The dorsal lumbotomy incision to expose the kidney
Splits the lumbodorsal fascia without incising muscle,. This approach allows entrance to the retroperitoneum without violation of musculature
The lumbodorsal fascia originates from the
The lumbodorsal fascia consists of how many layers
3- Posterior, middle and anterior
Posterior: covering for the sacrospinalis, latissimus dorsi origin
Middle: separates the anterior of of sacrospinalis from the posteror aspect of the quadratus lumborum,
Anterior: lumodorsal fascia probides the anterior covering to the quadratus lumborum muscle and forms the posterior margin of the retroperitoneum
All three layers of the lumbodorsal fascia join to form the a single thick aponeurosis lateral to the quadratus lumborum muscle before extending further anterolaterally, where they are contiguous with the aponeurosis of the ____________.
Transversus abdominis muscle
The psoas major joins the iliacus muscle, which originates ____, to become the _____ and insert on the _____ and _____ the thigh at the hip
1. Inner aspect of the iliac wing of the pelvis
3. lesser trochanter
What is the boundary of the retroperitoneum?
Posterior surface: lumbar vertebral bodies covered by shiny, longitudinal fibers of the anterior spinous ligament, these are flanked bilaterally by the psoas. Psoas is covered by the psoas sheath which are contiguous with the transversus abdominis muscle
LAterally: transversus abdominis
Superior: posterior insertion of the diaphragm along the lower ribs
Inferior: below the level of the iliac crest, iliopsoas forms the posterior confine
in a subcostal flank approach to the kidney, which of the ff may be incised to increase upward mobility of the 12th rib
the costovertebral ligament
What are the first abdominal branches of the aorta
the paired inferior phrenic arteries
which of the following arteries branches from the celiac trunk?
a. the left gastric
b. the right gastric
c. the pancreaticoduodenal
A. left gastric
The short celiac arterial trunk trifurcates into common hepatic, left gastric, and splenic branches
The renal arteries typically branch from the abdominal aorta at the level of the ____
the testicular arteries commonly originate from the
Abdominal aorta below the renal arteries
The inferior mesenteric artery can be sacrificed without complication
True, especially in individuals without atherosclerotic occlusive arterial disease
Which of the following drains directly to the IVC?
REnal veins, IMV,SMV,splenic veins
only renal vein, the rest drains into to the portal vein
the left gonadal vein usually enters the ____
inferior aspect of the left gonadal vein
left renal vein receives the ff
left adrenal, left lumbar, left gonadal
cysternal chyli is located
located at the 1st lumbar vertebra posterior to aorta
the right testis lymphatics drains into
the lumbar sympathetic chains
1. Run vertically in the retroperitoneum, ,medial to the psoas muscles
2. contain numerous sympathetic ganglia
3. Closely associated with the lumbar blood vessels
contain postganglionic sympathetic neurons supplying the lower ex
Disruption of which sympathetic nervous plexus on this anterior abdominal aorta during retrpoperioneal dissection will likely cause loss of seminal emission?
A. Celiac plexus
B. Renal plexus
C. Superior mesenteric plexus
D. Superior hypogastric plexus
D. superior hypogastric plexus
From book: At the lower extent of the abdominal aorta, much of the autonomic input to the pelvic urinary organs and genital tract travels through the superior hypogastric plexus. This plexus lies on the aorta anterior to its bifurcation and extends inferiorly on the anterior surface of the fifth lumbar vertebra. This plexus is contiguous bilaterally with inferior hypogastric plexuses, which extend into the pelvis. Disruption of the sympathetic nerve fibers that travel through these plexuses during retroperitoneal dissection can cause loss of seminal vesicle emission and/ or failure of bladder neck closure, resulting in retrograde ejaculation.
In the lateral abdominal wall, the iliohypogastric nerve will be found coursing in the plane:
deep to the transversalis fascia.
between the transversalis fascia and the transversus abdominis muscle.
between the transversus abdominis and internal oblique muscles.
between the internal oblique and external oblique muscles.
superficial to the external oblique muscle.
c. In between the transversus abdominis and internal oblique muscles.
The cremaster muscle is innervated by the:
genital branch of the genitofemoral nerve.
D. genital branch
In the retroperitoneum, where can the genitofemoral nerve be found?
Posterior to the psoas muscle
On the anterior surface of the psoas muscle
Lateral to the psoas muscle
Medial to the psoas muscle
B. the genitofemoral branch lies directly atop and parallels the psoas on most of its retroperitoneal course
Autonomic system divided into sympathetic and parasympathetic fibers. The sympathetitic ganglion originates from ___ while the parasymphatetic originates from ____. The major autonomic plexuses are associated with the primary branches of the aorta namely: ___, ___, ___
sympathetic: thoracic and lumbar portions
PArasymphathetic: Cranial and sacral collumns
Major autonomic branches: Celiac, superior hypogastric, inferior hypogastric plexus
The descending duodenum:
lies within the retroperitoneum.
receives the common bile duct.
lies lateral to the head of the pancreas.
lies anterior to the right renal hilum.
does all of the above.
e. The second part of the duodenum descends vertically, directly anterior to the right renal hilum, and this is intimately related on its posterior aspect to the medial margin of the right kidney, right renal vessels, renal pelvis, UPJ, upper right ureter, the CBD also lies posterior and drains into this part
The posterior surface of the tail of the pancreas is closely associated with:
the splenic artery.
the splenic vein.
the upper pole of the left kidney.
the left adrenal gland.
all of the above.
e all of the above
In cases of renal ectopia, the ipsilateral adrenal gland is typically:
found in its normal anatomic position in the upper retroperitoneum.
found in association with the contralateral adrenal gland.
found closely applied to the superior pole of the ectopic kidney.
found closely associated with the ipsilateral renal artery.
B. found in its normal position in the upper retroperitoneum
Which of the following statements is NOT true?
The right renal vein is much shorter than the left renal vein.
The right adrenal vein is much shorter than the left adrenal vein.
The right kidney is typically located lower in the retroperitoneum than the left kidney.
The right adrenal gland is typically located lower in the retroperitoneum than the left adrenal gland.
Both c and d
s one proceeds outward from the adrenal medulla, the three separate functional layers of the adrenal cortex are, in correct order:
zona reticularis, zona fasciculata, and zona glomerulosa.
zona fasciculata, zona reticularis, and zona glomerulosa.
zona glomerulosa, zona fasciculata, and zona reticularis.
zona glomerulosa, zona reticularis, and zona fasciculata.
zona reticularis, zona glomerulosa, and zona fasciculata.
Which of the following statements is (are) NOT true?
The adrenal medulla produces catecholamines in response to stimulation from the sympathetic nervous system.
The zona glomerulosa produces aldosterone in response to angiotensin II.
The zona reticularis of the adrenal cortex produces androgens in response to luteinizing hormone (LH).
The zona fasciculate of the adrenal cortex produces glucocorticoids in response to adrenocorticotropic hormone (ACTH).
Both b and c
C. it is regulated by ACTH not LH
The adrenal arteries are branches from:
the inferior phrenic arteries.
the renal arteries.
the celiac arterial trunk.
a, b, and c.