M104 T3 L1 Flashcards
What is meant by an organ that is primarily retroperitoneal?
it means that that organ has always been retroperitoneal - it would have developed posterior to the peritoneum and that is where it has remained and stays
What is meant by an organ that is secondarily retroperitoneal?
it means that that organ has developed intraperitoneally, within the peritoneum
and through development, due to the rotations of the abdominal structures, it has then become retroperitoneal
What does the mneumonic PEAR DUCKS stand for?
Pancreas, Esophagus, Aorta & IVC, Rectum
Duodenum, Ureter, Colon, Kidneys, Suprarenal glands
How does an organ that has developed become secondarily retroperitoneal?
the portion of the peritoneum that was encasing it will have obliterated and it will have moved posteriorly to be behind the peritoneum
What connects the organs listed in the mneumonic PEAR DUCKS?
they are all retroponeal structures
Is the oesophagus intraperitoneal or retro in the abdomen?
retro
Which portions of the colon are retroperitoneal?
ascending and descending
Are the ascending and descending portions of the colon primarily or secondarily retroperitoneal?
2o
Is the transverse colon retroperitoneal?
no, it is actually intraperitoneal
What are the organs of the urinary system? (KUBU)
Kidneys, Ureter, Bladder, Urethra
Which organs of the urinary system are retroperitoneal?
the Kidneys and the Ureter
Which organs of the urinary system are extraperitoneal?
Bladder, Urethra
Where are the kidneys located?
on the posterior abdominal wall
What is the vertebral span of the kidneys?
T12 - L3
What are the kidneys responsible for?
Regulate blood
Hormone production (e.g. calcitriol)
Excretion of waste
What percentage of cardiac output do the kidneys receive?
~20%
What aspects of the blood do the kidneys regulate?
ionic composition & pH
volume & pressure
What are the two regions of the kidneys?
Cortex (Glomerulus)
Medulla (Collecting ducts)
What occurs in the glomerulus?
blood filtration, the selective absorption of ions and water
What occurs in the ureters?
Urine is passed here from the glomeruli in the cortex
What is renal pain generally caused by?
Stretching capsule, due to increased internal pressure
Spasm of smooth muscle of the renal pelvis
Where is renal pain generally referred to?
T12 - near the subcostal nerve (spinal nerve T12)
Are renal transplants common?
yes, it is a fairly common procedure
What is the worst method of imaging the kidneys and why?
X-ray - not going to get the best view of soft tissue (the kidneys) bc the x-rays won’t be absorbed
Where are implanted kidney inserted into?
the iliac fossa
How is the iliac fossa accessed?
via an incision over and parallel to the inguinal ligament
vessels are anastomosed
a ureterocystostomy is performed straight into bladder
What vessels are anastomosed during a kidney transplant?
renal A+ V — ext. iliac A + V
What is it important to do when anastomosing vessels during a kidney transplant?
It is vital to tag which vessel is which
What can be done to produce a useful kidney xray?
using a good contrast medium - a radiopaque substance that is excreted through the kidneys
Why is it It is vital to tag which vessel is which during a kidney transplant?
to prevent (de)oxygenated blood mixing which will cause harmful effects for the kidney
Why are vessels in the iliac fossa anastomosed?
to connect them to the transplanted new kidneys
What percentage of kidney functionality is required before any issues are seen?
50% of one kidney only
What is the most prevalent organ to suffer malformations?
the kidneys
What are the different types of kidney malformations?
bi / uni lateral renal agenesis Supernumerary kidneys Renal fusion (horseshoe kidney) Ectopic kidney Simple / polycystic kidney
What blood vessel will prevent a horseshoe kidney from ascending to its anatomical position in the upper abdomen?
Inferior mesenteric artery
What structure is supplied by the Inferior mesenteric artery?
the LI
What are the adrenal glands otherwise known as?
the suprarenal glands
What shape is the Right adrenal gland?
pyRamidal
What shape is the Left adrenal gland?
semiLunar
What is the internal anatomy of the adrenal glands?
Cortex
Medulla
What does the adrenal gland cortex secrete?
Corticosteroids (e.g. cortisol) Sex hormones (e.g. progesterone)
What does the adrenal gland Medulla secrete?
Adrenaline (epinephrine)
Why is the extensive blood supply to the adrenal gland functionally significant?
bc it’s an endocrine gland - they produce hormones and circulate their products within the blood
Why are the ureters muscular?
so that they can do a peristaltic movement to help move urine along
How do kidney stones occur?
when calculi become lodged in the ureter preventing urine flow
What are the three narrowest points of the ureters? (PiLB)
at the Pelviureteric junction
when crossing iLiac vessels / pelvic brim
when entering the Bladder
How are kidney stones imaged?
plain film radiographs
CT Urography
How are plain film radiographs used to image kidney stones?
they are highlighted as the soft tissue of the ureter is not generally visible on x-rays
How is CT Urography used to image kidney stones?
CT utilising contrast medium to highlight the urine production and excretion
What causes renal colic pain?
the peristaltic movement of the ureters trying to help pass and urine moving along the kidney stone bc it’s a hard, stony structure
What is the standard treatment for kidney stones?
Shock wave lithotripsy
What is the difference between male and female urethras?
male is longer and the path is more convoluted than female
It also serves a reproductive purpose in males - is the shared pathway for the ejaculate
What type of pain is renal colic pain?
Generally felt in waves, but can also be felt on the skin
How does Shock wave lithotripsy work?
by pelting the kidney stones with sound waves to try and break them up, make them easier to pass
What is an alternative treatment for kidney stones?
Laparoscopic surgery - minimally invasive
When aren’t diuretics and IV fluids commonly used to treat kidney stones?
bc they can make the pain worse if the stone is not easily passible depending on its size
What are the four different parts of the male urethra going down?
pre-prostatic, prostatic
membranous, spongy
What are the lengths of the male and female urethras?
m: 20-25cm
f: ~4cm
Which group is more likely to contract a UTI and why?
Females bc of the short length of the urethra
What percentage of females will at some point suffer from a UTI?
50 to 60 %
What spaces are included in extraperitoneal space?
retroperitoneal space (posterior) preperitoneal space (anterior) retropubic space (inferior)
What arteries supply the adrenal glands?
suprarenal arteries (superior, inferior & middle)
What veins supply the adrenal glands?
suprarenal veins
What nerves supply the adrenal glands?
abdominopelvic (greater, less and least splanchnic)
