Anatomy of Peritoneal Folds and Ligaments

Questions and Answers

Which of the following ligaments is NOT labelled in the diagram?

Gastrohepatic ligament

Phrenicocolic ligament (correct)

Gastrophrenic ligament

Splenorenal ligament

Which part of the duodenum is intraperitoneal?

Fourth part

Second part

Third part

First part (correct)

Which of the following structures is usually intraperitoneal but sometimes retroperitoneal?

Ascending colon

Caecum (correct)

Rectum

Descending colon

What is the term for the folds of peritoneum that connect organs to the posterior abdominal wall?

Ligaments Signup and view all the answers

Which of the following organs is NOT retroperitoneal?

Appendix Signup and view all the answers

What is the term for the peritoneal fold that connects the liver to the anterior abdominal wall?

Falciform ligament Signup and view all the answers

Which of the following structures is NOT a retroperitoneal organ?

Stomach Signup and view all the answers

What is the term for the peritoneal fold that connects the small intestine to the posterior abdominal wall?

Mesentery Signup and view all the answers

What is a characteristic of the segmental arteries of the kidney?

They are end-arteries with no collateral supply. Signup and view all the answers

What is a consequence of ligation of any branch of a segmental artery?

The tissue supplied will undergo necrosis. Signup and view all the answers

Which of the following nerve(s) may be affected by an enlarged psoas muscle?

All of the above Signup and view all the answers

What is a feature of aberrant renal arteries?

They enter the kidney substance directly at a pole. Signup and view all the answers

What is a characteristic of interlobar veins?

They have free anastomoses between them. Signup and view all the answers

What is the primary cause of psoas abscess in patients with haemophilia?

Formation of haematomas Signup and view all the answers

How does pus from a psoas abscess typically manifest itself clinically?

Swelling at the top of the thigh, mimicking a femoral hernia Signup and view all the answers

What is the drainage pattern of the left gonadal vein?

It drains into the left renal vein. Signup and view all the answers

Which of the following is NOT a typical branch of the lumbar plexus?

Sciatic nerve Signup and view all the answers

What is the principal lymphatic drainage of the left kidney?

Left para-aortic lymph nodes. Signup and view all the answers

What is the consequence of blockage of the left renal vein?

It affects the left gonadal vein and suprarenal gland. Signup and view all the answers

What is the most common reason for psoas abscess formation?

Infection of the psoas muscle Signup and view all the answers

What is the termination point of the renal veins?

Inferior vena cava. Signup and view all the answers

What is the typical presentation of a psoas abscess in a patient with lumbar tuberculosis?

Swelling at the distal end of the psoas sheath and lower abdomen Signup and view all the answers

Which nerve is responsible for providing sensation to the anterior thigh?

Femoral nerve Signup and view all the answers

Which of the following nerves is NOT directly related to the abdomen?

Lateral femoral cutaneous nerve Signup and view all the answers

What anatomical structure lies anterior to the isthmus in the case of a horseshoe kidney?

Inferior mesenteric artery Signup and view all the answers

Which of the following characteristics is true about the positioning of the kidneys?

The right kidney is lower than the left Signup and view all the answers

How often does horseshoe kidney occur in births?

1 in 400 Signup and view all the answers

What anatomical feature is the primary reason the right kidney is lower than the left kidney?

Size of the liver Signup and view all the answers

What is the relative position of the ureters in relation to the psoas major muscle?

Anterior to the psoas major muscle Signup and view all the answers

Which of the following best describes the tilt of the kidneys?

The superior pole is more medially placed Signup and view all the answers

What is a common outcome if the isthmus of a horseshoe kidney cannot ascend properly?

Ureteric obstruction Signup and view all the answers

Which of the following statements is incorrect regarding kidney protection?

Both kidneys are equally protected by ribs Signup and view all the answers

What muscle is the middle part of the kidney primarily associated with?

Quadratus lumborum Signup and view all the answers

Where do the renal vessels enter and exit the kidneys?

Renal hilum Signup and view all the answers

Which of the following organs is located posterior to the parietal peritoneum?

Kidneys Signup and view all the answers

Which muscle is located medially to the kidney, renal pelvis, and ureter?

Psoas major Signup and view all the answers

What anatomical relation do the kidneys have concerning the diaphragm?

They are inferior to the diaphragm. Signup and view all the answers

Which structures lie anterior to the renal veins?

Renal arteries Signup and view all the answers

What surrounds the kidneys in the abdominal cavity?

Renal fascia Signup and view all the answers

What movement do the kidneys perform during respiration?

They descend and rise. Signup and view all the answers

Study Notes

Peritoneum and Ligaments

The peritoneum folds forward from the posterior abdominal wall to form ligaments and mesenteries.
Principal ligaments include the gastrophrenic, gastrohepatic, and splenorenal ligaments, positioned from superior to inferior.
Key mesenteries are the transverse mesocolon, the mesentery, and the sigmoid mesocolon.

Retroperitoneal Organs

Retroperitoneal organs include the suprarenal glands, kidneys, pancreas, ascending colon, descending colon, and rectum.
The first part of the duodenum is intraperitoneal; however, the rest is retroperitoneal.
The caecum is typically intraperitoneal but can occasionally be retroperitoneal.

Psoas Abscess

Psoas abscess can occur from infections or conditions like tuberculosis, leading to pus collection in the psoas sheath.
Symptoms include swelling near the thigh and lower abdomen, hip flexion, and significant pain.

Lumbar Plexus

Formed from the anterior rami of L1-L4, often with contributions from T12.
Key branches include iliohypogastric, ilioinguinal, genitofemoral, lateral femoral cutaneous, femoral, and obturator nerves.
Iliohypogastric, ilioinguinal, and genitofemoral nerves are particularly relevant to abdominal concerns.

Kidney and Ureter Positioning

Kidneys are located retroperitoneally, extending from T12 to L3 vertebrae.
The right kidney's upper part reaches the 12th rib, while the left reaches the 11th rib, influenced by the liver's position.
Ureters descend along the posterior wall, anterior to the psoas major muscle.

Relationship to Muscles and Diaphragm

Kidneys relate to the diaphragm, with movement during respiration.
Positioned against abdominal wall muscles: laterally on transversus abdominis, medially on psoas major, and on quadratus lumborum in the middle.

Renal Anatomy and Blood Supply

Renal artery divides into segmental arteries, supplying specific kidney segments with no anastomosis, critical for surgeries.
Accessory renal arteries can directly enter the kidney substance at poles.
Renal veins aggregate into two main veins leading to the inferior vena cava; the left renal vein drains the left gonadal vein.

Lymphatic Drainage

Principal lymphatic drainage of the left kidney occurs via left para-aortic lymph nodes.
Right kidney drains to inter-aortocaval and paracaval lymph nodes.
Lymphatic pathways are critical as they can influence pathology or metastasis in related organs.

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Description

This quiz covers the formation of ligaments and mesenteries from the posterior abdominal wall and their identification. It includes examples such as the gastrophrenic, gastrohepatic, and splenorenal ligaments, as well as the transverse mesocolon and mesentery.