Retroperitoneum Flashcards

1
Q

the retroperitoneal space is the area between

A

posterior portion of the parietal peritoneum and the posterior abdominal wall muscles

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2
Q

What are the 3 categories of the retroperitoneum

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

Layers - anatomy of the retroperitoneum picture

A

Transversalis fascia
Lateralconal fascia
Parietal peritoneum
Extraperitoneal space

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4
Q

structures within the anterior pararenal space

A

pancreas
duodenal sweep
ascending & descending colon
rectum

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5
Q

structures within the perirenal space

A

adrenal glands
kidneys
ureters
ao
ivc

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6
Q

structures within the posterior pararenal space

A

blood and lymph

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7
Q

which adrenal gland is more superior to the kidney?
which one is more medial to the kidney?

A

right adrenal = more superior
left adrenal = more medial

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8
Q

what is zonal anatomy of the retroperitoneum used for?

A

describe injuries and facilitate management of the injuries

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9
Q

how many zones of the retroperitoneum

A

3

zone 1 - cetromedial
zone 2 - lateral
zone 3 - pelvic

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10
Q

zone 1 - centromedial

A

great vessels
pancreas
duodenum

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11
Q

zone 2 - lateral

A

kidneys
renal vessels
ureters
ascending colon
descending colon
colic flexures

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12
Q

zone 3 - pelvic

A

whole pelvis
pelvic walls
rectosigmoid colon
iliac vessels
genitals

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13
Q

adrenal glands size

A

3-6cm long x 3-6mm thick x 2-4 cm wide

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14
Q

what do the adrenal glands produce?

A

hormones that help regulate metabolism, immune system, blood pressure, response to stress and other essential functions

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15
Q

where is the adrenal cortex

A

outer region and largest part

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16
Q

what are the three zones of the adrenal cortex & their hormones

A

zona glomerulosa - aldosterone
zona fasciculate - cortisol
zona reticularis - dhea and androgenic steroids

17
Q

cortisol & hydrocortisone

A

cortex:

times of stress
controls many things:
blood pressure
blood sugar
bone formation
sleep/wake cycle
allergic response

18
Q

Aldosterone

A

cortex:

regulating blood pressure and certain electrolytes

19
Q

DHEA and Adrogenic steroids

A

cortex:

estrogens and androgens

20
Q

Epinephrine & Norepinephrine

A

medulla:

initiate the flight or fight response
promote glycogenolysis

21
Q

arteries of the adrenal glands

A

Superior suprarenal branch of inferior phrenic a
middle suprarenal branch of AO
inferior suprarenal branch of renal artery

22
Q

veins of the adrenal glands

A

right - single vein from hilum to IVC
left - vein into left renal vein to IVC

23
Q

two major lymph-node bearing areas in Retroperitoneal cavity

A

iliac and hypogastric nodes within the pelvis

paraaortic group in the upper retroperitoneum

24
Q

what sonographic sign associated with paraaortic lymph nodes?

A

sandwich sign

25
Q

size of normal adrenal glands

A

3-6cm long x 3-6mm thick x 2-4 cm wide

26
Q

right diaphragmatic crura

A

longer, larger, lobular
associated with the anterior aspect of the lumbar vertebral ligament

bounded anterolaterally by the inferior vena cava
bounded posterolaterally - right adrenal + right lobe of liver

27
Q

left diaphragmatic crura

A

along anterior lumbar vertebral bodies in superior direction

inserts into central tendon of diaphragm

28
Q

sonography of diaphragmatic crura

A

imaged in TRV

29
Q

iliac fossa

A

region extending between the internal surface of the iliac wings, from the crest to the iliopectineal lne

30
Q

iliac fossa is known as

A

false pelvis

31
Q

iliac fossa contains

A

ureters
major branches of the distal great vessels
lymphatic vessels

32
Q

4 divisions of the pelvic retroperitoneum

A

prevesical
rectovesical
presacral
pararectal/paravesical

33
Q

sonography of the retroperitoneum

A

all scans include the kidneys and retroperitoneal muscles

34
Q

retroperitoneum sonography pitfalls

A

right crus of diaphragm
gas
no fluid