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CNIH > Abdo- retroperitoneum > Flashcards

Abdo- retroperitoneum Flashcards

1
Q

Where is the retroperitoneal space?

A
  • area between posterior portion of the parietal peritonuem and the posterior abdominal wall muscles
  • extends from diaphragm to the pelvis
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2
Q

retroperitoneal space lateral boundaries?

A
  • boundaries extend to the extraperitoneal fat planes within the trandversalis fascia
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3
Q

the retroperitoneal space medially?

A

encloses the great vessels

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4
Q

retroperitoneal space 3 categories?

A
  1. anterior pararenal space
  2. perirenal space
  3. posterior pararenal space
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5
Q

borders of the retroperitoneum?

  • superior
  • inferior
  • anterior
  • posterior
  • lateral
A

superior: diaphragm
inferior: pelvic rim
anterior: posterior parietal peritoneum
posterior: posterior abdominal wall muscle and spine
lateral: transversalis fascia and peritoneal portions of the mesentery

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6
Q

what is the anterior pararenal space?

A

the fat area between the posterior peritoneum and gerota’s fascia

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7
Q

what does the anterior pararenal space include? (5)

A
  • pancreas
  • descending portion of the duodenum
  • ascending and descending colon
  • superior mesenteric vessels
  • inferior portion of the common bile duct
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8
Q

where is the perirenal space?

A

space separated from the pararenal space by gerota’s fascia

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9
Q

perirenal space includes?

A
  • kidneys and adrenal glands
  • perinephric fat
  • ureters
  • renal vessels
  • aorta and IVC
  • lymph nodes
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10
Q

posterior pararenal space is located where?

A

space between gerota’s fascia and the posterior abdominal wall muscles

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11
Q

posterior pararenal space includes?

A
  • iliopsoas
  • the posterior abdominal wall
  • contains fat and nerves
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12
Q

SADPUCKER?

A 
S= suprarenal (adrenal) glands 
A= aorta/ IVC 
D= duodenum 
P= pancreas
U= ureters 
C= colon 
K= kidneys 
E= esophagus 
R= rectum
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13
Q

spaces in the retroperitoneum should be evaluated for? (4)

A
  • lymphadenopathy
  • neoplasms
  • fluid collections
  • ascites
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14
Q

division of abdominal lymph nodes (2)?

A
  • parietal

- visceral

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15
Q

lymph nodes functions?

A
  • filter the lymph of debris and organisms

- form lymphocytes and antibodies to fight infection

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16
Q

where are parietal nodes located?

A
  • loacted in retroperitoneum

- surround aorta

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17
Q

what is parietal nodes subdivided into? (7)

A
  • common iliac
  • epigastric
  • external iliac
  • iliac circumfrence
  • internal iliac
  • lumbar
  • sacral nodes
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18
Q

what drains into the paraaortic nodes?

A

kidney, adrenal gland, ovarian/testicular nodes

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19
Q

where are visceral nodes located?

A
  • within peritoneum
  • course along the vessels supplying the major organs
  • generally located at the hilum of the organ
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20
Q

Normal or abnormal lymph node?

A

normal

21
Q

normal or abnormal lymph node?

A

abnormal

22
Q

sono appearance of normal lymph nodes?

A
  • hypoechoic cortex
  • hyperechoic fatty center
  • smooth margins
  • oval shape
  • internal vascular blood flow especially at the hilum
  • usually measures <1cm
23
Q

sono appearance of abnormal lymph nodes?

A
  • enlarged hypoechoic mass >1cm
  • loss of hyperechoic fatty center
  • displacement of adjacent structures
24
Q

lymph nodes- infection?

A

smooth wall margins and oval shape typically caused by infection

25
Q

abnormal lymph nodes malignant characteristics?

A
  • irregular margins

- round shape

26
Q

paraaortic lymph nodes sonographically?

A
  • rounded
  • focal
  • echo-poor lesions
  • > 1cm
  • echo-poor masses
  • often displace kidney laterally
27
Q
A

paraaortic lymph node

28
Q

what might a sonographer detect in paraaortic lymph nodes?

A
  • mantle of nodes in paraspinal location
  • floating or anteriorly displaced aorta
  • mesenteric sandwich sign
29
Q

what is the mesenteric sandwich sign?

A
  • anterior and posterior node masses surrounding mesenteric vessels
30
Q

splenomegly should be evaluated in patients with what?

A

lyphadenopathy

31
Q

As gentle pressure is applied with the transducer in an effort to displace the bowel, the lymph nodes remain constant in shape T or F?

A

true

32
Q

3 node regions?

A

periaortic
pericaval
intraaortocaval

33
Q

lymph nodes associated pathology (3)?

A
  • lymphoma
  • renal carcinoma
  • metastatic disease
34
Q

non- vascular retroperitoneal pathology? (5)

A
  • lymphadenopathy
  • mesenteric adenitis
  • metastatic disease
  • benign masses
  • retroperitoneal fibrosis
35
Q

what is the most common primary retroperitoneal tumor?

A

lymphoma

36
Q

Sonographic evaluation for abdominal lymphoma is performed to determine the presence or absence of?

A
  • lymphadenopathy
37
Q

lymphoma- main areas to be evaluated?

A
  • hepatic and splenic hilum
  • celiac and SMA
  • paraaortic and renal hilum
38
Q
A

lymphadenopathy

39
Q

lymphoma accuracy of u/s?

A
  • detection 90% when lymph nodes are >2cm in diameter
40
Q

sono appearance of lymphoma?

A

ranges:

  • round
  • hypoechoic masses
  • anechoic masses with posterior enhancement
41
Q
A

Lymphoma

42
Q

most common primary malignancies that spread into the retroperitoneum are from the? (3)

A
  • breast
  • lung
  • testies
43
Q

what usually indicates seeding or invasion of the peritoneal surface?

A
  • ascites

- retroperitoneal tumor

44
Q

Benign retroperitoneal masses?

A

Fibromas
Schwannomas
Neurofibromas
Lipomas

Fluid collections:
Hematoma
Urinoma , lymphocele
Abscess, pseudocyst

45
Q

Retroperitoneal Fibrosis(Ormond’s Disease) is characterized by?

A
  • an idiopathic condition characterized by thick sheets of fibrous tissue in the retroperitoneal cavity
46
Q

fibrosis may encase and obstruct what?

A
  • ureters and vena cava with resultant hydronephrosis
47
Q

what is retroperitoneal fibrosis (Ormond’s disease) associated with? (4)

A
  • infiltrating neoplasms
  • acute immune diseases (crohn disease)
  • ulcerative colitis
  • sclerosing cholangitis
48
Q

Retroperitoneal Fibrosis(Ormond’s Disease) clinically?

A
  • abdominal pain
  • hypertension
  • oilgoanuria
49
Q

Retroperitoneal Fibrosis(Ormond’s Disease) on ultrasound?

A
  • abnormal hypoechoic tissue surrounding the anterolateral aspect of the aorta and/or the IVC

CNIH (69 decks)

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