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zAnatomy Block II > Posterior Abdominal Wall > Flashcards

Posterior Abdominal Wall Flashcards

1
Q

protection of kidneys

which is lower?

A

superior via ribs

R lower than L

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2
Q

where do they run spatially?

A

T11-L3

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3
Q

urinary organs in abdomen vs. pelvis

A

abdomen: kidneys, ureters
pelvis: urinary bladder, urethra

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4
Q

hilus location, contents

A

medial

renal artery/vein

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5
Q

path of urine

A

renal pyramid –> papilla (tip) –> minor calyx –> major calyx (several minor) –> renal pelvis –> ureter –> bladder

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6
Q

what layers do you pass through from ext to int

A

trasversalis fascia –> pararenal fat –> renal fascia –> perirenal fat –> renal capsule –> kidney

kidney –> renal capsule –> perirenal fat –> renal fascia –> pararenal fat –> transversalis

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7
Q

kidney blood supply?

A

one artery per kidney (sometimes 2)

level with SMA –> renal arteries branch from aorta

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8
Q

renal vein course?

what other 2 veins does the L receive?

A

R renal vein goes straight to IVC

L must run under SMA to get to IVC (also receives L adrenal and L gonadal??)

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9
Q

clinical problem w L renal vein

what’s the name of the syndrome?

A

if gap too small under SMA, venous blood backs up into L kidney, and down into the gonadal vein (PELVIC PAIN)
SMA syndrome –> NUTCRACKER

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10
Q

how do ureters enter bladder wall?

A

oblique angle, openings press back against vessel

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11
Q

sympathetics 3 target organs

A

body wall
viscera
adrenal medulla

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12
Q

body wall: pre/postsynaptic CB location?

A

lateral horn T1-L2
paravertebral chain ganglion (exits via gray ramus)
arrector pilli, BV, sweat glands

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13
Q

viscera (pre/post)

A

splanchnics (pre or post)
lateral horn T1-L2
post thoracic: paraV chain gang, cardiopulmonary splanch (post-syn)
abd/pelv: PREvertebral collateral gang

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14
Q

medulla

A

CB in lateral horn T1-L2
axon enters chain via white ramus, exit symp trunk via GREATER thoracic splanch (no synapse), synapse dir with chromaffin cells

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15
Q

preaortic aka pre vertebral aka collateral ganglia form which plexus?

A

preaortic plexus

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16
Q

ganglia named after BV’s

A

celiac
superior mesenteric
inferior mesenteric
aorticorenal ganglion (by renal arteries)

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17
Q

visceral pain fibers travel with?

A

sympathetic fibers

18
Q

parasympathetics

2 sources, where are the CB’s?

A

vagus & pelvic splanchnics (only splanchs that are not sympathetic)
presynaptic CB’s (BS or SC S2-S4)
post-syn in terminal ganglia

19
Q

vagus nerve plexuses (contain what 3 types of fibers?)

A 
cardiopulmonary plexus (PS, S, VS)
esophageal plexus (PS, S, VS)
20
Q

vagus supplies what structures?

A

thru midgut to L colic flexure (pre-G)

21
Q

pelvic splanchnic supply what?

A

hindgut & pelvic organs (pre-G)

leave via sacral spinal nerves

22
Q

preaortic plexuses (5) & fibers (4)

A

CB’s are sympathetic PG
fibers are pre&post symp, pre gang PS, VS

plexuses: celiac, SM, aorticorenal, IM, sup hypogastric

23
Q

anterior/posterior vagal trunk sends to?

A

both branch along lesser curvature
ant sens to liver and duodenum via lesser O
post sends to post up to end of midgut (L colic flex) via celiac ganglia (no synapse here)

24
Q

superior hypogastric plexus sits where?

A

on top of aortic bifurcation

25
Q

adrenal cortex/medulla derived from?

A

mesoderm/neural crest

26
Q

adrenal innervation

A

PS sympathetic greater thoracic splanchnic pierces muscle of diaphragm and travels thru celiac plexus (but does not synapse here)
lesser thoracic goes straight to adrenal gland

27
Q

muscles of posterior body wall

3 on back, all deep to what?

A 
quadratus lumborum (stabilizing pelv: attaches at ribs/sup pelv)
psoas major (loin)
psoas minor

all deep to erector spinae
out to in: thoracolumbar fascia –> quad –> major –> minor

28
Q

diaphragm movement

A

inspiration, domes flatten

expiration, domes rise

29
Q

stab wound in thorax or abdomen? where’s the boundary?

A

6th rib boundary moves, so could be in thorax or abdomen dep on exh/inh

30
Q

central tendon

A

muscles shorten and pull tendon down during inspiration

31
Q

holes in diaphragm that let stuff through:

SH, MnAL, MlAL, LAL

A

sternocostal hiatus: superior epigastrics
median arcuate ligament: aorta
medial arcuate ligaments: psoas muscles
lateral arcuate ligaments: quad lumborum

32
Q

weak spot in diaphragm?

A

vertebrocostal trigone

33
Q

R/L crura attach where?

which is around esophagus?

A

attach to L2 vertebra

R CRUS around esophagus

34
Q

3 major foramina
approx location on vertebra?
each includes what things?

A

vena caval T8: IVC + right phrenic nerve (during contraction this will open and allow more blood thru IVC)

esophageal hiatus T10: esophagus + vagal trunks + branch of L gastric artery

aortic hiatus T12: aorta + thoracic duct + azygos vein (behind diaphragm)

35
Q

sympathetic trunk runs behind which ligament?

A

behind medial arcuate ligament

36
Q

where do thoracic splanchnic nerves run thru diaphragm?

A

through crura

37
Q

diaphragmatic hernias: what pokes thru?

A

hiatal hernia…

stomach bulges up thru diaphragm into esophagus area

38
Q

abdominal aorta branches 5

A

parietal: inferior phrenic, 4 pairs of lumbar arteries
visceral: middle suprarenal, R/L rentals (25% of CO), ovarian/testicular

39
Q

blood to adrenals (arteries/veins)
SSA via?
MSA via?
ISA via?

A

superior suprarenal arteries (6-10 of these via inferior phrenic)
middle suprarenal artery (via aorta)
inferior suprarenal artery (via renal)
suprarenal veins (L to renal vein, R to IVC)

40
Q

what fibers from where are responsible for CONTRACTION of the external urethral sphincter?

A

somatomotor from S2-4

sympathetics relax detrusor and contract involuntary sphincter

41
Q

what fibers cause contraction of the detrusor and relaxation of the involuntary sphincter? where do they synapse?

A

parasympathetic pelvic splanchnics

42
Q

what three vessels join to form the thoracic duct and where?

A

R/L lumbar
intestinal trunks
L1-L2

zAnatomy Block II (7 decks)

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