Posterior Abdominal Wall & Kidney

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Questions and Answers

What is the shape of the right adrenal gland?

Triangular (correct)

Oval

Semilunar

Cylindrical

Which hormone is produced by the adrenal cortex?

Glucocorticoids (correct)

Insulin

Catecholamines

Epinephrine

What anatomical structure is found cranially to the adrenal glands?

Stomach

Kidney

Diaphragm (correct)

Liver

Where does the inferior adrenal artery originate from?

Renal artery Signup and view all the answers

Which statement about nephrolithiasis is correct?

Some small kidney stones may be asymptomatic. Signup and view all the answers

What structures primarily compose the bony part of the posterior abdominal wall?

Transverse processes, bodies, and intervertebral discs of L1-L5 Signup and view all the answers

Which muscles are included above the iliac crest in the muscular part of the posterior abdominal wall?

Psoas major, quadratus lumborum, and transversus abdominis Signup and view all the answers

What is the primary function of the kidneys in the urinary system?

Filter blood plasma to create urine Signup and view all the answers

What comprises the anterior layer of the thoracolumbar fascia?

Covers the quadratus lumborum ventrally Signup and view all the answers

Which part of the urinary system is responsible for collecting urine from the renal pyramids?

Renal pelvis Signup and view all the answers

Which of the following statements about the psoas minor muscle is true?

It is only present in approximately 60% of the population. Signup and view all the answers

What is the longest segment of the urinary system?

Ureter Signup and view all the answers

Which layer of the thoracolumbar fascia separates the deep back muscles from the quadratus lumborum?

Middle layer Signup and view all the answers

Where is a kidney stone most likely to be lodged as it crosses from the kidney into the ureter?

Internal iliac artery Signup and view all the answers

What triggers the contraction of the detrusor muscle during micturition?

Activation of the sacral parasympathetic system Signup and view all the answers

Which part of the urinary bladder is triggered to contract during the urge to urinate?

Body of the bladder Signup and view all the answers

What is the anatomical relationship of the fundus of the bladder in males?

In close proximity to the prostate and rectum Signup and view all the answers

What anatomical structure is located on the inferior surface of the bladder?

Neck of the bladder Signup and view all the answers

Which ligament connects the apex of the bladder to the umbilicus?

Median umbilical ligament Signup and view all the answers

What structure lies superior to the urinary bladder?

Small intestine in the peritoneal cavity Signup and view all the answers

What is the main function of the detrusor muscle?

To contract during urination Signup and view all the answers

Which artery is least likely to contribute to the blood supply of the ureter?

Inferior mesenteric artery Signup and view all the answers

Which anatomical space is situated between the urinary bladder and the pubic symphysis?

Retropubic space Signup and view all the answers

What structure is located between the medial umbilical ligaments and the median umbilical ligament?

Vesicoumbilical fascia of Delbet Signup and view all the answers

Which space is unique to males and located between the urinary bladder and the rectum?

Rectovesical septum Signup and view all the answers

What is the term for the hollow space located behind the interureteric crest in the bladder?

Retrotrigonal fossa Signup and view all the answers

Which structure forms the three corners of the trigone of the bladder?

Ureteric orifices and internal urethral orifice Signup and view all the answers

Which ligament specifically extends from the urinary bladder to the uterus?

Vesicouterine ligaments Signup and view all the answers

What type of muscles extends from the rectum to the anterior wall of the neck of the urinary bladder?

Rectovesicalis Signup and view all the answers

What is the name for the internal opening of the urethra in the bladder?

Internal urethral orifice Signup and view all the answers

Which of the following structures does NOT play a role in the fixation of the bladder?

Vesico-vaginal septum Signup and view all the answers

Which of the following is true about the mucosa of the trigone of the bladder?

It is smooth and non-folded. Signup and view all the answers

Which of the following is a function of the kidneys?

Filtration of plasma Signup and view all the answers

Where are the kidneys located in the body?

In the retroperitoneal space Signup and view all the answers

Which statement is true regarding the anatomical position of the kidneys?

The left kidney is closer to the median plane than the right Signup and view all the answers

Which of the following layers serves as the outermost covering of the kidney?

Renal fascia Signup and view all the answers

What is the hilum of the kidney?

A vertical slit on the medial border for vessels to enter and leave Signup and view all the answers

Which segment is NOT a segment of the kidney?

Lateral segment Signup and view all the answers

What is the primary composition of the renal cortex?

Glomeruli, proximal and distal tubules Signup and view all the answers

How many renal pyramids are typically found in the renal medulla?

8-15 Signup and view all the answers

Which type of fat surrounds the kidney and serves as a protective cushion?

Paranephric fat Signup and view all the answers

What occurs to the position of the kidneys during respiration?

They descend by 2.5 cm Signup and view all the answers

Which muscle is found below the iliac crest in the muscular part of the posterior abdominal wall?

Iliacus Signup and view all the answers

What is the role of the thoracolumbar fascia?

Enclosing the quadratus lumborum Signup and view all the answers

Which part of the urinary system is responsible for directing urine from the renal pyramids to the renal pelvis?

Minor renal calices Signup and view all the answers

Which of the following structures is located anterior to the psoas major muscle?

Psoas minor muscle Signup and view all the answers

Which layer of the thoracolumbar fascia serves as the aponeurotic origin of the latissimus dorsi?

Posterior layer Signup and view all the answers

From where does the ureter transport urine in the urinary system?

From the renal pelvis to the urinary bladder Signup and view all the answers

What anatomical structure covers the psoas major and iliacus muscles?

Fascia iliaca Signup and view all the answers

Which structure is responsible for collecting and storing urine before excretion?

Urinary bladder Signup and view all the answers

What is the primary function of the adrenal medulla?

Secretion of catecholamines Signup and view all the answers

Which arterial supply specifically contributes to the adrenal glands?

Inferior phrenic artery Signup and view all the answers

Where do nephrolithiasis stones most commonly form in the urinary system?

Collecting ducts Signup and view all the answers

In terms of anatomical relationships, what is located dorsally to the adrenal glands?

Perirenal fat capsule Signup and view all the answers

What is the function of the cortex in the adrenal gland?

Production of mineralocorticoids and glucocorticoids Signup and view all the answers

Where is a kidney stone most likely to be obstructed as it travels down the ureter?

Where the ureter crosses the internal iliac artery Signup and view all the answers

Which blood supply artery is NOT involved in supplying the ureter?

Testicular artery Signup and view all the answers

What is the primary role of the detrusor muscle during urination?

To contract and facilitate the release of urine Signup and view all the answers

Which part of the urinary bladder is primarily responsible for the urge to urinate?

Body of the bladder Signup and view all the answers

Which anatomical structure lies directly anterior to the urinary bladder?

Pubic symphysis Signup and view all the answers

What structure connects the apex of the bladder to the umbilicus?

Median umbilical ligament Signup and view all the answers

In females, which structure is located posterior to the urinary bladder?

Vagina Signup and view all the answers

Which space is found between the urinary bladder and the pubic symphysis?

Retropubic space Signup and view all the answers

Which artery is vital for the blood supply of the urinary bladder in females?

Uterine artery Signup and view all the answers

What triggers the activation of the sacral parasympathetic system during bladder contraction?

Increased urine volume in the bladder Signup and view all the answers

Which structure supplies the medulla of the kidney?

Vasa recta Signup and view all the answers

Where is the ureter likely to get constricted?

At the pelvic inlet Signup and view all the answers

Which blood vessels course along the border between the renal cortex and medulla?

Cortical radiate arteries Signup and view all the answers

What type of veins correspond to the capsular branches?

Stellate veins Signup and view all the answers

What anatomical feature is found at the pelvic brim concerning the ureter?

It crosses the common iliac artery Signup and view all the answers

Which organ is directly related to the ureter as it passes through the intramural part?

Urinary bladder Signup and view all the answers

What term describes the network of capillaries where filtration of blood occurs in the kidney?

Glomerular capillary plexus Signup and view all the answers

What anatomical feature plays a crucial role in the flow of urine from the renal pelvis to the bladder?

Ureter Signup and view all the answers

What anatomical structure corresponds with the straight venules exiting from the peritubular capillary network?

Arcuate veins Signup and view all the answers

In terms of lymphatic drainage from the kidney, where do the lymphatic plexuses from the parenchyma, fibrous capsule, and fat capsule terminate?

Lateral aortic nodes Signup and view all the answers

Which muscle is responsible for the contraction of the bladder during urination?

Detrusor muscle Signup and view all the answers

What is the primary function of the internal urethral sphincter?

To maintain continence by preventing involuntary leakage Signup and view all the answers

Which artery provides blood supply to the urinary bladder?

Inferior vesical artery Signup and view all the answers

Which part of the male urethra runs through the prostate?

Pars prostatica Signup and view all the answers

What type of muscle composes the external urethral sphincter?

Striated muscle Signup and view all the answers

What functional role do trigonal muscles play in urine function?

They control the opening and closure of the internal urethral orifice Signup and view all the answers

How long is the female urethra typically?

2.5 to 4 cm Signup and view all the answers

Which structure prevents semen from flowing into the bladder during ejaculation?

Internal urethral sphincter Signup and view all the answers

Which lymphatic drainage node is associated with the urinary bladder?

Paravesical nodes Signup and view all the answers

What type of muscle tissue is the internal urethral sphincter composed of?

Smooth muscle Signup and view all the answers

Study Notes

Posterior Abdominal Wall

Extends from the 12th rib to the pelvic brim; consists of bones, muscles, and fasciae.
Supports retroperitoneal organs, vessels, and nerves.

Components

Bony Part: Formed by L1-L5 vertebrae, intervertebral discs, and transverse processes.
- Upper part includes the inner surfaces of the 12th rib.
- Lower part comprises the iliac fossa.
Muscular Part:
- Above iliac crest: psoas major, quadratus lumborum, transversus abdominis.
- Below iliac crest: psoas major and iliacus muscles.
Fasciae:
- Psoas major and iliacus covered by fascia iliaca.
- Quadratus lumborum enclosed in anterior and posterior layers of thoracolumbar fascia.
Psoas minor present in 60% of individuals; located anterior to the psoas major.

Thoracolumbar Fascia

Composed of three layers:
- Posterior Layer: Aponeurotic origin of latissimus dorsi; covers deep back muscles.
- Middle Layer: Separates deep back muscles from quadratus lumborum.
- Anterior Layer: Covers quadratus lumborum ventrally.

Overview of the Urinary System

Kidneys: Filter blood plasma; produce urine.
Renal Calices: Collect urine from renal pyramids to renal pelvis.
Renal Pelvis: Continues to ureter.
Ureter: Longest segment, connects renal pelvis to bladder.
Urinary Bladder: Hollow organ behind pubic symphysis.
Urethra: Terminal segment; different lengths in males and females.

Kidney Functions

Plasma filtration, waste excretion, acid-base homeostasis, blood pressure regulation (via renin), hormone secretion (erythropoietin), vitamin D metabolism.

Location of the Kidney

Retroperitoneal space, opposite T12-L3; occupies epigastric, hypochondriac, lumbar, and umbilical regions.
Right kidney slightly lower due to liver; left kidney closer to the median plane.
Long axes directed downward and laterally; move approximately 2.5 cm during respiration.

Coverings of the Kidney

Paranephric Fat: Surrounds kidney, located between retrorenal layer and transversalis fascia.
Renal Fascia: Comprised of prerenal (anterior) and retrorenal (posterior) layers.
Perinephric Fat: Fat capsule surrounding the kidney.
Fibrous Capsule: Loosely covers kidney; firmly attached at hilum.

External Structures of the Kidney

Superior Pole: Covered by suprarenal gland.
Hilum: Vertical slit on medial border for renal vessels and pelvis.

Internal Structures of the Kidney

Renal Cortex: Composed of glomeruli, proximal and distal tubules.
Renal Medulla: Contains renal pyramids (8-15), intermediate tubules, and collecting ducts.

Blood Supply of the Ureter

Supplied by renal artery, internal iliac artery, superior vesicular artery, middle rectal artery.
Males have additional supply from testicular artery and artery to ductus deferens; females receive supply from ovarian and uterine arteries.

Urinary Bladder

Subperitoneal organ that collects urine; releases via contraction of detrusor muscle.
Mechanism of urination involves increased bladder tension, activating the sacral parasympathetic system to trigger detrusor contractions.

Parts of the Urinary Bladder

Body: Covered by peritoneum.
Fundus: Proximal to rectum (male) or vagina (female).
Neck: Continuous with urethra; prevents semen from entering bladder in males.
Apex: Directed towards pubic symphysis.
Median Umbilical Ligament: Extends from apex to umbilicus.

Syntopy of Urinary Bladder

Anterior: Pubic symphysis; posterior: rectum (males), vagina (females).
Superior: Small intestine (males), uterus (females); inferior: prostate (males), urogenital diaphragm (females).

Internal Structures of the Bladder

Ureteric Orifices: Slit-like ureter openings with no sphincters.
Trigone: Triangular area formed by ureteric and internal urethral orifices.
Interureteric Crest: Fold between ureteric openings.

Fixation of the Bladder

Smooth muscles and ligaments provide structural support.
Ligaments include rectovesical, pubovesical, and vesicouterine ligaments (females).

Adrenal Gland

Positioned on upper poles of kidneys at T11-T12 level; right adrenal gland triangular, left semilunar.
Cortex produces mineralocorticoids, glucocorticoids, and androgens; medulla secretes catecholamines.

Blood Supply of the Adrenal Glands

Supplied by superior, middle, and inferior adrenal arteries.
Venous drainage through suprarenal veins into IVC (right) and renal vein (left).

Nephrolithiasis

Kidney stones form in collecting ducts; may affect entire urogenital tract.
Localization and size influence symptoms; small stones can be asymptomatic.

POSTERIOR ABDOMINAL WALL

Extends from the 12th rib to the pelvic brim.
Composed of bones, muscles, and fasciae, providing support to retroperitoneal organs, vessels, and nerves.
Bony Part: Includes bodies, intervertebral discs of L1-L5, and transverse processes; divided by the iliac crest into upper (inner surfaces of 12th rib) and lower (iliac fossa) sections.
Muscular Part: Above iliac crest consists of psoas major, quadratus lumborum, and transversus abdominis; below includes psoas major and iliacus.
Fasciae: Psoas major and iliacus covered by fascia iliaca; quadratus lumborum enclosed by anterior and posterior layers of thoracolumbar fascia.
Psoas minor muscle present in only 60% of the population, located anterior to psoas major.

THORACOLUMBAR FASCIA

Comprises three layers:
- Posterior Layer: Origin of latissimus dorsi, covering deep back muscles.
- Middle Layer: Firm membrane separating deep back muscles from quadratus lumborum.
- Anterior Layer: Covers the ventral surface of quadratus lumborum.

OVERVIEW OF THE URINARY SYSTEM

Kidneys: Filter blood plasma to produce urine.
Renal Calices: Minor and major calices transport urine from renal pyramids to renal pelvis.
Renal Pelvis: Collects urine, continuous with ureter.
Ureter: Longest segment of the urinary system, connecting renal pelvis to urinary bladder.
Urinary Bladder: Hollow organ behind the pubic symphysis for urine storage.
Urethra: Final segment with female and male variations for urine excretion.

VASCULAR SUPPLY OF THE KIDNEY

Arteries:
- Arcuate arteries (two).
- Interlobular arteries, afferent and efferent arterioles, glomerular capillary plexus, peritubular capillaries, and vasa recta.
Venous System:
- Stellate veins, interlobular veins, straight venules, arcuate veins, interlobar veins, and renal veins (right and left).

REGIONAL ANATOMY OF THE HILUM OF THE KIDNEY

Renal vein and renal artery (four anterior segmental branches) and renal pelvis.
Types of renal calices: ampullary and branching.

URETER

Muscular tube that transports urine via peristaltic movements.
Parts of Ureter:
- Abdominal part in retroperitoneal space.
- Pelvic part in lesser pelvis.
- Intramural part passing through the bladder.
Constrictions:
- Pelviureteric junction.
- Pelvic brim at common iliac artery.
- Uretero-vesical junction entering bladder.

BLOOD SUPPLY OF THE URETER

Supplied by renal artery, internal iliac artery, superior vesicular artery, and middle rectal artery (plus specific arteries in males and females).

URINARY BLADDER – VESICA URINARIA

Subperitoneally located organ collecting and releasing urine through detrusor muscle contractions.
Micturition process triggered by bladder tension and sacral parasympathetic activation.
Parts:
- Body of bladder covered by peritoneum.
- Fundus, neck, apex, and median umbilical ligament connecting to umbilicus.

SYNTOPY OF URINARY BLADDER

Anterior: Pubic symphysis.
Posterior: Rectum (males), vagina (females).
Superior: Small intestine (peritoneal cavity), uterus (females).
Inferior: Prostate (males), urogenital diaphragm (females).

MUSCLES INVOLVED IN MICTURITION AND CONTINENCE

Detrusor Muscle: Three layers innervated by parasympathetic system.
Sphincter Vesicae: Circular smooth muscle at bladder neck innervated by sympathetic system.
Trigonal Muscles: Control the opening of urethral and ureteral orifices.

VASCULAR SUPPLY OF THE URINARY BLADDER

Arteries: Superior and inferior vesical arteries from umbilical and internal iliac arteries.
Veins: Vesical venous plexus drains into internal iliac vein.
Lymphatic Drainage: Paravesical nodes to common iliac nodes.

URETHRA

Female Urethra: Length of 2.5 to 4 cm, divided into intramural, pelvic, and perineal parts.
Male Urethra: Approximately 20 cm long with four segments: intramural, prostatic, intermedia, and spongiosa.

ADRENAL GLAND

Paired organ with right triangular and left semilunar shapes, positioned on upper poles of kidneys.
Blood Supply:
- Superior, middle, and inferior adrenal arteries from respective sources.
Venous Drainage: Right into IVC, left into left renal vein.

NEPHROLITHIASIS

Kidney stones form in collecting ducts; can affect the urogenital tract.
Size and localization determine symptoms; small stones may be asymptomatic.

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Description

This quiz covers the anatomy of the posterior abdominal wall, including its structure from the 12th rib to the pelvic brim. It includes details on the bony components, muscles, and fasciae that support retroperitoneal organs. Test your knowledge of this essential anatomical region!