Lecture 16: Posterior Abdominal Wall, Kidneys, & Ureters

Question 1

What are the borders of the posterior abdominal wall?

Answer 1

Superior: Level of T12 vertebra, 12th rib, diaphragm
Inferior: Superior pelvic aperture

Question 2

What is the pelvic aperture?

Answer 2

Also known as pelvic brim/inlet - it runs from pectineal and arcuate lines and posterior along the sacral promontory

Question 3

What are the 4 muscles of the posterior abdominal wall?

Answer 3

1. Quadratus Lumborum
2. Psoas Major
3. Iliacus
4. Psoas minor

Question 4

Action of quadratus lumborum (Bilateral and unilateral)

Answer 4

Bilateral: extends vertebral column
Unilateral: laterally flexes vertebral column

Question 5

Action of psoas & iliacus

Answer 5

Hip flexors

Question 6

The abdominal aorta enters the abdomen at the aortic hiatus. What level is this?

Answer 6

T12

Question 7

The abdominal aorta is _____________

Answer 7

Retroperitoneal

Question 8

At what level does the abdominal aorta bifurcate?

Answer 8

L4

Question 9

The abdominal aorta bifurcates into…

Answer 9

L/R common iliac arteries

Question 10

What are the branches of the abdominal aorta? (9 total in the list)

Answer 10

Celiac trunk
Superior Mesenteric
Inferior Mesenteric
L & R inferior phrenic
L & R middle suprarenal
L & R renal
L & R gonadal
4 pairs of lumbar arteries
Median (Middle) sacral

Question 11

Define aneurysm

Answer 11

Localized dilation of a vessel

Question 12

Where do abdominal aorta aneurysms typically occur?

Answer 12

Distal to renal arteries but ABOVE bifurcation

Question 13

An abdominal aneurysm breaks down what layer of the aorta

Answer 13

Middle (Tunica Media)

Question 14

T/F: You bleed out slowly with an aneurysm

Answer 14

F; you bleed out quickly.

Question 15

Describe the stenting of an aortic aneurysm

Answer 15

Stent - blow balloon up - widen area for blood flow

Question 16

IVC is the union of..

Answer 16

L/R common iliac veins

Question 17

The IVC is to the ____ of the abdominal aorta

Answer 17

Right

Question 18

What level does the IVC enter the thoracic cavity at the caval opening of diaphragm

Answer 18

T8

Question 19

R. Suprarenal and gonadal veins drain into…

Answer 19

IVC

Question 20

L. Suprarenal and gonadal veins drain into…

Answer 20

Renal V then to IVC

Question 21

What are the pre-aortic lymph nodes?

Answer 21

Celiac
Superior mesenteric
Inferior mesenteric

Question 22

Where do the pre-aortic lymph nodes receive lymph from?

Answer 22

Foregut

Question 23

What lymph nodes are chains of nodes around either side of aorta?

Answer 23

Lumbar lymph nodes (lateral aortic, para-aortic)

Question 24

What receives lymph from posterior abdominal wall structures and upper pelvic structures?

Answer 24

Lumbar lymph nodes

Question 25

Pre-aortic and lumbar lymph nodes drain to...

Answer 25

Cisterna chyli

Question 26

Where does the cisterna chyli begin?

Answer 26

Around level of L1-L2 vertebrae

Question 27

The cisterna chyli drains...

Answer 27

superiorly as the thoracic duct

Question 28

Milk fluid associated with lymph is called

Answer 28

Chyle

Question 29

List the somatic nerves (lumbar plexus) of posterior abdominal wall

Answer 29

Subcostal Iliohypogastric Ilioinguinal Genitofemoral Lateral femoral cutaneous Femoral Obturator

Question 30

What splanchnic nerves are not true splanchnic nerves?

Answer 30

Pelvic

Question 31

What is the parasympathetic supply to the posterior abdominal wall

Answer 31

L/R Vagus nerves

Question 32

At what level are the kidneys?

Answer 32

T12-L3 vertebrae

Question 33

T/F the kidneys are stuck in place

Answer 33

F; they can move up 2-3 inches when breathing

Question 34

Which kidney is slightly inferior? why?

Answer 34

R. Kidney - B/C of liver

Question 35

Describe cortex and medulla of the kidney

Answer 35

Cortx: outer Medulla: Inner

Question 36

The medulla subdivides into..

Answer 36

Renal pyramids

Question 37

What are the tips of renal pyramids?

Answer 37

Renal papillae

Question 38

What are renal columns?

Answer 38

Extensions of cortex that separate pyramids

Question 39

Renal papillae drain urine into...

Answer 39

Minor calyces

Question 40

Minor calyces drain into 2-3

Answer 40

Major calyces

Question 41

Major calyces drain into funnel-shaped

Answer 41

Renal pelvis

Question 42

Renal pelvis drains into...

Answer 42

Ureter

Question 43

From the kidney to outside, what is the order of CT coverings around the kidney

Answer 43

Renal capsule Perinephric fat Renal fascia Paranephric fat

Question 44

What is the blood supply to the kidney

Answer 44

Renal artery --> lobar (segmental) arteries

Question 45

Describe lobar (segmental) arteries

Answer 45

End arteries - if they are occluded, blood supply is cut off to that portion of the kidney

Question 46

The renal vein drains into the...

Answer 46

IVC

Question 47

What is the innervation of the kidney

Answer 47

Renal plexus

Question 48

What is the parasympathetic supply to the kidney?

Answer 48

Vagus (CN X) - No known effect

Question 49

What is sympathetic supply to the kidney?

Answer 49

Lesser thoraic (T10-11), least thoracic splanchnic nerves (T12)

Question 50

What is the function of the sympathetic nerves in the renal plexus?

Answer 50

Vasoconstricct renal vessels --> Less filtrate formation

Question 51

What are the afferent component (sympathetic) to the kidney?

Answer 51

T10-L1 - aka where pain is referred to.