Block 3 Posterior Abdominal Wall

Front 1

Abdominal contents suspended from posterior wall by

Back 1

Mesenteries & blood vessels associated with them

Front 2

Retroperitoneal structures are held to the wall by:
-E.g.

Back 2

Peritoneum
-Aorta, kidneys

Front 3

Secondary peritoneum structures
-PDAD

Back 3

Pancreas
(part) of duodenum
Ascending colon
Descening colon

Front 4

Retroperitoneal (all)
SAD PUCKER:

Back 4

Suprarenal glands
Aorta & IVC
Duodenum (half)
Pancreas
Ureters
Colon (ascending & descending)
Kidneys
Esophagus (anterior & left covered)
Rectum

Front 5

Primary retroperitoneal AUK

Back 5

Adrenal gland
UReter
Kidney

Front 6

IVC is located to the _____ of abdominal aorta

Back 6

Right

Front 7

Ureters travel deep to ____; superficial to ____

Back 7

Gonadal a. v. ; common iliac a. v.

Front 8

Left renal v. found under ____
-Complications

Back 8

Superior mesenteric a.
-Renal v. can be compressed

Front 9

Renal v. in relationship to renal a.

Back 9

Superficial to

Front 10

Iliacus m.
-O
-I
-A
-N
-V

Back 10

-Iliac fossa, ala of sacrum
-Lesser trochanter
-Flex thigh (with psoas)
-Femoral
-Medial femoral circumflex

Front 11

Psoas major m.
-O
-I
-A
-N
-V-O
-I
-A
-N
-V

Back 11

-transverse process/bodies T12-L5
-lesser trochanter
-Flex thigh & trubk
-L2-L3 of lumbar plexus
-Lumbar branch of iliolumbar a.

Front 12

Psoas major m.
-O
-I
-A
-N
-V

Back 12

-Bodies of T12-L1
-Pectineal line
-Aids in flexing trunk (weak)
-L1
-

Front 13

Arcuate ligaments of diaphragm
(3)

Back 13

Lateral
Medial
Median

Front 14

Lateral arcuate ligament goes over ____ m.

Back 14

Quadratus lumborum

Front 15

Medial arcuate ligament goes over ____ m.

Back 15

Psoas m.

Front 16

Median arcuate ligament goes over ____ m.

Back 16

Aorta

Front 17

___ forms the median arcuate ligament

Back 17

Left and right crus

Front 18

Stay in ____peritoneum when doing surgery, etc
-Risk of:

Back 18

Retro
-Adhesions, infection, peritonitis

Front 19

Sigmoid colon is __peritoneal

Back 19

Intra

Front 20

Aorta birfucates at what vertebral level

Back 20

L3 or L4

Front 21

_____ v. crosses under superior mesenteric a.
-Complication

Back 21

Left renal v.
-Creates pressure on left renal v.

Front 22

Gonadal a. and v. usually come off:

Back 22

just below renal a.

Front 23

Lateral arcuate ligament attaches to:

Back 23

12th rib

Front 24

Sympathetic chain is fond just medial to ____ in posterior abdominal wall

Back 24

Psoas m.

Front 25

Structure found at the very top of the diaphgragm

Back 25

LIver

Front 26

Topf of diaphragm dome vertebral level

Back 26

T8 or T9

Front 27

Hiati that will change levels with breathing:

Back 27

Caval foramne
Esophageal foramen

Front 28

Caval foramen spinal level

Back 28

T8

Front 29

Esophageal hiatus spinal level

Back 29

T10

Front 30

Aorta hiatus spinal level

Back 30

T12

Front 31

Spleen grows in association with:

Back 31

Foregut

Front 32

Spleen is a _____ organ (tissue type)
-If lost, pt more likely to get ____ (disease)

Back 32

Lymphoid
-Pneumonia

Front 33

Spleen is ___peritoneal

Back 33

Intra

Front 34

Spleen has attachments to:

Back 34

-Diaphragm
-Kidney
-Colon

Front 35

Right gonadal v. drains to:

Back 35

IVC

Front 36

Left gonadal v. drains to

Back 36

Left renal

Front 37

Aorta has ____unpaired branches & ___paired branches

Back 37

4; 6

Front 38

Aorta will change position with

Back 38

Fracture vertebral bodies

Front 39

Pair aortic aa. (6) GIRLS P

Back 39

Gonadal
Iliacs
Renal
Lumbar segmental
Suprarenal
Inferior phrenic

Front 40

Unpaired aortic aa. (4) SCIM

Back 40

1.Superior mesenteric
2. Celiac
3. Inferior mesenteric
4. Median sacral

Front 41

___ & ____ vv. drain into left renal v.

Back 41

Left gondadal
Suprarenal v.

Front 42

There are many suprarenal ____, but only one suprarenal ____

Back 42

Arteries; vein

Front 43

Left renal v. drains into ____

Back 43

Renal v.

Front 44

Right renal v. drains into

Back 44

IVC

Front 45

Other veins found coming off near suprarenal

Back 45

Rena, gonadal

Front 46

Which kidney sits lower?

Back 46

Right

Front 47

Which renal v. is longer?

Back 47

Left

Front 48

Structures at hilum from anterior to posterior (3)

Back 48

Vein --> Artery --> renal pelvis/ureter

Front 49

You can only transplant kidneys with a single ______

Back 49

Renal a.

Front 50

Function of kidneys BUFF BEA

Back 50

BP
Urine creation
Fluid balace
Filter
Bone marrow stimulation
Electrolyte
Acid/base balance

Front 51

Rib 11 covers superior part of ____ kidney;
-Which kidney doesn't usually have protection

Back 51

Left
Right

Front 52

Muscles protecting kidneys from posterior abdominal wall

Back 52

Psoas and quadratus lumborum

Front 53

Muscles protecting kidneys from posterior abdominal wall

Back 53

Psoas and quadratus lumborum

Front 54

Renal fascia separates:

Back 54

Para and perirenal fat

Front 55

Pain in kidney will refer to ____ because of ____ nn.

Back 55

Back and genitals; T12 & L1

Front 56

Renal fascia continuous with

Back 56

Transversalis fascia

Front 57

Anterior part of renal fascia joins with:

Back 57

Renal vessels coming out of hilum

Front 58

Posterior part of renal fascia joins with

Back 58

Fascia of psoas m.

Front 59

Swelling causes tissue compression of kidney because of:

Back 59

Renal capsule

Front 60

THere are ___ segments of the kidney, each supplied by their own a.

Back 60

5

Front 61

Segments of Renal a.
1.
2.
3.
4.

Back 61

Segmental
Lobar
Inerlobar
Arcuate

Front 62

___ and ____ arteries are end arteries

Back 62

Segmental
Interlobar

Front 63

5 segments of kidney (ASIPI)

Back 63

1. Apical
2. Anterosuperior
3. Anteroinferior
4. Posterior
5. Inferior

Front 64

Outer portion of kidney

Back 64

Cortex

Front 65

Inner portion of kidney

Back 65

Medulla

Front 66

Medulla tissue in form of

Back 66

Pyramids

Front 67

Cortical tissue between renal pyramids

Back 67

Cortical column

Front 68

___Found at end of pyramids

Back 68

Papilla

Front 69

Pyramids drain into ___

Back 69

Minor calices

Front 70

Minor calices drain into

Back 70

Major

Front 71

Major calicies drain into

Back 71

Renal pelvis

Front 72

Renal pelvis turns into

Back 72

Ureter

Front 73

Fat inside kidney:

Back 73

Hilar extension of perirenal fat

Front 74

____ found in cortex (physiological structure)

Back 74

Golmeruli

Front 75

Tissue of kidney

Back 75

Parenchyma

Front 76

All renal tubules from cortical drain to:

Back 76

Papilla (urine drips off; funnel function)

Front 77

Glomeruli and convoluted tubules found in:

Back 77

Cortical tissues

Front 78

The actual urine forming units:

Back 78

Glomeruli & convoluted tubules

Front 79

Structures found in renal medulla

Back 79

Loops of Henley, collecting ducts

Front 80

Ureter crosses over _____ at it's bifurcation

Back 80

Common iliac

Front 81

Ureter travels under (distal)

Back 81

Uterine a./ductus deferencs

Front 82

Places in ureters at risk of stones being stuck
1.
2.
3.

Back 82

As renal pelvis narrows (uteropelvic junction)
Crosses over pelvic brim
Entry into bladder (uterocystic junction)

Front 83

What creates the pressure valve of the bladder

Back 83

Ureter entrance

Front 84

Backup of fluid in ureter, increase in kidney pressure

Back 84

Hydronephrosis

Front 85

Non distensible area of bladder that is sensitive to pressure

Back 85

Trigone

Front 86

Trigone points

Back 86

2 ureter openins
urethra openings

Front 87

Muscles of bladder

Back 87

Detrusser

Front 88

____ is the "internal sphincter of the bladder" under autonomic control

Back 88

Bladder neck

Front 89

Sphincter under somatic control

Back 89

Sphincter urethra

Front 90

Sympathetics go to ____ of bladder

Back 90

internal sphincter

Front 91

Parasympathetics go to ____ of bladder

Back 91

Detrusor m.

Front 92

Bladder is ____nergic

Back 92

Cholinergic

Front 93

Internal sphincter (bladder neck) is ____ nergic

Back 93

Adrenergic

Front 94

Old man, can't urinate, hoarse, took OTC cold meds. Why?

Back 94

Cold meds are adrenergic 0 causing too much sympathetic tone & can't relax bladder neck

Front 95

Adrenal glands came form 2 different components of ____

Back 95

Intermediate mesoderm

Front 96

Adrenal medulla comes from _____

Back 96

Sympathetic neurons

Front 97

Adrenal cortex comes from

Back 97

Connective tissue

Front 98

Adrenal cortex functions pneumonic (exterior to interior)

Back 98

Salty
Sweet
Sexy

Front 99

Outermost later of adrenal cortex

Back 99

Glomerulosa

Front 100

Middle layer of adrenal cortex

Back 100

Fasiculata

Front 101

Innermost layer of adrenal cortex

Back 101

Reticularis

Front 102

Glomerulosa (outermost) produces ___ important in

Back 102

-Mineralocorticoids; sodium reabsorption

Front 103

Giving someone steroids or NSAIDS can affect

Back 103

Sodium balance

Front 104

Primary mineralocorticoid

Back 104

Aldosterone

Front 105

Fasiculata (middle cortex) produces

Back 105

Glucocorticoid

Front 106

E.g. of glucocorticoids (2)

Back 106

Cortisol
Hydrocortisone

Front 107

Reticularis (innermost cortex) produces ___ (e.g.)

Back 107

Androgens (testosterone)

Front 108

Adrenal Medulla produces:

Back 108

Epinephrine

Front 109

Diabetes should not receive -___ steroids

Back 109

Glucocorticoid

Front 110

___ nervous system uses epinephrine (and norepinephrine) as its postsynaptic NT

Back 110

Sympathetic

Front 111

Adrenal Medulla receives ____ nerve supply, acting like a _____

Back 111

Sympathetic; ganglion

Front 112

Adrenal Medulla receives preganglionics from:

Back 112

Least splanchnic n.

Front 113

Which portion of adrenal gland is under only hormonal control

Back 113

Cortex

Front 114

Adrenal medulla is a collection of modified _____ganglionic nerve cells designed to allow release of____ into blood

Back 114

Post; NT

Front 115

3 separate blood supplies to adrenal gland
1.
2.
3.

Back 115

Superior suprarenal off inferior phrenic
Middle suprarenal off aorta
Inferior suprarenal off renal a.

Front 116

Splanchnic nerves going to adrenal medulla come from ____ plexus

Back 116

Aorticorenal

Front 117

Subcostal root

Back 117

T12

Front 118

Iliohypogastric Ilioinguinal root

Back 118

L1

Front 119

Lateral femoral cutaneous lumbar nerve roots

Back 119

L2-L3

Front 120

Femoral n. roots

Back 120

L2-L4

Front 121

Obturator n roots

Back 121

L2-L4

Front 122

Lumbosacral trunk roots

Back 122

L4-L5

Front 123

Sciatic n. roots

Back 123

L4-S3

Front 124

Genitofemoral roots

Back 124

L1-2

Front 125

Nerve deep to psoas

Back 125

Obturator

Front 126

Nerve superificial to psoase

Back 126

Genitofemoral

Front 127

Nerve going abdominal wall over pubic symphysis

Back 127

Iliphypogastric

Front 128

Nerve traveling through superifical ring

Back 128

Ilioinguinal

Front 129

Function of genitofemoral n.

Back 129

Contraction of cremaster

Front 130

Greater splanchnic n. formed by ____; supplies ____

Back 130

T5-T9; celiac plexus for foregut

Front 131

Lesser thoracic splanchnic formed by ____; supplies ____

Back 131

T10-T11; Superior mesenteric plexus to midgut

Front 132

Least thoracic splanchnic formed by ____

Back 132

T12; aorticorenal ganglia and adrenal medulla

Front 133

Lumbosacral splanchnics supply (along with ____ a.)

Back 133

Hindgut; inferior mesenteric

Front 134

Vagus supplies ___ gut

Back 134

Fore and mid

Front 135

Pelvic splanchnics (parasymp) supply

Back 135

Hindgut

Front 136

Pulsitile mass on exam

Back 136

Aortic aneurism

Front 137

_____ needs exploring if gonads have cancer

Back 137

Paraaortic lymph nodes

Front 138

Complication of messing around in peritoneum

Back 138

Peritonitis

Front 139

Renal calculus can cause obstruction, resulting in _____

Back 139

Hydronephrosis

Front 140

Costal Vertebral Angle (CVA) tenderness, fever, and back pain = pyelonephritis

Back 140

Pyelonephritis

Front 141

Kidney infection results in ____itis

Back 141

Pyelonephritis

Front 142

Results of kidney failur

Back 142

Oligourea
Anemia

Front 143

Adrenal syndromes (CAP)

Back 143

Addisons Disease
Cushingnoid
Pheochromocytoma

Front 144

Addison's Disease
-result of:

Back 144

Cortical insufficiency (need to ADD more gluco/mineralocoritcoids)

Front 145

Cushingnoid

Back 145

Cortical adenoma (too many steroids)

Front 146

Pheochromocytoma
-High ___ and ___
-Caused by ____ producing too much ____

Back 146

-Heart rate and metabolism
-Adrenal gland tumor producing too much epinephrine