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[OS 206] 1st Exam > Trans - Retroperitoneum, Posterior Abdominal Wall, Lumbar Plexus > Flashcards

Trans - Retroperitoneum, Posterior Abdominal Wall, Lumbar Plexus Flashcards

1
Q

Contents of retroperitoneum

A

SADPUCKER

Suprarenal glands
Aorta and IVC (great vessels) 
Duodenum (descending and transverse) 
Pancreas (except tail)
Ureters
Colon (ascending and descending)
Kidneys
Esophagus
Rectum
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2
Q

Primarily retroperitoneal organs: definition and examples

A

Organs that are retroperitoneal since embryonic development

e.g. urinary organs, great vessels, thoracic esophagus, part of rectum

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3
Q

Secondarily retroperitoneal organs: definition and examples

A

Organs that become retroperitoneal due to post-embryonic rotation

e.g. pancreas (head, neck, body), duodenum (distal segments), colon (ascending and descending)

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4
Q

3 main compartments of retroperitoneum

A
  1. Anterior pararenal
  2. Perirenal
  3. Posterior pararenal
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5
Q

Perirenal space: contents

A

Kidney, adrenals, ureters, hilar vessels, lymph nodes, fat

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6
Q

Posterior pararenal space: contents

A

Fat

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7
Q

3 anatomic zones of retroperitoneum

A
  1. Centromedial
  2. Lateral
  3. Pelvic
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8
Q

Anatomic zone where hematoma needs immediate operation

A

Centromedial

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9
Q

Centromedial zone: contents

A

Great vessels - aorta and IVC

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10
Q

Lateral zone: contents

A

Suprarenal glands, kidneys, ureters, pancreas, colon (ascending and descending)

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11
Q

Pelvic zone: contents

A

Spermatic cord, ovarian vessels, bladder, distal ureters, branches of common iliac

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12
Q

Level of the caval hiatus

A

T8

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13
Q

Level of the esophageal hiatus

A

T10

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14
Q

Level of the aortic hiatus

A

T12

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15
Q

Psoas major: action

A

Pulls the leg and thigh towards the body

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16
Q

Psoas major: innervation

A

L2-L4

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17
Q

Psoas sign: definition

A

Sign indicating irritation of the iliopsoas group of hip flexors – manifests as pain in psoas region upon flexing hip

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18
Q

Iliacus: innervation

A

L2-L4

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19
Q

Iliacus: action

A

Thigh and trunk flexion

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20
Q

Quadratus lumborum: innervation

A

L1-L3

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21
Q

Location of bifurcation of abdominal aorta

A

L4 level

Left of the iliac crest, 2cm below the navel

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22
Q

Origin of median arcuate ligament

A

crura of diaphragm

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23
Q

Origin of medial arcuate ligament

A

psoas fascia

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24
Q

Origin of lateral arcuate ligament

A

quadratus lumborum fascia

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25
Q

What passes through the median arcuate ligament

A

aorta

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26
Q

What passes through the medial arcuate ligament

A

psoas major

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27
Q

What passes through the lateral arcuate ligament

A

quadratus lumborum

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28
Q

Level where the common iliac veins unite to form the IVC

A

L5

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29
Q

Path of blood from the abdominal viscera to the IVC

A

Viscera –> portal venous system (through liver) –> hepatic vein –> IVC

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30
Q

Veins of the posterior abdominal wall all drain into the IVC except for the (a)________ which drains into the (b)________

A

a. left gonadal vein

b. left renal vein

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31
Q

Lymph drainage of intraabdominal structures

A

Intestinal lymphatic trunk

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32
Q

Lymph drainage of retroperitoneal structures

A

Lumbar lymphatic trunk

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33
Q

Lymph drainage of foregut derivatives

A

Celiac nodes

34
Q

Lymph drainage of midgut derivatives

A

Superior mesenteric nodes

35
Q

Lymph drainage of hindgut derivatives

A

Inferior mesenteric nodes

36
Q

Cisterna chyli: definition

A

Dilated sac at the lower end of the thoracic duct into which lymph from the intestinal trunk and lumbar lymphatic trunks flow

37
Q

Difference in shape of suprarenal glands

A

Right – triangular/pyramidal

Left – semilunar

38
Q

Suprarenal cortex: function

A

Produce corticosteroids (mineralocorticoids and glucocorticoids) and androgens

39
Q

Suprarenal medulla: function

A

Produce catecholamines (fight or flight hormones during stress)

40
Q

Contributing nerves to the lumbar plexus

A

Ventral primary divisions of L1-L3
Greater part of L4
Contributions from T12

41
Q

Iliohypogastric nerve: divisions

A
  1. Lateral cutaneous branch
  2. Anterior cutaneous branch
  3. Muscular branches (to internal oblique, transversus abdominis)
42
Q

Iliohypogastric nerve: innervations

A

Abdominal muscles and skin of the inguinal and pubic regions

43
Q

Ilioinguinal nerve: divisions

A
  1. Cutaneous branch

2. Muscular branch

44
Q

Genitofemoral nerve: innervations

A

Caudal part of the parieties of the abdominal wall

45
Q

Genitofemoral nerve: divisions

A
  1. genital branch

2. femoral branch

46
Q

Genital branch of genitofemoral nerve: innervations

A

cremaster muscle and skin of scrotum/adjacent thigh

47
Q

Femoral branch of genitofemoral nerve: innervations

A

skin of proximal part of anterior surface of thigh

48
Q

Lateral femoral cutaneous nerve: innervations

A

Skin of thigh until knee

49
Q

Lateral femoral cutaneous nerve: divisions

A
  1. anterior branch

2. posterior branch

50
Q

The lateral femoral cutaneous nerve forms part of the ________ along with the anterior cutaneous branch of the femoral nerve and the infrapatellar branch of the saphenous nerve

A

Patellar plexus

51
Q

Calvin Klein syndrome is caused by _________

A

Compression of the lateral femoral cutaneous nerve, usually due to tight jeans

52
Q

Obturator nerve: innervations

A

Skin and adductor muscles of medial thigh

53
Q

Obturator nerve: divisions

A
  1. Anterior branch – to hip joint

2. Posterior branch – muscular branch to adductor muscles

54
Q

Accessory obturator nerve: innervation

A

Pectineus

55
Q

Largest branch of the lumbar plexus

A

Femoral nerve

56
Q

Which colic flexure is more superiorly located?

A

Left colic flexure

57
Q

Spinal nerve origin of iliohypogastric nerve

A

L1

58
Q

Spinal nerve origin of ilioinguinal nerve

A

L1

59
Q

Spinal nerve origin of genitofemoral nerve

A

L1, L2

60
Q

Spinal nerve origin of lateral femoral cutaneous nerve

A

L2, L3

61
Q

Spinal nerve origin of obturator nerve

A

L2, L3, L4

62
Q

Spinal nerve origin of accessory obturator nerve

A

L3, L4

63
Q

Spinal nerve origin of femoral nerve

A

L2, L3, L4

64
Q

T/F: retroperitoneal tumors are usually malignant

A

T

65
Q

Fascia anterior to the perirenal space

A

Fascia of Gerota (anterior renal fascia)

66
Q

Fascia posterior to the perirenal space

A

Fascia of Zuckerkandl (posterior renal fascia)

67
Q

Lateroconal fascia is a continuation of ________

A

Fascia of Zuckerkandl (posterior renal fascia)

68
Q

T/F: there is usually a need for surgical intervention in hematomas of the lateral retroperitoneum (anatomic zone)

A

F

69
Q

T/F: during surgery, both the internal iliac and external iliac arteries may be ligated

A

F, only the internal iliac may be ligated

70
Q

The right phrenic nerve passes through which hiatus

A

Caval hiatus

71
Q

The anterior and posterior vagal trunks pass through what hiatus

A

Esophageal hiatus

72
Q

T/F: the aorta passing through the aortic hiatus pierces the diaphragm

A

F, it runs posterior to the diaphragm

73
Q

Quadratus lumborm: action

A

Stabilizes the 12th rib during inspiration, lateral bending of the trunk

74
Q

The right gonadal vein drains into:

A

IVC

75
Q

What veins are part of the collateral circulation between the superior and inferior vena cavae

A
  1. inferior epigastric vein (IVC) and superior epigastric vein (SVC) anastomose at rectus sheath
  2. superficial epigastric vein (IVC) anastomoses with lateral thoracic vein (SVC)
  3. epidural venous plexus, lumbar veins (IVC), and azygos venous system (SVC) anastomose
76
Q

T/F: the IVC can be ligated suprarenally

A

F, they may only be ligated infrarenally. Suprarenal ligations cause kidneys to lose venous drainage

77
Q

Region where the IVC can be ligated

A

Infrarenally.

78
Q

Location of the suprarenal glands

A

Between the superomedial aspect of the kidney, and the diaphragm

79
Q

The suprarenal glands are enclosed by __________

A

Adipose capsule of the kidney

80
Q

A pathology affecting this muscle will affect all nerves of the the lumbar plexus

A

Psoas major

81
Q

Nerve that is involved in the cremasteric reflex

A

Genitofemoral nerve

82
Q

The left suprarenal vein drains into the (a)__________, while the right suprarenal vein drains into the (b)___________

A

a. Left renal vein

b. IVC

[OS 206] 1st Exam (12 decks)

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