Retroperitoneal organs of the posterior abdominal wall

Question 1

Peritoneal cavity

Answer 1

Space between the parietal peritoneum and visceral peritoneal.

Question 2

Retroperitoneal space

Answer 2

Several small spaces in the abdominal cavity- behind the peritoneum.

The spaces are behind the kidneys

Question 3

Intraperitoneal organs

Answer 3

Organs in the abdominal cavity completely enclosed by visceral peritoneum.

Examples:

• Liver
• Stomach
• Spleen
• Transverse colon
• Small intestines.

Question 4

Retroperitoneal organs

Answer 4

Organs in the abdominal cavity that have mesentery/peritoneum over its anterior surface only.

Primary retroperitoneal- developed in retroperitoneal space:

• Aorta
• IVC.
• Kidneys and adrenal galnds

Secondary retroperitoneal- started off developing intraperitoneal, then moved to retroperitoneal space:

• Pancreas
• Duodenum
• Ascending and descending colon.

Question 5

Retroperitoneal urinary organs

Answer 5

Kidneys

Ureter

Urinary bladder

Question 6

Location of the kidneys:

• Posterior
• Muscles around it
• Superior and inferior pole
• Right to left comparison

Answer 6

Posterior
- Posterior abdominal wall

Posterior abdominal wall muscles around it:

• Diaphragm, superior.
• Psoas major, medial
• Quadratus lumborum, posterior.

Superior pole:
- T12

Inferior pole:
- L3

Right is slightly lower because of the liver

Question 7

Organs of the right kidneys

Answer 7

Right adrenal glands

Liver

Right colic flexure

Duodenum

Question 8

Organs of the left kidneys

Answer 8

Left adrenal gland

Stomach

Spleen

Pancreas

Left colic flexure

Jejum

Question 9

Cortex

Answer 9

Outer layer of the kidney.

- Contains glomeruls

Question 10

Medulla

Answer 10

Middle layer of the kidney.

- Contains collecting ducts and forms renal pyramids.

Question 11

Renal parenchyma

Answer 11

The functional part of the kidneys:

- Cortex and renal pyramid

Question 12

Renal pelvis

Answer 12

Part of the kidney which urine exists—> forms the ureter

Question 13

VAN of the kidney

Answer 13

Renal artery- connects to the aorta just below superior mesenteric artery.

Renal vein- connects to inferior vena cava.
- Usually anterior to renal artery

Nervous supply:
Renal plexus

Question 14

Renal plexus

Answer 14

Nervous supply of the kidneys.

Enters the kidneys with the arterial branches

Question 15

Functions of the kidney

Answer 15

Regulate ionic composition of the blood

Regulates blood pH

Regulations blood volume and pressure

Produces hormones

Excretes waste

Question 16

Adrenal cortex

Answer 16

Outer layer of the adrenal glands.

Produces mainly two types of hormones

• Corticosteriods [cortisol]
• Sex hormones [progesterone]

Question 17

Adrenal Medulla

Answer 17

The core of the adrenal glands.

Produces adrenaline

Question 18

Vessels of the adrenal glands

Answer 18

Suprarenal arteries and veins

Arteries branch from aorta, renal artery and phrenic arteries

Question 19

Nerves of adrenal glands

Answer 19

Abdominopelvic: greater, lesser and least splanchnic

Question 20

Blood supply of ureter

Answer 20

Branches of:

• Renal artery
• Aorta
• Iliac artery

Question 21

3 likely constrictions in the ureter from kidney stones

Answer 21

Ureteropelvic junction: just leaving kidney

Crossing the iliac vessels at the pelvic brim

Entering the bladder.

Question 22

Bladder and urethra

Answer 22

Bladder: Inverted pyramid with the urethra at apex.

Urethra

• Exit of urine out of the body
• Much longer in men that women
• Both reproductive and urinary in males
• Passes under pubic symphysis and crosses the pelvic floor muscles to reach genitals.

Question 23

Kidney protection

Answer 23

Perirenal fat cushions kidneys.

- Fat between renal fascia and capsule

Question 24

Renal pain

Answer 24

Stretching of the capsule is sensed by afferent fibers in renal plexus.
- Follows least splanchnic nerve to the sympathetic trunk

Pain referred to T12- subcostal nerve.

Question 25

Renal colic

Answer 25

Peristaltic waves felt from ureter trying to pass a kidney stone.

Felt at T11-T12.

Can spread to the CNS and cause nausea.

Question 26

Renal transplatation

Answer 26

Kidney is transplanted into the iliac fossa- easy to access.

The incision is done parallel and above the lingual ligament.

Renal artery connect to external iliac artery.

Renal vein connected to external iliac vein.

Ureter is inserted straight into the bladder- ureterocystostomy

Question 27

Kidney malformations

Answer 27

Bilateral or unilateral renal agenesis- no kidney

Supranumery kidneys

Renal fusion

Ectopic kidney

Simple/ polycystic kidney