Posterior Abdominal Wall

where are the suprarenal glands located

attached to the superior border of the kidneys

which vertebrae make up the posterior abdominal area

L1-L5

midline boundary of the posterior abdominal wall

upper margin of the sacrum

how many vertebrae make up the sacrum

5

what composes the pelvic bone

iliac bone

superior border of the posterior abdominal wall

ribs XI and XII (floating ribs)

medial posterior abdominal muscles

psoas major

psoas minor

lateral posterior wall muscles

quadratus lumborum

inferior posterior wall muscle

iliacus

psoas major function, innervation

flexion of the thigh at the hip joint

anterior rami L1-L3

psoas minor function and innervation

weak flexion of lumbar vertebral column

L1

quadratus lumborum function and innervation

depress and stabilize rib 12; lateral bending of trunk

T12 and L1-L4

iliacus function and innervation

flexion of the thigh at the hip

femoral nerve (L2-L4)

superior muscle of the posterior wall

diaphragm

how is the diaphragm anchored to the lumbar vertebrae

via musculotendinous crura (right and left crus)

what connects the right and left crus of the diaphragm

median arcuate ligament

_ is just lateral to the left crus

medial arcuate ligament

what is the medial arcuate ligament attached to

medially: sides of L1 to LII

laterally: transverse process of L1

what is the lateral arcuate ligmaent attached to

medially: transverse process of L1

laterally: rib XII

what forms the lateral arcuate ligament

fascia of quadratus lumborum

what produces the right dome of the diaphragm

liver

right kidney + suprarenal gland (minorly)

what produces the left dome of the diaphragm

fundus of the stomach + spleen

left kidney and suprarenal gland (minorly)

location of left and right diaphragm domes

left: 5th intercostal space

right: rib V

kidneys are (retroperitoneal/intraperitoneal)?

retroperitoneal

kidneys lie in _

extraperitoneal connective tissue

what vertebrae do the kidneys extend

T12 - LII

how is the left kidney shaped/positioned compared to the right

longer and more slender

nearer to the midline

related structures to the right kidney

upper anterior surface: liver

medially: descending part of the duodenum

laterally: right colic flexure

inferior anterior surface: small intestine

related structures to left kidney

anterior superior pole: intraperitoneal stomach and spleen

medially: pancreas and jejunum

laterally: left colic flexure and descending colon

outside the renal capsule there is an accumulation of _

extraperitoneal fat (preinephric fat)

what encloses the kidneys

renal capsule

extraperitoneal/perinephric fat

extraperitoneal fascia (renal/Gerota's fascia)

paranephric fat

the anterior and posteiror renal fascia become continuous _

lateral margins of the kidney

the surfaces of the kidneys are covered by _

a fibrous capsule

what passes through the hilum of the kidney

renal artery

renal vein

renal pelvis

lymphatics

nerves

the renal hilum is continous with the _

renal sinus

layers of the internal kidney

renal cortex

renal medulla

the renal cortex has extensions called _

renal columns

the _ divide the renal medulla into pyramids

renal columns

orientation of the renal pyramid

base is directed outward toward renal cortex

apex projects inward toward renal sinus

what is the renal papilla

apical tip of the renal pyramid that contains openings of the papillary ducts draining the renal tubules

the minor calyx surrounds _

renal papillae

minor calicies receive urine from _

papillary ducts

what forms the major calyx

union of several. minor calyces in the renal sinus

what forms the renal pelvis

2-3 major calices

the renal pelvis becomes the _

ureter

arterial supply of the kidney

renal artery

positioning of the left renal artery

arises higher than the right

positioning/structure of the right renal artery

longer

posterior to the IVC

where do the renal arteries arise from

Aorta just below the SMA

as the renal artery approaches the hilum it _

divides into anterior and posterior branches

what do the anterior/posterior branches of the renal artery supply

renal parenchyma

how are renal veins situated in regards to renal artery

anterior

course of the left renal vein

crosses the midline anterior to the abdominal aorta and posterior to the superior mesenteric artery (sandwiched between aorta and SMA)

lymphatic drainage of kidney

lateral aortic (lumbar) nodes

path of the arisal of the ureteres

minor calices

major calices

renal pelvis

ureter

where does the renal pelvis become continous with the ureter

ureteropelvic junction

psoas major and iliacus insert into

lesser trochanter of the femur

quadratus lumborum function and inervation

stabilizes/depresses rib 12; assists in lateral bending of the trunk

T12 and L1-L4

right kidney location to the ribs

T12

left kidney location to the ribs

T11 and T12

renal arteries are _ to renal veins

posterior

clinical correlation of anatomical location of left hepatic vein

risk of compression by abdominal aorta aneurysm

ureters descened _ inferiorly

retroperitoneally

ureter constrictioon

ureteropelvic junction

pelvic inlet (pelvic brim)

entrance to bladder

most common renal cancer

renal cell carcinoma, clear cell type

clinical significance of ureter constrictions

potential sites for kidney stones to get lodged

suprearental

superior suprarenal artery (inferior phrenic a)

middle suprarental artery (aorta)

inferior suprarental arteries (renal a)

venous drainage of suprarenal gland

one vein that passes through the hilum

what forms the IVC

right and left common iliac veins

where does the IVC start

L5

location of celiac trunk

upper border of L1

location of SMA

lower border of L1

renal arteries location vertebra

approximately L2

location of abdominal aorta bifurcation

L4

what does the abdominal aorta bifurcate into

let and right common iliac arteries

where does the aortic plexus run

from T12 to abdominal aortic bifurcation (L4)

plexus of the inferior posterior wall

superior hypogastric plexus

L1 gives rise to which nerves

iliohypogastric n

ilioingunial n

what branches of the plexus does the genitofemoral n come from

L1 and L2

what branches give rise to the lateral cutaneous nerve of the thigh

L2 and L3

which nerve gives rise to subcostal n

T12

what branches does the genitofemoral nerve come from

L1 and L2

what branches does the femoral nerve come from

L2-4

what branches does the obturator nerve come from

L2-L4

vertebral level for IMA

L3

how do the left and right testicular veins merge into greater veins

left: to left renal vein

right: to IVC

what do the lumbar arteries supply

posterior abdominal wall

spinal cord

branches of the abdominal aorta can be classified as

visceral branches that supply organs

posterior branches that supply diaphragm/body wall

terminal branches

posterior branches of the abdominal aorta

inferior phrenic arteries

lumbar arteries

median sacral a

visceral branches of the abdominal aorta

celiac trunk (unpaired)

SMA (u)

IMA(u)

renal arteries (p)

middle suprarenal a (p)

testicular/ovarian arteries (p)

lymph nodes that are anterior to the abdominal aorta

pre-aortic nodes

lymph nodes are are positioned on the sides of the abdominal aorta

left/right lumbar (para-aortic) nodes

lateral/lumbar nodes receive lymph from

body wall

kidneys

suprarenal glands

testes/ovaries

the lumbar nodes form _

right and left lumbar trunks

abdominal nerve plexuses

celiac plexus

abdominal aortic plexus

superior hypogastric plexus

lumbar splanchnic nerves carry _ fibers

preganglionic sympathetic

the plexuses in the abdomen carry what kinds of fibers

preganglionic sympathetic

visceral afferent fibers