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145 Cards in this Set

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  • Back
What bones are involved in the posterior abdominal wall?
12th rib, 5 lumbar vertebrae, Sacrum, and wings of the ilium.
What does the psoas minor extend rom? What is its action?
The psoas minor ventures from T12-L1 to the pectinate line. It plays a minor role in flexing the trunk.
What does the iliolumbar ligament connect?
L5 transverse process to ileum.
What is the superior attachment of Quadratus lumborum?
The medial aspect of the 12th rib.
What is the medial attachment of the quadratus lumborum?
Transverse processes of vertebrae 1-4
What is the inferior attachemnt of the quadratus lumborum?
It attaches to the iliac crest.
What is the position of the quadratus lumborum relative to the vertebrae?
It is in plane above the vertebrae.
What innervates the quadratus lumborum?
T12-L4 Nerves
What is the action of both bilateral and unilateral quadratus lumborum contraction?
Bilateral = Extends lower back
Unilateral = flexes trunk laterally

Also fixes the 12th rib
What does the ala of the sacrum articulate with?
The ileum
What does the Psoes major muscle do?
Flexes the thigh and can help flex the trunk.
What is the medial attachment of the psoas major?
Transverse processes and bodies of lumbar vertebrae.
What is the inferior attachement of the psoas major?
The lesser trochanter of the femur.
What innervates the psoas major?
L2-L4 nerves.
What innervates the iliacus muscle?
L2-L4, femoral nerves.
What are the attachements of the iliacus muscle?
Superior 2/3 of the iliac fossa, Ala of sacrum, Ant. sacroiliac ligaments, lesser trochanter.
What ligament runs just between the ala of the sacrum and the ileum?
The Ant. sacroiliac ligament.
What is the iliopsoas muscle made up of? What is its major action?
The iliopsoas muscle is made up of the psoas major and the iliacus. Its major function is flexing the thigh.
What is a positive psoas sign indicate?
Inflammed appendix or some infected diverticula.
What 3 layers make up the thoracolumbar fascia?
2 from quadratus lumborum and 1 from erector spinae.
Where does the psoas fascia extend inferiorly?
Into the thigh
What is the superior-lateral extend of the quadratus lumborum fascia?
The arcuate ligament
What is the superior attachment of the psoas major?
The medial arcuate ligament.
What is the psoas abcess?
Where the Psoas opens up into part is the thigh
Where do the right and left crus attach (vertebrae) inferiorly?
L3-L4
What space does the superior epigastric artery pass through the diaphragm?
The sternocostal hiatus.
What is the vertebrocostal triangle? What can occur here?
A portion of the diaphragm wher there is only CT, no muscle. It is often a site for hernias.
What is the purpose of ligaments of the diaphragm?
To reinforce the diaphragm and seal it from herniation
Where does the Right crus extend from?
L1 to L3 or L4
Where does the left crus extend to?
L1 to L2
What forms the lateral arcuate ligament?
The quadratus lumborum
What forms the medial arcuate ligament?
The Psoas muscle
That is the ligament of tietz? Where does it attach?
The suspensitory liament of the duodenum. It attaches at the ilioduodenal junction.
Where does the phrenicocolic ligament attach?
To the left colic flexure
How does the diaphragm help blood flow?
It is tightly attached to the inferior vena cava and its contraction expands the vena cava.
At what level is the caval hiatus?
T8-T9 (vena cava)
At what level is the esophageal hiatus?
T10
What hiatus does the vagal trunks come through the diaphragm?
The esophageal hiatus
At what level does the Aorta pass behind the diaphragm? What pacess with it?
T12, also passes with thoracic duct, azygos and hemiazygos
Give the 3 major openings of the diaphragm from most superior to inferior.
Caval hiatus, esophageal hiatus, Celiac/aortal hiatus.
What is the motor inneration of the diaphragm and what is their origin?
The motor innervation is the phrenic nerves (C3-C5)
What is the sensory innervation of the diaphragm and what is their origin?
Phrenic nerves (C3-C5)
Intercostal nerves (T5-T11) and Subcostal nerves (T12)
What makes teh lower 6 or 7 intercostal nerves unique?
They are afferent only form the peripheral part of the diaphragm.
Where is diaphragmatic pain refered?
To the shoulder.
What is the blood supply if the diaphragm? (4)
Pericardiacophrenci A and V
Musclophrenic A and V
Superior Phrenic A and V
Inferior Phrenic A and V
What does the right internal thoracic vein supply?
The central tendon
What does the right internal thoracic vein give rise to?
The musculophrenic vein.
Where is the pericardiacophrenic artery found closely adhered to an important structure?
On the pericardial sac.
What supplies the superior surface of the diaphragm?
The superior phrenic arteries.
What do the left inferior phrenic artery and vein supply?
The central tendon.
Why is the Left inferior phrenic artery interesting?
It is the 1st branch of the thoracic aorta after passing through the hiatus.
What do the musculophrenic arteries supply?
THe peripheral muscular area of the diaphragm.
What structure do the musculophrenic arteries follow/course along?
The subcostal margin.
What are the 5 paired tributaries of the abdominal aorta from most superior to most inferior?
Inferior phrenic
Suprarenal
Right/left renal
Lumbar
Left/right gonadal (testicular or ovarian)
What vessel comes out of the spit of the abdominal aorta into the common ilaic arteries?
The median sacral.
From superior to inferior give the unpaired tributaries of the abdominal aorta.
Celiac, superior mesenteric, inferior mesenteric, median sacral.
What does the median sacral artery supply?
The sacrum
At what vertebral level does the aorta bifucate into the common iliac?
L4
What structure does the common iliacs course along?
Around the brim of the true pelvis (pelvic brim)
After the aorta splits into the common iliac? What are the paired superior branching arteries that it gives rise to?
The Iliolumbar arteries?
What are the two branches of the iliolumbar arteries? Which is more medial?
The Ascending lumbar is medial to the iliac branch.
What does the iliac branch of the iliolumbar artery supply?
The iliacus.
What two branches does the common iliac artery give off just before it passes under the inguinal ligament? Which courses laterally and which courses medially?
The deep iliac circumflex courses laterally and the inferior epigastric courses medially.
What does the lumbar artery supply?
The psoas and quadratus lumborum muscles.
How many sets of lumbar arteries are there?
3-4
How many sets are there of the inferior phrenic and what do they come off of?
3 sets of inferior phrenic arteries.

1 off of abdominal aorta
1 off of renal arteries.
What is an aortic aneurysm?
A bulging of the aorta.
What do the inferior phrenic arteries supply?
The abdominal side of the diaphragm
At what vertebral level does the renal arteries branch out from the abdominal aorta?
At L1
What is the largest vein the body?
IVC
Does the IVC contain valves?
NO!
Which is more superior the left or right inferior phrenic vein?
The right vein is more superior.
Give the tributaries of the IVC from most superior to inferior.
Hepatic veins, inferior phrenic veins, Right suprarenal vein, Renal veins, Lumbar veins, Right testicular vein (Between L3 and L4 veins), splits into common iliac veins.
Where does the left testicular or ovarian vein dump into?
The left renal vein.
Where does the right testicular or ovarian vein dump into?
Directly into IVC
What is the vein that comes out of the left common iliac vein just after the split from the IVC?
The median sacral vein.
What is the superiorly courseing vein that comes off of the common iliac veins? What is its named terminal branch?
The iliolumbar vein with its branch the ascending lumbar vein.
At what vertebral level does the IVC bifurcate?
L5
What are the branches off of the left renal vein?
Left supra renal, to azygos vein, and left testicular or ovarian vein.
What are the branches off of the right renal vein?
Only a branch that goes to the azygos vein (No other shown named branches).
Which is longer the left or right renal vein? Why?
The left renal vein is longer because it has to reach over the aorta.
In what general area are most of the abdominal lymphatics located?
On the posterior abdominal wall.
Where are visceral nodes found? With what do they frequently associate?
On organs within mesenteries. They frequently associate with arteries.
Where do the celiac nodes collect from (organs)? (3)
Stomach liver and duodenum.
Give 3 examples of visceral nodes.
Celiac nodes, superior mesenteric nodes, inferior mesenteric nodes.
Give 4 examples of parietal nodes.
Cysternae Chyli, lateral aortic (lumbarr) nodes, common iliac nodes, external iliac nodes.
At what vertebral level is the cysterne chyli?
L1-L2
Describe the flow of lymph to the thoracic duct from nodes in the abdomen.
Visceral nodes -> parietal lymph nodes -> cysternae chyle -> thoracic duct
With what are parietal nodes associated?
The abdominal wall and large arteries. (Common iliacs and aorta)
Put these in the proper orientation from superior to inferior nodes.

Cysterne chyli, external iliac nodes, lateral aortic (lumbar) nodes, celiac nodes, inferior mesenteric nodes, common iliac nodes, superior mesenteric nodes.
Celiac nodes, superior mesenteric nodes, cysterne chyli, lateral aortic (lumbar) nodes, inferiro mesenteric nodes, common iliac nodes, external iliac nodes.
What are visceral lymph nodes associated with?
Abdominal organs and mesenteries
Are parietal lymph nodes intra or retroperitoneal?
Retroperitoneal.
What are the 3 branches of the celiac visceral nodes?
Gastric, hepatic, and pacreaticosplenic
Which branch are the gastric nodes from? Where does it run? What does it drain?
From the celiac
Gastric nodes run along the greater and lesser curvature of the stomach. They drain the stomach and the esophagus.
Which branch are the Hepatic nodes from? Where does it run? What does it drain?
From Celiac
Runs along with hepatic artery
Drains stomach, duodenum, liver, gall bladder, and pancreas.
Which branch are the panccreaticosplenic nodes from? Where does it run? What does it drain?
From celiac
Run along splenic artery.
Drain stomach, spleen, and pancreas.
Which branch are the Mesenteric nodes from? Where does it run? What does it drain?
From superior mesenteric
Run along superior mesenteric artery.
Drain jejunum and ileum.
Which branch are the Ileocolic nodes from? Where does it run? What does it drain?
From the superior mesenteric
Run along the ileocolic artery.
Drain terminal ileum, appendix, cecum, and ascending colon.
Which branch are the mesocolic nodes from? Where does it run? What does it drain?
From Superior mesenteric
Run along middle colic artery.
Drain transverse and descending colon.
Where do the inferior mesenteric lymph nodes run? What does it drain?
Runs along the left colic, sigmoid and superior rectal arteries, Drains the descending colon, sigmoid colon and the rectum.
Name the 5 parietal nodes of the abdomen.
External iliac, internal iliac, common iliac, sacral, lumbar.
What do the external iliac nodes drain?
Drain abdominal wall below umbilicus, thigh and pelvic viscera
What do the internal iliac nodes drain?
Drain pelvic viscera perineum, gluteal region, and posterior thigh.
What do the common iliac nodes drain?
Drain pelvic viscera
What do the sacral nodes drain?
Drain rectum, prostate gland, uterus, and posterior pelvic wall
What do the lumbar iliac nodes drain?
Drain gonads, uterine tubes, uterus, kidneys, suprarenal glands, lateral and posterior abdominal wall and abdominal surface of the diaphragm.
What two structures is the cysternae Chyle located between?
IVC and psoas muscle
Which branch of the sympathetic trunk runs just by itself and is most superior in the abdominal sympathetic trunk? WHat is its spinal origin?
The subcostal nerve (T12)
What two nerves arise from L1? Which runs anterior to Quad. Lumborum?
The iliohypogastric and the ilioinguinal. The Iliohypogastric runs anteriorly to the Quad. Lumborum.
What is the origin of the genitofemoral nerve?
L1 and L2
What is the origin of the lateral femoral cutaneous nerve? What important structure does it go under?
L2 and L3, goes under ilioinguinal ligament.
What is the origin of the femoral nerve?
L2-L4
What is the origin of the Obturator nerve? What important structure does it pass under?
From L2-L4 passes underneath the superior pubic ramus.
What is the origin of the lumbrosacral trunk? Where does it run? What nerve does it give rise to?
It is from L4-L5 and it gives branches to the sacral plexus (psiatic nerve).
What are the neres of the lumbar plexus? (7) Give them from superior/lateral to inferior/medial. What do nerves of the posterior abdominal wall do? What do they not do?
Iliohypogastric, ilioinguinal, lateral femoral cutaneous, genitofemoral, femoral obturator, lumbrosacral trunk

The nerves are sensory or motor to the wall of the abdomen. NOT to abdominal viscera but do recieve contributions from sympathetic and parasympathetic nerves.
Within what muscle is the lumbar plexus located?
Within the psoas major muscle.
What are the functions of the kidneys?
Remove excess water, salts and nitrogenous wastes from the blood (maintain blood homeostasis). They also produce urine.
Where is the kidney located (vertebral level)? where is the hilum of the right and left kidneys?
The kidneys are retroperioneal, along the posterior abdominal wall at vertebral levels T12-L3. The hilum of the left kidney is at L1 while the right kidney is at L3.
What surrounds the kidney viscera?
A thin translucent fibrous capsule.
What 3 things make up the renal hilum?
The renal artery, vein and renal pelvis.
With what structure distally is the renal pelvis continuous with?
The ureter.
Where does the ureter lead?
To the urinary bladder.
What is the most exterior portion of the internal kidney structure called? What structure resides here?
The renal cortex. Glomeruli can be found here.
What are the areas between the renal pyramids called?
Renal columns.
With what is the renal cortex continuous with?
Renal columns.
Where are glomeruli found?
In the renal cortex and renal columns.
Describe the formation of a renal pyramid? What is another name for this area?
Each pyramid has a renal papilla at its apex of the pyramid and is capped by a minor calix. This area is also called the medulla.
What is contained within the renal sinus?
Fat, calices, renal pelvis, renal arteries and veins, autonomic nerves.
Describe the structural formation of the renal pelvis.
Many minor calixes which cap renal pyramids form major calixes which join to form the renal pelvis.
What are renal calcli?
Renal stones where salts precipitate.
At what point does the renal pelvis become the ureter?
After it leaves the hilum.
What spinal nerves innervate the ureter?
T11 to L2
Where is pararenal fat located? What is another name for it?
Pararenal fat covers the perirenal fat and kidney on the interior posterior abdominal surface and around behind the kidney.
Also called paranephritic fat.
Where is perirenal fat located? What is another name for it?
Perirenal fat is located all around the renal capsule and completely surrounds the kidney on all sides. It is in contact with the renal capsule.
Also called perinephritic fat.
What is another name for renal fascia? What two fat layers does it separate? With what is it continuous with?
The renal fasia is also called gerota's fascia. It separates perirenal and pararenal fat. It is continuous with tranversalis fascia and psoas fascia.
What is another name for suprarenal glands?
Adrenal glands.
What is the function of the suprarenal cortex?
Produces and secretes corticosteroids and androgens.
What is the function of the suprarenal medulla?
Chromaffin cells produces and secretes catecholamines (epinephrine and norepinephrine).
What are Chromaffin cells? Where are they found? What are they innervated by?
Chromaffin cells produce and secrete catecholemines. They are found in the medulla of the suprarenal glands. They are innervated by preganglionic sympathetic fibers of the grater splanchnic nerve.
What is the location of the suprarenal glands (vertebral level too)?
Retroperitoneal, along the posterior abdominal wall near vertebral level T11. It is located between the superomedial aspect of the kidney and diaphragm.
What are the 4 layers that surround the suprarenal glands? Name them from internal to external.
A fibrous capsule (separate from fibrous renal capsule) as well as perirenal fat, renal fascia, and pararenal fat.
What are the 3 arteries that supply the suprarenal glands and what is their origin?
The superior suprarenal artery is from the inferior phrenic artery.
The middle suprarenal artery is a branch off of the abdominal aorta. The inferior suprarenal artery is a branch off the renal artery.
What are the 2 veins that drain the suprarenal glands and what do they drain into?
The left suprarenal vein drains into the left renal vein. The right suprarenal vein drains into the inferior vena cava.
What innervates the suprarenal gland? (Nerve name)
Greater splanchnics.
What artery is the left suprarenal vein closest to as it exits the suprarenal gland?
To the inferior suprarenal artery.