Retroperitoneum

Question 1

the retroperitoneal space is the area between

Answer 1

posterior portion of the parietal peritoneum and the posterior abdominal wall muscles

Question 2

What are the 3 categories of the retroperitoneum

Answer 2

1. anterior pararenal space
2. perirenal space
3. posterior pararenal space

Question 3

Layers - anatomy of the retroperitoneum picture

Answer 3

Transversalis fascia
Lateralconal fascia
Parietal peritoneum
Extraperitoneal space

Question 4

structures within the anterior pararenal space

Answer 4

pancreas
duodenal sweep
ascending & descending colon
rectum

Question 5

structures within the perirenal space

Answer 5

adrenal glands
kidneys
ureters
ao
ivc

Question 6

structures within the posterior pararenal space

Answer 6

blood and lymph

Question 7

which adrenal gland is more superior to the kidney?
which one is more medial to the kidney?

Answer 7

right adrenal = more superior
left adrenal = more medial

Question 8

what is zonal anatomy of the retroperitoneum used for?

Answer 8

describe injuries and facilitate management of the injuries

Question 9

how many zones of the retroperitoneum

Answer 9

3

zone 1 - cetromedial
zone 2 - lateral
zone 3 - pelvic

Question 10

zone 1 - centromedial

Answer 10

great vessels
pancreas
duodenum

Question 11

zone 2 - lateral

Answer 11

kidneys
renal vessels
ureters
ascending colon
descending colon
colic flexures

Question 12

zone 3 - pelvic

Answer 12

whole pelvis
pelvic walls
rectosigmoid colon
iliac vessels
genitals

Question 13

adrenal glands size

Answer 13

3-6cm long x 3-6mm thick x 2-4 cm wide

Question 14

what do the adrenal glands produce?

Answer 14

hormones that help regulate metabolism, immune system, blood pressure, response to stress and other essential functions

Question 15

where is the adrenal cortex

Answer 15

outer region and largest part

Question 16

what are the three zones of the adrenal cortex & their hormones

Answer 16

zona glomerulosa - aldosterone
zona fasciculate - cortisol
zona reticularis - dhea and androgenic steroids

Question 17

cortisol & hydrocortisone

Answer 17

cortex:

times of stress
controls many things:
blood pressure
blood sugar
bone formation
sleep/wake cycle
allergic response

Question 18

Aldosterone

Answer 18

cortex:

regulating blood pressure and certain electrolytes

Question 19

DHEA and Adrogenic steroids

Answer 19

cortex:

estrogens and androgens

Question 20

Epinephrine & Norepinephrine

Answer 20

medulla:

initiate the flight or fight response
promote glycogenolysis

Question 21

arteries of the adrenal glands

Answer 21

Superior suprarenal branch of inferior phrenic a
middle suprarenal branch of AO
inferior suprarenal branch of renal artery

Question 22

veins of the adrenal glands

Answer 22

right - single vein from hilum to IVC
left - vein into left renal vein to IVC

Question 23

two major lymph-node bearing areas in Retroperitoneal cavity

Answer 23

iliac and hypogastric nodes within the pelvis

paraaortic group in the upper retroperitoneum

Question 24

what sonographic sign associated with paraaortic lymph nodes?

Answer 24

sandwich sign

Question 25

size of normal adrenal glands

Answer 25

3-6cm long x 3-6mm thick x 2-4 cm wide

Question 26

right diaphragmatic crura

Answer 26

longer, larger, lobular associated with the anterior aspect of the lumbar vertebral ligament bounded anterolaterally by the inferior vena cava bounded posterolaterally - right adrenal + right lobe of liver

Question 27

left diaphragmatic crura

Answer 27

along anterior lumbar vertebral bodies in superior direction inserts into central tendon of diaphragm

Question 28

sonography of diaphragmatic crura

Answer 28

imaged in TRV

Question 29

iliac fossa

Answer 29

region extending between the internal surface of the iliac wings, from the crest to the iliopectineal lne

Question 30

iliac fossa is known as

Answer 30

false pelvis

Question 31

iliac fossa contains

Answer 31

ureters major branches of the distal great vessels lymphatic vessels

Question 32

4 divisions of the pelvic retroperitoneum

Answer 32

prevesical rectovesical presacral pararectal/paravesical

Question 33

sonography of the retroperitoneum

Answer 33

all scans include the kidneys and retroperitoneal muscles

Question 34

retroperitoneum sonography pitfalls

Answer 34

right crus of diaphragm gas no fluid