Diaphragm, Kidneys, and Post. Abd. Wall

Question 1

____ innervate the diaphragm

Answer 1

right and left phrenic nerves

Question 2

phrenic n. comes from ____ and is found on the anterior surface of the ____; it descends between ____ to enter the thoracic cavity; passes into abdominal cavity with ____

Answer 2

cervical nerves (C3, 4, and 5); scalene m. ; subclavian artery and vein; IVC

Question 3

supplies right and left hemidiaphragms; sole motor innervation to the diaphragm

Answer 3

phrenic nerves

Question 4

supplies lateral borders of diaphragm and some sensory

Answer 4

intercostal nerves

Question 5

phrenic nerve is ___ sensory

Answer 5

30%

Question 6

irritation to both the superior and inferior surfaces of the CENTRAL part of the diaphragm is carried by sensory fibers in the ____

Answer 6

phrenic n.

Question 7

irritation to the superior and inferior surfaces of the PERIPHERAL portions of the diaphragm is carried by the _____

Answer 7

intercostal nerves

Question 8

phrenic n. originates from ____ spinal segments, which explains paralysis from ____ (paralysis of diaphragmatic respiration)

Answer 8

C3-5; cervical cord injuries

C3-5 spinal segments from somites from mesoderm

Question 9

paralyzed hemidiaphragm cannot _____

Answer 9

contract (descend)

Question 10

IVC passes through the diaphragm at vertebral level ___ via the ____

Answer 10

T8; vena cava foramen

Question 11

esophagus passes through diaphragm at vert. level ___ via _____

Answer 11

T10; esophageal hiatus

Question 12

aorta passes through diaphragm at vert. level ___ via ____

Answer 12

T12; aortic hiatus

Question 13

arcuate ligaments or lumbocostal arches

Answer 13

1 median arcuate ligament
2 medial arcuate ligaments
2 lateral arcuate ligaments

Question 14

median arcuate ligament arches over ____

Answer 14

aorta

Question 15

2 medial arcuate ligaments arch over ____

Answer 15

psoas muscles

Question 16

2 lateral arcuate ligaments arch over ____

Answer 16

quadratus lumborum muscles

Question 17

vessels of the diaphragm

Answer 17

• pericardiacophrenic & superior phrenic aa.
• inferior phrenic aa.
• musculophrenic aa.

Question 18

pericardiacophrenic and superior phrenic aa. supply the ____ via ____ and _____

Answer 18

superior surface of the diaphragm; internal thoracic a; thoracic aorta

Question 19

inferior phrenic a. supplies the ____ via the _____

Answer 19

inferior surface of diaphragm; abdominal aorta

Question 20

musculophrenia aa. supply the _____ via _____

Answer 20

periphery of the diaphragm; internal thoracic arteries

Question 21

the kidneys are located lateral to the vertebral column at level ____

Answer 21

T12-L3

Question 22

Superior pole of left kidney is at ____ and superior pole of right kidney is at ____

Answer 22

11th; 12th rib

Question 23

kidneys are encapsulated by ____ and ____

Answer 23

perirenal fat; renal fascia

Question 24

the kidneys ascend from the ____ during development

Answer 24

pelvis

Question 25

ectopic pelvic kidney remains ____; horseshoe kidney below _____ and transplanted kidneys are placed in the _____

Answer 25

anterior to sacrum; IMA; lower abdomen

Question 26

perirenal (or perinephric) fat is located _____ and pararenal (or paranephric) fat is located ____

Answer 26

inside the renal fascia; outside the renal fascia

Question 27

anterior most structures at hilums of the kidneys

Answer 27

renal veins

Question 28

renal arteries are between the ___ and ____

Answer 28

renal pelvis; renal vein

Question 29

____ is the most posterior structure at the hilum

Answer 29

renal pelvis

Question 30

____ is shorter because the IVC is positioned on the ____

Answer 30

right renal vein shorter than the left renal vein bc IVC is positioned on the right

Question 31

____ is shorter because the abdominal aorta is positioned on the ____

Answer 31

left renal a. shorter than right bc aorta positioned on left

Question 32

left renal vein crosses ___ to abdominal aorta, but ____ is anterior to the left renal vein

Answer 32

anterior; SMA

Question 33

outer most layer of the kidney is a ____

Answer 33

fibrous capsule

Question 34

outer 1/3 of the kidney

Answer 34

renal cortex

Question 35

inner 2/3 of the kidney

Answer 35

renal medulla

Question 36

renal medulla contains ____ and ____ between them

Answer 36

renal pyramids; renal columns

Question 37

receive apex of renal pyramids

Answer 37

renal papillae

Question 38

adjacent to renal papilla is the ____

Answer 38

minor calyx

Question 39

major calyces combine at _____

Answer 39

renal pelvis

Question 40

right renal artery passes posterior to the ____

Answer 40

IVC

Question 41

each renal artery divides into ____ at the hilum

Answer 41

segmental aa.

Question 42

vascular supply to the kidneys does not anastomose, so they are called _____

Answer 42

end arteries

Question 43

drainage of kidney/urine

Answer 43

renal papillae receive urine at tips/apex of pyramids > minor calcyes > major calyces > renal pelvis > ureter > urinary bladder > urethra

Question 44

ureter arteries arise from 3-4 sources:

Answer 44

- renal a. - testicular or ovarian aa. - abdominal aorta or common iliac a. - internal iliac a. (pelvic cavity)

Question 45

allows visualization of ureters and urinary bladder

Answer 45

intravenous urogram (IVU)

Question 46

in an IVU, pt is injected with ____; media are excreted by ____ and by _____

Answer 46

iodinated contrast medium; glomerular filtration; renal tubules

Question 47

kidney stones or ____ form in the ____ and progress to ____

Answer 47

calculi; kidney; renal pelvis

Question 48

kidney stones may spontaneously pass thru ____ to ____; may be subjected to ____ via _____

Answer 48

ureter; bladder; ultrasonic crushing; lithotripsy

Question 49

calculi cause _____ as waves of contraction force stone through ureter; ____ pain occurs and is referred with descent of stone

Answer 49

referred pain; rhythmic

Question 50

gradually moves _____ toward the groin; from ____ to _____ to ____

Answer 50

inferoanteriorly; from the side and back between ribs; to the pelvis to inguinal

Question 51

area of cutaneous innervation from calculi referred pain

Answer 51

T11-12

Question 52

the right adrenal or suprarenal gland is roughly ____; lies superior to right kidney and posterior to ____

Answer 52

triangular; IVC

Question 53

left adrenal (suprarenal) gland is more ____; lies _____ to the left kidney near the hilum

Answer 53

semilunar; superomedial

Question 54

adren (suprarenal) gland have their own _____

Answer 54

fibrous capsule

Question 55

outer portion of adrenal gland that produces adrenal steroids

Answer 55

adrenal cortex

Question 56

inner portion of adrenal gland that acts as sympathetic ganglion (modified neuronal cells), medullary, or chromaffin cells

Answer 56

adrenal medulla

Question 57

adrenal glands are richly vascularized due to ____

Answer 57

endocrine function

Question 58

3 sources of suprarenal arteries

Answer 58

1. superior suprarenal arteries (6-8) - come from inferior phrenic aa. 2. middle suprarenal arteries (1+) - come from abdominal aorta 3. inferior suprarenal arteries (1+) - come from renal aa.

Question 59

posterior abdominal wall musculature

Answer 59

``` transversus abdominis m. quadratus lumborum m. psoas major m. psoas minor m. diaphragm ```

Question 60

4 pairs of arteries that are branches of the abdominal aorta, superior to bifurcation

Answer 60

lumbar aa.

Question 61

the aorta bifurcates at about vertebral level ___ which is about the level of the ____

Answer 61

L4; umbilicus

Question 62

nerves of the posterior wall

Answer 62

ventral rami T12-L4; lumbar plexus of nn, located beneath fascia of posterior abdominal wall

Question 63

about 1 cm inferior to 12th rib; supplies sensory to anterior/lateral abdominal wall

Answer 63

subcostal nerve (T12)

Question 64

subcostal nerve (T12) supplies motor to abdominal mm. :

Answer 64

external oblique, internal oblique, transversus abdominis, pyramidalis, rectus abdominis, quadratus lumborum

Question 65

can arise from common trunk; descend anterior to quadratus lumborum; both supply abdominal muscles

Answer 65

iliohypogastric and ilioinguinal nerves (L1)

Question 66

____ supplies skin of suprapubic region

Answer 66

iliohypogastric n.

Question 67

____ runs through inguinal canal to supply it

Answer 67

ilioinguinal n.

Question 68

pierces psoas major m. and descends along anterior surface

Answer 68

genitofemoral n. (L1-L2)

Question 69

genitofemoral n. splits to ____ and ____

Answer 69

femoral branch; genital branch

Question 70

genitofemoral n. supplies skin ____ and supplies ____ (of the spermatic cord)

Answer 70

inferior and medial to inguinal ligament; cremaster m.

Question 71

descends anterior to iliacus m.; passes deep to the inguinal ring, inferior to ASIS

Answer 71

lateral femoral cutaneous n. (L2-L3)

Question 72

lateral femoral cutaneous n. supplies _____

Answer 72

anterior/lateral skin of the thigh

Question 73

runs between iliacus and psoas major mm. ; passes deep to inguinal ligament, inferior to ASIS

Answer 73

femoral n. (L2-L4)

Question 74

femoral n. supplies _____

Answer 74

sensory and motor to anterior thigh

Question 75

runs medial to psoas major mm.

Answer 75

obturator n. (L2-L4)

Question 76

obturator n. passes through ____ and supplies _____

Answer 76

obturator foramen; sensory and motor to medial thigh

Question 77

large n. trunk that crosses over ala of sacrum; descends into pelvis to help form sacral plexus; provides general contributions to both plexuses

Answer 77

lumbosacral trunk (L4-L5)