GROSS im not kidney you

Cranial (dorsal)

what body cavity houses the brain?

Spinal (Dorsal)

what body cavity houses the spinal cord?

Thoracic (Ventral)

What houses the lungs and heart?

Abdominal (Ventral)

What houses the GI tract?

Pelvic/Abdominopelvic (Ventral)

What houses and protects the male and female reproductive organs?

peritoneum

What lines the abdominopelvic cavity?

1. Visceral

2. Parietal

What are the 2 continuous layers of peritoneum?

Peritoneal cavity

What is the space between the 2 continuous layers of peritoneum?

abdominopelvic wall

What does the parietal peritoneum cover?

1. spleen and stomach

2. stomach and intestines

What does the visceral peritoneum cover?

same as with the blood and nerve supply of abdominal wall

What is the blood and nerve supply of parietal peritoneum?

same blood and nerve supply as the viscera of organ that it covers

What is the blood and nerve supply of visceral peritoneum?

Pressure Pain Heat and cold Laceration

Parietal peritoneum is sensitive to what?

False. Visceral peritoneum is insensitive to them

True or False: Visceral peritoneum is sensitive to touch, heat, cold, and laceration

it is stimulated primarily by stretching and chemical irritation

How is visceral peritoneum stimulated?

Yes it is well localized

Is pain localized in parietal peritoneum?

Yes, but poorly localized

Is pain localized in visceral peritoneum?

epigastric pain

If the pain is in foregut it is called?

umbilical pain (ex. appendicitis)

If the pain is in midgut it is called?

hypogastric pain the pubic region

If the pain is in hindgut it is called?

Diarrhea

Pain that is felt most likely from the visceral peritoneum which is stimulated primarily by stretching and chemical irritation.

stretching

Diarrhea may also lead to formation of gas or watery stool that will eventually cause

Localized

Pain coming from the parietal peritoneum caused by stab wounds or lacerations in the abdomen will mainly be?

periumbilical discomfort (midgut pain) secondary to distention of the appendiceal lumen that affects the visceral peritoneum

What does the patient experiences early in the appendicitis process?

localized right lower quadrant pain and tenderness as the inflammation becomes transmural and involves the parietal peritoneum

What does the patient experiences as the appendicitis progresses?

Intraperitoneal

There are no organs inside the peritoneal cavity, only peritoneal fluid

False: They are just invested or covered by the visceral peritoneum.

True or False: Abdominal organs, also called "intraperitoneal organs", are found inside the cavity.

Extraperitoneal

Structures that are structures found outside the peritoneum.

retroperitoneum

Structures behind the peritoneum such as kidney (kidney is its reference point)

anterior: parietal peritoneum posterior: posterior abdominal wall

Organs in extraperitoneal are bounded by?

Subperitoneal

Structures inferior to the peritoneum such as urinary bladder

anterior: parietal peritoneum posterior: anterior portion of the renal fascia

What are the boundaries of anterior pararenal space?

PADD: Pancreas Ascending Colon Descending Colon Duodenum

what are the contents of anterior pararenal space?

perirenal space

What is the space within the renal fascia?

anterior: anterior renal fascia posterior: posterior renal fascia

What are the boundaries of perirenal space?

KUPAR: Kidneys Ureter Perirenal Fat Adrenal Glands Renal Vessels

What are the contents of perirenal space?

Anterior: posterior renal fascia Posterior: posterior abdominal wall

What are the boundaries of posterior pararenal space?

retromesenteric space

What separates the anterior pararenal space from perirenal space

retrorenal space

what separates the perirenal space and posterior pararenal space and it is located behind the kidney?

SADPUCKER: Suprarenal glands(Adrenals), Aorta + IVC Duodenum (mid -> distal or 2nd to 4th part), Pancreas (except tail) Ureters Colon (A/D) Kidneys Esophagus (only abdominal part) Rectum (upper 3rd)

What are the retroperitoneal organs?

Primary

Organs that are already located retroperitoneally, at the beginning of development

Secondary

Embryologically located intraperitoneally at the beginning of their development, but are pushed retroperitoneally as they develop.

Pussy Cat Dolls: Pancreas (except tail) Colon (A/D) Duodenum (2nd to 4th)

What are the secondary organs?

• Floating Ribs 11 and 12

• Iliac crest

• Lumbar vertebra

What are the bone contents of the posterior abdominal wall?

QDIP

• Quadratus Lumborum

• Diaphragm (superiorly)

• Iliacus (covers iliac fossa)

• Psoas major and minor which are the primary muscle for hip flexion

What are the muscle contents of the posterior abdominal wall?

Aorta and IVC

• they are the major BV that will supply the distal parts of the body and will drain most of the blood

What are the blood vessel contents of the posterior abdominal wall?

False: there is a presence of lumbar plexus on retroperitoneum

True or False: There is no presence of lumbar plexus in retroperitoneum

Lumbar plexus

It is composed of the anterior rami of L1 to L4, then it will terminate immediately as your branches.

in some references, the subcostal branch of T12 will also contribute to it

hypogastric and inguinal area

Iliohypogastric nerve (L1) supplies the sensation of what area?

hypogastric and inguinal area

Ilioinguinal nerve (L1) supplies the sensation of what area?

internal oblique and transversus abdominis

Iliohypogastric nerve provide motor innervation in what muscles?

Anterior aspect of thigh and genital area

specifically, scrotum in males and labia in females

Genitofemoral nerve (L1-L2) supplies the sensation of what areas?

lateral aspect of thigh

Lateral Femoral Cutaneous Nerve (L2-L3) provides sensory innervation to where?

Meralgia Parasthetica

What condition will result if the lateral femoral cutaneous nerve (L2-L3) is impinged?

femoral nerve (L2-L4)

What supplies the hip flexors?

Obturator Nerve (L2-L4)

What supplies the adductor group of muscles?

Kidney

Main organ of the retroperitoneum as it lie retroperitoneally on the posterior abdominal wall.

T12 to L3

Kidney is located at what level?

The right kidney is slightly lower because of the presence of liver

Why is the right kidney slightly lower than the left?

tough fibrous capsule

The external surface of the kidney is covered by a?

Anterior surface of kidney

faces the peritoneum

Posterior surface of kidney

faces the posterior abdominal wall

Medial margin

it is concave and will serves as the area of entry and exit of the vascular structures via the hilum

convex

The lateral margin of kidney is?

suprarenal glands

Superior pole accommodates the?

by weak fascial septum

how is suprarenal glands separated from kidneys?

diaphragm

Where is the primary attachment of suprarenal gland?

inferior pole

It is a palpable surface landmark and a finger breadth superior to iliac crest

it surrounds the kidney

Relationship of perirenal (periphrenic) fat with kidney

Gerota's Fascia (anterior renal fascia)

Condensed membranous layer enclosing the kidneys, suprarenal glands, and fats.

transversalis fascia

Gerota's Fascia is continuous laterally with?

Anterior Renal Fascia

It blends with fascia covering the great vessels

posterior renal (zuckerkandl's) fascia

It blends with the fascia of the psoas muscle

Periureteric fascia

Inferomedial continuation of the renal fascia that delicately covers the surrounding ureter

right renal artery: lower and longer left renal artery: higher and shorter

Which renal artery is longer and lower? which is shorter and higher?

Anterior:

1. Superior (Apical) branch

2. Anterosuperior branch

3. Anteroinferior branch

4. Inferior (basal) branch

Posterior 5. posterior branch

What are the 5 segmental branches of renal artery?

brodel's line

a plane located in the posterolateral aspect of the kidney that is less vascular

brodel's line

to avoid bleeding, where does the incision made during the surgical removal of a renal stone?

emerge from hilum drains to IVC

Where does the renal vein emerge and drain?

right renal vein: shorter left renal vein: longer and will receive the tributaries before draining to IVC

which is shorter and longer in renal vein?

SUPR GoLUM

SUPRarenal vein Gonadal Vein Ascending LUMbar vein

What are the tributaries of renal vein?

UAV

• Ureter/Renal Pelvis

• Artery

• Vein

arrangement of structures at hilum of kidneys (posterior to anterior)

search youtube

SIGN TO STUDY FOR RENAL BLOOD FLOW

fibrous capsule

what covers the entire kidney up to its sinus

renal cortex

Outer

outside part of the kidney and covers the renal medulla

renal medulla

Inner

inside part of the kidney and contains little triangular pieces called the renal pyramids

renal pyramid

Located in the area of the medulla. Its tip or apex is pointing towards the sinus or the hilum, and its base facing the cortex

renal papilla

Tip of the renal pyramid where the urine empties into the minor calyx.

renal columns of bertin

Located between the renal pyramids.

renal sinus

Cavity within the center of the kidney and is lined continuously by the fibrous capsule

major calyx

it is formed by converging of 2-3 minor calyces

renal pelvis

it is formed by converging of 2-3 major calyces

it will be called the ureter

what will happen to the renal pelvis as it exits the hilum of kidney?

ureter

The urine collected in the renal pelvis will exit the kidneys via the?

ureter

it is a bilateral tubular organ

ureter

Extend or travel inferomedially after exiting the hilum of the kidney

psoas muscle pelvic brim bifurcation of common iliac arteries

where does the ureter pass over?