Abdomen 2 final Retroperitoneum review Flashcards
which of the following is not a retroperitoneal compartment?
a. anterior pararenal space
b. perirenal space
c. posterior parietal space
d. posterior pararenal space
c
which retroperitoneal space contains no organs?
posterior pararenal space
which of the following is NOT found within the anterior pararenal space?
a. pancreas
b. adrenal glands
c. ascending colon
d. distal CBD
b
which of the following is NOT found within the perirenal space?
a. kidneys
b. great vessels
c. adrenal glands
d. pancreas
d
what lymph nodes are located surrounding the major blood vessels of the retroperitoneum?
parietal lymph nodes
Parietal nodes can be found in the retroperitoneum do NOT surround which of the following vessels?
a. portal vein
b. celiac axis
c. internal iliac artery
d. superior mesenteric artery
a
What lymph nodes are located along the small bowel and mesentery?
lacteals
Lymph nodes affected by lymphadenitis typically do NOT have which of the following characteristics?
a. ovoid shape
b. loss of the fatty hilum
c. hyperemia
d. larger than normal
b
primary malignant lymph nodes do NOT have which of the following characteristics?
a. more hypoechoic
b. round shape
c. loss of the fatty hilum
d. hyperemia
d
which of the following statements regarding lymphadenopathy and AIDS is false?
a. enlarged lymph nodes appear hyperechoic with a loss of the fatty hilum
b. enlarged lymph nodes appear hypoechoic and bowel wall thickening may also be seen
c. lymph nodes in patients with tuberculosis may appear anechoic due to necrosis
d. patients with AIDS may develop Kaposi sarcoma and lymphoma
a
which of the following is NOT a malignant tumor of the retroperitoneum?
a. liposarcoma
b. rhabdomyosarcoma
c. myxosarcoma
d. retroperitoneal fibrosis
d
what is the most common primary malignancy of the retroperitoneum?
liposarcoma
what is the sonographic appearance of liposarcomas?
extremely large, poorly marginated, complex retroperitoneal mass
what is the most common site for retroperitoneal infections?
anterior pararenal space
what is the most common cause of posterior pararenal fluid collections?
abscess or hemorrhage from aortic disease
Your patient presents with a history of pancreatitis to rule out the presence of a pseudocyst. Which retroperitoneal compartment would contain a pseudocyst?
anterior pararenal space
a patient presents with a history of left ureteropelvic junction obstruction. A fluid collection is seen surrounding the left kidey. What is the likely diagnosis of the fluid collection?
urinoma
while performing an abdominal examination on a patient, you suspect the lymph nodes surrounding the great vessels are enlarged. What is the normal measurement for the lymph nodes in this location?
less than 10 mm
which retroperitoneal compartment contains the psoas and quadratus lumborum muscles?
posterior pararenal space
while performing an abdominal sonogram you notice multiple rounded hypoechoic structures in the splenic and left renal hilum. These structures appear to be distorting the surrounding blood vessels. What is the most likely diagnosis ?
lymphadenopathy
Where is the retroperitoneum located?
between the parietal peritoneum and the anterior transversalis fascia
which statement describes the posterior pararenal space?
a. it contains the pancreas and the ascending and descending colong
b. it is between renal fascia and transversalis fascia and contains fat
c. it contains the kidney, the renal vessels, the adrenal gland, perinephric fat, aorta, and inferior vena cava
c. it contains organs and fat
b
which statement describes the anterior pararenal space?
a. it is bordered anteriorly by the anterior renal fascia
b. it contains the pancreas and the ascending and descending colon
c. it is between the renal fascia and transversalis fascia and contains fat
d. it contains the kidney, the renal vessels, the adrenal gland, perinephric fat, aorta, and inferior vena cava
b
what lymph nodes around the aorta and inferior vena cava provide the most reliable indicator of lymphadenopathy?
posterior
what pathology describes the enlargement of lymph nodes caused by inflammation, primary neoplasia, or metastasis?
lymphadenopathy
what is the typical sonographic appearance of enlarged lymph nodes?
oval with low- to medium-level echo pattern
what is the most common type of soft tissue malignant tumor that can occur in fatty tissue anywhere in the body but are most frequently seen in the extremities and the retroperitoneal tissues?
liposarcomas
what is a common neoplasm associated with acquired immune deficiency syndrome?
lymphoma
what may fuse together to form a lobulated mantle-like soft tissue mass anterior to the great vessels?
enlarged retroperitoneal lymph nodes
the distal CBD can be located embedded in which retroperitoneal compartment?
anterior pararenal space
why should a sonographer select a lower frequency with either an anterior or coronal scanning approach?
obtain best penetration
Solid masses are usually _____ in the retroperitoneum.
metastic
Most common primary malignancy of the retroperitoneum.
liposarcoma
what develop as an extension from an adjacent organ such as renal infection, diverticulitis, and Chron’s disease?
retroperitoneal abscess
what can happen because of a tear in the urinary collecting system?
urinoma
Fluid collections in the posterior pararenal space are most commonly associated with what?
aortic disease
The anterior pararenal space contains a portion of?
digestive tract, pancreas, distal CBD
What is a smooth muscle tumor and is the 2nd most common primary malignancy?
leiomyosarcoma
a pocket of infection typically containing pus, blood, and degenerating tissue
abscess
enlargement of lymph nodes due to inflammation, primary neoplasia, or metastasis
adenopathy
fluid, such as blood, bile, or urine, that is forced out or leaks out of its normal vessel into the surrounding tissues or potential spaces
extravasate
a thin sheet-like tissue that separates musclss
fascia
a term used to describe the aorta and IVC together
great vessels
an extravasated collection of blood localized within a potential space or tissues
hematome
blood borne virus that attacks T lymphocytes resulting in their destruction or impairment eventually leading to AIDS
HIV
Distortion or displacement of normal anatomy due to a mass, neoplasm, or fluid collection
mass effect
the spread of cancer from the site at which it first arose to a distant site
metastasis
planes that are perpendicular or 90 degrees to each other
orthogonal
a new growth of benign or malignant origin
primary neoplasm
an extravasated urine collection due to a tear of the urinary collecting system
urinoma
extravasated lymphatic fluid within the retroperitoneum
lymphocele
primary modality for evaluating the retroperitoneal cavity
CT
What lymph nodes are located surrounding the major blood vessels of the retroperitoneum?
parietal lymph nodes
what lymph nodes are located along the small bowel and mesentery?
lacteals
what is the most common primary malignancy of the retroperitoneum?
liposarcoma
What is the sonographic appearance of a liposarcoma?
extremely large, poorly marginated, complex retroperitoneal mass
what is the most common site for retroperitoneal infections?
anterior pararenal space
what is the most common cause of posterior pararenal collections?
abscess or hemorrhage from aortic disease
the area that lies behind the peritoneal membrance is referred to as the
retroperitoneum
the retroperitoneum lies between the parietal peritoneum and anterior to the
transverse fascia
lymph nodes are located 360 degrees around the great vessels. The nodes that lie posterior to the great vessels may displace the aorta and IVC _____ when enlarged.
anteriorly
a fluid collection that may occur following lymph node dissection for cancer staging
lymphocele
Retroperitoneal fluid collections include:
abscess, hematoma, urinoma, lymphocele
Fluid collections within the perirenal space are generally associated with _____ abnormalities.
renal
an enlargment of lymph nodes due to an inflammatory process is called
lymphadenitis
the second most common primary retroperitoneal malignany is
leiomyosarcoma
Malignant tumors tend to be _____ and more _____ than their benign counterparts
larger
complex
The major compartments of the retroperitoneum
anterior pararenal space
perirenal or perinephric space
posterior pararenal space
The anterior pararenal space is bordered anteriorly by the _____ ______ ______ and posteriorly by the _____ ______ ______.
posterior parietal peritoneum
anterior perirenal fascia
The perirenal space is bordered anteriorly by the _____ and posteriorly by the _____.
anterior renal fascia
posterior renal fascia
The posterior renal space lies between the _____ and the _____.
posterior renal fascia
transversalis fascia
Solid masses found in the retroperitoneum are usually _____ and most frequently involve the _____.
metastatic
lymph nodes
On color or power Doppler, lymphadenitis demonstrates
hyperemia
Primary malignant nodes tend to become more ____ to _____ and round shaped with a length to width ratio of less than two
hypoechoic
anechoic
______ is a very common finding in patients with AIDS
lymphadenopathy
Chronic inflammatory process that results in fibrous tissue proliferation affecting and encasing the great vessels, ureters, and lymphatics of the retroperitoneum
retroperitoneal fibrosis
Primary malignancies of the retroperitoneum include:
liposarcoma
leiomyosarcoma
rhabdomyosarcoma
myxosarcoma
fibrosarcoma
Most common primary malignancy of the retroperitoneum, representing 95% of all fatty retroperitoneal tumors
liposarcoma
Most common site for retroperitoneal infections is
anterior pararenal space
Sonographically, enlarged lymph nodes typically appear as
oval to round shaped masses with a low to medium level echo patter
Sonographically primary malignant nodes tend to be
more hypoechoic to anechoic, more round than oval in shape, asymmetric cortical widening and loss of normal fatty hilum
A distortion or displacement of normal anatomy due to a mass, neoplasm, or fluid collection
mass effect
Which retroperitoneal space contains no organs?
posterior pararenal space
what are lymph nodes that are found surrounding the major blood vessels of the retroperitoneum?
parietal lymph nodes
what are lymph nodes found along the small bowel and mesentery called?
lacteals
What is the most common cause of posterior pararenal fluid collections?
Abscess or hemorrhage from aortic disease
which retroperitoneal compartment would contain a pseudocyst?
anterior pararenal space
A fluid collection is seen surrounding the left kidney. What is the likely diagnosis of the fluid collection?
urinoma
what is the normal measurement for lymph nodes surrounding the great vessels
less than 10 mm
which retroperitoneal compartment contains the psoas and quadrates lumborum muscles?
posterior pararenal space
Sonographic findings of retroperitoneal fibrosis
large, hypoechoic mass surrounding the abdominal aorta
indicate the two primary functions of lymph nodes
filter lymph
immune surveillance
what structures functions to filter lymph
lymph nodes
Lymphatic _____ drain into the subclavian veins
ducts
What cell type has receptors on their surface that enables them to recognize nonself antigens
lymphocytes
Malignant smooth muscle tumors in uterus and GI tract
leiomyosarcomas
Dense, fibrous sheets of connective tissue extending from the perirenal space to dome of bladder
Retroperitoneal fibrosis
Best diagnostic toll for Cystic masses/ retroperitoneal fluid collections is?
FNA
Abscess presents with
leukocytosis
fever
point tenderness
urinoma is due to:
trauma
obstruction
renal transplant
sonographic appearance of benign lymph node pathology is
echogenic lymph node with fatty hilum
adenopathy is secondary to lymphoma is usually _____ in appearance
sonolucent
adenopathy secondary to metastatic disease is usually ______.
complex
the fluid that enters the lymphatic plexus is referred to as
lymph
In the retroperitoneum, lymph nodes are usually divided into
deep abdominal (or parietal) lymph nodes
Superficial abdominal (or visceral) lymph nodes
lymph nodes encircling the aorta or IVC or both are considered abnormal in size if they are greater than
> 10
the anterior pararenal space contains portions of the :
digestive tract
pancreas
distal common bile duct
The perirenal space contains the:
kidneys
adrenal glands
perinephric fat
aorta
IVC
The posterior pararenal space contains
no organs, only fat
retroperitoneal infections most commonly occur in the ________ space as a result of appendicitis, bowel inflammation, trauma, or pancreatitis
anterior pararenal
Fluid collections in the _____ are generally associated with renal abnormalities such as nephritis, ruptured renal artery aneurysm, or bleeding from a renal neoplasm
perirenal space
Fluid collections in the _______ space are most commonly associated with aortic disease and may include hemorrhage from rupture or infection from surgical procedures
posterior pararenal
Which retroperitoneal compartment contains the pancreas, the ascending colon, and the descending colon?
anterior pararenal space
Which lymphatic nodes are located in the retroperitoneum?
Mesenteric
What pathology describes the enlargement of lymph nodes caused by inflammation, primary neoplasia, or metastasis?
Lymphadenopathy
Which echo pattern is usually seen with primary malignant nodes like those seen with lymphoma?
Round shaped, hypoechoic to anechoic
what is the extent of the retroperitoneum?
From the diaphragm superiorly to the pelvic brim inferiorly
what is the primary difference in the sonographic appearance between retroperitoneal fibrosis and para-aortic lymphadenopathy?
Renal fascia is less echogenic and smaller
