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NME Emma copy and edit > Retroperitoneal Organs of the Posterior Abdominal Wall > Flashcards

Retroperitoneal Organs of the Posterior Abdominal Wall Flashcards

1
Q

What does retro mean in reference to anatomy?

A
  • behind
  • space posterior to the parietal peritoneum, along the posterior abdominal wall (PAW)
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2
Q

What does the mnemonic SAD PUCKER relate to in terms of retroperitoneal organs?

A
  • S = suprarenal (adrenal) gland
  • A = aorta/IVC
  • D = duodenum (second and third part)
  • P = pancreas (except tail)
  • U = ureters
  • C = colon (ascending and descending)
  • K = kidneys
  • E = (o)oesophagus
  • R = rectum
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3
Q

What is the main role of the urinary system?

A
  • produce and excrete urine
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4
Q

What is included in the urinary system and what is the flow from the top to the bottom?

A
  • kidneys = retroperitoneal
  • ureter = retroperitoneal
  • bladder = extraperitoneal (outside of peritoneam)
  • urethra = extraperitoneal (outside of peritoneam)
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5
Q

What is the name of the plane where the kidneys hilium can be located?

A
  • transpyloric plane (crosses epigastric region)
  • has upper and bottom parts above and below hilium
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6
Q

The kidneys hilium can be located at the transpyloric plane (crosses epigastric region) and has superior and inferior parts above and below the hilium. What vertebrae can they be located at?

A
  • thoracic 12 to lumbar 3
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7
Q

The kidneys hilium can be located at the transpyloric plane (crosses epigastric region) and has superior and inferior parts above and below the hilium. The kidneys are in range from T12 to L3 vertebrae. Where holds the kidneys in place on the posterior anterial wall?

A
  • parasternal gutter
  • upper poles are closer to medial line
  • lower poles further away from midline
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8
Q

Why is the right kidney slighly lower than the left kidney?

A
  • liver pushes it down
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9
Q

The kidneys have 4 main functions, what are they?

A

1 - Filtration

2 - Excretion of waste

3 - Regulating blood (ionic composition & pH, volume & pressure)

4 - Hormone production

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10
Q

There are 5 layers of the kidneys from inside to outer, what are they?

A

1 - kidney

2 - renal capsule – tough fibrous

3 - perirenal fat – extraperitoneal fat (seperates kidney and adrenal gland)

4 - renal fascia – perirenal fascia (encloses kidney and adrenal gland)

5 - pararenal fat –insulates

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11
Q

Label the organs 1-7?

A

1 - liver

2 - inferior vena cave

3 - right kidney

4 - abdominal aorta

5 - left kidney

6 - spleen

7 - stomach

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12
Q

When looking at an image of the kidney how are you able to identify if it is a left or right kidney?

A
  • the pelvis and ureters are most posterior
  • behind major blood vessels
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13
Q

What are the 2 regions of the kidney that makes up the renal parenchyma?

A
  • 2
  • outer cortex
  • inner medulla
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14
Q

The functional units of the kidneys are caller nepherons, where are they located?

A
  • outer cortex
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15
Q

The glomeruls is where blood is filtered in the kidneys, where are glomeruls located?

A
  • within nepherons
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16
Q

The renal columns are located where within the kidneys?

A
  • inside the inner medulla
  • either sides of the pyramids
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17
Q

At the bottom of the pyramids, where they attach to the minor calyces is called what?

A
  • renal papilla
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18
Q

At the bottom of the pyramids, where they attach to the minor calyces is called what renal papilla. They then form the major calyces, which go on to form the what?

A
  • renal pelvis
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19
Q

At the bottom of the pyramids, where they attach to the minor calyces is called what renal papilla. They then form the major calyces, which go on to form the what renal pelvis. What does this then go onto form?

A
  • the ureter
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20
Q

What is the renal sinus in the kidneys?

A
  • extension of the renal pelvis
  • contains renal calyces, blood vessels, nerves and fat
  • fat supports as packaing marterial to hold pelvis in place
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21
Q

What is the organisation of what enters and leaves the renal hilium from anterior to posterior?

A
  • renal vein
  • renal artery
  • renal pelvis then forms the uterus
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22
Q

What part of a nephron begins filtering the blood?

A
  • glomerulus
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23
Q

Once the glomerulus has filter blood in the kidneys, what 2 major things happen?

A
  • O2 and nutrients are extracted
  • filtrate passes through tubulues out of renal papilla
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24
Q

What are the major blood vessels of the kidneys?

A
  • right and left arteries and veins
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25
Q

How are the kidneys innervated parasympathetically?

A
  • vagus nerve
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26
Q

How are the kidneys innervated sympathetically?

A
  • T10 to L2
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27
Q

Where do the renal arteries originate from?

A
  • abdominal aorta
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28
Q

Once the renal arteries enter the kidneys, what 2 things do they divide into?

A
  • anterior and a posterior divisions
29
Q

Once the renal arteries enter the kidneys, they divide into the anterior and a posterior divisions. What do they then divide into?

A
  • five segmental arteries
  • provide blood to 5 parts of the kidneys
30
Q

Once the renal arteries enter the kidneys, they divide into the anterior and a posterior divisions. They then divide into five segmental arteries and then into what?

A
  • interlobar arteries
  • forms around the renal pelvis
31
Q

Once the renal arteries enter the kidneys, they divide into the anterior and a posterior divisions. They then divide into five segmental arteries and then into interlobar arteries that form tree like projectsion between medulla and cortex. What do the arteries then go onto form?

A
  • arcuate arteries and then interlobular arteries
32
Q

Once the renal arteries enter the kidneys, they divide into the anterior and a posterior divisions. They then divide into five segmental arteries and then into interlobar arteries that form tree like projectsion between medulla and cortex. The arteries then go onto form arcuate arteries and then interlobular arteries. The arteries will then enter the nepherons, specicially the glomeruls. What is the name for an artery entering and leaving the glomerulus?

A
  • entering = afferent
  • leaving = efferent
33
Q

Once blood leaves the glomerulus via the efferent arteries, where does blood travel to, and eventually merge with the same named veins?

A
  • vasa recta
34
Q

Renal arteries are anatomical end arteries, meaning there is no communication between them. What is the physiological relevenc of this?

A
  • if kidney is damaged in trauma or is obstructed it can eventually lead to ischemia and necrosis of renal parenchyma supplied by this branch
35
Q

During development arteries can form and attach to the kidneys, but not through the normal channel of the hilium. What are these arteries called?

A
  • aberrant arteries
36
Q

Durng development, where do the kidneys develop, before thenmoving up to their final location?

A
  • in the pelvis
37
Q

What is a horseshoe kidney?

A
  • kidneys fuse (bind) together at the bottom during development and resemble a horseshoe
  • inferior mesenteric artery can limit the kidneys from ascending to their anatomical poisition
38
Q

What is the function of the ureters and what are they made of?

A
  • transport urine from kidney to bladder
  • made of smooth muscle tubes
39
Q

Where do the ureters begin and end?

A
  • commence at pelvis of kidney
  • end at trigone-urinary bladder (posteriorly)
40
Q

The autonomic-ureteric plexus provides autonomic control of the ureter, but what vertebrae does this cover?

A
  • T11-L2
41
Q

The ureters have 3 natural sites where they are constricted, what are these called?

A

1 - pelvi-ureteric junction (at L2-L3)

2 - crossing iliac vessels/pelvic brim, travels over the pelvic blood vessels (water over the bridge)

3 - entering bladder at the ischial spine

42
Q

What is the junction where the uterers enter the bladder?

A
  • ureteropelvic junction
43
Q

What is the name given to pain of the kidneys that can be caused by stones that block the urinary tract?

A
  • Renal colic
44
Q

Kidney stones can cause blockage of the urinary tract, what does this do to the kidney?

A
  • stretching the renal capsule, due to increased internal pressure
  • cause spasms of smooth muscle of renal pelvis
45
Q

If a patient has kidney stones can cause blockage of the urinary tract, this can cause pain called renal colic. Where would this pain generally be felt?

A
  • cutaneous (referring to skin) over T12
  • part of subcostal nerve
  • often referred to as loin to groin
46
Q

Renal transplant is a fairly common surgical procedure. Instead of being placed in the same location as the old kidney, where is the transplanted kidney placed?

A
  • into the iliac fossa
47
Q

Renal transplant is a fairly common surgical procedure. Instead of being placed in the same location as the old kidney, the transplanted kidney is placed in the iliac fossa. What anatomical landmark is used to identify where the incision is placed for this operation?

A
  • over and parallel to the inguinal ligament
48
Q

Renal transplant is a fairly common surgical procedure. Instead of being placed in the same location as the old kidney, the transplanted kidney is placed in the iliac fossa. The incision is placed for over and parallel to the inguinal ligament. What is done to ensure blood flow to the transplanted kidney?

A
  • vessels are anastomosed
  • renal artery to external iliac artery
  • renal vein to external iliac vein

(It is vital for surgeon to tag which vessel is which)

49
Q

Renal transplant is a fairly common surgical procedure. Instead of being placed in the same location as the old kidney, the transplanted kidney is placed in the iliac fossa. The incision is placed for over and parallel to the inguinal ligament. To ensure urine can then travel from the kidney to the bladder an uretero-cystostomy is then done, what is a uretero-cystostomy?

A
  • connection between urterus and bladder
50
Q

What is the suprarenal gland more commonly known as?

A
  • adrenal gland
51
Q

What is the fascia called in the kidney that encloses the suprarenal (adrenal) glands?

A
  • renal fascia
  • also called Gerotas fascia
52
Q

The left and right suprarenal (adrenal) glands are different shapes, what are the two different shapes?

A
  • right = pyramidal
  • left = semilunar
53
Q

Are the suprarenal (adrenal) gland and the kidneys connected?

A
  • no
  • perirenal fat seperates them
54
Q

The suprarenal (adrenal) gland and the kidneys are not directly connected, they are seperated by the perirenal fat. Why is this important?

A
  • incase they need to be removed
55
Q

There are 2 layers to the suprarenal (adrenal) gland, what are they?

A
  • inner = medulla
  • outer = cortex
56
Q

Is the suprarenal (adrenal) gland, classified as an exocrine or endocrine organ?

A
  • enDocrine (Ductless)
  • secretes hormones directly into blood
57
Q

The suprarenal (adrenal) gland is classified as an endocrine organ. What are 2 hormones that the cortex secretes?

A

1- corticosteroids (e.g. cortisol)

2 - sex hormones (e.g. progesterone)

58
Q

The suprarenal (adrenal) gland is classified as an endocrine organ. what is 1 hormones that the medulla secretes?

A
  • adrenaline (epinephrine)
59
Q

As the suprerenal (adrenal) gland is an endocrine organ it requires an extensive blood supply. What are the arteries vessels labelled in the inage below?

A

1 = superior suprarenal arteries

2 = medial suprarenal arteries

3 = inferior suprarenal arteries

60
Q

As the suprerenal (adrenal) gland is an endocrine organ it requires an extensive blood supply. Where do the left and right adrenal veins drain into?

A
  • right = inferior vena cava
  • left = left renal vein
61
Q

Autonomic control for the suprarenal (adrenal) gland is from 3 nerves, what are they?

A
  • greater splanchnic nerve
  • lesser splanchnic nerve
  • least splanchnic nerve
62
Q

What is the wall of the bladder composed of?

A
  • smooth muscle
  • called detrusor muscle
63
Q

What is the name of the site in the bladder where urine leaves the bladder?

A
  • urethera
64
Q

The apex of the bladder, which is the bottom lies in relation to what joint in the pelvis?

A
  • close to the pubic symphysis
65
Q

The apex of the bladder is located close to the pubic symphysis. It is akso connected to the umbilicus by what ligament?

A
  • median umbilical ligament also called the urachus
66
Q

The side walls of the bladder will narrow forming the neck of the bladder. The neck then continues to narrow and forms what?

A
  • urethra
67
Q

The urethra is how we pass urine from the bladder. What is the urethra composed of?

A
  • a muscular duct
68
Q

The urethra is how we pass urine from the bladder. Is it longer in men or women, and why is this?

A
  • shorter in females (opens in perineum), also conributes to increased UTIs in women
  • longer in males (also serves reproductive purpose in males for ejaculation)

NME Emma copy and edit (61 decks)

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