Spaces Flashcards
What is the space between the parietal peritoneum and visceral peritoneum
peritoneal cavity
What are the compartments within the peritoneal cavity
lesser sac
greater sac
pouch of Douglas (rectouterine/rectovesical)
______ is the serous membrane. that forms the lining of the abdominal cavity and covers most of the abdominal organs.
peritoneum
Parietal peritoneum
outer layer of the peritoneum, lines the abd wall
Visceral peritoneum
inner layer of the peritoneum, covers the organs
Lesser sac
space between the LIV, PANC, STO (LPS)
entrance is the epiploic foramen
Greater sac
rest of the peritoneal cavity that is not the lesser sac
in the presence of ascites, could see floating bowel
Pouch of Douglas
peritoneal recess extending b/w the rectum and uterus
Intraperitoneal structures
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?
The retroperitoneum is a posteriorly located compartment that lies between the ____ ______ and the ______ ____ ______.
transversalis fascia and posterior parietal peritoneum
What is the order of the “ABD Sandwich”?
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
What is the only organ that is neither peritoneal or retroperitoneal?
bladder, lies between the two spaces
Two layers of renal fascia known as ____ ____, divides the retroperitoneum coronally into ____ compartments, which inlcude:
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
Where are the kidneys and adrenals located?
within the perirenal space, separated from pararenal spaces by Gerota’s fascia on ant/post sides
Structures located in the retroperitoneum
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
The QL and psoas muscles lie _____ to the _____ _____ space and are separated from this space by their own fascia called _____ ______.
posterior
posterior pararenal space
transversalis fascia
What is retroperitoneal fibrosis also known as?
Ormond’s disease or infammatory aneurysm
What is retroperitoneal fibrosis?
A dense fibrous tissue proliferation confined to the paravertebral region
Sonographic features of retroperitoneal fibrosis
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
What is assoicated with retroperitoneal fibrosis?
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
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 ____.
Ao
Associated causes of retroperitoneal fibrosis
malignancy displacing ureters medially inflammatory periaortitis chronic retroperitoneal inflammation retroperitoneal trauma autoimmune disease connective tissue disease irradiation drugs (beta-blockers, methysergide, methyldopa)
What substitutes in the case of inferior vena cava obstrruction?
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
The azygous is ______ and the _______ is considered to be a tributary of the azygous vein.
unpaired
hemiazygous
The azygous vein is located on the _____ and the hemiazygous vein is located on the _____.
right
left
What is the abdominal counterpart of the azygous-hemiazygous system above the diaphragm?
ascending lumbar veins
The ascending lumbar veins are branches of the _____ ______ ____.
common iliac veins
they travel in a path lateral to the spine and posterior to the psoas muscle
The left ascending lumabr vein at the level of the diaphragm joins the left ______ _____ to form the ______ _____.
subcostal vein
hemiazygous vein
Where are the crus of the diaphragm located?
ant to Ao
sup to celiac axis
post to IVC
What planes can the crus be visualuzed?
long and transverse
The crus is located _____ and _____ to all structures except the _____.
medial and posterior
