Retroperitoneum

Question 1

Increased BUN levels (blood urea nitrogen) will point to which organ of interest?

Answer 1

Kidneys

Question 1

Where is the left adrenal gland anatomic relation to the abdominal aorta and diaphragmatic crus?

Answer 1

Lateral

• anteromedially to the left kidney, posterior to the stomach

Question 2

Patient has abdominal pain and increased serum amylase. There is a pocket of fluid in the left pararenal space. What is the most likely etiology of this mass?

Answer 2

Pancreatic pseudocyst

(serum amylase raises with acute pancreatitis)

Question 3

Which retroperitoneal compartments contain no solid organs?

Answer 3

Posterior pararenal space and retrofascial space

Question 4

Which retroperitoneal space do the kidneys lie in?

Answer 4

Perirenal space

Question 5

A patient with the history pheochromocytoma means which structure will be most beneficial in identification of this abnormality?

Answer 5

Adrenal glands

pheochromocytoma = tumour in the adrenal glands

Question 6

What is the correct anatomic location of the right adrenal gland?

Answer 6

Posterior to the IVC

Question 7

What structure is not retroperitoneal in location?

Spleen
Kidney
Pancreas
Aorta
Psoas Muscles

Answer 7

Spleen

Question 8

You suspect a left adrenal mass while scanning - what following condition may simulate an adrenal mass?

• thickened diaphragmatic crus
• accessory spleen
• gastric diverticulum
• retroperitoneal lymphadenopathy
• all of the above

Answer 8

all of the above

Question 8

Increased lipase levels should direct the sonographer to which organ?

Answer 8

Pancreas

Question 9

Which retropertioneal compartment contains the psoas and the quadratus lumborum muscles?

Answer 9

Retrofascial space

Question 10

An anechoic mass with multiple septations located lateral to the midline and 2 cm below the abdo wall after a surgery is most likely going to be what?

Answer 10

Lymphocele

Question 11

What retroperitoneal compartment contains the aorta?

Answer 11

Anterior pararenal space

Question 12

What is the anatomic location of the right diaphragmatic crus?

Answer 12

Posterior to the inferior vena cava and right renal artery

Question 13

Which retroperitoneal compartment is most frequently involved with a pseudocyst?

Answer 13

Anterior pararenal space

Question 14

What structure will be evaluated to identify retropertioneal fibrosis?

Answer 14

Aorta

Question 15

What type of structure is are the adrenal glands? (endocrine vs exocrine)

Answer 15

Endocrine

Question 16

What is Addison disease? (also known as adrenocortical insufficiency)

Answer 16

A life threatening condition, caused by partial or complete failure of adrenocortical function

Question 17

What is Cushing syndrome?

Answer 17

Metabolic disorder, resulting from chronic and excessive production of cortisol by adrenal cortex. The body cannot regulate secretions or cortisol of adrenocorticotrophic hormone (ACTH) - also known as hyperadrenalism.

Question 18

What are the diaphragmatic crura?

Answer 18

Fibers that connect the vertebral column and diaphragm.

Superior to the celiac axis, lie anterior to the aorta, and posterior to the IVC.

Question 19

What is a neuroblastoma?

Answer 19

Malignant tumor of the adrenal gland found in young children

Question 20

What is the most common malignant tumor of the adrenal gland in young children?

Answer 20

Neuroblastoma

Question 21

What does the cortex of the adrenal gland do?

Answer 21

Secretes steroids

Question 22

What does the medulla of the adrenal gland do?

Answer 22

Secretes catecholamines: epinephrine and norepinephrine

Regulates blood pressure and heart rate

Question 23

What shape is the right adrenal gland?

Answer 23

Triangle or pyramid - similar to a Y or V

Question 24

What shape is the left adrenal gland?

Answer 24

Like a crescent moon or semilunar shape.

Question 25

Elevation of potassium indicates what?

Answer 25

An association with Addison disease

Question 26

Decrease in potassium indicate what?

Answer 26

Cushing disease, hyperaldosteronism

Question 27

Elevation in adrenocorticotrophic hormone indicate what?

Answer 27

Adrenal tumor, Cushing disease, and lung tumor

Question 28

A decrease in aldosterone is associated with which disease?

Answer 28

Addison disease

Question 29

Decrease in sodium in labratory values can indicate what?

Answer 29

Addison disease

Question 30

Addison disease is indicated by which lab values?

Answer 30

Decrease in sodium
Decrease in aldosterone
ELEVATION of potassium