Retroperitoneal organs of the posterior abdominal wall

Question 1

What are the contents of the retroperitoneum?

Answer 1

Pancreas, Duodenum, Esophagus, Ureter, Aorta & IVC, Colon, Rectum, Kidneys, Suprarenal glands.

Question 2

Can you remember the mnemonic for the contents of the retroperitoneum?

Answer 2

PEAR DUCKS (Pancreas, Duodenum, Esophagus, Ureter, Aorta & IVC, Colon, Rectum, Kidneys, Suprarenal glands).

Question 3

What additional structures are found in the retroperitoneum besides the mnemonic “PEAR DUCKS”?

Answer 3

Nerves, Lymphatics.

Question 4

Can you remember the mnemonic for the additional structures in the retroperitoneum?

Answer 4

SAD PUCKER (Suprarenal glands, Arteries, Diaphragm, Pancreas, Ureters, Colon, Kidneys, Esophagus, Rectum).

Question 5

What is the Transpyloric Plane?

Answer 5

It is an imaginary horizontal plane passing through the lower border of the pylorus of the stomach, which corresponds to the L1 vertebra level.

Question 6

What are the anterior relationships of the kidneys?

Answer 6

12th Rib, Area for diaphragm, Area for Q. lumborum, Area for psoas.

Question 7

What are the posterior relationships of the kidneys?

Answer 7

12th Rib, Area for diaphragm, Area for Q. lumborum, Area for psoas, 11th Rib, Aorta, IVC.

Question 8

What are the fascia and coverings of the kidneys?

Answer 8

The kidneys are surrounded by renal fascia, which consists of an anterior layer (Gerota’s fascia) and a posterior layer.

Question 9

What is the blood supply to the kidneys?

Answer 9

The blood supply to the kidneys involves the renal arteries. The renal artery gives rise to anterior and posterior divisions, followed by segmental arteries, interlobar arteries, arcuate arteries, interlobular arteries, afferent arterioles (capillary network of glomerulus), efferent arterioles (supplying the outer 2/3rd of the cortex forming peritubular network), and vasa recta (supplying oxygenated blood to the inner 1/3rd of the cortex and medulla).

Question 10

What are the branches of the renal artery supplying the kidneys?

Answer 10

Superior, Posterior, and Anterior branches.

Question 11

What are the surfaces of the kidneys where the blood supply is located?

Answer 11

Superior, Anterior, and Inferior surfaces.

Question 12

What is Brödel’s line in relation to the kidneys?

Answer 12

Brödel’s line is a horizontal line on the posterior surface of the kidney that represents the approximate level of the renal artery and vein.

Question 13

How do the kidneys drain venously?

Answer 13

The kidneys have venous drainage through the renal veins.

Question 14

What are the components of the prevertebral plexus that supply the kidneys?

Answer 14

Coeliac plexus, Aortic plexus, Superior hypogastric plexus, Inferior hypogastric plexus, Preganglionic sympathetic and visceral afferents from thoracic and lumbar splanchnic nerves, Preganglionic parasympathetic and visceral afferent fibers from the Vagus nerve, Preganglionic parasympathetic fibers from pelvic splanchnic nerves.

Question 15

What is the parasympathetic nerve supply to the kidneys?

Answer 15

Vagus nerve and pelvic splanchnic nerves (S2-4).

Question 16

What is the sympathetic nerve supply to the kidneys?

Answer 16

Lesser splanchnic nerves (T10-L2), Least splanchnic nerves (T10-L2), Lumbar splanchnic nerves (L1-2).

Question 17

What are the sources of visceral afferents for the kidneys?

Answer 17

Parasympathetic: Vagus nerve and pelvic splanchnic nerves (S2-4).
Sympathetic: Lesser splanchnic nerves (T10-11), Least splanchnic nerves (T12), Lumbar splanchnic nerves (L1-2).

Question 18

What is the location of renal and ureteric pain?

Answer 18

Kidney pain is typically referred to the lower hypochondrium or lumbar region (T10-L2). Ureteric pain may radiate from the T11-L2 region to the inguinal region and groin.

Question 19

What are the lymph nodes involved in the lymphatic drainage of the kidneys?

Answer 19

Internal iliac, External iliac, Common iliac, Pre-aortic, Right and Left para-aortic, Cysterna Chylii, Thoracic Duct.

Question 20

What are some common kidney malformations?

Answer 20

Bilateral/unilateral renal agenesis, Supernumerary kidneys/ureters, Renal fusion (Horse-shoe kidneys), Ectopic kidney, Simple/polycystic kidney.

Question 21

What is the significance of kidney malformations in applied anatomy?

Answer 21

Kidney malformations are common and can have clinical implications in terms of renal function, urinary tract complications, and associated conditions.

Question 22

Where are the adrenal glands (suprarenal glands) located?

Answer 22

The adrenal glands are located on top of the kidneys.

Question 23

What are the internal structures of the adrenal glands?

Answer 23

The adrenal glands have two main structures: the cortex and the medulla.

Cortex: It produces corticosteroids (such as cortisol and aldosterone) and adrenal androgens.
Medulla: It produces adrenaline (epinephrine).

Question 24

What is the nerve supply to the adrenal glands?

Answer 24

The adrenal glands receive sympathetic innervation from preganglionic fibers originating from T8-L1 spinal levels, specifically from the greater, lesser, and least splanchnic nerves.

Question 25

What is the relationship between the adrenal glands and the kidneys?

Answer 25

The adrenal glands are located on top of the kidneys, with the right adrenal gland situated slightly superior and posterior to the right kidney, and the left adrenal gland positioned superior and medial to the upper pole of the left kidney.

Question 26

What are the key components of the internal structure of the kidneys?

Answer 26

The kidneys consist of the renal cortex and renal medulla.

Question 27

What is the structure of a nephron?

Answer 27

A nephron is the functional unit of the kidney. It consists of a renal corpuscle (glomerulus and Bowman’s capsule) and renal tubules (proximal convoluted tubule, loop of Henle, and distal convoluted tubule).

Question 28

What are the key features of the urinary bladder anatomy?

Answer 28

The urinary bladder is highly distensible. Its key features include the body, base, apex, neck, and trigone. The lining of the bladder is composed of transitional cell epithelium

Question 29

What is the blood supply to the ureter?

Answer 29

The ureter receives its blood supply from various sources, including branches of the renal artery, gonadal arteries, and common iliac arteries.

Question 30

What is the structure and function of the urethra?

Answer 30

The urethra is a muscular duct that transports urine from the bladder to the outside of the body. In females, it is shorter and opens in the perineum. In males, it is longer and also serves a reproductive purpose in ejaculation. The male urethra is divided into pre-prostatic, prostatic, membranous, spongy, and navicular fossa parts.

Question 31

What are the different components of the innervation of the lower urinary tract?

Answer 31

The innervation of the lower urinary tract involves parasympathetic effects (contracting detrusor muscle, vasodilation, penile erection), sympathetic effects (relaxing detrusor muscle, vasoconstriction, ejaculation), and visceral afferents (sensory input).

Question 32

What are the sites of ureteric obstruction?

Answer 32

Ureteric obstruction can occur at various sites along the ureter. Some common sites include:

Ureteropelvic junction (UPJ) obstruction: Narrowing or blockage at the junction between the renal pelvis and the ureter.
Ureterovesical junction (UVJ) obstruction: Narrowing or blockage at the junction between the ureter and the bladder.
Mid-ureteral obstruction: Narrowing or blockage in the middle portion of the ureter.
Distal ureteral obstruction: Narrowing or blockage near the ureterovesical junction or as the ureter enters the bladder.

Question 33

What are the possible causes of ureteric obstruction?

Answer 33

Ureteric obstruction can be caused by various factors, including:

Kidney stones or ureteral stones
Tumors or masses in the urinary tract
Urinary tract infections
Congenital abnormalities
Scar tissue or strictures
Blood clots
External compression due to nearby structures or organs
Inflammation or swelling

Question 34

What are the clinical symptoms of ureteric obstruction?

Answer 34

Ureteric obstruction can present with symptoms such as:

Flank or abdominal pain
Hematuria (blood in urine)
Decreased urine output or difficulty urinating
Urinary tract infections
Hydronephrosis (enlargement of the kidney due to backup of urine)
Fever or chills (if associated with infection)

Question 35

How is ureteric obstruction diagnosed?

Answer 35

Diagnosis of ureteric obstruction may involve various methods, including:

Imaging studies such as ultrasound, CT scan, or MRI
Urine analysis to check for blood or infection
Urodynamic studies to assess urinary flow and function
Cystoscopy to visualize the ureter and bladder
Ureteroscopy or retrograde pyelography for direct visualization and assessment