Lecture 3 - Retroperitoneum, Liver and Spleen Flashcards
Fill in the blanks of the retroperitoneal structures in direct contact with the posterior abdominal wall
What are the primary retroperitoneal structures?
Abdominal aorta and its branches
Inferior vena cava and its tributaries
Kidneys and ureters
Adrenal glands
Nerves (lumbar plexus and sympathetic trunk)
What does primary retroperitoneal structure mean?
Those structures that developed outside the parietal peritoneum - never had a mesentery
List 3 superimposed structures in the abdomen
Duodenum, pancreas and spleen - all retroperitoneal apart from spleen and tail of pancreas
What are the 4 parts of the duodenum and how are they related to structures around them?
First part has a mesentery and lies anterior to the bile duct, HPV and gastroduodenal artery Secondary part has the bile/pancreatic ducts opening to it and the roof of the transverse mesocolon crosses it Third part is crossed anteriorly by the superior mesenteric artery and vein Fourth part leads into the jejunum
How do the superimposed structures appear? FITB
Sketch from vessels, kidney, spleen and finally duodenum and pancreas
Where does the pancreas lie in relation to the surrounding structures?
Head, neck and uncinate processes lie in G of duodenum anterior to left kidney Body extends to left side across aorta to left kidney Tail is from kidney to spleen in dorsal foregut mesentery (lieno-renal/spleno-renal ligament)
What are the kidneys surrounded by when in situ?
Perinephric fat, renal fascia and paranephric fat
What are the relations of the kidneys? FITB
NB: each kidney is different and liver is anterior to upper RK and jejunum to lower LK
What are the visceral relations of the kidney?
Adrenal glands on both sides Liver on the right 2nd part of duodenum on the right Ascending colon on the right Descending colon and stomach on the left Spleen on the left Tail of pancreas on the left Coils of small bowel especially on the left
What surface projections occur from the kidneys?
What are the positions of the 2 kidneys relative to each other?
There is greater separations at inferior ends of kidneys and ureters are located anterior to transverse processes of lumbar vertebrae Right is often lower than left 12th ribs run diagonally across posterior surfaces of kidney
What are the posterior relations of the kidneys?
Lie on the diaphragm, psoas, quadratus lumborum and transversus abdominis Between kidneys and muscles cross the T12 (subcostal) and L1 (ilio-hypogastric and ilioinguinal) nerves
When is a posterior approach to the kidneys used?
For open surgery and renal biopsy
Fill in the blanks of the posterior relations of the kidney
x
Fill in the blanks of the embryo in 5th week of IUL
Fill in the blanks of the mesenteries in relation to the stomach, liver and spleen
Where does the liver develop and what structures is it attached to?
Develops in ventral foregut mesentry Connected to anterior abdominal wall by falciform ligament Connected to stomach by lesser omentum Direct contact with part of diaphragm
What is the surface anatomy of liver?
Deep to ribs 7-11, mostly under cover of ribs Extends across R hyperchondrium, epigastrum and left hyperchondrium
Fill in the blanks of the anatomical lobes of the liver, anteriorly
Fill in the blanks of the anatomical lobes of the liver, posteriorly
What are the names of the 4 lobes of the liver?
Right/left vascular lobe Quadrate lobe, caudate lobe
What is the visceral surface of the liver surrounded by (which viscera)?
Gall bladder and IVC mark the separation into functional R and L lobes Grooves for foetal veins mark out minor parts of function L lobe (quadrate/caudate lobes) Porta of liver separates Q and C lobes
What does the porta carry?
Hepatic artery, portal vein, common bile duct and lymphatics
