Renal_Anatomy_Postabdwall

Front 1

List the 4 posterior abdominal wall (PAW) mm

Back 1

Psoas Major M.
Psoas Minor M.
Quadratus Lumborum M.
Iliacus M.
-

Front 2

Which ligament likely to become tender and site of Tx for PAW mm problems

Back 2

Iliolumbar Ligament

Front 3

For Psoas Major M.:
O:
I:
Inn:
Action?

Back 3

O:TPs of T12-L5
I: Lesser Trochanter w/ Iliopsoas Tendon (common tendon)
Inn: L2, L3, L4 via Lumbar Plexu
--Flexes thigh at hip. If platned, flexes trunk at hip. Can sidebend unilaterally.

Front 4

What Pierces the Psoas Major M.?
What is relation of Psoas Minor (if present) to the piercing item?

Back 4

Genitofemoral Nerve pierces Psoas Major
--it pierces/comes out Lateral to tendon of Psoas Minor

Front 5

For Psoas Major M.:
O:
I:
Inn:
Action?

Back 5

O: Bodies & Disc of T12 and L1
I: Pectineal Line on Superior Ramus of Pubis
Inn: L1 (L2)
Axn: Depresses rib 12, fixes rib during deep inspiration. Assists in extension of trunk; acting unilaterall sidebends ipsilaterally (same as major)

Front 6

For Quadratus Lumborum M.:
O:
I:
Inn:
Action?

Back 6

O: Iliac Crest and Iliolumbar Ligament
I: 12th Rib (inferomedial border)
tips of Lumbar TPs
Inn: T12-L4
Axn: Main: Sidebend Trunk & Pull Ribs Down
- Extends and Laterally Flexes vertebral column. Fixes rib during inspiration

Front 7

For Iliacus M.:
O:
I:
Inn:
Action?

Back 7

O: Iliac fossa of pelvis
I: LEsser trochanter of femur via iliopsoas tendon
Inn: Femoral N (L2, L3, L4)
Axn: Flexes Thigh at Hip. With Limbs fixed, flexes PELVIS on Thigh

Front 8

Which mm. cannot flex Trunk?

Back 8

Iliacus
-has NO attachments in Spine/Trunk
-though it can flex pelvis appears as trunk flexion

Front 9

how superior does dome of diaphragm extend?
What are It's Boundries?

Back 9

5th Rib/Xiphisternal Joint
Costal Margin (laterally)
Body of T12 (inf)

Front 10

What are the 3 origins of the Diaphragm?
Where do they insert?

Back 10

Sternal Origin
Costal Origin
Lumbar Origin (threads to vertebrae)
--Inserts into Central Tendon from these 3 peripheral origins

Front 11

Which crus is longer, and forms the Esophageal hiatus?

Back 11

Right Crus

Front 12

Describe Left Crus?

Back 12

Short, Lateral
Meet at Aortic Hiatus

Front 13

What do the Posterior Origins of the Diaphragm form?

Back 13

Arcuate Ligaments over PAW structures:

Front 14

What are the 3 Arcuate Ligaments: what do they overlay?

Back 14

Median Arcuate Ligament: over aorta
Medial Arcuate ligs: Over Psoas Major mm. & Sympathetic Trunks
Lateral Arcuate Ligs: OVer Quadratus mm & Subcostal N&Vasc.

Front 15

What are lumbocostral arches?

Back 15

Aka for Arcuate Ligaments
-note: these are potential sites for hernias?

Front 16

What are the 2 potential sites of hernias

Back 16

Vertebrocostal Triangle

Sternocostal Triangle

Front 17

How is a Congenital (pleuroperitoneal) Diaphragmatic Hernia caused?

Back 17

Septum transversum fails to fully separate pleural cavity for peri cavity

Front 18

What is Bochdaleks Hernia?

Back 18

Vertebrocostal Triangle: btw 12th Rib and Diap: most common
-Hypoplastic Left Lung and Pulm HTN.

Front 19

What does Scaphoid Abdomen indicate?

Back 19

Bochdaleks Hernia at Vertbrocostal Triangle:
Left Posterolateral defect where guts herniate into left pleural space

Front 20

i ate 10 eggs at 12? List Contents (aside from anagram ones of each hiatus) of I ate/Venal Cava Foramen?

Back 20

IVC-T8: Terminal Br of R. Phrenic N.
Lymphatics from Liver

Front 21

i ate 10 eggs at 12? List Contents (aside from anagram ones of each hiatus) of 10 eggs? (3)

Back 21

Esophageal Hiatus-T10
-Esophageal Br of L. Gastric A.
-Anterior & Posterior Vagal trunks
-Lymphatics

Front 22

i ate 10 eggs at 12? List Contents (aside from anagram ones of each hiatus) of at 12 (Aortic Hiatus)

Back 22

Aortic Hiatus-T12:
Thoracic Duct

Front 23

What is another Hiatus in diaphragm? Contents?

Back 23

Sternocostal Hiatus
Superior Epigastric Vessels

Front 24

What are arteries of the superior surface of the Diaphragm ?

Back 24

Pericardiacophrenic A.
Musculophrenic A.
Superior Phrenic A.

Front 25

Inferiorly?

Back 25

Inferior Phrenic aa and vv
-From celiac trunk or aorta
--Right: post to IVC
Left: post to esophagus
--Posterior Br give off Suprarenal aa.

Front 26

What are the MOTOR Nerves to the Diaphragm? Roots?
What do they run with?

Back 26

Phrenic N , C3, C4, C5

--ONLY motor nerves to diaphragm
Runs with branches of Inferior Phrenic A.

Front 27

What are the SENSORY Nerves to the Diaphragm? Roots?
What do they run with?

Back 27

Phrenic N carries SENSORY NN. from Central Tendon
-Intercostal nn. carry sensory nerves from peripheral part

Front 28

Where do Surface Lymphs of Inferior Ab drain to?

Back 28

Celiac nodes/ superior lumbar nodes

Front 29

Where do Superior (thoracic) Surface Lymphatics drain?

Back 29

Posterior Diaphragmatic nodes-->posterior mediastinal nodes

Anterior Diaphragmatic nodes--> parasternal nodes

Front 30

What are the 3 Vascular Planes for Abdominal Aorta Branches?

Back 30

1. Anterior Midline=Unpaired VISCERAL (asymetric organs w/ VISCERAL peritoneum) (GIT= Celiac, SMA, IMA)
2. Lateral = Paired Visceral (again, (symetric) organs w/ visceral covering) (Urogenital and Endocrine Organs)
3. Posterolateral =Paired Parietal (sit on Parietal Part of Peritoneum/body wall) (diaphragm and body wall

Front 31

What are the 3 examples of AAA Lateral, Paired Visceral Br?

Back 31

Urogenital & Endocrine Dist:
1. Suprarenal
2. Renal
3. Gonadal

NOTE: with Renal, Suprarenal, think LEVEL of L1
L2 for Gonadal (testicular/ovarian)

Front 32

What are the 3 examples of AAA Posterolateral, Paired Parietal (segmental) Br?

Back 32

Diaphragm & Body Wall Arteries:
1. Subcostal (ie 'intercostals below T12) --but emerges level is L2
2. Inferior Phrenic -- first br below diaphragm--so level is T12
3. Lumbar Aa. --- will be leveled at L1-L4 obviously

Front 33

WHat are the 3 Paired branches of AAA?

Back 33

Inferior Phrenic
Middle Suprarenal
R/L Renal

Front 34

What is branched from Inferior L/R Phrenic Aa?

Back 34

Superior Suprarenal aa
(L&R

Front 35

What is Branched from R/L Renal Aa?

Back 35

Inferior Suprarenal Aa

also 5 Lobar/segmental aa in kidney

Front 36

What branches from bifid of AAA?

Back 36

Median Sacral A.

Front 37

What becomes of AAA after Bifurcation?

Back 37

L/R Common Iliac A.

Front 38

What are 2 Br on L/R of Common Iliac Aa?

Back 38

External Iliac--becomes Femoral
Internal Iliac--goes behind sacral nerve roots

Front 39

What Aa branch medially from the L and R External Iliac Aa?

Back 39

Inferior Epigastric Aa

Front 40

What Aa branch LaterallY from the L and R External Iliac Aa?

Back 40

Deep Circumflex Aa
--this and Inf. Epi given off beore becoming L/R Femoral A.

Front 41

Which Vein is liable to nutcracker syndrome? what causes this?

Back 41

Left Renal Vein
--passes under SMA, if SMA swells it would squish it

Front 42

What V branches inferiorly from L/R Renal V?

Back 42

L/R Testicular/Ovarian V

Front 43

Which Vv dumb into IVC just above where Hepatic Vv do?

Back 43

Inferior Phrenic Vv (L/R)

-analogous to Inf. Phrenic Aa coming out of AAA just above Celiac --except celiac is much lower than Hepatic Vv-->IVC

Front 44

What are the 4 major Lymphatic Channels that Empty into the Thoracic Duct?

Back 44

2 Parietal lymphatic trunks
2 Intestinal Lymphatic trunks

Front 45

What lymphatic body can be found below the Thoracic Duct/ thoracic duct exits/begins from it?

Back 45

Chyle Cistern

Front 46

Where do the following Parietal Lymphatics Drain into:
1. Common Iliac Lymph
2. Deep Inguinal (lowerlimb)
3. Lateral Aortic/lumbar nodes
(PAW, Retro Orgs)

Back 46

All into the Lumbar Lymphatic Trunks
-L and R
---these can drain into Thoracic, which egins around L1, L2

Front 47

Which trunks form Thoracic Duct?

Back 47

Lumbar (2 parietal) and Intestinal (2 visceral) lymphatic Trunks
--around L1,L2

Front 48

With Visceral Intestinal Lymph that follows Arterial Distribution--ie, celiac-, SM-, IM- lypmh-- goes to where?

Back 48

All these nodes from viscera to their Celiac/SM/IM distribution to Intestinal Lymphatic Truns (2, visceral)
-->Cisternal Chyle- (25% have)->thoracic duct

Front 49

Moving on to the Terminal Part of large intestine?

Back 49

The ANUS,
shit stuff
--surrounded by Internal and External Anal Sphincters

Front 50

What is eq to Haustrae in Anal Canal?

Back 50

Transverse Rectal Folds
--always there--have nothing to do with tinae coli--

Front 51

What is potential space for fluid posterior to anus in women?

Back 51

Rectouterine Pouch
--Pouch of Douglas

Front 52

Widenings of Anal Canal?

Back 52

Rectal Ampulla
--bordered by Transverse Rectal Folds

Front 53

What is point where Levator Ani converge ?

Back 53

Anorectal Junction

Front 54

Which mm of Levator Ani mm group forms a sling at Anorectal Junction--gives anus a 80 degre curve?

Back 54

Puborectalis mm

--believe this goes wrong in kids afraid to poo--

Front 55

With the Anorectal Junction being a line at the Top, and the Pectinate line at bottome, what are 3 features of anal canal btw these ?

Back 55

Anal Columns--go to top of ARJxn
Anal Sinuses: superior to anl valves, btw columns
Anal Valves: join the inferior ends of the rectal columns

Front 56

What does the Pectinate line of Anal Canal mark?

Back 56

Line joining the inferior ends of the anal valves; where hindgut meets ECTOderm

Front 57

What are components of External Anal Sphincter?

Back 57

Is continuation of Lavator Ani Inferior to the Puborectalis sling
-1. Deep part
2. Superficial part
3, Subcutaneous Part
----is Voluntary mm.

--note: parts 1-3 are from superior to inferior--but deep to shallow if exploring the anus, like a true mensch

Front 58

Internal Anal SPhincter

Back 58

no fun
Just Involuntary mm

Front 59

When Superior to the Pectinate Line, what is:
Blood Supply?
Venous Drainage?

Back 59

Superior to Pectinate LineL
Blood: Superior Rectal A.
Vv: Internal Rectal Vv Plexus-->IMV-->Portal V

Front 60

When Inferior to the Pectinate Line, what is:
Blood Supply?
Venous Drainage?

Back 60

When Inferior to the Pectinate
Blood: Inferior Rectal A.
Vv: External Rectal Vv Plexus-->Internal Iliac V.

Front 61

When Superior to the Pectinate Line, what is:
Nerves:
Lymph:

Back 61

When Superior to the Pectinate Line
Nerves: visceral, pain, fibers travel with S2-S4
Lymph: Internal iliac nodes

Front 62

When Inferior to the Pectinate Line, what is:
Nerves:
Lymph:

Back 62

When Inferior to the Pectinate
Nerves: Somatic: senstitive to pain, touch and temperature
Lymph: Superficial inguinal nodes

Front 63

Hemorroids:
if Prolapsed Vv =

Back 63

Internal Hems of Vv. Internal Rectal Plexus

Front 64

Hemorroids if External due to ?

Back 64

Thrombosed Vv of External venous Plexus

Front 65

What is venous flow from Superior Rectal V as it applies to Internal Prolapsed Hems?

Back 65

Sup Rectal V -->IMV--> Splenic V -->Portal V.
--often strangulate-bright blood
-painless

Front 66

What is venous flow from Inferior Rectal V as it applies to External Thrombosed Hems?

Back 66

Inf Rectal V-->Internal iliac V-->IVC
--Painful
-Caused by Incompetent valves, preggers, inc Abd pr, constipation, aging

Front 67

Causes for Internal, painless Hems?

Back 67

Portal HPTN
Chronic Consti/Straining
aging