Posterior Abdominal Wall

Question 1

what spaces is the retroperitoneal space continuous with

Answer 1

pelvic cavity
diaphragm
subserous fascia

Question 2

what nerves are associated with the posterior abdominal wall

Answer 2

T12-L5

Question 3

what areas drain lymph through the retroperitoneal space

Answer 3

GI tract
pelvis
reproductive organs

Question 4

what forms the esophageal hiatus

Answer 4

right crus of the diaphragm

Question 5

what for the aortic hiatus

Answer 5

right and left crura of the diaphragm

Question 6

what forms the median arcuate ligament?

Answer 6

right and left crura of diaphragm

Question 7

tendinous arches of the diaphragm

Answer 7

meidan, medial and lateral form as thickenings of transferals fascia

Question 8

what is the blood supply to the diaphragm

Answer 8

superior- pericardiacophrenic, musculophrenic

inferior- inferior phrenic from aorta

Question 9

what is the innervation of the diaphragm

Answer 9

motor and sensory- phrenic (C3,4,5)

intercostals- sensory

Question 10

where is the referred pain location for the diaphragm

Answer 10

shoulder

Question 11

where are the 3 openings in the diaphragm and what goes through them

Answer 11

T8- IVC
T10- esophagus
T12- aorta

Question 12

where is the median arcuate ligament

Answer 12

aortic hiatus

Question 13

where is the medial arcuate ligament

Answer 13

over psoas major

Question 14

where is the lateral arcuate ligament

Answer 14

over quadratus lumborum

Question 15

what main structures pass through the diaphragm and where do they go through

Answer 15

IVC- T8
esophagus- T10
aorta- T12

Question 16

what passes through the esophageal hiatus

Answer 16

esophagus

vagus trunks

Question 17

what passes through the aortic hiatus

Answer 17

aorta
thoracic duct
sometimes the asecending lumbar veins

Question 18

what passes through the crura of the diaphragm

Answer 18

greater and lesser splanchnic nerves

sometimes the ascending lumbar veins

Question 19

what are the 4 muscles of the posterior abdominal wall

Answer 19

quardatus lumborum
posts major
psoas minor (sometimes)
iliacus

Question 20

where is the quadratus lumborum muscle and what does it form

Answer 20

superior to the iliac crest

forms lateral arcuate ligament

Question 21

function of the quadrates lumborum muscle

Answer 21

flex trunk

Question 22

where is the posterior major muscle and what does it form

Answer 22

next to spine

forms medial arcuate ligament

Question 23

function of posts major

Answer 23

hip flexor

Question 24

where is the posterior minor muscle and what does it form

Answer 24

tendon on top of psoas major
may be missing
forms medial arcuate ligament

Question 25

function of psoas minor

Answer 25

hip flexor

Question 26

where is the iliac muscle

Answer 26

in the iliac fossa

Question 27

function of iliac muscle

Answer 27

hip flexor

Question 28

what does the subcostal nerve supply

Answer 28

T12- hypogastric region

Question 29

where is the iliohypogastric nerve

Answer 29

L1- lowest cutaneous nerve on the abdomen

Question 30

where is the ilioinguinal nerve and what does it supply

Answer 30

L1- in the inguinal canal skin of scrotum and medial thigh sensory aspect of cremaster reflex

Question 31

where is the genitofemoral nerve and what does it supplly

Answer 31

L1-2 on the surface of the psoas muscle | splits into 2 nerves- genital and femoral branches

Question 32

where is the genital branch of the genitofemoral nerve and what does it do

Answer 32

medial branch of genitofemoral nerve in the spermatic cord supplies the cremaster reflex

Question 33

where is the femoral branch of genitofemoral nerve

Answer 33

lateral branch of genitofemoral nerve | goes to medial thigh to assist in cremaster reflex

Question 34

what does the lateral femoral cutaneous nerve supply

Answer 34

L3-4, anterior superior iliac spine

Question 35

where is the femoral nerve and what does it supply

Answer 35

L2-4 posteiror and lateral to psoas | hip flexors and knee extensors

Question 36

where is the obturator nerve and what does it supply

Answer 36

L2-4, exits obturator foramen and supplies the adductors

Question 37

where is the lumbosacral trunk

Answer 37

L4-5 on the surface of the sacrum | gives off sciatic nerve

Question 38

what is Gerota's fascia

Answer 38

surrounds the kidneys closed superiorly and laterally, but opened inferiorly and medially so blood and urine can move between left and right and drain into the pelvic cavity

Question 39

what covers kidneys

Answer 39

periphrenic fat and Gerona's fascia

Question 40

where is the right kidney

Answer 40

T12-L3 (due to liver)

Question 41

where is the left kidney

Answer 41

T11-L2

Question 42

why are the right renal artery and left renal vein longer than their partners

Answer 42

aorta is on left | IVC is on right

Question 43

nutcracker relationship

Answer 43

the left renal vein is between the SMA and the aorta | can increase the pressure in the left gonadal vein and cause a varicocele

Question 44

what is the right kidney in contact with

Answer 44

``` liver ascending colon ileum duodenum suprarenal gland ```

Question 45

what is the left kidney in contact with

Answer 45

``` stomach spleen pancreas transverse mesocolon descending colon jejunum suprarenal gland ```

Question 46

what are the 5 segmental branches of the renal artery

Answer 46

``` apical- top most anteriorly anterior superior- second anteriorly anterior inferior- third anteriorly inferior- last anteirorly posterior- goes to posterior side ```

Question 47

what is the order of vessels from the renal artery

Answer 47

segmental--> interlobar--> arcuate--> interlobular--> afferent arteriole--> glomerulus--> efferent arteriole

Question 48

what is the innervation of the kidney

Answer 48

least splanchnic nerve

Question 49

where does the ureter exit the kidney

Answer 49

at the hilum, most posterior structure

Question 50

why does compression of the left renal vein cause a varicocele

Answer 50

the left gonadal vein drains into the left renal vein before reaching the IVC compression of the left renal vein backs up the blood into the left gonadal vein

Question 51

describe the path of the ureter

Answer 51

passes posteriorly to the gonadal vessels | passes anteriorly to common iliac vessels, lateral to the internal iliac vessels to enter the pelvis

Question 52

what is the blood supply of the ureters while they are in the retroperitoneum and from where does the blood supply originate (significance?)

Answer 52

renal artery gonadal artery aorta originates medially- reflect the ureters medially here

Question 53

what is the blood supply of the ureters while they are in the pelvis and from where does the blood supply originate (significance?)

Answer 53

vesicle artery uterine artery middle rectal artery originates laterally- reflect ureters laterally here

Question 54

what are the 3 points where kidney stones are most likely to get stuck

Answer 54

ureteropelvic junction crossing iliac vessels ureterovesicle junction

Question 55

what is the arterial supply to the suprarenal gland

Answer 55

branches of inferior phrenic, aorta, renal

Question 56

what is the venous supply draining the suprarenal galnd

Answer 56

1 vein right- IVC left- drains to renal vein

Question 57

what is the innervation of the suprarenal glands

Answer 57

preganglionic fibers (lesser and least splanchnic T10-T12) that do not synapse at the ganglion but go directly to chromatin cells of medulla

Question 58

what is the name for kidney stones

Answer 58

renal calculi

Question 59

what is the innervation to the ureter

Answer 59

T11-L2

Question 60

where is referred pain for the kidney/ureter

Answer 60

starts on side and then goes inferiorly down around back

Question 61

path of metastasis of left bladder cancer

Answer 61

left iliac--> paraaortic--> aortic-> interaorticocaval

Question 62

path of metastasis for right bladder cancer

Answer 62

right paracaval-> interaorticocaval-> aortic-> left para-aortic

Question 63

drainage path of things superior to umbilicus

Answer 63

superior to parasternal and axillary nodes

Question 64

drainage path of things inferior to umbilicus

Answer 64

skin and superficial fascia- inferior to inguinal nodes | muscle- exteral iliac nodes via inferior epigastric and deep iliac circumflex