M104 T3 L1

Question 1

What is meant by an organ that is primarily retroperitoneal?

Answer 1

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

Question 2

What is meant by an organ that is secondarily retroperitoneal?

Answer 2

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

Question 3

What does the mneumonic PEAR DUCKS stand for?

Answer 3

Pancreas, Esophagus, Aorta & IVC, Rectum

Duodenum, Ureter, Colon, Kidneys, Suprarenal glands

Question 4

How does an organ that has developed become secondarily retroperitoneal?

Answer 4

the portion of the peritoneum that was encasing it will have obliterated and it will have moved posteriorly to be behind the peritoneum

Question 5

What connects the organs listed in the mneumonic PEAR DUCKS?

Answer 5

they are all retroponeal structures

Question 6

Is the oesophagus intraperitoneal or retro in the abdomen?

Answer 6

retro

Question 7

Which portions of the colon are retroperitoneal?

Answer 7

ascending and descending

Question 8

Are the ascending and descending portions of the colon primarily or secondarily retroperitoneal?

Answer 8

2o

Question 9

Is the transverse colon retroperitoneal?

Answer 9

no, it is actually intraperitoneal

Question 10

What are the organs of the urinary system? (KUBU)

Answer 10

Kidneys, Ureter, Bladder, Urethra

Question 11

Which organs of the urinary system are retroperitoneal?

Answer 11

the Kidneys and the Ureter

Question 12

Which organs of the urinary system are extraperitoneal?

Answer 12

Bladder, Urethra

Question 13

Where are the kidneys located?

Answer 13

on the posterior abdominal wall

Question 14

What is the vertebral span of the kidneys?

Answer 14

T12 - L3

Question 15

What are the kidneys responsible for?

Answer 15

Regulate blood
Hormone production (e.g. calcitriol)
Excretion of waste

Question 16

What percentage of cardiac output do the kidneys receive?

Answer 16

~20%

Question 17

What aspects of the blood do the kidneys regulate?

Answer 17

ionic composition & pH

volume & pressure

Question 18

What are the two regions of the kidneys?

Answer 18

Cortex (Glomerulus)

Medulla (Collecting ducts)

Question 19

What occurs in the glomerulus?

Answer 19

blood filtration, the selective absorption of ions and water

Question 20

What occurs in the ureters?

Answer 20

Urine is passed here from the glomeruli in the cortex

Question 21

What is renal pain generally caused by?

Answer 21

Stretching capsule, due to increased internal pressure

Spasm of smooth muscle of the renal pelvis

Question 22

Where is renal pain generally referred to?

Answer 22

T12 - near the subcostal nerve (spinal nerve T12)

Question 23

Are renal transplants common?

Answer 23

yes, it is a fairly common procedure

Question 24

What is the worst method of imaging the kidneys and why?

Answer 24

X-ray - not going to get the best view of soft tissue (the kidneys) bc the x-rays won’t be absorbed

Question 25

Where are implanted kidney inserted into?

Answer 25

the iliac fossa

Question 26

How is the iliac fossa accessed?

Answer 26

via an incision over and parallel to the inguinal ligament vessels are anastomosed a ureterocystostomy is performed straight into bladder

Question 27

What vessels are anastomosed during a kidney transplant?

Answer 27

renal A+ V --- ext. iliac A + V

Question 28

What is it important to do when anastomosing vessels during a kidney transplant?

Answer 28

It is vital to tag which vessel is which

Question 29

What can be done to produce a useful kidney xray?

Answer 29

using a good contrast medium - a radiopaque substance that is excreted through the kidneys

Question 30

Why is it It is vital to tag which vessel is which during a kidney transplant?

Answer 30

to prevent (de)oxygenated blood mixing which will cause harmful effects for the kidney

Question 31

Why are vessels in the iliac fossa anastomosed?

Answer 31

to connect them to the transplanted new kidneys

Question 32

What percentage of kidney functionality is required before any issues are seen?

Answer 32

50% of one kidney only

Question 33

What is the most prevalent organ to suffer malformations?

Answer 33

the kidneys

Question 34

What are the different types of kidney malformations?

Answer 34

``` bi / uni lateral renal agenesis Supernumerary kidneys Renal fusion (horseshoe kidney) Ectopic kidney Simple / polycystic kidney ```

Question 35

What blood vessel will prevent a horseshoe kidney from ascending to its anatomical position in the upper abdomen?

Answer 35

Inferior mesenteric artery

Question 36

What structure is supplied by the Inferior mesenteric artery?

Answer 36

the LI

Question 37

What are the adrenal glands otherwise known as?

Answer 37

the suprarenal glands

Question 38

What shape is the Right adrenal gland?

Answer 38

pyRamidal

Question 39

What shape is the Left adrenal gland?

Answer 39

semiLunar

Question 40

What is the internal anatomy of the adrenal glands?

Answer 40

Cortex | Medulla

Question 41

What does the adrenal gland cortex secrete?

Answer 41

``` Corticosteroids (e.g. cortisol) Sex hormones (e.g. progesterone) ```

Question 42

What does the adrenal gland Medulla secrete?

Answer 42

Adrenaline (epinephrine)

Question 43

Why is the extensive blood supply to the adrenal gland functionally significant?

Answer 43

bc it's an endocrine gland - they produce hormones and circulate their products within the blood

Question 44

Why are the ureters muscular?

Answer 44

so that they can do a peristaltic movement to help move urine along

Question 45

How do kidney stones occur?

Answer 45

when calculi become lodged in the ureter preventing urine flow

Question 46

What are the three narrowest points of the ureters? (PiLB)

Answer 46

at the Pelviureteric junction when crossing iLiac vessels / pelvic brim when entering the Bladder

Question 47

How are kidney stones imaged?

Answer 47

plain film radiographs | CT Urography

Question 48

How are plain film radiographs used to image kidney stones?

Answer 48

they are highlighted as the soft tissue of the ureter is not generally visible on x-rays

Question 49

How is CT Urography used to image kidney stones?

Answer 49

CT utilising contrast medium to highlight the urine production and excretion

Question 50

What causes renal colic pain?

Answer 50

the peristaltic movement of the ureters trying to help pass and urine moving along the kidney stone bc it's a hard, stony structure

Question 51

What is the standard treatment for kidney stones?

Answer 51

Shock wave lithotripsy

Question 52

What is the difference between male and female urethras?

Answer 52

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

Question 53

What type of pain is renal colic pain?

Answer 53

Generally felt in waves, but can also be felt on the skin

Question 54

How does Shock wave lithotripsy work?

Answer 54

by pelting the kidney stones with sound waves to try and break them up, make them easier to pass

Question 55

What is an alternative treatment for kidney stones?

Answer 55

Laparoscopic surgery - minimally invasive

Question 56

When aren't diuretics and IV fluids commonly used to treat kidney stones?

Answer 56

bc they can make the pain worse if the stone is not easily passible depending on its size

Question 57

What are the four different parts of the male urethra going down?

Answer 57

pre-prostatic, prostatic | membranous, spongy

Question 58

What are the lengths of the male and female urethras?

Answer 58

m: 20-25cm f: ~4cm

Question 59

Which group is more likely to contract a UTI and why?

Answer 59

Females bc of the short length of the urethra

Question 60

What percentage of females will at some point suffer from a UTI?

Answer 60

50 to 60 %

Question 61

What spaces are included in extraperitoneal space?

Answer 61

``` retroperitoneal space (posterior) preperitoneal space (anterior) retropubic space (inferior) ```

Question 62

What arteries supply the adrenal glands?

Answer 62

suprarenal arteries (superior, inferior & middle)

Question 63

What veins supply the adrenal glands?

Answer 63

suprarenal veins

Question 64

What nerves supply the adrenal glands?

Answer 64

abdominopelvic (greater, less and least splanchnic)