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Summer 2014 - ABD 2 ✔️ > Retroperitoneum & Adrenal > Flashcards

Retroperitoneum & Adrenal Flashcards

0
Q

a _______ is a double layer of peritoneum that extends from the body wall to an organ in the abdominopelvic cavity

A

mesentery

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1
Q

the body cavity contains a large network of serous membranes is called the _________

A

peritoneum

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2
Q

what does the mesentaries do

A

hold some organs in place, suspending them from the body wall

tend to transmit important vessels and/or nerves

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3
Q

organs that have mesentaries are called ________ or ________

A

intraperitoneal or peritoneal

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4
Q

organs that have NO MESENTARIES are called _________

important

A

retroperitoneal

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5
Q

the retroperitoneal space technically is outside the peritoneum, between the ______ and the ______

A

abd and back

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6
Q

it is sometimes referred to as the retroperitoneum or __________ because of its location

A

extraperitoneum

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7
Q

________ organs are freely suspended by mesenteries. give examples of organs

A

intraperitoneal organs

stomach, liver, GB, spleen, jejunum, ileum, transverse colon, sigmoid colon, uterus, and ovaries

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8
Q

what develop and remain outside the peritoneal cavity

A

primarily retroperitoneal organs

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9
Q

what develop in the mesentaries, but get pushed against the body wall during growth so that only half of their surface or less is covered by peritoneum

A

secondarily retroperitoneal organs

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10
Q

define retroperitoneum

A

area between the posterior portion of the parietal peritoneum and posterior abd wall muscles

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11
Q

the retroperitoneum is delineated laterally by the lateral borders of the ______ ______ muscles and _______ leaves of the mesentery

A

quadratus lumborum

peritoneal

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12
Q

the retroperitoneal organs are the ones that adhere to the ______ ______ ______ and are not suspended by a ___________

A

posterior abd wall

mesentery

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13
Q

what are the 3 spaces within the retroperitoneum

A

anterior pararenal space
perirenal space
posterior pararenal space

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14
Q

what is found within the anterior pararenal space

A

second part of the duodenum
pancreas
ascending and descending colon

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15
Q

the perirenal space is surrounded by anterior and posterior layers of ______ ______

A

Gerotas’ fascia

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16
Q

what is found within the perirenal space

A 
kidney
adrenal
proximal ureter
renal vessels
ao
ivc
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17
Q

what is found within the posterior pararenal space

A

iliopsoas muscle

lymphatics

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18
Q

Pathologic processes can stretch from the anterior abd wall to the _________ space, ________, and _________ tissues of the back and flank

A

subdiaphragmatic space
mediastinum
subcutaneous tissues

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19
Q

retroperitoneum is protected by what parts

A

spine
ribs
pelvis
musculature

makes US difficult

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20
Q

retroperitoneum is _______ to assess by US. what is best to use

A

difficult

CT

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21
Q

retroperitoneum extends from the ________ to the _____ _____

A

diaphram to pelvic brim

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22
Q

retrofascial space is an…

A

extension of pathological processes - into the muscles

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23
Q

define diaphragmatic crura

A

linear muscular portions of the diaphragm

right crus / left crus

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24
describe the right crus
longer and larger posterior and medial to ivc posterior to renal artery anterior and medial to right kidney
25
indications for a retroperitoneal scan
``` fever pain palpable mass bleeding distended abd ```
26
retroperitoneal scan will help in ruling out ________ collection...examples
fluid collection - hematoma, urinoma, ascites
27
what are bean shaped structures found in lymphoid tissue
lymph nodes - found along the great vessels
28
what are hypogastric nodes within the pelvis
iliac or para-aortic lymph nodes
29
para-aortic lymph nodes are within the _____ _____
upper retroperitoneum
30
indirect signs of para-aortic lymph nodes
sma and ao course of sma displacement of vessels floating ao
31
normal lymph nodes are less than _____ cm
1
32
what will you do if the para-aortic lymph nodes are enlarged with infection or tumor
scan along ao and ivc, pancreatic head, and liver porta hepatis
33
examples/types of para-aortic lymph nodes
``` mantle floating bilateral leg swelling lymphadenopathy consistent non moving pattern ```
34
describe iliac fossa
region between the iliac wings false pelvis contains ureter, distal great vessels and lymphatics
35
what muscles are part of the retrofascial space
psoas quadratus lumborum iliac
36
bilateral pararectal is bounded by _______ and ______ ______ fascia - lateral to rectum
piriformis and levator ani
37
describe prevesical
pubis to anterior margin of the bladder - space of Retzius
38
describe rectovesical
between bladder and rectum
39
describe presacral
between rectum and sacrum
40
AO enters the abd at ____ and bifurcates at ____ into the _____ _____ arteries
L1 L4 common iliac
41
IVC is from the _____ _____ _____ junction
common iliac veins
42
adrenal glands can also be called what
suprarenal glands
43
describe adrenal vessels
3 arteries - suprarenal branches single vein drains each gland
44
name 2 types of endocrine glands
cortex - outer - 90% of gland medulla - inner
45
what are the 3 zona's in the cortex
zona glomerulosa zona fasciculate zona reticularis
46
describe zona glomerulosa
regulates electrolytes produces aldosterone
47
describe zona fasciculate
produces glucocorticords
48
describe zona reticularis
stimulates testosterone and estrogen
49
steroids: describe mineralocorticoids PART OF CORTEX
regulates electrolyte metabolism aldosterone
50
steroid: describe glucocorticoids PART OF CORTEX
regulates carbohydrate metabolism cortisone and hydrocortisone
51
PART OF CORTEX... ACTH - what is is example of hypofunctions and hyperfunctions
ACTH - adrenocorticotropic hormone form the pituitary hypofunctions - Addison's disease hyperfunctions - Cushing's, Conn's, or adrenogenital syndrome
52
PART OF THE CORTEX hormones: male? female?
androgens male sex hormone estrogens female sex hormone secretes both regardless of gender
53
describe the medulla part of the adrenal gland
central portion regulates blood pressure secretes epinephrine and nonepinephrine
54
shape of the adrenal glands: left and right
left - semilunar right - triangular
55
______ adrenal glands are proportionately larger compared to the kidney
infant 1/3 size of kidney for infants 1/13 size of kidney for adults
56
infant adrenal gland looks like what
thin echogenic core -- medulla surrounded by thick transonic zone - cortex
57
where are the adrenal glands
anterior, medial, and superior to the kidneys medial right adrenal gland posterior to the IVC left adrenal is more medial to the kidney
58
indications for an adrenal exam
``` hypertension decreases hematocrit - hemorrhage distention anxiety sweating weight loss follow up to CT ```
59
adrenal glands characteristics
hypoechoic structure sometimes highley echogenic fat surrounds the gland usually smaller than 5 cm
60
why don't we see the adrenal gland on US
patient size surrounding fat bowel gas ability to move patients
61
describe right adrenal gland
triangular or pyramidal shape lateral to crus line up IVC, liver, and superior kidney
62
describe left adrenal gland
crescent or semilunar posterior and medial to left crus posterior to tail of pancreas line up AO, spleen, and superior kidney
63
adrenal gland function syndromes of the cortex
addison's adrenogenitial conn's cushing's
64
describe Addison's disease
hypofunction - decreased functions, not enough production of cortisol and aldosterone atrophy of the cortex prognosis - good with steroid replacement therapy
65
what are symptoms of Addison's disease **deals within the cortex**
increased sodium retention tissue edema hyperpigmentation fatigue and muscle weakness
66
describe adrenogenital syndrome (AG) **deals within the cortex**
excessive secretion symptoms - hormonal changes
67
describe conn's syndrome **deals within the cortex**
hyperaldosteronism excessive secretion of aldosterone symptoms - muscle weakness, hypertension
68
describe Cushing's syndrome **deals within the cortex**
hyperfunction excessive secretion of cortisol may have pituitary involvement symptoms - moon face, buffalo hump, psychiatric issue
69
describe waterhouse-friderichsen syndrome
bilateral adrenal hemorrhage infection can be fatal if not treated immediately
70
describe adrenal cysts
``` anechoic well defined borders through transmission round smooth ```
71
describe adrenal hemorrhage
severe trauma or infection MOST COMMON adrenal abn in newborns decreased hematocrit result of traumatic vaginal delivery
72
adrenal medulla tumors: describe pheochromocytoma
excessive epinephrine and nonepinephrine sonographically - unilateral, homogeneous pattern lab tests - metanephrine, catecholamine
73
adrenal medulla tumors: pheochromocytoma are usually ______ list symptoms...
benign ``` headaches tachycardia tremors anxiety excessive sweating uncontrollable HTN ```
74
describe benign adrenal adenoma
solid well defined round
75
adrenal gland _____ and _____ also exists
CA metastasis
76
adrenal medulla tumors: describe adrenal neuroblastoma
MOST COMMON malignancy of the adrenal gland in children arise from medulla sonographically - echogenic mass, metastatic to live
77
what is the most common tumor of infancy, representing ____% of all neonatal tumors
adrenal neuroblastoma 30%
78
do not confuse a neuroblastoma with what
nephroblastoma - Wilm's tumor of the kidney
79
malignant retroperitoneal tumors: ``` neurogenic? leiomysarcomas? liposarcomas? fibrosarcomas? rhabdomyosarcomas? lymphomas? teratomatous? histiocytoma? ```
``` neurogenic - nerve root leiomysarcomas - smooth muscle liposarcomas - adipose - MOST COMMON fibrosarcomas - connective rhabdomyosarcomas - skeletal muscle lymphomas - lymphatics teratomatous - skin, muscle, tissue histiocytoma - immune system ```
80
benign retroperitoneum tumors: ``` fibroma? lipoma? mesothelioma? myxoma? teratoma? ```
``` fibroma - connective tissue lipoma - fatty tissue mesothelioma - epithelial cells myxoma - connective tissue teratoma - varied tissue ```
81
what is a urinoma
walled off collection of urine sonolucent unless infected
82
what is a hemorrhage
sonolucent areas or organized thrombus **adrenal hemorrhage
83
what is an abscess
complex pattern do not confuse gas pattern with normal bowel
84
what is a hematoma
collection of blood
85
describe transudative ascites
CHF or renal failure
86
describe exudative ascites
malignancy or inflammatory
87
what is ormond's disease
thick sheets of fibrous tissue
88
symptoms of ormond's disease
flank and back pain weight loss nausea and vomiting malaise
89
what criteria is described for a retroperitoneal mass
``` assess in 2 dimensions measure assess if it is fixed or free determine echogenicity discover solid, complex, or cyst relationship to other organs ```
90
what can ormond's disease be mistaken for
horseshoe kidneys

Summer 2014 - ABD 2 ✔️ (9 decks)

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