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Description
Flashcards by Ashutosh Kumar, updated more than 1 year ago
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Created by Ashutosh Kumar
about 8 years ago
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| Question | Answer |
| Describe the vertebra levels the kidneys extend between: Describe the muscles the kidneys lie on: Describe the rib levels the kidneys are beneath: | The kidneys extend between the T12 and L3 vertebra, with the left kidney higher than the right, which is pushed down by the liver. The kidneys lie on muscles, from medial to lateral; psoas major, quadratus lumborum and transversus abdominis. The superior pole of the right kidney is deep to rib 12 whereas the superior pole of the left kidney is deep to ribs 11 and 12. |
| Describe the origin and relations of the gonadal arteries: Describe the drainage of the gonadal veins: | The gonadal arteries arise from the abdominal aorta (L2), just inferior to where the renal arteries arise (remember that the gonads developed from the genital ridge on the posterior abdominal wall). The gonadal arteries will travel over the ureter on both sides ('Bridge over the water'). The right gonadal vein will drain into the IVC whereas the left gonadal vein will drain into the left renal vein. |
| Describe the coverings of the kidney: | From inner to outer: 1. Renal capsule. 2. Perinephric fat (accumulation of extraperitoneal fat). 3. Renal fascia (extraperitoneal fascia). 4. Paranephric fat. |
| Describe the structure of the kidney: | The kidney consists of an outer cortex and inner medulla. The cortical tissue will, in bands, invade into the medulla. This will cause the medullary tissue to aggregate together forming renal pyramids. The apices of the pyramids are called renal papillae, and face into the renal sinus. The renal papillae are surrounded by minor calyces which receive the urine. Several minor calyces will unite to form a major calyx, which in turn will unite with others to form the renal pelvis; the funnel shaped proximal end of the ureter. |
| Describe the blood supply to the suprarenal/adrenal glands: | The suprarenal glands receive blood supply via 3 arteries: 1. Superior suprarenal artery; from the inferior phrenic artery. 2. Middle suprarenal artery; from the abdominal aorta. 3. Inferior suprarenal artery; from the renal arteries. |
| Describe the anatomical considerations of the blood supply to the kidney: | The right renal artery travels behind the IVC. Firstly, this is because the abdominal aorta is located to the left of the IVC. Secondly, the renal artery is an artery and is therefore under higher pressure than the IVC. Therefore, if the artery were to travel in front of the IVC, it would compress the underlying IVC. Hence, the right renal artery travels behind the IVC to avoid this. The left renal vein is 3x longer than the right renal vein, since the IVC is located to the right of the abdominal aorta. |
| Describe the course of the ureter: Name the sites of narrowing of the ureter: Name the site the ureter is narrowest at: | The ureter descends retroperitoneally from the ureteropelvic junction (approximately L1) just medial to the tips of the transverse processes of the lumbar vertebrae. It will then descend inferiorly across the medial surface of the psoas major and enter the true pelvis by crossing over the bifurcation of the common iliac vessels and sacroiliac joint. As it travels towards the ischial spine it will then turn and enter the bladder at an oblique angle. Narrowings: 1. Ureteropelvic junction. 2. Pelvic brim (bifurcation of common iliacs). 3. Ureterovesical junction (entry into bladder; narrowest site). |
| Name the branches of the abdominal aorta that are Paired visceral: Unpaired visceral: Paired parietal: Unpaired parietal: | Paired visceral: Right and left middle suprarenal, renal and gonadal arteries. Unpaired visceral: Celiac trunk, SMA and IMA. Paired parietal: Lumbar and inferior phrenic arteries. Unpaired parietal: Median sacral artery. |
| Describe the formation of the IVC: List the tributaries of the IVC: | The IVC forms by the unison of the common iliac veins (L5) behind the left common iliac artery. Tributaries: 1. Common iliac veins. 2. Lumbar veins. 3. Right gonadal vein. 4. Renal veins. 5. Right suprarenal vein. 6. Inferior phrenic veins. 7. Hepatic veins. 8. Azygos vein. |
| Describe the muscles of the posterior abdominal wall: Name and describe the ligaments formed: Describe the attachments of the psoas major and iliacus muscles: | Psoas major: lies adjacent to the vertebral bodies. Psoas minor: Sometimes present on the anterior surface of psoas major. Quadratus lumborum: Spans the gap between the iliac crest and T12 vertebrae. Both muscles are ensheathed in fascia. The fascia on the anterior surfaces of the psoas major and quadratus lumborum are thickened superiorly to form the medial and lateral arcuate ligaments respectively. The ligaments serve as a point of attachment for the diaphragm. The iliacus is in the iliac fossa and together with the psoas attaches to the lesser trochanter of the femur. |
| Describe the formation of the lumbar plexus: List and describe the relations of the major branches: | The lumbar plexus is formed from the anterior rami of L1-L4 spinal nerves. The plexus is formed in the psoas major on the posterior abdominal wall. 1. Ilioinguinal and iliohypogastric (L1); arise from the main trunk and descend steeply on the quadratus lumborum. 2. Lateral cutaneous nerve of the thigh (L2, L3); runs on the anterior surface of the iliacus. 3. Genitofemoral (L1, L2); runs on the anterior surface of psoas major. 4. Femoral nerve (L2-4); lateral to psoas major. 5. Obturator nerve (L2-4); medial to psoas major. 6. Lumbosacral trunk (L4, L5); link lumbar and sacral plexuses. |
| Describe the diaphragm: List the attachments of the diaphragm: Describe the hiatuses and structures which pierce the diaphragm: | The diaphragm is a muscular sheet with a central tendon. Attached to the sternum, costal margin, lumbar vertebrae (right and left crura) and arcuate ligaments (median arching over aorta, medial over psoas and lateral over quadratus lumborum). Caval hiatus (T8): IVC and right phrenic nerve. Esophageal hiatus (T10): Esophagus and vagus nerves. Aortic hiatus (T12): Aorta, thoracic duct and azygos vein. Left phrenic nerve, splanchnic nerves and hemiazygos veins make their own perforations. |
| Describe the location of the cisterna chyli: Describe the formation of the cisterna chyli: | The cisterna chyli is a saccular dilatation to the right of the abdominal aorta, just under the diaphragm. It is contributed to by the intestinal trunk and right and left lumbar trunks. It continues superiorly as the thoracic duct. |
| Describe the pathogenesis and effects of a congenital diaphragmatic hernia: | The diaphragm develops from the septum transversum fusing with adjacent structures. If this process is defective, then the diaphragm is incomplete and the abdominal contents can herniate superiorly into the chest. This can impair lung development and the newborn baby may well present with life-threatening respiratory failure. |
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