Anatomy

Question 1

Retroperitoneal structures (SAD PUCKER)

Answer 1

Suprarenal (adrenal) glands 
Aorta and IVC
Duodenum (2nd through 4th parts) 
Pancreas (except tail)
Ureters 
Colon (descending and ascending) 
Kidneys
Esophagus (lower 2/3) 
Rectum (partially)

Question 2

Kidney vertebral levels

Answer 2

Right kidney - T12 - L3

-right lower than left due to liver

Question 3

R kidney is in contact with

Answer 3

• Serosal surface or liver
• 2nd part of duodenum
• Right colic flexure
• Jejunum

Question 4

L kidney is in contact with

Answer 4

• Stomach
• Spleen
• Tails of pancreas
• Left colic flexure
• Jejunum

Question 5

Posterior relationships of kidney

• ribs and nerves
• muscles

Answer 5

Ribs
-11th and 12th ribs

Nerves
-Subcostal (T12) and iliohypogastric (L1)

Muscles

• diaphragm
• psoas major
• quadratus lumborum
• aponeurosis of transverse abdominis muscle

Question 6

Relationship of renal pelvis to renal artery

Answer 6

Lies posterior to artery

Question 7

R vs L testicular (ovarian) vein drainage

Answer 7

L testicular (ovarian) vein -> drains into L renal vein

Right -> straight into IVC

Question 8

Relationship of abdominal ureter to:

• testicular (ovarian) vessels
• pass anterior to which muscle

Answer 8

• pass posterior to vessels

- pass anterior to surface of psoas

Question 9

Relationship of pelvic ureter

• vessels
• peritoneum

Answer 9

cross common or external iliac artery near bifurcation of common iliac

• Descends along the lateral wall of the pelvis and curves anteromedially to the
base of the urinary bladder while remaining deep to the peritoneum

Question 10

Superior suprarenal artery arises from?

Answer 10

inferior phrenic artery

Question 11

Middle suprarenal artery arises from?

Answer 11

Abdominal aorta near ciliac trunk

Question 12

Inferior suprarenal artery arises from?

Answer 12

Renal artery

Question 13

R vs left suprarenal vein drainage

Answer 13

L empties in L renal vein

R empties directly into IVC

Question 14

Unpaired arteries to GI tract from aorta

Answer 14

o Celiac trunk
o Superior mesenteric artery
o Inferior mesenteric artery

Question 15

Paired arteries to 3 paired abdominal organs from aorta

Answer 15

o Suprarenal
o Renal
o Testicular (ovarian) arteries

Question 16

Paired arteries to abdominal wall from aorta

Answer 16

o Inferior phrenic

o Lumbar arteries

Question 17

Lumbar arteries

• how many pairs
• supply the?
• origin
• pass deep to

Answer 17

4 pairs

posterior abdominal wall

posterior abdominal aorta

psoas major muscle

Question 18

Bifurcation of abdominal aorta occurs at which vertebral level

Answer 18

L4

Question 19

Umbilicus projects superior or inferior to bifurcation of aorta (thin person)

Answer 19

Superior

Question 20

Arterial supply to abdominal portion of ureters arises most commonly from? less commonly from?

Answer 20

Most commonly -> renal arteries

Less commonly

• gonadal arteries
• abdominal aorta
• common iliac arteries

Question 21

Urinary bladder

-superior vs posterior surfacess

Answer 21

Superior surface
• Covered by peritoneum

Posterior surface
• Covered by peritoneum on its superior part
• Covered by endopelvic fascia on its inferior part as well as the inferolateral surfaces

Question 22

Apex of bladder identified by attachment of?

Answer 22

Urachus

Question 23

Extrarenal duct system begins at the

Answer 23

Minor calyx

Question 24

Large kidney stones may lodge at one of which three natural constrictions of ureter

Answer 24

1. Where renal pelvis joins the ureter
2. Where ureter crosses pelvic brim
3. At the entrance of the ureter into the urinary bladder

Question 25

Esophagus lies immediately posterior to

Answer 25

L atrium and part of L ventricle

Question 26

Esophagus plexus innervates which portion of esophagus

Answer 26

Inferior

Question 27

R vs L vagus nerve - relationship to esophageal plexus

Answer 27

Right -> posterior Left -> anterior

Question 28

Anterior and posterior vagal trunks pass through diaphragm with what? which vertebral level?

Answer 28

Esophagus - T10

Question 29

Thoracic duct - relationship to azygos vein and esophagus - pass through diaphragm with? vertebral level?

Answer 29

- left of azygos vein posterior to esophagus | - w/ aorta (T12)

Question 30

Posterior intercostal veins drainage on R vs L

Answer 30

Right -> azygos vein Left - top half -> accessory hemiazygos vein - bottom half -> hemiazygos vein

Question 31

White vs gray rami communicantes based on position

Answer 31

White is more lateral

Question 32

Greater splanchnic nerve Lesser Least

Answer 32

Greater -> T5-T9 sympathetic ganglia Lesser -> T10-11 Least -> T12

Question 33

Pleural tap location

Answer 33

Midaxillary line Intercostal space 6, 7, or 8 Low in intercostal space to avoid damaging neurovascular bundle

Question 34

Oblique fissure location

Answer 34

deep to 5th rib LATERALLY deep to 6th costal cartilage ANTERIORLY

Question 35

Horizontal fissure location

Answer 35

Deep to 4th rib and 4th costal cartilage

Question 36

Median arcuate ligament found at the?

Answer 36

aortic hiatus

Question 37

Left vs right crura of diaphragm

Answer 37

left crura -> L1-L2 -passes to left of esophageal hiatus Right crura -> L1 - L3 -muscle fibers decussate around esophageal hiatus (T10)

Question 38

Medial vs median vs lateral arcuate ligaments

Answer 38

1. Lateral arcuate ligament - paired - bridges the anterior surface of the quadratus lumborum muscle. 2. Medial arcuate ligament - paired - bridges the anterior surface of the psoas major muscle 3. Median arcuate ligament - Unpaired - bridges the anterior surface of the aorta at the aortic hiatus

Question 39

Pleural and peritoneal coverings of the peripheral part of diaphragm receive sensory innervation from

Answer 39

lower intercostal nerves (T5-T11) and subcostal nerve

Question 40

What gives rise to respiratory system

Answer 40

foregut - endoderm surround by splanchnic mesoderm

Question 41

Embryo - central tendon

Answer 41

Septum transversum

Question 42

Embryo - left and right crura of diaphragm

Answer 42

Gut mesenchyme

Question 43

Embryo - outer diaphragm

Answer 43

body wall mesenchyme

Question 44

Gap b/w thorax and abdomen during development? filled in by?

Answer 44

Pericardioperitoneal canal -> pleuroperitoneal membrane

Question 45

Embryo - kidney formation

Answer 45

Ureteric bud + metanephric blastema ureteric bud from collecting duct on up to DCT is blastema

Question 46

Smooth walled structure in posterior bladder wall called? due to (embryo)?

Answer 46

TRIGONE Portion of mesonephric ducts incorporated into bladder wall -> exstrophy of bladder