Retroperitoneum Flashcards
the retroperitoneal space is the area between
posterior portion of the parietal peritoneum and the posterior abdominal wall muscles
What are the 3 categories of the retroperitoneum
- anterior pararenal space
- perirenal space
- posterior pararenal space
Layers - anatomy of the retroperitoneum picture
Transversalis fascia
Lateralconal fascia
Parietal peritoneum
Extraperitoneal space
structures within the anterior pararenal space
pancreas
duodenal sweep
ascending & descending colon
rectum
structures within the perirenal space
adrenal glands
kidneys
ureters
ao
ivc
structures within the posterior pararenal space
blood and lymph
which adrenal gland is more superior to the kidney?
which one is more medial to the kidney?
right adrenal = more superior
left adrenal = more medial
what is zonal anatomy of the retroperitoneum used for?
describe injuries and facilitate management of the injuries
how many zones of the retroperitoneum
3
zone 1 - cetromedial
zone 2 - lateral
zone 3 - pelvic
zone 1 - centromedial
great vessels
pancreas
duodenum
zone 2 - lateral
kidneys
renal vessels
ureters
ascending colon
descending colon
colic flexures
zone 3 - pelvic
whole pelvis
pelvic walls
rectosigmoid colon
iliac vessels
genitals
adrenal glands size
3-6cm long x 3-6mm thick x 2-4 cm wide
what do the adrenal glands produce?
hormones that help regulate metabolism, immune system, blood pressure, response to stress and other essential functions
where is the adrenal cortex
outer region and largest part
what are the three zones of the adrenal cortex & their hormones
zona glomerulosa - aldosterone
zona fasciculate - cortisol
zona reticularis - dhea and androgenic steroids
cortisol & hydrocortisone
cortex:
times of stress
controls many things:
blood pressure
blood sugar
bone formation
sleep/wake cycle
allergic response
Aldosterone
cortex:
regulating blood pressure and certain electrolytes
DHEA and Adrogenic steroids
cortex:
estrogens and androgens
Epinephrine & Norepinephrine
medulla:
initiate the flight or fight response
promote glycogenolysis
arteries of the adrenal glands
Superior suprarenal branch of inferior phrenic a
middle suprarenal branch of AO
inferior suprarenal branch of renal artery
veins of the adrenal glands
right - single vein from hilum to IVC
left - vein into left renal vein to IVC
two major lymph-node bearing areas in Retroperitoneal cavity
iliac and hypogastric nodes within the pelvis
paraaortic group in the upper retroperitoneum
what sonographic sign associated with paraaortic lymph nodes?
sandwich sign
size of normal adrenal glands
3-6cm long x 3-6mm thick x 2-4 cm wide
right diaphragmatic crura
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
left diaphragmatic crura
along anterior lumbar vertebral bodies in superior direction
inserts into central tendon of diaphragm
sonography of diaphragmatic crura
imaged in TRV
iliac fossa
region extending between the internal surface of the iliac wings, from the crest to the iliopectineal lne
iliac fossa is known as
false pelvis
iliac fossa contains
ureters
major branches of the distal great vessels
lymphatic vessels
4 divisions of the pelvic retroperitoneum
prevesical
rectovesical
presacral
pararectal/paravesical
sonography of the retroperitoneum
all scans include the kidneys and retroperitoneal muscles
retroperitoneum sonography pitfalls
right crus of diaphragm
gas
no fluid
