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ABD Boards! > Retroperitoneam > Flashcards

Retroperitoneam Flashcards

1
Q

What is the peritoneum?

A

serous membrane that forms the lining of the abdominal cavity and covers most of the abdominal organs

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2
Q

What are the layers of the peritoneum?

A
  1. Parietal peritoneum: outer layer, lines abdominal cavity

2. Visceral Layer: inner layer, covers the abdominal organs

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3
Q

What is the space called between the two layers?

A

Peritoneal cavity

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4
Q

What are the compartments of the peritoneal cavity?

A
  1. Lesser Sac
  2. Greater Sac
  3. Pouch of Douglas
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5
Q

What is the Lesser Sac?

A
  • Space between the liver. pancreas, and stomach

- entrance to lesser sac is epiploic foramen

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6
Q

What is the Greater Sac?

A
  • rest of peritoneal cavity

- when imaging ascites with floating bowel, this is greater sacs

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7
Q

What is Pouch of Douglas?

A
  • Rectouterine Pouch
  • between uterus and rectum (females)
  • rectovesical space (males)
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8
Q

What are the Intraperitoneal structures?

A
  • stomach
  • jejunum
  • 1st part of duodenum
  • appendix
  • spleen
  • cecum
  • transverse sigmoid
  • rectum
  • liver
  • uterus
  • fallopian tubes
  • ovaries
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9
Q

What is the Retroperitoneum?

A

Posteriorly located compartment that lies between the transversalis fascia and the posterior parietal peritoneum

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10
Q

How many layers does Gerotas Fascia have?

A

2

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11
Q

What do the two layers of gerotas fascia divide into?

A
  1. anterior pararenal space
  2. perirenal space
  3. posterior pararenal space
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12
Q

Where do the kidneys and adrenal glands lie?

A

Perirenal space

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13
Q

What muscles lie posterior pararenal space?

A

Quadratus Lumborum and Psoas Muscles

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14
Q

What is the first major branch off of the aorta?

A

Celiac axis

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15
Q

What are the branches off of the celiac axis?

A
  1. Common hepatic artery
  2. Left gastric artery
  3. splenic artery
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16
Q

What branches off of the common hepatic artery?

A
  1. proper hepatic artery

2. Gastroduodenal artery (GDA)

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17
Q

What are the two branches off of the celiac axis?

A
  1. common hepatic artery

2. splenic artery

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18
Q

What vessels travels parallel to the aorta?

A

SMA

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19
Q

What are the Doppler waveforms for the SMA?

A
  • fasting state: High resistance

- Postprandial: Low resistance, increased velocity

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20
Q

Where do the renal arteries arise from aorta?

A

lateral walls of aorta just below the origin of the SMA

21
Q

Where does the RRA pass posterior to?

A

IVC

22
Q

What renal artery is shorter>

A

LRA

23
Q

Where does the IMA arise from aorta?

A

Anterior aspect of distal aorta

- with SMA and CA stenosis or occlusion is becomes enlarged

24
Q

Know about the IVC…..

A
  • right of Aorta and posterior pancreatic head
  • Dilates with cardiac failure and fluid overload
  • Tumor: Renal cell carcinoma
25
Q

What is the most common filter for the IVC?

A

Greenfield filter

- filters used to prevent ascent of lower extremity vein thrombus

26
Q

How are IVC filters placed?

A
  • catheters with entry at the femoral vein or internal jugular vein
27
Q

Know about hepatic veins…

A
  • right, middle, left

- drain into the IVC

28
Q

What is the “Nutcracker Syndrome”?

A

engorgement of the left renal vein due to its compression by the SMA and aorta

29
Q

Where do the gonadal veins drain into?

A

Left gonadal vein: LRV

Right gonadal vein: IVC

30
Q

What is retroperitoneal fibrosis?

A
  • Ormond’s disease or inflammatory aneurysm

- dense fibrous tissue proliferation confined to the paravertebral region

31
Q

What would a retroperitoneal fibrosis look like?

A
  • hypoechoic midline mass

- typically at aortic bifurcation

32
Q

What is retroperitoneal fibrosis associated with?

A
  • bilateral ureteral obstruction

- progressive loss of kidney function

33
Q

Where are the adrenal glands?

A
  • Right adrenal gland: triangle or pyramid. Superior, anterior and medial of upper pole of kidney
  • Left adrenal gland: crescent shaped located anteriomedial to upper pole
34
Q

What hormones does the adrenal cortex produce?

A
  • Mineralocorticoids (Aldesterone)
  • Glucocorticoids (Cortisol)
  • Androgens
35
Q

What are the adrenal cortical hormones regulated by?

A

Pituitary Gland

36
Q

What might tumors of the adrenal gland and anterior pituitary gland produce?

A
  • overproduce or underproduce ACTH and ACH
37
Q

What does the adrenal medulla produce?

A
  • epinephrine (Adrenalin)

- norepinephrine

38
Q

What is Cushings Syndrome?

A
  • excessive cortisol secretion
39
Q

What is Conn Syndrome?

A
  • primary aldosteronism

- excessive aldosterone secretion

40
Q

What is Hirsutism?

A
  • Overbundance hair

- caused by excessive androgen production

41
Q

Know about Adrenal Cortical Carcinoma…

A
  • Majority of patients produce with Cushings syndrome
  • Rare tumor > Poor prognosis
  • Invade Renal veins and IVC
42
Q

What is a Pheochromocytoma?

A
  • originate from adrenal medulla
  • occur along nerve chain
  • majority > benign
43
Q

What do Pheochromocytoma secrete?

A

Norepinephrine

Epinephrine

44
Q

Know about Adrenal Neuroblastoma…

A
  • malignant tumor arising from sympathetic nervous system
  • Palpable mass
  • Most common adrenal mass in infancy and childhood
  • increase in blood and urine catecholamines
  • Metastatic disease
45
Q

What is a Myelolipoma?

A
  • benign, nonfunctioning adrenal masses that contain fat, bone elements
  • hyperechoic masses in adrenal bed
  • Artifact: Propagation speed artifact
46
Q

What is Adrenal Lymphoma?

A

Adrenal involvement with lymphoma is common and frequently bilateral

  • Diffuse, hyperplasia or mass like
  • Non-Hodgkin disease is most common cell type
47
Q

Know about Adrenal Mets…

A
  • 4th common metastatic site after lungs, liver and bone

- most common sites: lung, breast, skin, kidney, thyroid, and colon cancers

48
Q

What is a Adrenal Hemorrhage?

A
  • most common in neonate

- large size of the neonatal adrenals and their high degree of vascularity which makes them vulnerable to birth trauma

49
Q

What is the most common adrenal mass in newborn?

A

Adrenal Hemorrhage

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