Retroperitoneal organs of the posterior abdominal wall Flashcards
Peritoneal cavity
Space between the parietal peritoneum and visceral peritoneal.
Retroperitoneal space
Several small spaces in the abdominal cavity- behind the peritoneum.
The spaces are behind the kidneys
Intraperitoneal organs
Organs in the abdominal cavity completely enclosed by visceral peritoneum.
Examples:
- Liver
- Stomach
- Spleen
- Transverse colon
- Small intestines.
Retroperitoneal organs
Organs in the abdominal cavity that have mesentery/peritoneum over its anterior surface only.
Primary retroperitoneal- developed in retroperitoneal space:
- Aorta
- IVC.
- Kidneys and adrenal galnds
Secondary retroperitoneal- started off developing intraperitoneal, then moved to retroperitoneal space:
- Pancreas
- Duodenum
- Ascending and descending colon.
Retroperitoneal urinary organs
Kidneys
Ureter
Urinary bladder
Location of the kidneys:
- Posterior
- Muscles around it
- Superior and inferior pole
- Right to left comparison
Posterior
- Posterior abdominal wall
Posterior abdominal wall muscles around it:
- Diaphragm, superior.
- Psoas major, medial
- Quadratus lumborum, posterior.
Superior pole:
- T12
Inferior pole:
- L3
Right is slightly lower because of the liver
Organs of the right kidneys
Right adrenal glands
Liver
Right colic flexure
Duodenum
Organs of the left kidneys
Left adrenal gland
Stomach
Spleen
Pancreas
Left colic flexure
Jejum
Cortex
Outer layer of the kidney.
- Contains glomeruls
Medulla
Middle layer of the kidney.
- Contains collecting ducts and forms renal pyramids.
Renal parenchyma
The functional part of the kidneys:
- Cortex and renal pyramid
Renal pelvis
Part of the kidney which urine exists—> forms the ureter
VAN of the kidney
Renal artery- connects to the aorta just below superior mesenteric artery.
Renal vein- connects to inferior vena cava.
- Usually anterior to renal artery
Nervous supply:
Renal plexus
Renal plexus
Nervous supply of the kidneys.
Enters the kidneys with the arterial branches
Functions of the kidney
Regulate ionic composition of the blood
Regulates blood pH
Regulations blood volume and pressure
Produces hormones
Excretes waste
Adrenal cortex
Outer layer of the adrenal glands.
Produces mainly two types of hormones
- Corticosteriods [cortisol]
- Sex hormones [progesterone]
Adrenal Medulla
The core of the adrenal glands.
Produces adrenaline
Vessels of the adrenal glands
Suprarenal arteries and veins
Arteries branch from aorta, renal artery and phrenic arteries
Nerves of adrenal glands
Abdominopelvic: greater, lesser and least splanchnic
Blood supply of ureter
Branches of:
- Renal artery
- Aorta
- Iliac artery
3 likely constrictions in the ureter from kidney stones
Ureteropelvic junction: just leaving kidney
Crossing the iliac vessels at the pelvic brim
Entering the bladder.
Bladder and urethra
Bladder: Inverted pyramid with the urethra at apex.
Urethra
- Exit of urine out of the body
- Much longer in men that women
- Both reproductive and urinary in males
- Passes under pubic symphysis and crosses the pelvic floor muscles to reach genitals.
Kidney protection
Perirenal fat cushions kidneys.
- Fat between renal fascia and capsule
Renal pain
Stretching of the capsule is sensed by afferent fibers in renal plexus.
- Follows least splanchnic nerve to the sympathetic trunk
Pain referred to T12- subcostal nerve.
Renal colic
Peristaltic waves felt from ureter trying to pass a kidney stone.
Felt at T11-T12.
Can spread to the CNS and cause nausea.
Renal transplatation
Kidney is transplanted into the iliac fossa- easy to access.
The incision is done parallel and above the lingual ligament.
Renal artery connect to external iliac artery.
Renal vein connected to external iliac vein.
Ureter is inserted straight into the bladder- ureterocystostomy
Kidney malformations
Bilateral or unilateral renal agenesis- no kidney
Supranumery kidneys
Renal fusion
Ectopic kidney
Simple/ polycystic kidney
