Peritoneum & Retroperitoneal

Question 0

Kidneys lie in

Answer 0

Perirenal space

Question 1

Striated hypo post to kidneys

Answer 1

Quadratus lumborum

Question 2

Peri aorta several hypo meas > 2 cm adj to the celiac trunk and SMA. Most likely

Answer 2

Para aortic lymph nodes

Question 3

Ab pain, inc serum amylase, fluid pocket in left pararenal space. Most likely

Answer 3

Pancreatic pseudocyst

Question 4

Suspect retroperitoneal fibrosis. What structure image

Answer 4

Aorta

Question 5

See lymph nodes adj to Abd aorta. Should include

Answer 5

Diameter meas of each lymph node

Question 6

Patient has pheochromocytoma. Evaluate

Answer 6

Adrenals

Question 7

Hx of lung cancer. MC mets from lung is ___ evaluate

Answer 7

Adrenals

Question 8

Right adrenal gland location

Answer 8

Post to IVC

Question 9

Looking for lymphadenopathy search

Answer 9

Splenic hilum, porta hepatis, renal hilum, and para aortic area

Question 10

Striated posterior medial to kidney

Answer 10

Psoas muscle

Question 11

Differentiating renal vs adrenal mass

Answer 11

Scan patient during deep inspiration and expiration. Adrenals are fixed. Kidneys will move.

Question 12

Simulates adrenal mass

Answer 12

Thick diaphragmatic crus
Accessory spleen
Gastric Diverticulum
Retroperitoneal lymphadenopathy

Question 13

Anatomic relationship of left adrenal gland

Answer 13

Lateral to the Abd aorta and diaphragmatic crus

Question 14

Location of right diaphragmatic crus

Answer 14

Posterior to ivc and right renal artery

Question 15

Criteria asses Nodular disease

Answer 15

Only lymph nodes meas > 1 cm are abnormal

Question 16

Palp mass post renal tx anechoic mass with multiple septations lateral to midline

Answer 16

Lymphocele

Question 17

Retroperitoneal compartment contain no solid organs

Answer 17

Posterior pararenal space and retrofascial space

Question 18

Retroperitoneal compartment containing psoas and quadratus lumborum muscles

Answer 18

Retrofascial space

Question 19

Retroperitoneal compartment mc involved with pseudocyst

Answer 19

Anterior pararenal space

Question 20

Retroperitoneal compartment contains aorta

Answer 20

Anterior pararenal space

Question 21

Greater sac

Answer 21

Diaphragm to pelvis

Question 22

Lesser sac

Answer 22

Behind stomach

Question 23

Peritoneum

Answer 23

Parietal layer: lines cavities

Visceral layer: lines organs

Question 24

Mesentery

Answer 24

Attached sm intestine to abdominal wall

Question 25

Greater and lesser omentum

Answer 25

Attaches stomach and duodenum

Question 26

Spaces (where fluid can collect)

Answer 26

``` Rt & Lt subphrenic space Perihepatic Rt sub hepatic (morrisons pouch) Lt subhepatic (lesser sac and gastro hepatic recess) Perinephric space Paracolic gutters 4 Pelvic CDS (retrovesicle space) ```

Question 27

Ligaments

Answer 27

Double folds of peritoneum Falciform, coronary, lt triangular, Ligamentum teres, lig venosum, lesser omentum

Question 28

Hernia

Answer 28

Defect in Abd wall, protrusion of contents, bowel peristalsis

Question 29

Retroperitoneum

Answer 29

From diaphragm to pelvic floor Contains: kidneys, adrenals, great vessels, pancreas, duodenal sweep, asc & desc colon, abd lymph nodes, somatic nerves, Prostate, uterus, bladder

Question 30

Retroperitoneal spaces

Answer 30

Anterior pararenal space Perirenal space Posterior pararenal space

Question 31

Lymphadenopathy

Answer 31

Floating aorta sign: nodes post to aorta elevate aorta and appears floating Sandwich sign: nodes ant and post to aorta Donut ring sign: all around aorta Sonographic silhouette: nodes ant to aorta attenuate beam and can't see ant wall of aorta

Question 32

Retroperitoneal tumors

Answer 32

Primary tumors rare, usually mets Can grow big before detected Lymphoma, liposarcoma, leiomyosarcoma, teratoma, fibrosarcoma, myxosarcoma, Rhabdomyosarcoma

Question 33

Benign tumors

Answer 33

Lipomas, sarcomas, fibromas, myxomas, teratomas, neurofibromas

Question 34

Teratoma

Answer 34

Retroperitoneal 4th MC site

Question 35

Retroperitoneal fibrosis

Answer 35

Fibrous tissue forms a hypo mass that blocks the ureters and causes hydronephrosis. Hypo mass. Lower sacral region. Assoc with aortic aneurysm

Question 36

Cystic masses

Answer 36

Abscess, hematomas, urinomas, lymphocele

Question 37

Fibrosarcoma US

Answer 37

Hyperechoic, complex