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Miranda's Flash Cards > ABD Board-Retroperitoneum > Flashcards

ABD Board-Retroperitoneum Flashcards

1
Q

the serous membrane that forms the lining of the abd cavity and covers most of the abd organs

A

peritoneum

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2
Q

two layers of peritoneum

A

parietal-outer layer lines the abd cavity

visceral peritoneum-inner layer cover the abd organs

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3
Q

space between the two peritoneum layers is the

A

peritoneal cavity

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4
Q

two compartments of the peritoneal cavity

A

lesser sac

greater sac

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5
Q

space that is situated between the liver, pancreas, and stomach. The entrance to this is the epiploic foramen

A

lesser sac

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6
Q

the rest of the peritoneal cavity . Where ascites and floating bowel are

A

greater sac

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7
Q

a peritoneal recess extending between the rectum and the uterus. In men the correcspoinding space is the __________

A

pouch of douglas (rectouterine pouch)

rectovesical pouch

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8
Q

intraperitoneal structures (12 of them)

A

stomach

jejunum

1st part of juedenum

appendix

spleen

cecum

transcerse and sigmoid colon

rectum (part of)

liver

uterus

fallopian tubes

ovaries

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9
Q

posteriorly located compartment that lies between the transversalis fascia and the posterior parietal peritoneum

A

retroperitoneum

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10
Q

the ____ ______ divide the retroperitoneum coronally into three compartments

A

renal fascia (gerotas fascia)

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11
Q

three compartments of the retroperitoneum

A

anterior pararenal space

perirenal space

posterior pararenal space

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12
Q

kidneys and adreanal glands lie

A

within the perirenal space and are separated from the pararenal spaces by the anterior and posterior renal foascia (gerotas fascia)

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13
Q

organs in the retroperitoneum

sad pucker

A

suprarenal (adrenal gland)

aorta/IVC

duodenum (2nd and 3rd part adn 4th)

pancreas (not tail)

ureters

colon (ascending and desending)

kidneys

(o)esophagus

rectum

Also:

prostate

lymphatics

gonadal vessels

superior meseteric vessels

renal vessels

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14
Q

the quadratus lumborum and psoas muscles lie posterior to the posterior pararenal space and are separated from this space by

A

their own fascia (transversalis fascia)

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15
Q

the Aorta enters the abd cavity in a ______ location

A

posterior

becomes more anterior as is travels caudally

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16
Q

The IVC maintains ______ as it courses throughout the retroperitoneum

A

horizontal

doesn’t go more anterior or posterior

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17
Q

1st major branch of aorta

A

celiac axis

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18
Q

the celiac axis is ____ to the pancreas

A

superior

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19
Q

celiac axis branches into

A

common hepatic artery

left gastric artery

splenic artery

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20
Q

celiac axis terminates with the

A

bifurcation of the common hepatic artery and the splenic artery

sea gull or dove sign

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21
Q

what artery extends cranially from the celiac axis

A

left gastric artery

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22
Q

2nd branch off aorta about 1cm inferior to celiac axis

A

superior mesenteric artery

parallels the aorta and is posterior/inferior to the body of the pancreas

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23
Q

SMA doppler waveforms

A

fasting state - high resistance

postparandial(after eating) - low resistance, increased velocity

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24
Q

the renal arteries arise from the _____ walls of the aorta just below the origin of the _______

A

lateral

superior mesenteric artery

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25
Q

the right renal artery passes ____ to the IVC

A

posterior

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26
Q

the inferior mesenteric artery arises from the ____ aspect of the aorta

A

anterior

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27
Q

the IVC lies ______ to the pancreatic head and liver

A

posterior

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28
Q

the IVC _____ with cardeiac failure and fluid overload

A

dilates

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29
Q

most common tumor to involve the IVC

A

renal cell carcinoma

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30
Q

reasons the IVC could be displaced

A

liver mass(posterior/medial)

right renal artery aneurysm (superior/anterior)

lymphadenopathy (anterior)

toruous aorta (lateral)

right renal / adrenal mass (medial/anterior)

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31
Q

used to prevent the ascent of lower extremity vein thrombus

A

IVC filters

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32
Q

most common IVC filter

A

greenfield filter

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33
Q

proper location for an IVC filter

A

inferior to the renal veins

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34
Q

IVC filters are placed by

A

catheters with entry at the femoral vein or internal jugular vein

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35
Q

the left renal vein passses

A

anterior to the aorta and posterior to the SMA

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36
Q

nutcracker syndrome

A

engorgement of the left renal vein due to its compression by the SMA and sorta

37
Q

the right gonadal vein drains into the ___ and the left gonadal vein drains into the ____ _____ ____

A

IVC

left renal vein

38
Q

a dense fibrous tissue proliferation confined to the paravertebral region

A 
retroperitoneal bibrosis
AKA
ormonds disease
AKA
inflammatory aneurysm
39
Q

retroperitoneal fibrosis extends

A

rarely superior to the level of L-2 and may extend inferiorly to the dome of the bladder

generally centered at the aortic bifurcation

40
Q

retroperitoneal fobrosis appears

A

usually as a hypoechoic midline mass

41
Q

retroperitoneal fobrosis is associated with

A

bilateral ureteral obstruction as it envelopes structures rather than displacing them***

progression will cause loss of renal function

IVC and lymphatic compression leads to lower extremity edema and gonal vein involvement will cause scrotal swelling

42
Q

bibrosis develops as an

A

immunologic response to antigens within altherosclerotic plaques

usually begins around a severely atherosclerotic aorta

43
Q

veins that provide an alternate pathway for venous return in the case the IVC gets obstructed

A

azygos and hemiazygos veins

unpaired

hemiazygos is considered tributary

connect the proximal IVC to the superior vena cava

can’t see them until they dilate to be used

44
Q

azygos vein in located on the

A

right

45
Q

hemiazygos vein in located on the

A

left

46
Q

branches of the common iliac veins

couterparts of the azygos/hemiazygos system

travel lateral to the spine and posterior to the psoas muscle

A

ascending lumbar veins

47
Q

the right ascending lumbar vein at the level of the diaphragm joins the

A

right subcostal vein

48
Q

the right ascending lumbar vein and the right subcostal vein join to form the

A

azygos vein

49
Q

left ascending lumbar vein at the level of the diaphragm joins the

A

left subcostal vein

50
Q

the left ascending lumbar vein and the left subcostal vein join to form the

A

hemiazygos vein

51
Q

the adreanal glands and kidneys are in the

A

perirenal space

52
Q

the crus of the diaphragm lies ____ and ____ to the right adrenal gland

A

medial and posterior

53
Q

the right adrenal gland is shaped like a

A

triangle

54
Q

right adrenal gland is located

A

on the superior, anterior, and medial aspect of the upper pole of the right kidney

portions of the gland extend postior to the IVC

55
Q

the left adrenal gland is shaped like a

A

cresent

56
Q

left adrenal gland is located

A

anteriomedial to the upper pole of the left kidney

57
Q

the aorta and the crus of the diaphragm are located ____ to the left adrenal gland

A

medial

58
Q

the tail of the pancreas is located _____ to the left adreanal gland

A

anterior

59
Q

the crus of the diaphragm is located

A

anterior to the aorta

superior to the celiac axis

posterior to the IVC

medial and posterior to all structures except the aorta

60
Q

three arterys that support the adrenal gland

A

suprarenal branch of the inferior phrenic artery

suprarenal branch of the aorta

suprarenal branch of the renal artery

61
Q

vein that drains the right adrenal gland

A

right suprarenal vein drains into the IVC

62
Q

vein that drains the left adrenal gland

A

left suprarenal vein drains into the left renal vein

63
Q

the adrenal cortex produces

A

mineralocorticoids (aldosterone)

glucocorticoids (cortisol)

androgens

64
Q

the adrenal gland and the _____ gland function together to regulate hormone production

A

pituitary gland

65
Q

the adrenal medulla produces

A

catecholamines:

epinephrine (adrenalin)

norepinephrine

66
Q

benign

can be hyperfunctioning or nonhyperfunctioning

A

adrenal adenoma

67
Q

syndromes that can be a result of adrenal hyperfunctioning

A

cushings

conn

hirsutism

68
Q

rare tumor with poor prognosis

majority of patients present with cushings syndrome and metastatic involvement

hard to tell the difference from adenoma

tendency to invade renal veins and IVC

A

adrenal cortical cacinoma

rumor removal or biopsy is based on size (3-6cm)

69
Q

originate in the adrenal medulla but can be ectopic

majority are benign

secrete catecholamines (norpinephrine and epinephrine)

assocaited with multiple endocrine neoplasia (MEN) and von hoppel lindau disease

A

pheochromocytoma

70
Q

malignant rumor arising from the sympathetic nervous system

commonly in the adrenal medulla but may also occur in neck, chest, or pelvis

palpable ABD mass

most common adrenal mass iof infancy and early childhood

2 months - 2 years

A

adrenal neuroblastoma

71
Q

appearance of adrenal neuroblastoma

A

solid mass that dosplaces the ipsiliateral (same side as) kidney inferiorly into the pelvis

increased blood and urine catecholamines:

epinephrine

norepinephrine

dopamine

72
Q

benign, nonfunctioning adrenal masses that contain fat and bone elements

seen as hyperechoic masses in the adrenal bed

associated with propagation speed artifact due to fat

A

myelolipoma

73
Q

usually bilateral

may be diffuse resembling hyperplasia or mass like

non hodgkin disease is the most common cell type

A

adrenal lymphoma

74
Q

the adreanal glands are the ___ most common metastatic site after lungs, liver, and bone

A

4th

75
Q

most common in the neonate

caused by the large size of the neonatal adrenals and high degree of vascularity making them vulnerable to birth trauma

A

adrenal hemorrhage

76
Q

appearance of adrenal hemorrhage

A

varies due to blood coagulation

normal evolution of hematoma ends with pseudocyst formation

decreasing hematocrit

77
Q

if a mass is identified adjacent to the adrenal glands of a newborn it is most likely

A

a hemorrhage

adrenal hemorrhage is the most common adrenal mass in a newborn

78
Q

The IVC will be displaced ____ by a right liver mass

A

posterior

79
Q

the IVC will bedisplaced ___ by a right renal artery aneurysm

A

anterior

80
Q

the IVC wil be displaced ___ by a tortuous aorta

A

right

81
Q

the IVC will be displaced ____ by a right adrenal mass

A

medial / anterior

82
Q

the IVC will be displaced ____ by a right renal mass

A

medial / left

83
Q

although lymphadenophy typically surrounds longitudinal vessels in the ABD, it commonly displaces the vessels, such as the IVC and SMA ___

A

anteriorly

84
Q

what direction will the splenic vein be displaced by a left adrenal mass

A

anterior

85
Q

what direction will the bladder be displaced by a hematoma in the puch of Douglas

A

anterior

86
Q

with a gastric outlet obstruction and dilatation of the somach, what direction will the pancreatic tail be displaced

A

posterior

87
Q

what direction will a mass in the incinate process displace the SMV

A

anterior

88
Q

what direction will a neuroblastoma displace the ipsilateral kidney

A

inferior

89
Q

what direction wil a mass in the left lobe of the liver displace the gastroesophageal junction

A

posterior

Miranda's Flash Cards (14 decks)

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