Posterior Abdominal Wall

Front 1

name the muscles posterior to the kidneys

Back 1

Quadratus lumborum
Diaphragm

Front 2

the muscle immediately posterior to middle and inferior portion of kidney -
attachments
innervation
action

Back 2

L: medial 1/2 of superior part rib 12 + transverse process --> iliolumbar ligament and internal lip iliac crest
inn: T12 - L4
Action: Extend vertebral column (bilateral)
Flex colum (unilateral)
fix rib during inspiration

Front 3

Muscle laying anterior to quadratus lumborum

Back 3

psoas maj m.

Front 4

psoas maj m.
attachments
innervation
action

Back 4

T12 - L5 vert --> attach w/ iliacus to lesser trochanter of femur
inn: ant. rami L1-3
action - flex thigh and trunk

Front 5

muscle laying in iliac fossa
attachment
innervation
action

Back 5

Iliacus m.
2/3 iliac fossa to lesser trochanter femur
inn: Femoral n. (L2-4)
action: flex thigh/trunk

Front 6

main muscle of inspiration
attachments

Back 6

posterior surface xiphoid
7-9 costal cartilages
distal part of rib 10-12
lateral and medial arcuate ligaments
R crura (LI-III) - pushed down by liver
L crura (LI-II)
Median arcuate ligament

Front 7

formation of Lateral arcuate ligament is by what fascia?

Back 7

quadratus lumborum fascia

Front 8

formation of medial arcuate ligament is by what fascia?

Back 8

thickening of psoas major fascia

Front 9

what fibers are active with damage to diaphragm causing pain?
where is the pain actually felt

Back 9

phrenic n. afferents (C3-5)
pain is felt in R or L shoulder - referred pain

Front 10

motor component of nerve to diaphragm

Back 10

phrenic efferent

Front 11

additional afferent from body wall to diaphragm innervates with the phrenic. Why?

Back 11

portion of the diaphragm develops from body wall

Front 12

what is the order of splanchnic n. (SN) as they traverse diaphragm.
anterior to posterior

Back 12

1. Greater SN
hemiazygous v. - inbetween
2. Lesser SN
3. Least SN - passes through medial arcuate ligament

Front 13

cutaneous innervation to medial thigh is by what n?

Back 13

obturator n. (L2-4)

Front 14

Cutaneous inn. to portion inferior to middle of inguinal ligament is by what n.?

Back 14

Genitofemoral n. (L1-2)

Front 15

Cutaneous inn. to lateral thigh is by what n.?

Back 15

lateral cutaneous n. (L2,3)

Front 16

Cutaneous inn. to portion superior to patella is by what n.?

Back 16

femoral n. (L 2-4)

Front 17

Cutaneous inn. to medial portion of thigh inferior to medial inguinal ligament is by what n.?

Back 17

ilioingunal n. (L1)

Front 18

blood supply is cut off at the T12 hiatus of diaphragm. What vessels are first affected and what do they supply?

Back 18

Inferior phrenic aa.
supply blood to diaphragm and to suprarenal gland as br. --> superior adrenal a.

Front 19

if blood supply were stopped in the inf. phrenic a. what other blood supply is there for diaphragm?

Back 19

thoracic side receives blood
Pericadiophrenic a.
br. of musculophrenic a.
br. small superior phrenic a. - a br. of aorta

Front 20

patient presents with difficulty breathing and pain in chest and stomach. potential problem?

Back 20

Hiatal hernia - paraesophogeal hernia

Front 21

what slides through esophageal hiatus in paraesophageal herniation

Back 21

portion of fundic stomach and peritoneal sac

Front 22

what passes through hiatus in a sliding esophagus hiatal hernia

Back 22

pericardial sac
cardiac region of stomach (attached to esophagus)
attenuated phrenoesophageal ligament

Front 23

what vertebral level is esophageal hiatus and what passes through with esophagus?

Back 23

T10
vagus nn. pass with esophagus

Front 24

if a clumsy surgeon ligated both the uterine a. and the structure nearest it, what would happen?

Back 24

Hydronephrosis
ligated ureter
backed up urine to kidney

Front 25

where is pain referred to with calculi in ureter?
what else refers pain at this level?

Back 25

T11-L2
LOIN TO GROIN pain
bowels also refer pain at this level

Front 26

causes of AAA

Back 26

smoking
drinking
stress

Front 27

patient presents with caput madusae. what is wrong with the portal caval system?

Back 27

hypertension in the caval system
the anastamoses in the paraumbilical v. pick up the slack and return blood back to caval system

Front 28

patient presents with dark blood in sputum. alcoholic. what is likely causing his symptoms?

Back 28

leaking esophageal varices
medical emergency
death likely

Front 29

what type of organ is the kidney and suprarenal gland?

Back 29

retroperitoneal organ

Front 30

what spinal levels are the kidneys?

Back 30

T11 - L3
the R is slightly lower - Liver

Front 31

What nerves are important to remember when removing kidney?

Back 31

SHI(T)
Subcostal n.
ilioHypogastric n.
ilio Inguinal n.

Front 32

What is immediately anterior to the R kidney? Immediately posterior?

Back 32

descending duodenum
quadratus lumborum

Front 33

What is immediately anterior to L kidney?

Back 33

Tail of pancreas @ hilum of kidney

Front 34

what is contained in the leinorenal ligament (splenorenal)

Back 34

splenic a. and v.

Front 35

what is the name of the fat immediately surrounding the kidney?

Back 35

pErirenal fat

Front 36

what is the name of the fat surrounding the fat, surrounding the kidney? outer layer of fat

Back 36

pArarenal fat

Front 37

what is vertebral level of Renal aa.?

Back 37

transpyloric plane
L1

Front 38

typically how many branches have the renal aa.?

Back 38

5 branches for 5 lobes

Front 39

what is the position of the ureter LV/ S1 region?

Back 39

the ureter crosses over and in between the branching of the common iliac a.

Front 40

in the female, the _____ passes _______ the ureter and the ______ does the same in males

Back 40

uterine a.
over
ductus (vas) deferens

Front 41

what fibers supply the ganglia for the kidneys? what is the ganglion called?

Back 41

preganglionic efferent fibers
to the Aorticorenal ganglion
fibers are from the Least and the Lesser Splanchnic n.

Front 42

where is pain felt when there is pain in the kidney, and what fibers channel the signal

Back 42

visceral afferents travel back to T10 - L1

Front 43

what cells are responsible for producing endocrine secretions to the suprarenal gland? what are the secretions and in what percentage?

Back 43

Chromaffin cells
80% Epinephrine
20% Norepinephrine

Front 44

what fibers are responsible for communicating the signal to chromaffin cells in the suprarenal gland?

Back 44

preganglionic sympathetic n.

Front 45

what is the n. that signals chromaffin cells to release epinephrine/norepi?

Back 45

Greater splanchnic n

Front 46

is there any parasympathetic control over the adrenal glands?

Back 46

NO

Front 47

What divides the anal venous drainage?

Back 47

Dentate line

Front 48

what is the significance of the dentate line?

Back 48

superior - veins drain to Portal system
inferior - veins drain to Caval system - via pudendal v. -> internal iliac - > common iliac - > IVC

Front 49

what is the Dentate line also called?

Back 49

Pectinate line