Kidney

Question 1

Psoas Major: Origin & Insertion

Answer 1

Origin: T12-L5 transverse processes. Insertion: Lesser trochanter of femur.

Question 2

Psoas Major: Action & Innervation

Answer 2

Flexes thigh/trunk. Innervation: L1-L3 (lumbar plexus).

Question 3

Psoas Minor: Prevalence & Significance

Answer 3

Absent in 40% of people. Inserts on pectineal line (pelvis).

Question 4

Psoas Minor: Clinical Relevance

Answer 4

If present, may mimic abdominal pain (e.g., appendicitis).

Question 5

Posterior Relations of Right Kidney

Answer 5

Diaphragm, 12th rib, quadratus lumborum, psoas major, subcostal N/V.

Question 6

Posterior Relations of Left Kidney

Answer 6

Same as right + splenic flexure of colon (uniquely).

Question 7

Nerves Posterior to Kidney

Answer 7

Subcostal (T12), iliohypogastric (L1), ilioinguinal (L1).

Question 8

Renal Angle (Costovertebral Angle)

Answer 8

Formed by 12th rib & lumbar spine. Tenderness = pyelonephritis.

Question 9

How to Elicit CVA Tenderness?

Answer 9

Percuss or fist-tap over renal angle. Positive in pyelonephritis.

Question 10

Floating Kidney (Nephroptosis)

Answer 10

Kidney descends >2 vertebrae (or 5 cm) on standing.

Question 11

Nephroptosis: Symptoms & Risks

Answer 11

Postural pain, hydronephrosis, ureteric kinking.

Question 12

Nephroptosis: Diagnosis

Answer 12

IVP or ultrasound in supine vs. standing positions.

Question 13

Psoas Abscess: Key Feature

Answer 13

Hip flexion pain + fever. Think TB (classic) or staph.

Question 14

Psoas Sign (Clinical Test)

Answer 14

Patient lies on left, extend right thigh → pain = appendicitis/abscess.

Question 15

Quadratus Lumborum: Kidney Relation

Answer 15

Posterior to kidney; separates it from transversus abdominis.

Question 16

Subcostal Nerve (T12): Kidney Relation

Answer 16

Runs posterior to kidney; supplies lower abdominal wall.

Question 17

Iliohypogastric Nerve (L1): Kidney Relation

Answer 17

Posterior to kidney; supplies suprapubic region.

Question 18

12th Rib: Kidney Relation

Answer 18

Rib overlaps upper pole; site for percutaneous nephrostomy.

Question 19

Renal Angle vs. Murphy’s Sign

Answer 19

Renal angle: Kidney pain. Murphy’s: Gallbladder pain.

Question 20

Floating Kidney vs. Ptosis

Answer 20

Nephroptosis: Kidney moves. Ptosis: Drooping (e.g., eyelid).

Question 21

Psoas Major vs. Iliacus

Answer 21

Psoas: Lumbar spine. Iliacus: Iliac fossa. Both insert at lesser trochanter.

Question 22

Psoas Minor: Evolutionary Significance

Answer 22

Vestigial in humans; functional in climbing mammals.