3.a) The retroperitoneum Flashcards
State 6 primary retroperitoneal structures.
Kidneys and Ureters Adrenal glands Aorta and IVC Nerves: lumbar plexus, sympathetic trunk Oeosphagus Rectum
State 3 secondary retroperitoneal structures.
Duodenum (except the 1st part)
Ascending and Descending Colon
Pancreas (except tail)
Describe primary retroperitoneal structures
Developed outside the parietal peritoneum
Never had a mesentery
List 3 superimposed structures
Duodenum
Pancreas
Spleen
Describe the positioning of the duodenum
1st part: 1st 2 cm has a mesentery. Lies anterior to the bile duct, portal vein and gastroduodenal artery.
2nd part: Bile duct and pancreatic ducts open into it. Root of the transverse mesocolon crosses it
3rd part: Crossed anteriorly by the superior mesenteric artery and vein
4th part: leads into the jejunum
Positioning of pancreas
Head, neck, uncinate process: lie in “G” of duodenum anterior to IVC
Body: extends to the left side across the aorta to left kidney
Tail: kidney to spleen in dorsal foregut mesentery (spleno-renal ligament)
Describe the arrangement of the kidneys in the body. What vertebral level are they at?
Hilum at vertebral level L1
Left kidney is slightly higher than the right.
Superior poles of the kidneys are closer to the median plane than inferior poles.
12th ribs run diagonally across posterior surface of kidneys
What part of the pancreas is intraperitoneal?
Tail of the pancreas (it is encased by the splenorenal ligament)
What is the pancreas derived from?
Ventral and dorsal pancreatic bud
What is the name of the mesentery between the spleen and the left kidney?
Lieno-renal ligament or spleno-renal ligament
Describe the visceral relations of the kidneys.
RIGHT kidney:
covered superiorly by the liver, inferiorly by the hepatic flexure
2nd part of the duodenum
Ascending colon
LEFT kidney: covered by the coils of small intestine Descending colon and stomach Tail of the pancreas Spleen Left colic flexure
Adrenal glands on both sides
Describe where the ureters lie.
Ureters lie anterior to the transverse processes of the lumbar vertebrae
Which rib runs posterior to the kidneys?
12th ribs run along the posterior surface of the kidneys
At which 3 places does the ureter narrow?
Ureteropelvic junction
Pelvic brim (where common iliac vessels cross)
Entrance of urinary bladder
What are the posterior relations of the kidneys?
Lie on the diaphragm, psoas major, quadratus lumborum and transversus abdominis.
