Spaces

Question 1

What is the space between the parietal peritoneum and visceral peritoneum

Answer 1

peritoneal cavity

Question 2

What are the compartments within the peritoneal cavity

Answer 2

lesser sac
greater sac
pouch of Douglas (rectouterine/rectovesical)

Question 3

______ is the serous membrane. that forms the lining of the abdominal cavity and covers most of the abdominal organs.

Answer 3

peritoneum

Question 4

Parietal peritoneum

Answer 4

outer layer of the peritoneum, lines the abd wall

Question 5

Visceral peritoneum

Answer 5

inner layer of the peritoneum, covers the organs

Question 6

Lesser sac

Answer 6

space between the LIV, PANC, STO (LPS)

entrance is the epiploic foramen

Question 7

Greater sac

Answer 7

rest of the peritoneal cavity that is not the lesser sac

in the presence of ascites, could see floating bowel

Question 8

Pouch of Douglas

Answer 8

peritoneal recess extending b/w the rectum and uterus

Question 9

Intraperitoneal structures

Answer 9

STO
jejunum - loops of intetsine
1st part of duodenum
appendix
spleen
cecum
TRV and sigmoid colon
rectum - superior part
LIV
UT
Fallopian tubes
ovaries
panc tail?

Question 10

The retroperitoneum is a posteriorly located compartment that lies between the ____ ______ and the ______ ____ ______.

Answer 10

transversalis fascia and posterior parietal peritoneum

Question 11

What is the order of the “ABD Sandwich”?

Answer 11

Anterior
Transversalis fascia
Ant parietal peritoneum
Peritoneal space
Post Parietal peritoneum
\_\_\_\_\_\_\_\_\_\_
Ant pararenal space
Ant renal fascia (Gerota's fascia)
Perirenal space
Post renal fascia (Gerota's fascia)
Post pararenal space (empty)
Transversalis fascia
Posterior

Question 12

What is the only organ that is neither peritoneal or retroperitoneal?

Answer 12

bladder, lies between the two spaces

Question 13

Two layers of renal fascia known as ____ ____, divides the retroperitoneum coronally into ____ compartments, which inlcude:

Answer 13

Gerota’s fascia
3

post parietal peritoneum
----------
anterior pararenal space
------ant renal fascia (Gerota's)
perirenal space (kdineys and adrenals)
------post renal fascia (Gerota's)
posterior pararenal space
-------
transversalis fascia
posterior

Question 14

Where are the kidneys and adrenals located?

Answer 14

within the perirenal space, separated from pararenal spaces by Gerota’s fascia on ant/post sides

Question 15

Structures located in the retroperitoneum

Answer 15

kidneys
ureters
adrenal glands
ascending/descending colon
2/3/4th parts of duodenum
PANC (heda, neck, body)
Ao
IVC
Renal vessels
Superior mesenteric vessels
gonadal vessels
lymphatics
prostate
part of rectum
part of esophagus

Question 16

The QL and psoas muscles lie _____ to the _____ _____ space and are separated from this space by their own fascia called _____ ______.

Answer 16

posterior
posterior pararenal space
transversalis fascia

Question 17

What is retroperitoneal fibrosis also known as?

Answer 17

Ormond’s disease or infammatory aneurysm

Question 18

What is retroperitoneal fibrosis?

Answer 18

A dense fibrous tissue proliferation confined to the paravertebral region

Question 19

Sonographic features of retroperitoneal fibrosis

Answer 19

hypoechoic ML mass

• generally centered at the aortic bifurcation
• rarely extends superior to the level of L2 and may extend inferiorly to the dome of the liver

Question 20

What is assoicated with retroperitoneal fibrosis?

Answer 20

bilateral ureteral obstruction - it envelopes structures rather than displacing them

• nonspecific symptoms so delayed Dx leads to progressive loss of renal function
• Also, IVC and lymphatic compression leads to lower extremity edema and gonadal vein involvement ay cause scrotal swelling

Question 21

The exact cause of retroperitoneal fibrosis has not been definitively described, most cases are idiopathic (60-70%)
May develop as an immunologic response to antigens within altherosclerotic plaues, so fibrosis often begins around a atherosclerotic ____.

Answer 21

Ao

Question 22

Associated causes of retroperitoneal fibrosis

Answer 22

malignancy displacing ureters medially
inflammatory periaortitis
chronic retroperitoneal inflammation
retroperitoneal trauma
autoimmune disease
connective tissue disease
irradiation
drugs (beta-blockers, methysergide, methyldopa)

Question 23

What substitutes in the case of inferior vena cava obstrruction?

Answer 23

The azygous and hemizaygous veins provide an alternate pathway for venous return by connecting the proximal abdominal IVC to the SVC
-normally not visulaized until they are forced to dilate due to caval obstruction

Question 24

The azygous is ______ and the _______ is considered to be a tributary of the azygous vein.

Answer 24

unpaired

hemiazygous

Question 25

The azygous vein is located on the _____ and the hemiazygous vein is located on the _____.

Answer 25

right

left

Question 26

What is the abdominal counterpart of the azygous-hemiazygous system above the diaphragm?

Answer 26

ascending lumbar veins

Question 27

The ascending lumbar veins are branches of the _____ ______ ____.

Answer 27

common iliac veins

they travel in a path lateral to the spine and posterior to the psoas muscle

Question 28

The left ascending lumabr vein at the level of the diaphragm joins the left ______ _____ to form the ______ _____.

Answer 28

subcostal vein

hemiazygous vein

Question 29

Where are the crus of the diaphragm located?

Answer 29

ant to Ao
sup to celiac axis
post to IVC

Question 30

What planes can the crus be visualuzed?

Answer 30

long and transverse

Question 31

The crus is located _____ and _____ to all structures except the _____.

Answer 31

medial and posterior