Posterior Abdominal Wall

Front 1

Muscles of Posterior abdominal wall:

Back 1

Psoas major/minor
Quadratus lumborum
Iliacus

Front 2

Action of Psoas major/minor:

Back 2

Major: Flex hip
Minor: nothing

Front 3

Action of Quadratus lumborum:

Back 3

Bend trunk to side

Front 4

Action of Iliacus

Back 4

Flex hip

Front 5

Result of obturator nerve injury:

Back 5

Unable to adduct leg

Front 6

Result of Femoral nerve injury:

Back 6

Unable to FLEX HIP and EXTEND KNEE/LEG

Front 7

Result of L2/3/4 injury:

Back 7

Unable to Flex hip only (can still extend knee)

Front 8

How are kidneys situated in relation to abdominal cavity?
Vertebral level of kidneys:

Back 8

Retroperitoneal
T12 - upper pole
L3 - lower pole

Front 9

How are the kidneys positioned in relation to each other?

Back 9

Right kidney is LOWER than left

Front 10

Where are the adrenals in relation to the kidneys?

Back 10

Anterior

Front 11

Where are the renal pyramids -cortex or medulla?

Back 11

Medulla

Front 12

Where are the glomeruli?

Back 12

Cortex

Front 13

Where are the renal columns?

Back 13

Between pyramids

Front 14

What runs in the columns?

Back 14

LOBAR arteries and veins - connecting the renal arters to arcuate arteries/interlobar arteries

Front 15

Flow of urine thru kidneys:

Back 15

1. Glomeruli
2. Collecting ducts
3. Medullary ray
4. Medullary pyramid
5. Renal papillae
6. Minor calyx
7. Major calyx
8. Renal pelvis
9. Ureter
10. Urinary bladder/urethra

Front 16

Plexus that gives efferent nerve fibers to kidneys:

Back 16

Aorticorenal plexus

Front 17

How renal nerves get from Aorticorenal plexus to kidneys:

Back 17

Follow renal artery

Front 18

Spinal cord segments associated w/ Renal afferents:

Back 18

T10-T12

Front 19

Renal Colic:

Back 19

intense pain from kidney stones - referred to T12-T12 but actually peristaltic spasms in ureters

Front 20

Fron to back Relationship of renal vessels and ureter:

Back 20

Vein -> Artery -> Ureter

Front 21

Which renal vein is longer?

Back 21

Left

Front 22

Major difference between L/R gonadal veins:

Back 22

Left - drains into L renal vein

Right - drains into IVC directly

Front 23

Scrotum vericocele

Back 23

Dilation of the left scrotum b/c its vein drains to a smaller vessel (renal) than right (IVC)

Front 24

Result of left scrotum vericocele:

Back 24

Infertility due to increased temperature of left testicle.

Front 25

Order of bloodflow INTO kidneys:

Back 25

Renal artery
Segmental artery
Interlobar artery
Arcuate artery
Interlobular artery
Afferent artery / glomeruli

Front 26

What structure passes IMMEDIATELY anterior to the left renal vein?

Back 26

Superior mesenteric artery

Front 27

Where is the URETER situated in relation to abdominal vessels?

Back 27

-Posterior to gonadal vessels
-Anterior to Iliac vessels

Front 28

What 3 layers surround the kidneys?

Back 28

-Pararenal fat
-Transversalis Fascia (inside pararenal fat)
-Perirenal fat (inside fascia)

Front 29

Relatively common inherited kidney disorder:

Back 29

Polycystic kidney - kidney covered w/ external cysts

Front 30

What do 10% of patients w/ Polycystic kidney present w/?

Back 30

Berry's aneurism - in Circle of Willis

Front 31

What supplies blood to Ureter:
-Upper 1/3
-Middle 1/3
-Lower 1/3

Back 31

Upper = Renal Artery
Middle = Gonadal Artery
Lower = Superior vesicular artery

Front 32

What gives sympathetic innervation to the ureters?

Back 32

T12-L2

Front 33

What gives parasymp innervation to the ureters?

Back 33

Vagus nerves and Sacral Outflow

Front 34

Major difference in Adrenals Shapes:

Back 34

Right = triangle

Left = SemiLunar

Front 35

2 main parts to the adrenal gland:

Back 35

-Cortex
-Medulla

Front 36

3 sources of blood supply to adrenals; where ea comes from:

Back 36

1. Superior Suprarenal A. - from inferior phrenic artery
2. Middle Suprarenal A. - directly off Aorta
3. Inferior Suprarenal A. - from Renal Artery

Front 37

Innervation of the Adrenal Gland:

Back 37

Cortex = POSTganglionic sympathetic fibers

Medulla = PREganglionic sympathetic fibers

Front 38

What is produced
-By cortex
-By medulla

Back 38

Cortex = corticoids

Medulla = adrenaline (catecholamines)

Front 39

Nerves of the lumbar plexus:

Back 39

Subcostal
Iliohypogastric
Ilioinguinal
Genitofemoral
Lateral cutaneous femoral n.
Obturator

Front 40

Origin of Subcostal; where does it run?

Back 40

T12
-Across quadratus lumborum
-Pierces Transversus Abdominis muscle

Front 41

Innervation provided by Subcostal nerve:

Back 41

Cutaneous sensory to region inferior to Umbilicus, superior to Pubic Symphysis.

Front 42

Origin of Iliohypogastric; what does it innervate?

Back 42

L1
Cutaneous sensory to skin/muscl above external inguinal ring.

Front 43

Landmark nerve in Hernia Operations: why?

Back 43

Ilioinguinal - b/c it goes THROUGH THE INGUINAL RING.

Front 44

Numbness in abdomen after hernia surgery indicates:

Back 44

The iliohypogastric and ilioinguinal nerves were cut.

Front 45

Origin of Genitofemoral nerve: How does it run?

Back 45

L1-L2
PIERCES PSOAS MAJOR then BIFURCATES

Front 46

Genitofemoral nerve bifurcates into:

Back 46

-Genital branch - runs thru inguinal ring to cremaster muscle
-Femoral branch - cutaneous sensory

Front 47

What nerve fibers are in the genitofemoral nerve?

Back 47

MIXED - sensory and motor

Front 48

What motor innervation does Genitofemoral provide?

Back 48

Cremasteric Reflex

Front 49

Which kidney is most commonly used in transplants?

Back 49

Left

Front 50

Who is more hurt by a transplant?

Back 50

Donor - have to go deeper to get it out