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M2 gi anat; Histo > 1.2.2 Retroperitoneum > Flashcards

1.2.2 Retroperitoneum Flashcards

1
Q

What is the 1st part of the duodenum anterior to?

A

bile duct, portal vein and gastroduodenal artery

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2
Q

what is the 1st part of the duodenum posterior to?

A

liver, gallbladder

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3
Q

2nd part of the duodenum

  • receives the common bile duct and pancreatic duct
  • crossed by _________
  • lies on the _________________
A

transverse colon;

right kidney and ureter

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4
Q

3rd part of duodenum:

- crossed anteriorly by the ______________

A

superior mesenteric artery and vein

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5
Q

4th part of the duodenum

  • leads to the jejunum, to form the _________
  • once it reaches the jejunum, the rest of the small intestines become intraperitoneal
  • passes left of aorta
A

duodenojejunal junction

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6
Q

Posterior relations of Pancreas

Head: ______, _______
Neck: formation of portal vein, superior mesenteric vesssels
Body: splenic vein, left suprarenal gland, renal vessels, ____, ____, _____________
tail: close contact of spleen

A

bile duct; IVC,

aorta, SMA, left kidney

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7
Q

Pancreas
Head, neck
- Lies within the C shaped part of the duodenum
- anterior to __________

Uncinate process

  • lies within the C shaped part of the duodenum
  • anterior to ____
  • posterior to SMA

Body crosses the vertebral bodies and travels to the left side across the aorta to the left kidney and spleen

Tail (intraperitoneal): foes towards the hilum of sleen, enclosed by the ________ and ______ (dorsal foregut mesentery)

A

superior mesenteric vessels;

IVC

splenorenal ligament; gastrosplenic ligament

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8
Q

What is the arterial supply of the pancreas

  • mainly from _______
  • anterior & posterior superior pancreaticoduodenal artery from gastroduodenal artery which is a branch of _______ which is a branch of celiac trunk
  • anterior & posterior inferior pancreaticoduodneal artery from SMA

Venous drainage of pancreas: tributaries of splenic and superior mesenteric parts of hepatic portal vein, majority into ______

A

splenic artery; common hepatic artery; splenic veins

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9
Q

What is the lymphatic drainage of pancreas?

A

Pancreaticospleno lymph nodes, some pyloric lymph nodes which drains into celiac, hepatic and superior mesenteric lymph nodes

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10
Q

Anterior relations to pancreas

  • stomach (separated by _______)
  • hilum of spleen (to left)
  • duodenum

Posterior relations to pancreas

  • IVC
  • aorta
  • superior mesenteric vessels
  • splenic artery (along ________)
  • common bile duct
  • crura of diaphragm
  • ____ plexus
  • left kidney and suprarenal gland
A

lesser sac: superior borders; coeliac

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11
Q

Kidneys

  • located at __________ vertebrae level
  • upper poles lie underneath ribcage (11th-12th ribs) and lower poles are exposed inferior to the ribcage (3-4cm above _________)
  • hilum lies at the _____________, with ureters along the tips of the lumbar transverse processes
  • right kidney lower than the left,
  • upper poles are ____ to the median plane than the lower poles
  • 12th ribs run diagonally across the posterior surface of the kidneys
A

T12-L3; iliac crest; L1 (transpyloric plane), closer

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12
Q

Adrenal gland- sits on top of the upper pole of the kidney

Arterial supply

  • superior suprarenal arteries from the __________
  • middle suprarenal arteries - from the _____ or the renal arteries
  • inferior suprarenal arteries: from the ______

Right suprarenal vein drains into IVC, left suprarenal vein drains in to left renal vein.

A

inferiorphrenic arteries; abdominal aorta; renal arteries

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13
Q

Anterior relations of right kidney

  • Upper pole: __________________
  • near hilum: ________
  • lower pole: small intestinal loops (jejunum)
  • lateral aspect ______________
A

Right lobe of liver; descending part of duodenum, ascending colon/ right colic flexure

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14
Q

Anterior relations of the left kidney

  • upper pole: ____ & _____
  • splenic area near hilum: tail of the left pancreas and splenic flexure
  • lower pole: jejunum
  • lateral border: ________________
A

stomach & spleen; descending colon on lateral border

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15
Q

Blood supply of kidneys

  • branches of abdominal aorta (L1-L2)
  • passes _____ to respective renal veins to reach hilum
  • branch into 5 segmental arteries to reach hilum –> do not anastomose

venous drainage

  • renal veins
  • left renal vein longer than right vein, passes between ___ & _____ (if compressed in aneurysm in either vessel –> nutcracker syndrome)
A

posterior; aorta; SMA

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16
Q
  1. Posterior relations of kidneys
    - Kidneys lie on the diaphragm, ___, ______ and transverse abdominis
    - A posterior approach to the kidneys is used for open surgery and for renal biopsy
    - Spinal nerves cross between the kidneys and the muscles (posterior abdominal wall muscles) – T12 (_______) and L1 (___________ and ilioinguinal) nerves
A

psoas major, quadratus lumborum;
subcostal;
illiohypogastric

17
Q

Renal coverings – the kidneys are situated in a large amount of fat

  • Kidneys are surrounded by perinephric fat which is enclosed in a sheath – renal fascia
  • Renal fascia is surrounded by ____________
  • Both these fat tissues provide support for the kidneys and the kidneys are kept in place on the posterior abdominal wall
A

paranephric fat

18
Q

Aorta:

  • Enters at T12, descend down into lumbar vertebra, split into the common iliac arteries at the ___ vertebrae level
  • unpaired derivatives: celiac trunk, SMA, IMA and ___________
  • paired arteries: testicular/ ovarian arteries, rennal arteres, inferior phrenic arteries and lumbar arteries
A

L4; median sacral artery

19
Q

Course of ureters
• Begins at renal pelvis
• Travels along medial border of psoas
• Continues anterior to tips of L2- 5 transverse processes
• Enters pelvis anterior to _____, at bifurcation of common iliac artery
• Continues anterior to _____________
• Runs along lateral wall of pelvis
• Turns antero medially at ischial spine to enter posterolateral wall of bladder
• Runs obliquely through bladder wall 1 2 cm before reaching ureteric orifice (forms flap valve mechanism –> prevents retrograde reflux)

A

SI joint; internal iliac artery

20
Q

IVC: union of right and left iliac veins at ____, ascends in front of vertebral body

A

L5

21
Q

5 nerves of the lumbar plexus (L1-L4)

Iliohypogastric
- supplies the ___________

Ilioinguinal
- supplies the anterior abdominal wall muscles, anterior part of external genitilia and anteromedial upper thing

Lateral cutaneous nerve
- formed from L2-L3 spinal nerves, compressed when person wear tight pants

Obturator nerve

Femoral nerve
- supply quadriceps

and __________

A

anterior abdominal wall muscles; genitofemoral nerve

22
Q

What are the 2 posterior relations of the duodenum?

A

Kidney

M2 gi anat; Histo (9 decks)

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