The Retroperitoneum Flashcards
State the structures found on the posterior abdominal walls and how can this be divided?
SAD PUCKER
Primary: Kidneys and Ureters Suprarenal glands Aorta and IVC Oesophagus Rectum
Secondary:
Duodenum (2nd and 3rd)
Pancreas (not tail)
Colon (ascending and descending)
Which organs are in contact with the posterior abdominal wall?
Aorta (and IVC)*
Colon (ascending and descending)
Kidneys
Describe the way the duodenum is divided, and describe the vertebral levels with the length of each part?
First part - 1st 2 cm has a mesentery. Lies anterior to the bile duct, portal vein and gastroduodenal artery.
Second part - Bile duct and pancreatic ducts open into it. Root of the transverse mesocolon crosses it
Third part – Crossed anteriorly by the superior mesenteric artery & vein
Fourth part (5 cm)- leads into the jejunum
The first ‘superimposed structure 5 cm long, L1 level 7-10 cm, rt of L1-L3 6-8 cm, crosses L3 5 cm, to L2
Describe the arrangement of the kidneys in the body. What vertebral level are they at?
The kidneys are at vertebral level L1 - the left kidney is slightly higher than the right.
The superior poles of the kidneys are closer to the median plane than the inferior poles.
The 12th ribs run posteriorly across the back of the kidneys.
3-4 cm superior to the iliac crest
5 cm from the vertebral bodies
What are the primary retroperitoneal structures?
Abdominal aorta and its branches Inferior vena cava and its tributaries Kidneys & ureters Adrenal glands Nerves (lumbar plexus & sympathetic trunk)
These structures developed outside the parietal peritoneum. They never had a mesentery.
Describe the pancreas location?
Exocrine and endocrine gland
Derived from buds growing into dorsal and ventral foregut mesenteries
Head, neck, uncinate process - lie in “G” of duodenum anterior to IVC
Body - extends to the left side across the aorta to left kidney
Tail - kidney to spleen in dorsal foregut mesentery (lieno-renal or spleno-renal ligament)
Describe the arrangement of the renal veins.
The renal veins join the inferior vena cava. The left renal vein runs anterior to the aorta just under the superior mesenteric artery.
What are the four parts of the duodenum and how long are each of them?
Superior - 1.5 cm
Descending - 2.7 - 10 cm
Inferior - 3.6 - 8 cm
Ascending - 4.5 cm
What structures are near the first part of the duodenum?
The first part of the duodenum is anterior to the common bile duct, the hepatic portal vein and the gastroduodenal artery.
What structures open into the second part of the duodenum
The common bile duct and the pancreatic duct open into the duodenum through the ampulla of vater. There is a small lump in the duodenum at this point called the major duodenal papilla. The release of substances from the ampulla of vater is controlled by the sphincter of Oddi.
What structures are close to the third part of the duodenum?
Superior mesenteric artery and vein cross anteriorly.
What part of the pancreas is intraperitoneal?
Tail of the pancreas (it is encased by the splenorenal ligament)
What is the pancreas derived from?
The ventral pancreatic bud and the dorsal pancreatic bud
What is the name of the mesentery between the spleen and the left kidney?
Lieno-renal ligament or spleno-renal ligament
What is the space between the liver and the right kidney called?
Heptorenal recess (of Rutherford and Morris)