Retroperitoneal organs of the posterior abdominal wall Flashcards
What is the retroperitoneal space?
A space within the abdominopelvic cavity
“Retro” refers to “behind”
-Whereas “intra” means “within”
Where is the retroperitoneal space?
The space is posterior to the parietal peritoneum
What are primary and secondary retroperitoneal structures?
- Primary develop in the retroperitoneally
- Secondary develop intraperitoneally and then become retroperitoneal
What are the retroperitoneal structures?
Which portions of the colon are retroperitoneal?
A.Ascending
B.Descending
C.Ileum
D.Jejunum
E.Transverse
A.Ascending
B.Descending
Secondary retroperitoneal
What is the urinary system?
Where are the kidneys?
Located on the posterior abdominal wall
Span from T12 - L3
What are the kidneys responsible for?
- Regulating blood:
- ionic composition & pH
- volume & pressure
- Hormone production (e.g. calcitriol)
- Excretion of waste
Kidneys recieve ~___% of cardiac output
20
What are the 2 regions of the kidney?
- Cortex - Glomerulus
- Medulla - Collecting ducts
What happens in the kidney?
Blood is filtered at the glomerulus
Selective absorption of ions and water occurs
Urine is then passed into the ureters
Lable the internal anatomy of the kidney
How are kidneys imaged?
Contrast radiography, CT or MRI needed
-Due to soft tissues
What muscles are labelled?
What is renal pain caused by?
- Stretching capsule, due to increased internal pressure
- Spasm of smooth muscle of the renal pelvis
Where is renal pain felt?
Renal pain is generally referred to the cutaneous area of T12
-Territory of the subcostal nerve
Where is renal pain felt?
How is a renal transplant performed?
Fairly common surgical procedure - Video
The implanted kidney is inserted into iliac fossa
-Accessed via an incision over and parallel to the inguinal ligament
The vessels are then anastomosed:
- Renal artery to external iliac artery
- Renal vein to external iliac vein
It is vital to tag which vessel is which
A ureterocystostomy is then done straight into bladder
Kidneys are the most prevalent organ to suffer _________
Kidneys are the most prevalent organ to suffer malformations
What malformations can kidneys cause?
- Bilateral/Unilateral renal agenesis
- Supernumerary kidneys
- Renal fusion
- Ectopic kidney
- Simple/polycystic kidney
Label the kidney malformation and the types shown
Label the types of kidney malformation
What blood vessel will prevent a horseshoe kidney from ascending to its anatomical position in the upper abdomen?
A.Coeliac trunk
B.Gonadal vein
C.Inferior mesenteric artery
D.Superior mesenteric artery
E.Umbilical vein
C.Inferior mesenteric artery
What are the suprarenal/adrenal glands?
Supra = above
Separate from kidneys in own fascial compartment
Shape:
Right - pyramidal
Left - semilunar
What is the internal anatomy of the adrenal glands?
- Cortex:
- Corticosteroids (e.g. cortisol)
- Sex hormones (e.g. progesterone)
- Medulla:
- Adrenaline (epinephrine)
Label the diagram
What is the neurovascular supply to the adrenal glands?
- Sup., Mid. & Inf. suprarenal arteries
- Suprarenal veins
- Abdominopelvic n. (greater, less and least splanchnic)
Why is the extensive blood supply to the adrenal gland functionally significant?
A.Close relation to the abdominal aorta
B.Close relation to the kidneys
C.High metabolic rate
D.It is an endocrine gland
Removal of damaged red blood cells
D.It is an endocrine gland
What are the ureters?
Muscular tubes to convey urine to the bladder
How do kidney stones form?
Calculi can become lodged in the ureter preventing urine flow.
The three narrowest points are:
- Pelviureteric junction
- Crossing iliac vessels/pelvic brim
- entering bladder
What is circled in red?
Calculi can become lodged in the ureter preventing urine flow.
The three narrowest points are:
- Pelviureteric junction
- Crossing iliac vessels/pelvic brim
- entering bladder
(circled in red)
Can kidney stones be seen on imaging?
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.
Whats the diagnosis?
How can CT urography be used?
-CT utilising contrast medium to highlight the urine production and excretion
What are the causes of renal colic?
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 on the skin
What is the standard treatment for kidney stones?
A.Diuretics
B.IV fluids
C.Laparoscopic surgery
D.Pain management
E.Shock wave lithotripsy
E.Shock wave lithotripsy
What is the bladder?
The bladder is the distensible muscular sac which acts as a reservoir for urine
What is the urethra?
The urethra is the muscular duct which conveys urine from the bladder to the external environment
What are the 2 differences between male and female urethras?
- Length differs greatly between males and females
- It also serves a reproductive purpose in males
Which group is more likely to contract a urinary tract infection (UTI)?
A.Children
B.Females
C.Males
D.Smokers
Under 30s
B.Females
Which structures pass through the hilum of the kidney?
the renal vein and artery
accompanying autonomic nerves and lymphatics
pelvis of the ureter
