iliacus - diaphragm

Question 31

what is the nerve that supplies motor and sensory innervation to the anterior and lateral abdominal wall

Answer 31

subcostal n. (most superior)

Question 32

at what spinal level does the subcostal n. originate

Answer 32

T12

Question 33

what 2 nerves that run together supply motor and sensory innervation to the abdominal muscles and descends anterior to quadratus lumborum

Answer 33

Iliohypogastric (usually superior) | Ilioinguinal

Question 34

what specific region does the iliohypogastric nerve supply

Answer 34

skin of the suprapubic region

Question 35

what nerve pierces and descends anterior to the psoas major muscle

Answer 35

genitofemoral n.

Question 36

what spinal level do the iliohypogastric and ilioinguinal nn. originate from

Answer 36

L1

Question 37

what does the genitofemoral nerve bifurcate into ?

Answer 37

gental branch and femoral branch

Question 38

wt what spinal level does the genitofemoral n. originate from ?

Answer 38

L1-L2

Question 39

what nerve descends anterior to the iliacus m. and deep to the inguinal ring ?

Answer 39

lateral femoral cutaneous n.

Question 40

what spinal level does the lateral femoral cutaneous n. originate from and what does it supply

Answer 40

L2-L3 | -supplies anterior and lateral thigh

Question 41

the femoral n. originates at what spinal level and runs b/w what 2 muscles of the posterior abdominal wall ?

Answer 41

- L2-L4 | - runs b/w the iliacus and psoas major mm.

Question 42

what does the femoral n. innervate

Answer 42

motor and sensory to the anterior thigh

Question 43

what does the obturator n. innervate

Answer 43

motor and sensory to the medial thigh

Question 44

where does the obturator n. originate ? where is it located in reference to the psoas major mm.

Answer 44

- L2-L4 | - runs medial and deep to psoas major mm.

Question 45

what is the name of the plexus that crosses over the ala (wings) of the sacrum ? what spinal level does it originate at ?

Answer 45

lumbosacral trunk | -L4-L5