retroperitoneal organs of the posterior abdominal wall

Question 1

what is the retroperitoneal space? 2

Answer 1

• a space within the abdominopelvic cavity

- posterior to the parietal peritoneum

Question 2

describe the retroperitoneal organs and structures? 11

Answer 2

• primary structures develop retroperitoneally
• secondary develop intraperiotneally and then become retroperitoneal
• Pancreas
• Esophagus
• Aorta and IVC
• Rectum
• Duodenum
• Ureter
• Colon (transverse)
• Kidneys
• Suprarenal glands

Question 3

describe the urinary system? 4

Answer 3

• Produces and excretes urine
• Spans the kidneys to the urethra
• Kidneys and ureter and retro
• Bladder and urethra are extraperitoneal

Question 4

where are the kidneys located? 2
what are they responsible for? 3
cardiac output?

Answer 4

• posterior abdominal wall
• span from t12- L3
• regulating blood, ionic composition and pH, volume and pressure
• hormone production
• excretion of waste
• receive around 20%

Question 5

describe the internal anatomy of the kidneys? 5

Answer 5

• there are 2 regions
• cortex- glomerulus
• medulla- collecting ducts
• blood is filtered at the glomerulus, selective reabsorption of ions and water then occurs
• urine is passed to the ureters

Question 6

what is the minor calyx?

Answer 6

• collects the urine from the pyramids

Question 7

what is the major calyx? 2

Answer 7

• formed from the coming together of minor calices

- 2-3 per kidney

Question 8

what is the renal hilum?

Answer 8

• passageway for vessels and ureter

Question 9

what is the renal pelvis?

Answer 9

• the coming together of major calices

Question 10

what is the ureter?

Answer 10

• once pelvis narrows and wall thickens

Question 11

describe renal imaging? 2

Answer 11

• axial views are important to understand cynical application
• contrast radiography, CT or MRI needed due to soft tissues

Question 12

describe renal pain? 2

Answer 12

• generally caused by stretching capsule due to increased internal pressure and spasm of smooth muscle of the renal pelvis
• renal pain is generally referred to the cutaneous area of T12 which is the territory of the subcostal nerve

Question 13

describe a renal transplant? 4

Answer 13

• fairly common surgical procedure
• the implanted kidney is inserted into the iliac fossa and is accessed via an incision over and parallel to the inguinal ligament
• the vessels are then anastomosed: the renal artery to the external iliac artery and the renal vein to the external iliac vein. it is vital to tag which vessel is which
• a ureter cystotomy is then done straight into the bladder

Question 14

describe kidney malformations? 6

Answer 14

• Kidneys are the most prevalence organ to suffer malformations
• Bilateral/ unilateral renal agenesis
• Supernumerary kidneys
• Renal fusion
• Ectopic kidney
• Simple/ polycystic kidney

Question 15

describe the suprarenal/ adrenal glands? 8

Answer 15

• Separate from kidneys in own fascial compartment
• Right= pyramidal
• ## Left= semilunarInternal anatomy:
• Cortex: corticosteroids (cortisol), sex hormones (progesterone)
• Medulla: adrenaline
• .
• Neurovascular supply:
• Superior, mid and inferior suprarenal arteries
• Suprarenal veins
• Abdominopelvic nerves (greater, less and least splanchnic)

Question 16

describe the ureters? 8

Answer 16

• Muscular tubes to convey urine to the bladder
• Kidney stones can occur here
• Calculi can become lodged in the ureter preventing urine flow
• The three narrowest points are:
• Pelviureteric junction
• Crossing iliac vessels/ pelvic brim
• Entering the bladder

Question 17

how can kidney stones be seen? 4
what do they cause?
how are they treated?

Answer 17

• Can be seen on plain film radiographs
• Highlights the kidney stones as the soft tissue of the ureter is not generally visible on x-rays
• CT urography is also a useful method
• CT utilising contrast medium to highlight the urine production and excretion
• Cause of renal colic- pain caused by peristaltic movement of ureters trying to move the stone, generally felt in waves, but can also be felt in the skin
• Standard treatment is shock wave lithotripsy

Question 18

describe the bladder and the urethra? 4

Answer 18

• The bladder is the distensible muscular sac which acts as a reservoir for urine
• The urethra is the muscular duct which conveys urine from the bladder to the external environment
• Length differs greatly between males and females
• It also serves a reproductive purpose in males