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Anatomy > Diaphragm, Kidneys & Posterior Abdominal Wall > Flashcards

Diaphragm, Kidneys & Posterior Abdominal Wall Flashcards

1
Q

What is the principal muscle of respiration that is dome shaped and separates the thoracic cavity from the abdominal cavity?

A

Diaphragm

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2
Q

The phrenic nerve originates from C - C spinal segements

A

C3-5

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3
Q

What is the path of the phrenic nerve?

A
  • originates at C3,4,5
  • descends along ant. scalene
  • through thoracic inlet
  • inferiorly to diaphragm
  • left side- thru m.
  • right side- thru caval opening
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4
Q

The left phrenic nerve passes through the _________

A

diaphragm m.

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5
Q

The right phrenic never passes through the _____ ______

A

caval opening

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6
Q

Sympathetic trunks pass ________ to the diaphragm

A

posterior

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7
Q

What nerve supplies the right and left hemidiaphram?

A

phrenic

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8
Q

What nerve supplies lateral borders of the diaphragm?

A

intercostal nerves

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9
Q

The phrenic nerve is primarily ______

A

motor & 30% sensory

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10
Q

Paralysis from cervical cord injuries results in ___________

A

paralysis of diaphragmatic respiration (lose inhalation ability bc inability to contract the diaphragm)

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11
Q

When you have a paralyzed hemidiaphragm you cannot _____ (descend) the diaphragm

A

contract

  • diaphragm remains high in throax
  • recognizable on radiographic chest films
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12
Q

When is hemidiaphragm paralysis due to phrenic nerve damage visible on film?

A

-only when you inspire (not seen with expiration)

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13
Q

What vertebral level is the vena cava (caval opening) foramen found and what passes thru it?

A
  • T8

- IVC

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14
Q

What vertebral level is the esophageal hiatus and what passes thru it?

A
  • T10

- esophagus

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15
Q

What vertebral level is the aortic hiatus and what passes thru it?

A
  • T12

- aorta

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16
Q

The _____ crus of diaphragm is longer and broader and continues down to L3 vertebral level

A

right

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17
Q

The _______ arcuate ligament(s) (lumbocostal arch) arches over the aorta (aorta hiatus)

A

Median arcuate ligament (1)

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18
Q

The _______ arcuate ligament(s) arch over the psoas mm.

A

medial arcuate ligament (2- both sides)

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19
Q

The ______ arcuate ligament(s) arch over quadratus lumborum mm.

A

lateral arcuate ligament (2-both sides)

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20
Q

The ________ & _______ aa supply the superior surface of the diaphragm

A

-pericardiacophrenic
-superior phrenic
(via internal thoracic & thoracic aorta)

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21
Q

The ______ ______ artery supplies the inferior surface

A 
inferior phrenic 
(via abdominal aorta)
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22
Q

What artery supplies the periphery of the diaphragm?

A

Musculophrenic aa (via int. thoracic aa.)

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23
Q

Venous drainage of the diaphragm is via accompanying vv to the ________

A

Inferior Vena Cava (IVC)

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24
Q

The superior epigastric vessels remain _______ to diaphragm inferiorly

A

anterior

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25
Q

The kidneys are retroperitoneal and located lateral to the vertebral column at ____ - ____

A

T12-L3

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26
Q

Which kidney is typically more superior?

A

left kidney, due to liver being on the right side (pushes kidney down)

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27
Q

The superior pole of the L kidney is at the ____th rib and the R kidney is at the _____ th rib

A
  • 11

- 12

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28
Q

What encapsulates the kidneys?

A

-peri-renal fat + renal fascia

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29
Q

The kidneys _____ from _____ during development

A
  • ascend

- pelvis

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30
Q

What results when the kidney remains anterior to the sacrum?

A

ectopic kidney

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31
Q

What results when the kidneys are below the IMA?

A

horseshoe kidney

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32
Q

Transplanted kidneys are placed in the ____ _____

A

lower abdomen (usually have 3 kidneys bc dont remove others)

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33
Q

What encapsulates the kidneys but not completely around the inferior surface b/c it continues on the ureters?

A

-renal fascia

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34
Q

What found external to the renal renal capsule and provides a cushion around renal fascia?

A

para-nephric fat

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35
Q

What is found internal to the renal capulse and completely encapsulates the kidney?

A

peri-nephric fat

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36
Q

The inferior vena cava is most ______

A

Anterior

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37
Q

What is the organization of arteries and veins anterior to posterior near the kidney?

A 
(Anterior)
-Renal vein
-Renal artery
- Pelvis of ureter
Posterior
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38
Q

What are the functions of the kidneys?

A
  • filter blood
  • produce urine
  • reduce blood volume, creating urine volume (pulls H2O) out of blood
  • BP regulation (Blood volume dependent)
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39
Q

What are the 3 layers of the kidney?

A
  • fibrous capsule (outer)
  • Renal cortex- (outer 1/3)
  • Renal medulla- (inner 2/3)
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40
Q

The renal medulla contains the renal _____

A

pyramids

41
Q

Where does urine flow once it is produced in the nephron of the kidney?

A
  • Renal papillae (@ apex of pyramids receive urine)
  • minor calyces
  • major calyces (2-3)
  • renal pelvis
  • ureter
  • urinary bladder
  • urethra
42
Q

The kidney vasculature is __________

A

asymmetric

43
Q

The _____ renal artery is longer and passes posterior to IVC

A

right

44
Q

The renal arteries divide at ________ into _______ arteries

A
  • hilum

- segmental arteries (5 end arteries)

45
Q

What do the segmental arteries supply?

A
  • each lobe in the kidney
46
Q

Renal veins are ______ to renal arteries

A

anterior

47
Q

Renal veins drain to IVC, the _____ renal vein is longer and passes anterior to the aorta

A

Left

48
Q

The ureters cross anterior to the _____ ______ mm to enter the bladder

A

psoas major

49
Q

The ureters run _____ _____ to gonadal vessels and anterior to the ___ _____ artery

A
  • obliquely posterior

- ext. eiliac a.

50
Q

The _____ renal pelvis & ureters are fairly common

A

bifid

51
Q

Occasionally you can find this type of ureter that pass over the pelvic brim posterior to common or ext. iliac a or v.

A

Retrocaval ureter

52
Q

What are the 3-4 sources that the ureter arteries arise from?

A
  • renal a
  • testicular or ovarian a.
  • abdominal aorta
  • internal iliac a. (pelvic cavity)
53
Q

The veins of the ureters drain into _______ named vv.

A

similiarly

54
Q

What test allows visualization of the ureters and bladder and detection of kidney stones?

A

Intravenous urogram (IVU)

  • inject patient w/ iodinated contrast medium
  • excreted by glomerular filtration + by renal tubules
55
Q

What form in the kidney, progress to the renal pelvis and are usually associated w/ considerable pain in the ureter or urethra?

A

kidney stones (calculi)

56
Q

What are the three ways that a kidney stone can be removed?

A
  • spontaneously pass thru ureter into bladder
  • larger than 1cm = surgically
  • ultrasonically crushed = lithotripsy
57
Q

Referred pain from a calculi (kidney stone) is associated with ______ __ _____ to force the stone down thru ureter

A
  • waves of contraction (peristalsis)
58
Q

Referred pain from a calculi is rhythmic pain that occurs & is referred w/ ______ of the stone and changes w/ _____ of obstruction.

A
  • descent

- level

59
Q

Referred pain gradually moves ________ toward gron from side & back btw ribst to pelvis to _____ area (area of cutaneous innervation T11-T12)

A
  • inferoanteriorly

- inguinal

60
Q

What glands sit on the superior poles of the kidneys?

A

Adrenal (suprarenal) glands

61
Q

The _____ adrenal (suprarenal) gland is roughly triagular and lies superior to kidney, posterior to IVC

A

right

62
Q

The _____ adrenal (suprarenal) gland is semilunar and lies superiormedial to kidney near hilum

A

left

63
Q

What are the three layers of the adrenal gland?

A
  • fibrous capsule
  • adrenal cortex
  • adrenal medulla
64
Q

This surrounds the adrenal gland?

A

fibrous capsule

65
Q

The _____ ____ is in the outer portion of the adrenal gland

A

adrenal cortex

66
Q

The adrenal gland produces ____ _____ and modifies cells of the medulla

A

adrenal steroids

67
Q

The _____ _____ is the inner portion of the adrenal gland that acts as a sympathetic ganglion

A

adrenal medulla

68
Q

The adrenal medulla has _____ cells (modified neurons w/out axons) where preganglionic _______ synapse and produce ____ and ____ (endocrine function)

A
  • chromaffin
  • sympathetics
  • norepinephrine
  • epinephrine
69
Q

The adrenal gland is ______ vascularized due to ______ funciton

A
  • richly

- endocrine

70
Q

What are the three sources of the suprarenal aa?

A
  • sup. suprarenal aa (6-8)
  • middle suprarenal aa (1+)
  • Inf. suprarenal aa (1+)
71
Q

The sup. suprarenal artery (6-8) comes from the ____ ____ artery

A

inferior phrenic

72
Q

The middle suprarental artery (1+) comes from the ______ aa

A

abdominal

73
Q

The inf. suprarenal aa (1+) comes from the _____ aa

A

renal

74
Q

What are the 6 muscles of the posterior abdominal wall?

A
  • transversus abdominus (from ant to post abdominal wall)
  • quadratus lumborum
  • psoas major
  • psoas minor
  • iliacus
  • diaphragm
75
Q

What is the main arterial supply to the posterior abdominal wall?

A

Lumbar aa (4 pairs)

76
Q

The lumbar aa (4 pairs) are branches of _____ _____ superior to the _____

A
  • abdominal aorta

- bifurcation

77
Q

The abdominal aorta bicurcates at _____ the level of the _____

A
  • L4

- umbilicus

78
Q

What are the main nerves of the posterior abdominal wall?

A
  • Ventral rami (T12-L4)
    -Lumbar plexus of nn
    (beneath fascia of post. abd. mm.)
79
Q

The sympathetic trunks are located _____ and continuous w/ _______ portions

A
  • posterior

- thoracic

80
Q

This nerve is ~ 1cm inferior to 12th rib and supplies sensory to ant./lat. abdominal wall (hip)

A

Subcostal n. (T12)

81
Q

The ________ nerve also supplies MOTOR to abominal mm; External oblique, Inferior oblique, Transversus abdominis, pyramidalis, Rectus abdominis, Quadratus lumborum

A

subcostal (T12)

82
Q

The inferior extent of subcostal nerve (T12) is the ______ ______ branch that is halfway btw umbilicus and pelvis

A

anterior cutaneous

83
Q

What vertebral level is the subcostal nerve?

A

T12

84
Q

These 2 nerves can arise from a common trunk and descend anterior to quadratus lumborum

A
  • Iliohypogastic & Ilioinguinal nn (L1) (sensory + motor)
85
Q

What vertebral levels is the iliohypogastric and ilioinguinal nerves?

A

L1

86
Q

The _______ nerve supplies skin of suprapubic region and abdominal mm

A
  • iliohypogastric
87
Q

The ______ nerve passes over ilium and runs thru inguinal canal to supply it and it supplies abdominal mm

A

ilioinguinal

88
Q

The _____ nerve pierces psoas major m. and descends along the anterior surface to split into ______ branch and _____ branch (more medial)

A
  • genitofemoral nerve (L1-L2)
  • femoral
  • genital
89
Q

The genitofemoral nerve (L1-2) supplies skin inferior & medial to _______ ligament and the ______ m. (of spermatic cord)

A
  • inguinal

- cremaster

90
Q

What vertebral level is the genitofemoral nerve?

A

L1-2

91
Q

The ____ _____ ____ nerve descends anterior to iliacus m. and passes deep to inguinal ring (inferior to ASIS)

A

Lateral Femoral Cutaneous N (L2-3)

92
Q

The Lateral Femoral cutaneous nerve (L2-3) supplies anterior/lateral skin of the ______

A

thigh

93
Q

What nerve runs between iliacus & psoas major mm., passes deep to inguinal liagment and inferior to ASIS?

A

Femoral N (L2-4)

94
Q

The Femoral nerve (L2-4) supplies sensory and motor to the ______ thigh

A

-anterior thigh (large nerve)

95
Q

The femoral nerve is from what vertebral level?

A

L2-4

96
Q

The ____ nerve runs medial to psoas major mm. and passes thru obturator foramen

A

obturator n (L2-4)

97
Q

The obturator n (L2-4) supplies sensory and motor to _____ thigh

A

medial thigh

98
Q

This large n trunk crosses over ala of sacrum and descends into pelvis to help form the sacral plexus?

A
  • lumbosacral trunk (L4-5)
99
Q

This nerve trunk provides general contributions to both plexuses (lumbar and sacral)?

A

lumbosacral trunk

Anatomy (12 decks)

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