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MIDS 127 > Retroperitoneum > Flashcards

Retroperitoneum Flashcards

1
Q

Where is the retroperitoneum space?

A

-Posterior to peritoneal
-Anterior to transversalis fascia

(extends from diaphragm to pelvic brim)

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2
Q

What does the retroperitoneum include?

A

-Diaphragmatic crura (tendon)
-Pancreas
-Distal CBD
-Duodenum
-Kidneys
-Adrenals
-AO/IVC
-SMA/SMV
-SA/SV
-HA
-Lymph vessels + nodes

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3
Q

Is u/s the gold standard?

A

No, CT is

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4
Q

What are the 3 spaces of the retroperitoneal?

A

-Anterior pararenal
-Perirenal/perinephric
-Posterior pararenal

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5
Q

Where is the anterior renal/gerota fascia?

A

Anterior to great vessels, kidneys + adrenals

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6
Q

Where is the posterior renal/zuckerkland fascia?

A

-Fuses with anterior laterally
-Posterior to kidney

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7
Q

How are fascial planes fused/unfused?

A

Fused: superiorly
Unfused: inferiorly

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8
Q

What does the anterior pararenal space include?

A

-Pancreas
-Distal CBD
-Duodenum
-Colon
-Fat

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9
Q

What does the perirenal/perinephric space include?

A

-Kidneys
-Adrenals
-Vessels (AO + IVC)
-Fat

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10
Q

What does the posterior pararenal space include?

A

-Only fat (no organs)

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11
Q

What is diaphragmatic crura?

A

Tendinous fibers that blend in with the anterior longitudinal ligament of the veretrbal column

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12
Q

Which crus is longer?

A

Right (also more lobular)

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13
Q

What are the functions of the lymphatic system?

A

-Collects plasma fluid that oozes
-Collects cellular debris + bacteria
-Absorbs + transports dietary fat

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14
Q

What is chyle cistern?

A

-Collecting area in mid-retroperitoneum
-Collects lymph from lower extremities + pelvis before ascending to thoracic duct

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15
Q

Where are parietal nodes found?

A

Surrounds great vessels
(in retroperitoneum)

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16
Q

Where are visceral nodes found?

A

Found at the hilum of organs
(in peritoneal)

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17
Q

Where are lacteal nodes found?

A

-Along small + mesentery
-Absorbs dietary fat

18
Q

Are normal retroperitoneal lymph nodes seen on u/s?

A

No, only if abnormally enlarged

19
Q

Are normal superficial lymph nodes seen on u/s?

A

Yes

20
Q

What do normal lymph nodes look like?

A

-Oval/almond shaped
-Echogenic central fatty hilum

(if not, then indicates malignancy)

21
Q

Which space m/c has the most amount of fat?

A

Perirenal space

(think b/c it can help identify the kidneys)

22
Q

Are perirenal fascia planes always visible?

A

No

23
Q

What does diaphragmatic crura look like?

A

-Hypoechoic structure
-Surrounded by hyperechoic tissue

24
Q

What does the quadratus lumborum + psoas muscles look like?

A

-Hypoechoic structures
-Echogenic linear fibers running along the length of it

25
Q

What is the m/c site for a fluid collection?

A

Anterior pararenal space

(b/c appendix, duodenum, colon + panc are close by)

26
Q

What does the echogenicity of blood look like with hematomas?

A

-Acute anechoic
-Echogenic when clots
-Hyperechoic as it ages

27
Q

What is the m/c cause of a lymphocele?

A

Iatrogenic from medical procedure

28
Q

When will a lymphocele develop?

A

10-21 days after surgery or up to 8 weeks after transplant

29
Q

What is the m/c cause of a urinoma?

A

Obstruction

(LABS: hematuria)

30
Q

Lightbulb for an abscess?

A

Increased WBC’s

31
Q

What is retroperitoneal fibrosis?

A

Chronic inflammation where tissue grows + surrounds the great vessels, ureters + lymphatics

(located in perinephric space or around ureters)

32
Q

What is the m/c cause of RP fibrosis?

A

Idiopathic

33
Q

What gender is RP fibrosis m/c in?

A

Men

34
Q

What do solid neoplasms usually involve?

A

Lymph nodes

35
Q

Lightbulb for lymphadenopathy?

A

Common in patiens with HIV/AIDS

36
Q

What indicates malignancy with enlarged lymph nodes?

A

-No fatty hilum*
-Round shape*
-Avascular areas
-Asymmetric cortical widening

37
Q

What is lymphadenitis?

A

-Enlarged, inflamed lymph nodes
-Has fatty hilum
-Has normal oval/almond shape

38
Q

Are primary neoplasms common?

A

Nope, m/c are metastases

39
Q

What is the m/c malignant neoplasm of the RP?

A

Liposarcoma

40
Q

What is the 2nd m/c malignant neoplasm of the RP?

A

Leiomyosarcoma

41
Q

Characteristics of liposarcomas?

A

-M/c men
-M/c malignant neoplasm
-Very large
-Poorly defined
-Anterior to spine + psoas muscles
-Anemia

42
Q

Characteristics of leiomyosarcomas?

A

-M/c women
-2nd m/c malignant neoplasm
-Has gas, necrosis + hemorrhage
-Well defined

MIDS 127 (14 decks)

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