Session 3A - the Retroperitoneum

Question 1

Where are the perineum and the peritoneum located?

Answer 1

peritoneum - the lining of the abdominal cavity

perineum - (in the pelvic area) the area between the pubic bone and the tailbone

Question 2

State the retroperitoneal abdominal viscera and whether they are primarily or secondarily peritoneal?

Answer 2

Suprarenal (adrenals)
Aorta and IVC
Duodenum (is secondarily retroperitoneal, except for he first part)
Pancreas (secondarily)
Ureters
Colon (ascending and descending are secondarily)
Kidneys
oEophagus
Rectum

Question 3

What is meant by the peritoneal reflections?

Answer 3

the peritoneum develops into a highly folded, complex structure to fulfil its function

they are: the mesentery and the omentum

Question 4

What is the mesentery?

Answer 4

a double layer of visceral peritoneum
it connects an intraperitoneal organ to the posterior abdominal wall
it provides a pathway for nerves, blood vessels and lymphatics to travel from the body wall to the viscera

Question 5

How is the mesentery named?

Answer 5

the mesentery of the small intestine is just celled ‘the mesentery’
mesentery related to other parts of the GI system is named accordingly to the viscera it connects to

Question 6

What are the omenta?

Answer 6

sheets of the visceral peritoneum that extend from the stomach and proximal part of the duodenum to other abdominal organs

Question 7

What is the greater omentum?

Answer 7

• descends from the greater curvature of the stomach and the primal part of the duodenum, then folds back up and attaches to the anterior surface of the transverse colon
• consists of 4 layers of visceral peritoneum

Question 8

What is the lesser omentum?

Answer 8

• a double layer of the visceral peritoneum

- attaches to the lesser curvature of the stomach and the proximal part of the duodenum to the liver

Question 9

What are the primarily retroperitoneal organs? (NO MESENTERY)

Answer 9

• kidneys and ureters
• adrenal glands
• aorta and IVC
• nerves
• oesophagus
• rectum

Question 10

What are the secondarily retroperitoneal organs?

Answer 10

• duodenum (except the first part)
• pancreas (TAIL IS INTRAPERITONEAL)
• colon (ascending and descending only)

Question 11

Which 4 structures are retroperitoneal and in contact with he posterior abdominal wall?

Answer 11

kidneys
IVC
aorta
descending aorta

Question 12

What is at the third part of the duodenum and how can it cause vomiting?

Answer 12

(it is crossed anteriorly by the superior mesenteric artery and vein)
posterior to it is the abdominal aorta and IVC
the large number of arteries can squash and obstruct the duodenum (which can lead to vomiting)

Question 13

What is the pancreas derived from?

Answer 13

derived from buds growing from into the dorsal and ventral foregut mesenteries

Question 14

What are the 5 areas of the pancreas and where are they located in reference to the other superimposed structures?

Answer 14

head, neck and uncinate process - lie in the ‘G’ of the duodenum, anterior to the IVC
body - extends to the left side across the aorta to left kidney
tail - kidney to spleen in dorsal forgeut mesentery

Question 15

What are the visceral relations of the right kidney?

Answer 15

adrenal gland
liver
2nd part of the duodenum
acedning colon

Question 16

What are the visceral relations of the left kidney?

Answer 16

adrenal gland
descending colon
stomach
spleen
tail of the pancreas
(coils of the small bowel)

Question 17

At what level is the hilum of the kidneys?

Answer 17

at the transpyloric plane - L1

Question 18

With reference to the vertebra, where are the ureters located?

Answer 18

anterior to the transverse processes of lumbar vertebrae

Question 19

Describe the position of the kidneys

Answer 19

• right is lower the left

- upper poles are close to the median plane than ehe lower poles

Question 20

At what 3 places do the ureters narrow?

Answer 20

• the ureteropelvic junction
• at the pelvic brim (where the common iliac vessels cross)
• entrance to the urinary bladder

Question 21

What are the posterior relations of the kidneys?

Answer 21

lie on the diaphragm, psoas, quadratus lumborum and transverse abdominis muscles
the T12 and L1 nerves cross between the kidneys and the muscles