Retroperitoneum Flashcards
This is the serous membrane that forms the lining of the abd cavity and covers most of the abd organs.
peritoneum
Name the two layers of the peritoneum.
parietal and visceral
This is the space between the parietal and visceral peritoneum containing serous fluid.
the peritoneal cavity
T/F? In males, the peritoneal cavity is completely closed.
true
The peritoneal cavity is ___ and essentially ___ to the outside environment.
sterile, closed
T/F? In females, the peritoneal cavity is completely closed.
FALSE, there is a communication between the cavity and the outside via the fallopian tubes.
Name the two compartments of the peritoneal cavity.
lesser sac and greater sac
This is the space that is situated between the liver, pancreas, and stomach. The entrance is the epiloic foramen.
lesser sac
The is the space that is situated around the bowel and lower organs.
greater sac
This is a posterior compartment that lies between the transversalis fascia and the parietal peritoneum.
retroperitoneum
This is the connective tissue that circles the inner abd.
transversalis fascia
The superior border of the retroperitoneum is the…
diaphragm.
The inferior border of the retroperitoneum is the…
pelvic rim.
The anterior border of the retroperitoneum is the…
parietal peritoneum.
The posterior border of the retroperitoneum is the…
posterior abd wall muscles.
The lateral border of the retroperitoneum is the…
transversalis fascia and peritoneal portions of the mesentery.
Name the three spaces within the retroperitoneum.
perirenal space, anterior pararenal space, and posterior pararenal space
What connective tissue divides the retroperitoneum into its three spaces?
Gerota’s (renal) fascia
Kidneys and adrenals lie within the ___ space of the retroperitoneum.
perirenal
The perirenal space is separated from the pararenal spaces by the…
anterior and posterior renal (Gerota’s) fascia.
This is the fat area between the peritoneum and Gerota’s fascia.
anterior pararenal space
This is the space between Gerota’s fascia and the posterior abd wall muscles.
posterior pararenal space
SAD PUCKERS is the acronym for what now?
The organs in the retroperitoneum
What does SAD PUCKERS stand for?
Suprarenal Ao/IVC Duodenum Pancreas Ureters Colon Kidneys Esophagus Rectum SMV
These muscles lie in the pararenal space, separated by the transversalis fascia.
psoas and quadratus lumborum muscles
This retroperitoneal condition presents as a dense fibrous tissue proliferation confined to the paravertebral region.
retroperitoneal fibrosis, Ormond’s disease, or inflammatory aneurysm
Where along the aorta does Ormond’s disease tend to appear?
at the bifurcation
Sonographically, this retroperitoneal condition appears as a hyperechoic midline mass.
retroperitoneal fibrosis
This retroperitoneal condition is associated with bilateral ureteral obstruction as it envelopes structures rather than displace them.
retroperitoneal fibrosis
This is the most likely complication of retroperitoneal fibrosis.
hydronephrosis
What causes most cases of retroperitoneal fibrosis?
idiopathic
The adrenal glands are ___ to the kidneys.
anterior, medial, and superior
These are the smallest paired organs found in the abdomen.
adrenal glands
How can we differentiate between adrenal masses and renal masses during an u/s exam?
They will separate during deep inspiration and in the upright position.
Which adrenal gland is shaped like a triangle or pyramid?
right
Which adrenal gland is shaped like a cresent?
left
This part of the adrenal gland is hypoechoic and typically less echogenic than the surrounding retroperitoneal fat.
cortex
This is the echogenic linear structure within the adrenal gland.
medulla
What percentage of the adrenal gland is cortex?
90%. Which makes the medulla 10%.
What three arteries supply each adrenal gland?
suprarenal branch of the inferior phrenic artery, suprarenal branch of the aorta, and suprarenal branch of the renal artery
Which veins drain the adrenal glands?
the right suprarenal vein (drains into the IVC) and the left suprarenal vein (drains into the left renal vein)
What kind of hormones does the cortex produce?
steroids
What kind of steroids does the adrenal cortex produce?
mineralocorticoids (aldosterone)
glucocorticoids (cortisol)
androgens (gonadal hormones)
What do mineralocorticoids do?
Help maintain the body’s fluid & electrolyte balance
What do glucocorticoids do?
Modify the body’s response to inflammation
The adrenal cortical hormones (ACH) are regulated by the ___ hormones of the ___ gland.
adrenocorticotropic, anterior pituitary
The adrenal gland and the anterior pituitary gland function together to…
regulate hormone production.
Which hormones does the adrenal medulla produce?
epinephrine and norepinephrine
Indications for an adrenal u/s:
- tachycardia
- severe anxiety
- HTN
- Abd distention
- sweating
- weight loss
- diabetes mellitus
- eval of a previously seen mass
This adrenal condition is rare, usually unilateral, and asymptomatic.
adrenal cysts
Sonographically, this adrenal condition appears in the typical cystic pattern and may calcify or hemorrhage.
adrenal cysts
This is a benign adrenal cortical mass, usually asymptomatic or elevated adrenal hormones.
adrenal adenoma
Adrenal hyperplasia, adenomas, or adenocarcinomas are tied to…
adrenal cortical hyperfunctioning.