Retroperitoneum Flashcards
what does the retroperitoneum contain?
where is it located?

containing the kidneys, adrenal glands, ureters, duodenum, ascending colon, descending colon, pancreas and the large vessels and nerves.
b/t the posterior portion of the parietal peritoneum and posterior abdominal wall muscle

what are teh borders of the retroperitoneum?
The space extends from the diaphragm to the pelvis. Note the posterior abdominal muscles, psoas and quadradus lumborum muscles are posterior to the retroperitoneum.

what are the abdominal retroperitoneal spaces and what do they have inside of them?
Peri = around - think of the perimeter of something.
Para = Alongside
I think of the 2 letter a’s running alongside the r.

what are the 3 abdominal retrpoeritoneal spaces?
Anterior Pararenal space – bound anteriorly by the posterior parietal peritoneum and posteriorly by the anterior renal fascia (Gerota’s)
–
Perirenal space – is the space surrounded by Gerota’s fascia (surrounds kidney)
–
Posterior Pararenal space – The small area between the posterior renal fascia (Gerota’s) and the transversalis muscle

identify the 3 abd retrperitoneal spaces


what are the 4 subdivisions of the pelvic retrop?
Prevesical
•
Rectovesical
•
Presacral
Bilat. – pararectal/paravesical

where does the pelvic retrop lie?
Lies between pubis and sacrum. From A/P
–
Lies between pelvis peritoneal reflect and pelvic diaphragm i.e. muscles of the pelvic floor. From S/I

The ______ is part of the immune system, made up of a network of conduits that carry a clear fluid called___.
lymphatic system, lymph
_______ associated with the lymphatic system is concerned with immune functions in defending the body against the infections and spread of tumors.
what does it consist of ?
Lymphoid tissue
It consists of connective tissue with various types of white blood cells enmeshed in it, most numerous being the lymphocytes
where are lymph nodes found?
ina number of areas w/i the body
http: //www.youtube.com/watch?v=qEIV6c61kx4&feature=related
http: //www.youtube.com/watch?v=ZdYxx4CHb-A&feature=related
are all lymphatic retrop?
no, some are intraperitoneal *similar appearance despite location
what moves lymph?
muscles
are lymph nodes seen in a healthy adult?
who might you see these in?
generally not – it is covered by body fat
children or thin adults
_____ are lymphatics chain follows AO from thoracic to abdominal cavities and Iliac arteries
paraortic nodes


what is the normal size of a lymph nodE?
what is it’s sonographic appearance?
<1 cm
•
Homogeneous, ovoid, smooth borders, well defined
•
Hilum – echogenic due to fatty tissue
•
Hypoechoic
•
Nodes will not change shape or move like bowel will

When lymph nodes are enlarged they cause a _____ to become evident. this is when an organ is being pushed upon by some type of mass lesion.
“mass effect”
what do you see int he top lt image?

mass effect
what are these examples of?

retroperitoneal lymph nodes
what are these examples of?

peripancreatic lymph nodes (pt has history of lymphoma)
same below

what are these examples of?

paraortic lymph nodes (pt has history of AIDS)

what do you need to remember when scanning lymph nodes?
sometimes slow motion will not allow you to see it.
The space between the parietal peritoneum and the muscles and bones of the posterior abdominal wall. “
This phrase best describes
a. The peritoneal space
b. The retroperitoneal space
c. Morrison’s pouch
d. Pouch of Douglas
e. B and C
b
- All of the following anatomy is found in the retroperitoneal space EXCEPT.
a. periaortic lymph nodes
b. kidneys
c. antrum of the stomach
d. ureters
c
The upper/superior extent of the retroperitoneal space is the
a. pelvic brim
b. diaphragm
c. dome of the liver
d. inferior border of the liver
b
The retroperitoneal space is important for the sonographer to understand because
a. of how it interacts with certain pathologies and diseases.
b. it is routinely seen with US.
c. it is the site of the majority of abdominal pathologies.
d. of its echogenicity and echotexture it can be confusing to image.
a
All of the following are true of the lymphatics of the retroperitoneum EXCEPT.
a. There are found in “chains” and follow the course of the thoracic aorta, abdominal aorta and iliac arteries.
b. Are typically smaller than 1cm in a healthy individual.
c. Have a hilum, where vessels and nerves enter and leave, which is echogenic on US.
d. Are typically not visualized with US, even in a pathologic state.
d
Normal lymph nodes will have a(n)
a. hyperechoic appearance.
b. hypoechoic appearance.
c. oval shape.
d. rough borders.
e. two of the above
f. none of the above
e
The hilum of the lymph node will appear _____ on US because of its tissue make up.
a. hypoechoic
b. hyperechoic
c. isoechoic
d. anechoic
b
All of the following are true with regards to abdominal lymph node locations EXCEPT.
a. are found only in the retroperitoneum
b. are found both in the peritoneum and the retroperitoneum
c. can be seen in the portahepatis
d. can be seen in the peripancreatic area
a
Lymph nodes through out the body can become enlarged when all of the following occur EXCEPT.
a. fighting an infection
b. invaded by cancer
c. a nearby system is inflamed, i.e. pancreatitis, hepatitis, etc…
d. too much transducer pressure is used
d
This drawing is great, notice how the lymph fluid comes into the node on its periphery and is filtered, before exiting in the central core of the node. The area of the node in the circle is know as the what?

hilum