Questions and Answers
Which of the following nerves is NOT related to the posterior aspect of the right kidney?
What is the level of the lumbar vertebral column where the kidneys are located?
Which of the following muscles is NOT related to the posterior aspect of the left kidney?
What is the name of the plexus that continues inferiorly as the superior hypogastric plexus?
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Which of the following structures is NOT located at the hilum of the kidney?
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Which of the following muscles is posterior to the ureter as it descends?
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What is the shape of the right suprarenal gland?
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Which of the following arteries is a branch of the renal artery?
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Where does the common iliac artery end?
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What is the origin of the cortex of the suprarenal gland?
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What is the location of the union of common iliac veins?
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What is the relationship between the left suprarenal gland and the pancreas?
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What is the most common location for kidney stones to occur along the ureter?
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What is the structure that the inferior vena cava (IVC) pierces?
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Which of the following nerves is responsible for the motor function of the cremaster muscles?
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What is the location of the common sympathetic trunk (lumbar part)?
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Which nerve provides sensory innervation to the medial thigh?
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What is the function of the gray communicating rami?
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Which nerve provides motor innervation to the iliacus and pectineus muscles?
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What is the origin of the preganglionic fibers within the lumbar sympathetic trunk?
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Which nerve provides sensory innervation to the skin of the root of the penis and scrotum?
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What is the function of the aortic plexus?
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What is the level of the vertebral column where the kidneys are located?
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Which of the following muscles is related to the posterior aspect of both kidneys?
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What is the structure that exits the renal sinus through the hilum?
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Which of the following structures is NOT located in the anterior relations of the left kidney?
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What is the superior relation of the kidneys?
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What is the structure that the ureter descends on?
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What is the origin of the Psoas minor muscle?
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What is the insertion of the Psoas major muscle?
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Which muscle is a weak trunk flexor?
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What is the nerve supply of the Psoas major muscle?
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What is the action of the Psoas major muscle when the thigh is fixed?
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What is the origin of the Iliacus muscle?
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Which nerve provides sensory innervation to the mons pubis and labium majus?
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Which muscle is innervated by the femoral nerve?
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What is the location of the common sympathetic trunk (lumbar part)?
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Which nerve receives white communicating rami from the upper 2 lumbar spinal nerves?
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Which nerve provides sensory innervation to the upper medial thigh?
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What is the function of the gray communicating rami?
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Which nerve provides motor innervation to the cremaster muscles?
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What is the structure that receives fibers from the greater, lesser, and least splanchnic nerves?
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Study Notes
Prevertebral Ganglia
- Include celiac, aortico-renal, and superior and inferior mesenteric ganglia
- Superior hypogastric plexus is an inferior continuation of the aortic plexus
Kidneys
- Location: T12-L3, with the right kidney situated lower due to the right lobe of the liver
- Parts: anterior and posterior surfaces, superior and inferior poles, medial and lateral borders
- Hilum: contains renal vessels, pelvis, lymph vessels, and autonomic nerves
- Anterior relations:
- Right kidney: liver, 2nd part of duodenum, right colic flexure
- Left kidney: spleen, stomach, pancreas, left colic flexure
- Posterior relations:
- Right kidney: psoas major, quadratus lumborum, transversus abdominis, diaphragm, 12th rib
- Left kidney: same as above, plus 11th rib
- Superior relations: suprarenal gland
- Renal sinus: contains renal pelvis, vessels, and autonomic nerves, with adipose tissue
Ureter
- Descends on psoas major muscle, anterior to common iliac artery
- Sensory innervation:
- Upper medial thigh
- Skin of root of penis and scrotum (males)
- Mons pubis and labium majus (females)
Nerves
- Lateral femoral cutaneous nerve: sensory innervation of anterior and lateral thigh to knee
- Femoral nerve: sensory innervation of anterior thigh and medial surface of leg, motor innervation of iliacus, pectineus, and anterior thigh compartment muscles
- Obturator nerve: sensory innervation of medial thigh, motor innervation of obturator externus, pectineus, and medial thigh compartment muscles
- Genitofemoral nerve: sensory innervation of genital branch (anterior scrotum, mons pubis, and labium majus) and femoral branch (upper anterior thigh), motor innervation of cremaster muscles
Common Sympathetic Trunk
- Composed of 3-5 interconnected ganglia
- Location: passes posterior to medial arcuate ligament, along medial border of psoas major, and posterior to common iliac vessels
- Branches: receives white communicating rami from upper 2 lumbar spinal nerves, gives off gray communicating rami to all lumbar spinal nerves
Aortic Plexus
- Receives fibers from greater, lesser, and least splanchnic nerves, lumbar splanchnic nerves, and vagus nerves
- Bifurcates at the lateral wall of the pelvis, anterior to internal iliac artery, to the level of the ischial spine
Suprarenal Glands
- Left gland: pyramidal shape, with anterior relations to pancreas, stomach, and lesser sac, and posterior relations to diaphragm
- Right gland: crescent shape, with anterior relations to right lobe of liver and IVC, and posterior relations to diaphragm
- Cortex: derived from mesoderm
- Medulla: derived from ectoderm (neural crest cells), innervated by preganglionic fibers
- Arteries: superior suprarenal arteries (branches of inferior phrenic artery), middle suprarenal artery (branch of abdominal aorta), and inferior suprarenal artery (branch of renal artery)
Common Iliac Artery
- Terminal branch of abdominal aorta
- Starts at L4, ends at L5/S1
External Iliac Artery
- Continuation of common iliac artery
- Branches: inferior epigastric artery, deep circumflex iliac artery
- IVC: union of common iliac veins at L5, pierces central tendon of diaphragm
- Visceral tributaries: left and right renal veins, right suprarenal vein (left drains into left renal vein), right ovarian/testicular veins (left drains into left renal vein), and hepatic veins
- Parietal tributaries: inferior phrenic veins, 4 pairs of lumbar veins, and median sacral vein
Sensory and Motor Nerves
- Upper medial thigh is innervated by sensory nerves.
- Males: Skin of root of penis and scrotum is innervated by sensory nerves.
- Females: Mons pubis and labium majus are innervated by sensory nerves.
- Lateral femoral cutaneous nerve innervates the anterior and lateral thigh to the knee.
- Femoral nerve has both sensory and motor functions:
- Sensory: innervates the anterior thigh and medial surface of the leg.
- Motor: innervates iliacus, pectineus, and anterior thigh compartment muscles.
Obturator Nerve
- Medial to psoas major, the obturator nerve has both sensory and motor functions:
- Sensory: innervates the medial thigh.
- Motor: innervates obturator externus, pectineus, and medial thigh compartment muscles.
Genitofemoral Nerve
- Anterior to psoas major, the genitofemoral nerve has both sensory and motor functions:
- Sensory: innervates the genital branch (anterior scrotum and mons pubis and labium majus) and femoral branch (upper anterior thigh).
- Motor: innervates cremaster muscles.
Common Sympathetic Trunk (Lumbar Part)
- Consists of 3-5 interconnected ganglia.
- Location: passes posterior to the medial arcuate ligament, along the medial border of psoas major, and posterior to the common iliac vessels.
- Branches:
- Receives white communicating rami from upper 2 lumbar spinal nerves, carrying preganglionic fibers.
- Gives off gray communicating rami to all lumbar spinal nerves, carrying postganglionic fibers.
Aortic Plexus
- Receives fibers from the greater, lesser, and least splanchnic nerves, lumbar splanchnic nerves, vagus nerves, and prevertebral ganglia (celiac, aortico-renal, superior and inferior mesenteric).
Superior Hypogastric Plexus
- Inferior continuation of the aortic plexus.
Kidneys
- Location: T12-L3, with the right kidney sitting lower due to the right lobe of the liver.
- Parts:
- Anterior and posterior surfaces.
- Superior and inferior poles.
- Medial and lateral borders.
- Hilum: contains the renal vein, artery, and pelvis, as well as lymph vessels and autonomic nerves.
- Anterior relations:
- Right kidney: liver, 2nd part of duodenum, and right colic flexure.
- Left kidney: spleen, stomach, pancreas, and left colic flexure.
- Posterior relations:
- Right kidney: psoas major, quadratus lumborum, transversus abdominis, diaphragm, and 12th rib.
- Left kidney: same as above, plus the 11th rib.
- Superior relations:
- Suprarenal gland.
Renal Sinus
- Contains the renal pelvis, which exits through the hilum and continues with the ureter.
- Components:
- Renal artery and vein.
- Major and minor calyces.
- Lymph vessels.
- Autonomic nerves.
- Adipose tissue.
Ureter
- Descends on the psoas major muscle, anterior to the common iliac artery.
- Posterior abdominal wall components:
- Lumbar vertebrae and intervertebral discs.
- Wing of ilium.
- 12th rib.
- Psoas major and minor muscles.
- Iliacus muscle.
- Quadratus lumborum muscle.
- Transversus abdominis muscle (posterior part).
- Lumbar part of the diaphragm.
Muscles
- Psoas major:
- Origin: transverse vertebral processes of all lumbar vertebrae and sides of bodies and intervertebral discs of T12-L5.
- Insertion: enters under the inguinal ligament, lesser trochanter.
- Nerve: ventral rami L1-L3.
- Action: hip flexion.
- Psoas minor:
- Origin: sides of bodies and intervertebral discs of T12-L1.
- Insertion: iliopubic eminence.
- Nerve: ventral rami L2-L3.
- Action: weak trunk flexor.
- Iliacus:
- Origin: iliac fossa.
- Insertion: lateral to psoas major.
- Nerve: femoral nerve.
- Action: weak trunk flexor.
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Description
This quiz covers the anatomy of prevertebral ganglia, kidneys, and related structures. Learn about the location, parts, and features of these organs.
