Retroperitoneum - Part 4 Flashcards
What is Addison disease caused by?
By partial or complete failure of adrenocortical function
- hypofunction
What gets destroyed with Addison disease?
Adrenal cortex
What do you lose with Addison disease?
Loss of cortisol and aldosterone secretions
How is Addison disease diagnosed?
Diagnosis is established if the amount of cortisol in the plasma and steroid in the urine do not increase after stimulation with ACTH
What is the cause of Addison disease? (5)
- Autoimmune reaction 2. Tuberculosis
- Adrenal hemorrhage 4. Chronic infection
- Surgical removal of both adrenal glands
What are the clinical findings for Addison disease? (9)
- Anorexia
- Bronze skin pigmentation
- Chronic fatigue
- Dehydration
- Emotional changes
- GI disorders
- Hypotension
- Weakness
- Salt cravings
What gets elevated with Addison disease?
Serum potassium
What decreases with Addison disease? (2)
- Serum sodium
2. Glucose
Is Addison disease more common in males or females?
Females
Adrenogenital syndrome
Congenital disorder causing excessive secretion of sexual hormones and adrenal androgens
What are the causes of Adrenogenital syndrome? (2)
- Adrenal tumor
2. Hyperplasia
What are the clinical findings of Adrenogenital syndrome? (4)
- Increases in body hair
- Deepening of the voice
- Atrophy of the uterus
- Acne
What is increased with Adrenogenital syndrome?
Androgen production
Conn syndrome
Excessive production of aldosterone
What causes Conn syndrome? (2)
- Adrenal hyperplasia
- male prevalence - Adrenal carcinoma
- rare
What is the most common cause of Conn syndrome?
Adrenal adenoma
- 70%
- female prevalence
What are the clinical findings for Conn syndrome? (3)
- Hypertension
- Muscular weakness
- Abnormal electrocardiogram
What is elevated with Conn syndrome?
Aldosterone
Cushing disease
Rare and serious disorder resulting from excessive production of cortisol
- excessive use of cortical hormones
What does Cushing disease result in?
Accumulation of fat on the abdomen, face, upper back, and upper chest
What is the most common cause of Cushing disease?
Pituitary mass
What are other causes of Cushing disease? (2)
- Adrenal mass
2. Polycystic ovarian disease
What is there an excessive amount of with Cushing disease?
Glucocorticoid hormone
What are the clinical findings for Cushing disease? (8)
- Fatigue
- Purplish striae on the skin
- Decrease in immunity to infection
- Emotional changes
- Increase in thirst and urination
- Muscle weakness
- New onset of diabetes mellitus
- Osteoporosis
What is elevated with Cushing disease? (3)
- ACTH
- WBCs
- Blood glucose levels
What is decreased with Cushing disease?
Serum potassium
What are all the borders of the retroperitoneum? (5)
- Superior = diaphragm
- Inferior = pelvic rim
- Anterior = posterior parietal peritoneum
- Posterior = posterior abdominal wall muscles and spine
- Lateral = transversalis fascia and peritoneal portions of the mesentery
What are the 3 spaces in the retroperitoneum?
- Anterior pararenal
- Posterior pararenal
- Perirenal
Where is the anterior pararenal space in the retroperitoneum?
Fat area between the posterior peritoneum and Gerota’s fascia
What does the anterior pararenal space in the retroperitoneum include? (5)
- pancreas
- Descending portion of the duodenum
- Ascending and descending colon
- Superior mesenteric vessels
- Inferior portion of the CBD
Where is the posterior pararenal space in the retroperitoneum?
Space between Gerota’s fascia and the posterior abdominal wall muscles
What does the posterior pararenal space in the retroperitoneum include? (3)
- Iliopsoas
- Quadratus lumborum muscles
- Posterior abdominal wall
What does the posterior pararenal space in the retroperitoneum contain? (2)
- Fat
2. Nerves
Where is the perirenal space in the retroperitoneum?
Space separated from the pararenal space by Gerota’s fascia
What does the perirenal space in the retroperitoneum include? (8)
- Kidneys
- Adrenal glands
- Perinephric fat
- Ureters
- Renal vessels
- Aorta
- IVC
- Lymph nodes
